HomeMy WebLinkAbout10-28-11 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
REV-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 015129
RHOADES KIMBERLY L
191 UNION HALL ROAD
CARLISLE, PA 17013
fold
ESTATE INFORMATION: ssN: ~s~-18-255s
FILE NUMBER: 2110-0309
DECEDENT NAME: MINICH NELSON L
DATE OF PAYMENT: 10/28/201 1
POSTMARK DATE: 10/28/201 1
couNTY: CUMBERLAND
DATE OF DEATH: 03/ 13/2010
REMARKS: RECEIPT TO ATTY
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 ~ S 12,092.20
TOTAL AMOUNT PAID:
S 12,092.20
CHECK# 259
INITIALS: HEA
sE,aL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
1505610143
REV-1500 Exl°'-'°' ~
PA De artment of Revenue OFFICIAL USE ONLY
p Pennsylvania county cone rear File Number
Bureau of Individual Taxes e~"a^"a'~OFR°'~'"1°
Po Box.2soso~ INHERITANCE TAX RETURN 21 10 0309
Harrisburg, PA 17128-OS01 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
191 18 2558 03 13 2010 O1 30 1924
Decedent's Last Name Suffix Decedent's First Name MI
MINICH NELSON L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
MINICH CABBIE R
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ~ 2, Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
q. Limited Estate ~ 4a Future Interest C p ise ~ 5. Federal Estate Tax Return Required
(date of death arte~r 12-~1~2-82)
® Decedent Died Testate
6' (Attach copy of Wilq
~ pecedent~ intainedla Living Trust
g. Total Number of Safe Deposit Boxes
g. Litigation Proceeds Received
10. ~nP~vertv Craendrt (datge5pf death
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L BANGS 717 730 7310
First line of address
429 SOUTH 18TH STREET
Second line of address
City or Post Office
CANS HILL
State ZIP Code
PA 17011
REGISTER OF WILLS USE,QIVLY
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Correspondent's e-mail address:
Under s of pery'ury, 1 declare that 1 have examined this return, inducting accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, and complete. Dedaratton of preparer other than the personal representable is based on all information of which preparer has any knowledge.
L. Rhoades /~ a~-~C
191 Union Hall Road, Carlisle, PA 17013 ~~ 'a~
SI TUBE OF P EP , ~ OTH REPRESENTATIVE GATE
~.J^J Michael L. Bangs /~ - ate- //
ADDRESS
429 South 18th Street, Camp Hill, PA 17011
Side 1
1505610143 1505610143
REV-1500 EX
oe~d~,rSN~: Minich, Nelson L.
Decedent's Social Security Number
191 18 2558
RECAPITULATION
266,356.57
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship {Schedule C)......... 3.
4. Mortgages ~ Notes Receivable (Schedule D) ........................................................ 4.
190.86
5• Cash, Bank Deposits $ Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule ~ ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8 Miscellaneous lynq Probate Property
Se
arate Billin
Re
uested
h
l
S
d
G
p
g
............
q
) U
(
c
e
u
e 7.
8. Total Gross Assets (total Lines 1-7) ..................................................................... g, 2 66 , 547.43
4,810.40
9. Funeral Expenses ~ Administrative Costs (Schedule H) ....................................... 9.
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Scheduled) .............................. 10.
11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 4 , 810.4 0
12• Net Value of Estate (Line 8 minus Line 11) ............................
..............................
12. 2 61 , 737.03
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14, 2 61 , 737.03
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15.
16. Amount of Line 14 taxable 2 61 737.03 16
at lineal rate X .045
~ .
17. Amount of Line 14 taxable
at sibling rate X .12 0.00 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0 18.
19. Tax Due ................................................. ................................................................. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
1505610243
0.00
11,778.17
0.00
0.00
11,778.17
Side 2
15D561D243 1505610243
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10-0308
DECEDENTS NAME
Minlch, Nelson L.
STREET ADDRESS
370 South Middlesex Road
CITY
Carlisle STATE
PA ZIP
17015
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 11,778.17
Total Credits (A + B) (2)
(3) 314.03
(4)
(5) 12,092.20
Make Check Pa able to: REGISTER OF WILLS AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :............................................................................... ^ ^x
b. retain the right to designate who shall use the property transferred or its income :.................................. x
c. retain a reversionary interest; or ............................................................................................................... x
d. receive the promise for life of either payments, benefits or care? ............................................................ x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^ ^x
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................:......... ^ ^x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 yyears of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1502 El(+ (11.Oti)
SCHEDULE A
REAL ESTATE
coMwaawFxrn of aErwsr~viww
Ire~artuace r~x rsEruRr~
resroe-rr or_ceoear
ESTATE OF FILE NUMBER
Minich, Nelson L. 21-10-0309
All real property owned solety or as a tenant M common must bs reported at felt market value. Fak market value is defined as the price at which properly would be
e of the relevant fads
elled to bu
both hevirn
roasonable knowled
er and a willir
seller
neitlrer bein
cort
or Bell
n
ed between a wfllir
bu
h
.
pp
g
p
,
g
p
y
,
a
g
q
y
exc
Real property which b JoiMly~owned with right or survivorship must bs dladosad on schedule F.
Attach a copy of the settlement sheet K the property has been sold
krclude a copy of the dead showing dscedenYs Interest tl owned es tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate /Green Hill Lot #34 -Vacant land, 1.320 acres, Parcel No. 08-10-0630-115. The 60,093.24
property was sold on October 7, 2011 (see HUD attached).
2 Real estate at 201 Union Hall Road -Parcel No. 29-06-0023-049. This property was sold on 85,974.75
August 24, 2011 (see HUD attached)
3 Real estate at 797 Waggoners Gap Road -Parcel No. 06-19-1645-065. This property was sold 120,288.58
on July 22, 2011 (see HUD attached)
TOTAL (Also enter on Line 1, Recapitulation) I 266,356.57
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 forth software only The Lackner Group, Inc. Forrn PA-1500 Schedule A (Rev. 11-08)
Rev-1b08 p(r (ti-98)
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
COAaJONYYEAI.TM OF Pearsnv~wa
eeiERRANCE TA7C RETURN
RESIDQlr DECEDENT
ESTATE OF (FILE NUMBER
Minich, Nelson L. 21-10-0309
Include the pro of litigation and the date the proceeds were received by the estate.
All properly jol yormsd with the rlyM of survlvorahlp must be dfsdosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Everett Cash -refund of homeowners insurance on 221 N. Middleton Road property 76.00
2 Frederick Mutual -refund of unearned homeowners insurance on Waggoners Gap Road 114.86
property
TOTAL (Also enter on Line 5, Recapitulation) I 190.86
(If more apace is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Folm PA-1500 Schedule E (Rev. 6-98)
REV-1151 Ex+ (10-08)
~o~~~~~~~~a
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF I FILE NUMBER
Minich, Nelson L. 121-10-0309
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
B.
1
2.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State
Year(sl Commission paid
Attomev's Fees Michael L. Bangs
Zio
550.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address .
City State Zio _
Relationship of Claimant to Decedent
4. I Probate Fees
5. Accountant's Fees
6. Tax Retum Pn3parer's Fees
7. Other Administrative Costs 4,260.40
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 4,810.40
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Minich, Nelson L. 21-10-0309
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 Other Administrative Costs
Automotive of York
18.94
2 Borough of Carlisle -Water bill - 797 Waggoners Gap Road (April) 65.94
3 Borough of Carlisle -Water for 797 Waggoners Gap Road 72.90
4 D&D Septic -Union Hall Road property 30.00
5 Frederick Mutual Insurance -homeowners insurance for 797 Waggoners Gap Road property 264.50
6 Jeff Monet -roof repair work done at 201 Union Hall Road 325.00
7 Ken Snyder -mowing at Green Hill property 300.00
8 Ken Snyder -mowing at Green Hill lot (July) 300.00
9 Ken Snyder -mowing at Green Hill property 300.00
10 Ken Snyder -final mowing at Green Hill property 120.00
11 Lowe's -Front door lock replacement at Union Hall Road property 26.35
12 N. L. Minich 8 Sons -snow removal at 797 Waggoners Gap Road property 26.87
13 North Middleton Township -permit for 201 Union Hall Road 10.00
14 Northeastern -plumbing work done for water system at Union Hall Road 57.32
15 PPBL Electric - 797 Waggoners Gap Road (April) 120.83
16 PPSL Electric - 201 Union Hall Road (May) 27.70
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Minich, Nelson L. 21-10-0309
ITEM
NUMBER
DESCRIPTION
AMOUNT
17 PPBL Electric - 797 Waggoners Gap Road (May) 115.50
18 PPBL Electric - 201 Union Hall Road (June) 37.34
19 PPBL Electric - 797 Waggoners Gap Road (June) 75.30
20 PPBL Electric - 201 Union Hall Road (July) 36.92
21 PPBL Electric - 797 Waggoners Gap Road (July) 49.89
22 PPBL Electric -Waggoners Gap Road (final bill) 53.33
23 PPBL Electric -Union Hall Road (July) 26.17
24 PPBL Electric -Union Hall Road (final) 34.10
25 Richard Henson -mowing at 797 Waggoners Gap Road 100.00
26 Richard Henson -mowing at Waggoners Gap Road and Union Hall Road properties 110.00
27 Richard Henson -mowing at Waggoners Gap Road and Union Hall Road properties 100.00
28 Richard Henson -mowing at Waggoners Gap Road and Union Hall Road properties 120.00
29 Richard Henson -mowing at Waggoners Gap Road and Union Hall Road properties 120.00
30 Richard Henson -mowing at Waggoners Gap Road property 60.00
31 Richard Henson -mowing at Union Hall Road property 50.00
32 Rodney Fraker -Return of security deposit (201 Union Hall Road) 550.00
33 Rodney Fraker -Reimbursement for purchase of oil at Union Hali Road property 349.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Minich, Nelson L. 21-10-0309
ITEM
NUMBER DESCRIPTION AMOUNT
34 Sollenbergers -Notary fee to transfer title of mobile home (Union Hall Road) 39.50
35 Strickler Agency -insurance for 201 Union Hall Road property 146.00
36 Strickler Insurance -insurance on Green Hill property 21.00
H-67 4,260.40
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
REV-1513 EX+ (11-08)
SCHEDULE J
CO"'~S~°~~~^"'" BENEFICIARIES
ESTATE OF
FILE NUMBER
Minich, Nelson L. 21-10-03 09
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
~ distnbutions, and transfers
under Sec. 9116 a 1.2
1 Michelle M. Bottoms Granddaughter one~ixth of
2822 Spring Flower Drive residue
Wilson, NC 27896
2 Carla Feuchtenberger Granddaughter one-sixth of
Post Office Box 353 residue
Newville, PA 17241
3 Charlene L. Feuchtenberger Granddaughter one-sixth of
129 Beetem Hollow Road residue
Newville, PA 17241
4 Charles N. Minich Jr. Grandson one-sixth of
411 Easy Road residue
Carlisle, PA 17015
5 Kimberly L. Rhoades Granddaughter one-sixth of
191 Union Hall Road residue
Carlisle, PA 17013
See continuation schedule attached Continuation
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COV~R SHEETI
Copyright (c) 2009 forrn software only The Lackner Group, Inc. Forrn PA-1500 Schedule J (Rev. 11-08)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Nelson L. Minich 03/13/2010 191-18-2558
Item i Name and Address of Person(s) I
Number) Receiving Property Relationship
6 Teresa K. Garrick Granddaughter
Post Office Box 87
Plainfield, PA 17087
__
Share of Estate Amount of Estate
(words) (3S$)
one-sixth of residue
Total
1
~~~ A. Settlement Statement (HUD-1)
,~
OMB Approval f~lo. 2502-0265
1. ^ FHA 2. ^ RHS 3. ^X Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance C e Number:
11.0057 6600110444
4. ^ VA 5. ^Conv. Ins. ,
C. Note: This form is furnished to gore you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown Ite s marked
"(p.o.c)" ware paid outside the dosing; they are shown here for informa!ional purposes and are not included in the totals. ;
D. Name & Address of Borrower: E. Name & Address of Seller: F. Name 8 Address of Le der:
Steven P. Cataman, Dawn G. Calaman Nelson L. Minich Estate Graystone Tower Bank
2231 Ritner Highway, Carlisle, PA 17015 CIO Bangs Law Office, 429 South 18th Street, Camp 3840 Hempland Road, Mounivif~e, PA 17554
Hil( PA 17011
G. Property Location H. Settlement Ayent: I. Settl_emenj,Ddte: 1W07 Q11
Lot ft34 Minich Drive Red Rose Abstract Disbursement Date: 10/0 011
Carlisle, PA 17015 140 N. Lime Street, Lancaster, PA 17602 ,
Dickinson Township
I
717-394-7054
Place of Settlement: TitleExpress
Carlisle, PA 17015 Printed 1 D/072011 at 8:1 ~ am
by PS
103. Settlement charges to bonower (line 1400) 7,928.75 1403. ~ l
104. 404.
Ad ustments for items aid seller in advance • Ad'ustments for items aid b seller in advance I
106. CityAown taxes 10/07/2011 to 12/31/2011 1.59 406. Cityltown taxes 10!07!2011 to 12131/'1011 1.59
107. County taxes 10!07201 i to 12!312011_, _
_. .. 38.64- .. - 407.:.Cawlyaaxes - - - ----10/071281'rio 3?r3~tR911 ! ~ ,
1d8. Assessments ro 408. Assessments !o i
109. School taxes 10/072011 to 06/302012 720.01 409. Scholl taxes 10/072011 to 061302012 720.01
110. 470.
111• 411.
112. 412.
120• Gross Amount Due from Borrower 73,688.99 420. Gross Amount Due to Seller 65,760.24
200. Amounts Paid b or in Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit a earnest money 1,000.00 301. Excess deposit (see instructions)
202. Pdrrcipal amount of new loan(s) 502. Settlement charges to seller (line 1400) 5,667.00
203. ExisB to s taken su ell l0 503. Existin loa s taken su 'ect to
204. Consirucbon Loan $226,000.00 504. Payoff of first mortgage loan
205. Initial Disbursement 8,390.00 505. Payoff of second mortgage loan
206. ~.
207. 507.
208. 508.
209. 509.
To'r ibetia tin" ` - -~' . ,_. r~frir4ts"'&` , ~Ikyr
_
210. City/totim taxes to 0. Cilyflown taxes
to
211. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
214.
215.
[tb. 516.
217. 517.
216. ~ 18.
219. 519.
~0• ToW Pald b Ifor Borrower 9,390.00 520. Total Reduction Amount Due Seller 5,667.00
300. Cash at Settlement trontlto Borrower 600. Cash at Settlement tolfrom Seiler
301. Gnus amount due from txxrower (line 120) 73,688.99 bpi. Gross amount due to seller (line 420) 65,760.24
302, less amounts paid byJfor borrower (line 220) 9,390.00 602. Less reduGions in anaunt due seller (line 520) 5,667,00
31)3. Cash Q From ^ To Borrower 64,298.99 603. Cash ^X To ^ From Seller 60,093.24
pi ~,pppMp - - -- --- --------,.._.,__,. _. ,-.--~_~..
4bWP+•~WJ VY00MB epMtl n,nbr. MO wKW,MiM/bwwnE. pis dudoaW.bM,tlMOry. TMbMMO,W bNO'.tl. MO'~Mb.NE8P~mwK.~..... - ila~~tlfen JU,i9M
pnwefi
are
700. Total Real Estate Broker Fees $ 3,900.00 Paid From aid From
Divisiondcanmission line 700 as follows: Borrower's Seller's
701• $1,950.00 to Wolfe & mpany Realtors Funds at und5 tit
702. $1,950.00 to Help-U-Sell Realty Settlement S ttlement
703. Commission paid at sedlement 3 ~ ~
A00. Items Pa ble in Connection with Loan
801. Our origination charge (Inctudes Origination Print 0.00096 or $0.00) $4,350.00 (from GFE #1)
802. Your credit or charge (points) for the spedfic interest rate chosen $ (from GFE #2)
803. Your adjusted origination charges (from GFE A) 4,350.00
804. Appraisal fee to A raisal L istics $370.00 P.O.C. B' (from GFE #3) ~ -
805. Credit report to First American Credce {from GFE #3) 28.00
806. Tax service to Gra stone Tower Bank (from GFE #3) 79.00
807. Flood certification to Corel is Flood Services (from GFE #3) 10.00
808. Appraisal Management Fee to A raisal Man emenl $80.00 P.O.C. B' (from GFE #3)
900. hems R ufred b 1.w~dewtabs Pad•in.Adva+se
901. Daily interest charges from from 1 0/0 712 01 1 to 11/0112011 @ $O.OOlday (from GFE #10)
902. Mon a insurance emium months to from GFE #3
903. Homeowner's insurance for 1 ears to State Farm (from GFE #1 t) 409.00
904• months to from GFE #11
1000. Reserves sited with Lender
1001. Infiai deposit for your escrow account (from GFE #9)
1002. Homeowner's insurance nanths $ O.OOlmonth $
1003. Mon a insurance months $ /month
1004. Pr taxes months $ (month
1005. months $ /month
1006. Assessments months $ O.OO/month $
1007. Aggregate Adjustment $
1100. Tide Cha es
1101. Title services and lenders Gtle insurance from GFE #4 2,233.75
1102. Settlement ordosing fee to Patricia A. Shirk $200.W
1103. Owner's title insurance from GFE #5 "'
1104. Lendefstitleinsurance $1,763.75 -.
1106. Owner's title pdicy limit $226,000.00 Owners Policy
1107. Agent's portion of the total title insurance premium $1,435.44
1108. Underwritefs portion of the total title insurance premium $328.31
1109. Basic RatelEnds 100, 300, 900, 710 to $
1110• Bringdown to Red Rose Abstract $150.00
1111. Notary Fees to Patrida A. Shirk $45.00
1112. emaillwire/ovemightfew to Red Rose Abstract $75.00
1113. Tax Cen Fee to Card n McOuillen $ 5.00
1114. Atlomey fees to 8 s Laws 0f6ce 650.00
1200. Government Recordin and Transfer Cha es
1201. Government recording charges $ (from GFE #7) 148.00
1202• Deed 562.00 Mort a $86.00 Release $
1203. Transfer taxes $ (from GFE #8) 650.00
1204. CityiCounty tax/stamps peed $650,00 Mort $
1205. State Taxlstamps peed $650,00 Mort $ 650.00
1207. Record Stip. Against liens 21,00
i
1300. Additional Settlement Cha es
1301. Required services that you can shop for (from GFE #6)
1302• St+rveY to Eric Diffenbau h Surve in 462.
1303. to
1304. to
1305. to
' ~ ~ r 7,928.75 5,667.00
'Paid outside d dosing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bro(K)er. "Credit by lender shown on page 1. "'Credit by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUD-1
Com orison of Good Faith Estimate GF and HUD~1 Cha es
Cha That Cannot Increase HUD-1 Line Number
Our origination charge #601
Your aedit a charge (points) for the specit~c interest rate chosen q 802
Your adjusted origination charges p 803
Transfer taxes g 1203
Ch es That in Total Cannot Increase More Than 10°h
Government receding charges g 1201
Appraisal fee g 804
Credit repel g 805
Tax service g 806
Flood certifiption q 807
Appraisal Management Fee #808
Owner's 8tle insurance # 1103
Cha es That Can Chan e
Initial deposit for your escrow amount q 1001
Daily interest charges from #901 $ !da
Homeowners insurance q 903
Title services and lenders Gtle insurance q 1101
>R
Good Faith Estimate H Q7
4,450.00 4,350.00
0.00 0.00
4,450.00 4.350.00
850.00 650.00
Good Faith Estimate H D-1
160.00 148.00
370.00 370.00
8.00 28.00
79. 79.00
10.00 10.00
80.00 80.00
0.00 0.00
727.00 715.00
$ -12.00 •1.6506%
Your ini8ai ban amount is $226,000,00
Your ban term is 30. years
Your initial interest rate is 4.3750°k
Your initial monthly amount owed for prindpal, interest, and any mortgage $1,128.39 indudes ~
insur~flis.. _. '[X~ Principal
0 Interest
^ Mortgagelnsurance
Can your interest rate dse? ~ No. L J Yes, it can rise to a maximum of °k. The first change
will be on I I and can change again every years after 1 1 Ev ry change
date, your interest rate can increase or decrease by %. Over the life of he loan, your
interest rate is guaranteed to never be lower than °k a higher than Y°.
Evan if you make payments on time, can your ban balance dse? ^X No. ^ Yes, it can rise to a maximum of $
Even if you make payments on time, can your monthly amount owed to X^ No. ^ Yes, the first increase can be on I 1 and the monthly
principal, interest, and mortgage insurance rise? amount owed ran rise to $
The maximum it can ever rise to is $
Goes your loan have a prepayment penalty? ^X No. [] Yes, your maximum prepayment penalty is $
Does your loan have a balloon payment? ^X No. 1. ~ Yes, you have a balloon payment of $ due in
nears on 1 !
Total monthly amount owed including esuow account payments ^ You do not have a monthly escrow payment fe items, such as property taxes
and homeowners insurance. You must pay these items directly yourself.
0 You have an additional monthly escxow payment of $
that results ~~ a total initial monthly amount owed of $1,128.39. This indudes prin 'pal, interest, ar
mortgage insurance and any items checked below:
Q Property taxes Q Homeowner's insurance
^ Flood insurance ^
^ ^
Note: If you have any questions about the SetBement Charges and Loan Terms listed on this form, please contact your lender
are
~.
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HU6~1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction I further certify that I have received a wpy of the HUD-1 Settlement Statement.
Sven P. Calaman Dawn G. Calaman
. -
s ~-.
t?~
LMi' e
The HVO-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be
disbursed in accordance with this statement.
SETTLEMENT AGENT
/~~? ~/~
DATE
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPC
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1007 AND SECTION 1010.
Previous editions are obsolete Page 4 of 4 HUC
IOIIII I W Vl ~.YtAJ !S IIRIOOOOR idlt 1
a Settlement Statement - U.S. Depatlriient o(14ouaing and urban gevelapmenl
B. Tvoa of Loan OMB Anoraval Ne_ 2502-02E5 FINAI
1. ^FHA 2. ^FmHA 3. ^Ctxty. Unha.
4. VA 8. flfe Number
11335 7. Loan Number 8. Mortgage Instsanoa Case Number
C.Note: tbwu^brMa'Ypnap ora.ara.r,.awr.wort.alum.aeap~.lwo.~dnnerl~,d~d.ebaumm.
wNtt~lO:MkwabbYlba^ralraMrik^ babUPM^daWaenNsx aM~w~rd^rkrnLPanWarp^n
~aR^m tRa.d^^ r+..^+ r~a.btr^.w nr u . s. cad. s.croo t6ot .nd awen taro. TilleExge~Selllamenl3yslem
OtU23f2011 09:49 KL
0. NAME OF BORROYVER: Seth Edward Graham and Rehtslxa 8. Cuaham
ADDRESS: 45 West Battlmore S a Cultate PA 17013
E. NAt~ OF SELLER Estate of Neon L. Minkh
ADDRESS: 191 Uniort H~1 Road Carnal PA 17013
F. NAME ~ LENDER: Cash
ADDRESS:
G. PROPERTY ADDRESS: 201 Unton Hstl Road, Cadisle, PA 17013
North MI on Townshi
H. SETTLEMENT AGENT: Cornerstone Lapd Tranafa', Inc., Teiephona: 717-730.9664 Fax: 717.730.9665
• BSS Fo Road Carlisle PA 17015
i. 5E1TLB~tI]rT OATS: 08124/2[111
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S T SA Tt N:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101 on 95 OOD,~ 401 s 95 000,00
1 P 402. P
- 1845.75
104. .. 404.
105. - 405.
9nsnis for acme sill aelkr h advance Ad uetmems Tor Hems old b caper h advance
106. Cil Aown taxes
;...~ ~ : ;~,:; ,.. ~., <..,
.:.408'?:: ... taxes ;!;;::.~:. _ ,:... • :...
107. Count tax '' ~ 0&24!11 12131111 '-t 9:74 ~ ~
'= i 0 411.1` 1213U1~1 ~' 129.74
iDB. sdroal taxes • '.:.::: 00124111: '06190112 - 1990.08 _
408. Sidicol 11 112:' ' 1 39D,06
109. ..
110.
_......
4 ,
111. • ::~:::. 41i.
112. >;,.•.._ ,.. - . i
120. GROSS AMOUNT OUE FROM BORROWER #~'-T*I 98 5155 420. GROSSAMOUNT'DUE TO SELLER':`':.'':`. `" 96 519.80
200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REOOCTIONS INAMOUNT D E'TO S G: R
201. 4 000:00 s De aee' " • o
202. Pain amount of new bans 602 Seltlemenl ro leper Inc 1 10 545.05
Z03. b a taken et b 503. a cubed b
204. R
205. 505.
206.
207. 507.
21~. 5~.
209.
A m Ids fo R Id sell ustmerlts for items un i seller
210. C9 /lowntazes 540. Cii ntaxas
211
212 Scholl taxes 5 2 Schoat lezq
213. Scholl Taxes 513. Sdad Taxes
214. 544.
215. 51 .
216. 546.
247. 517
216. 519.
219. 519.
220. TOTAL PAID BYIFOR BORROWER 1000.00 520. TOTAL REDUCTION AMOUNT DUE SELL 10545.05
300. CASH AT SETTLEMENT t°ROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
304. Grass attrotlN due Dom lxxmwer 1 86 365.55 801, Gross eaiotad due ro eater ine 420 96 519.80
Lass 'd 1 D00.00 due segor Inc 520 10545.05
303. CASH FROM BORROWER 97365.55 603. CASH TO SELLER 85 974.75
statsnnm~ ~. aST~T~ E~ ~r m~WkbW~ti r. npatw Ma r»M°P e~'Pe..r~°u,u~rsR~iwlra~rr rp~o~bra ~C^ina sM Poor dapia~Mdkana. s mtua
m'"~.r^.. a m. tr^.. r~..a.r a. tn^..akw.
Yeu ^r^ngW^a °YlabPiabe tlr ^leetsRw~l~~,tl~, TwRAMa; 7atlata2l Mhlaraortat 4gwM~rpXWlbaon aumMr. atarmrotPmAd^y^urmP^q Wpq~rldwglkdai
rwmew, r^^ way h^ eta b 4N ^roYwrW P~kwlwipau0 rY bw. Nntl^rpwb~ of Ndw1. I esYfj l~ti rw nunbRr rhovin an Ihk WMmNi Is my rnmrt OnP^lrrldRndF+tlm Mmr.r.
Tfi: J ~ liBl~ 81MNATUREtBK I
SELLER(S) MEW I.UtLNJO AOOREb6:
6BlER1E) PFtoNE MUMeER6 pt) IWl
~.,w.a.,.,..,..,.y,.w.,. ._......__ .._. ,..._ __ _
U.S. DEPARTMENT ~ HOUSING AHD URBAN' - =VELDPMENT F8e Number, CL1 ` ~ FINAL PAGE 2
CCTTI eR1CIJT CTA'1"~IA~IJT Taleevnroee f.'eehm.inf Cuale.n Omlorl nRf7Af711Si al nO•dQ KI
L. SETTLEMENT CHARGES PAID FROM PAID FROM
7011. TOTAL. SAtJ:SIBROKER' OMMISSIQN based an 95000.00 = 5400.(10 BORROWER'S SELLER'S
Divisxln of cortmisaiall a• FUNDS AT FUNDS AT
701. 5 400.00 Hel U-Sell Dntrvller Rea SETTLEMENT SETTLEMENT
702.5 b
703, ~ 5 400.00
800. REMS PAYABLE IN CONNECTION WITH LOAN
i. Loan a0an Fee
802. DLscount XI
803. Fee
804. Credit R art
805.
807.
~.
809.
810.
611.
900. tTEMIS R URtED 8Y LENDER TO 8E PAID IN ADVANCE
901. Mdareat:. d
902. 0 mont ,_ .
903. Hazard InsuiarlrE Prenllum far 0 moot
904.
905.
1000. RESERVES.DEROSITED.WMt LENDER FOR
- ...
1001. Hazard hno
1003. C8 P Tex
1004. Tax mo
1005. mo: hllo
1009. nt :00 0.00
1100. TITLE.CHARGE3 ..::,•. , _ ;' ,:: . < .... , :.. , .
1161. orC ae .
102. Abslrad or i6k Seardl
1103. TAIe n
1104. Inalaance Bin r
11 meat n
1106. Noi Fees o Kandi Canker 5.00 16.00
11 7 eas iC set 8 s Es . 950.00
es above Penn No:
1108. le klauralrce to Cornerstone Land Transfer A ant for FNTIC 828.75
es above
1109. Lens Pol
1110. Owner's 95 000.04 •828.75
1111.
1112.
1113. Reimb for Tax Cart Cornerstone Lend Transfer A for FNTIC 5.00
1200. GOVERNMENT RECD DING AND TRANSFER CHARGES
1201 Fees S 82.00 • Release 62.00
1202. Cd tazistam Daedf9~.00 a 950.00
1203. Deed 950 a 950.00
1204. Deed
1208.
1300, ADDITIONAL SETTLEMENT CHARGES
1301 11-12 Slinol Tax b Robin K 8o0enb r 1598.05
t30 to Home Paramount Pest Control Com 1007.00
1303. DSD Sa tla 8s Tollet Rentals 625.40
1400. TdTAL SETTLEMENT CHARGES erlt~ an Ares 103 Sed'oon J and 60 Section 1845.75 10545.05
NW CemFICATroN aF auTeR ANO aeual
wANNwe:1T is A caws ro KNOVellmr uAICeFAt~ srATweNrs ToTrn Tlw rwo-~ s.n.~.M sw.n.~t whlN 1 nw. wed u. wr rW,mrrY.~mra M Lis
UfaT~ aTATEa ON THIa OR ANY SIIRM FONIA. PENALTEa UPON CONVICTION trlxe(m Ilrva ewlatl orwi errs Ilse ixW~ b M dMhv n.awd.nw wilh 1Ns l.kmsnl
G1N NCIGLINIE A FWEAlA7 a~0f9~1T. FOR OETALa SEE TIRE S&
~.e. ~a secTx~N,ml ANO SaCTA7N,014 ~a~/~
SErnEl1ENTA6 /! LATE
~> ~d1~iJ ear/
~,
'~.~il~ a1 A. Settlement Statement (HUD-1)
OMB Approval No. 2502-0265
FINAL
^ RHS 3. ®Conv. Unins.
1. ^ FHA 2 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
. CL11307 6007829
4. ^ VA 5. ^ Conv. Ins.
C. Note: This form is famished to give you a statement of actual seltkiment costs. Amounts paid to and by the settlement agents are shown Items marked
'(p.o.c)' were paid outs'Me the dosing they are shown here for informational purposes and are not included in the totals.
D. Name & Address of Borrower: E. Name & Address of Seller: F. Name 8 Address of Lender:
Anthony G. SeibeA, Shirley A l.auglenan Estate of Nelson L Mink:ts Cde Taylor Bank
329E Street, Carlisle, PA 17013 797 Waggoners Gap Road, Cadisle, PA 17013 7789 East M36, Whitrare Lake, MI 48169
G. Property Locatlort: H. Settlement Agent: I. Settlement Date: 07/22/2011
797 Waggoners Gap Road Cornerstone Land Transfer Agent for FNTIC Disbursement Date: 0 7/2 212 0 1 1
Carlisle, PA 17013 4705 E. Trinde Road, Mechanksburg, PA 17050
Carlisle Borough
Place of Settlement: Tit1eF_xpress
4705 E. Trksdle Road, Mechanicsburg, PA 17050 Printed 07/21/2011 at 4:06 pm
by KL
100. Gross Artrorrrrt Due trap Borrower 400. Gross Amourrt Due to Seller
101. Contract sales price 130,000.00 401. Contract sales price 130,000.00
102. Peisortal 402. Personal
103. Settlernersl dtarges to borrower (fine 1400) 4,732.27 403.
104. 404.
105. 405.
for Items id setler in advance Ad stmerrls for kerns seller in advance
106. C8yllam taxes to 406. Ciryltorm taxes to
107. County taoces 0727J2011 b 12/31/2011 386.55 407. Caunry taxes 07/22/2011 l01213112011 386.55
108. Assessments l0 408. Assessments to
109. School Taxes 0712712011 to 061301'2012 1,970.49 409. 07/22/2011 l0 06130/2012 1,970.49
110. 410.
111. 411.
112. 412.
120. Gross Amotmt Due from eorrmiuer 137,091.31 120. Gross Amount Due to Seller 132,359.04
200. Mronnb Paid or b Behalf of Borrower 500. Redtretloris h Amount Due to Seger
201. Depasft or earnest money 2,000.00 501. Exasss deposit (see instnsctions)
202. Pdncipal amormt of new ban(s) 91.000.00 502. Settlement charges b sefier (I'me 1400) 12A70.46
203. Ex s taken to 503. s taken su ' to
204. 504. P d first mat loan
205. 505. Payoff of secaitd mortgage coats
206. 506.
207. 507.
208. 508.
209. 509.
for Items un selkr for Items un b 'seller
10. CdyAoam laxe.4 b 5 0. CilyAorm taxes b
21 t. County taxes to 511. County taxes to
212. Assesstrsarls b 512. Assessments to
213. Sdsod Taxes b 513. to
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. ToW paid eortetuer 83,000.00 520. Total Reductlors Nnount Due Setler 12,070.46
300. Cash at Settlernetit frarrrflo Borrower 600. Cash at SelUanterit tolfrom Seller
301. Grass amount due from lxxrawer Qine 120) 137,091.31 601. Gross attiocxit due to seller (fine 420) 132.359.04
302. Less ameuMs paid byllor borrower lace 220) 93,000.00 602. Less reducdons b amount due seler (fine 520) 12.070.46
303. Cash ^X from ^ To Borrower 44,091.31 603. Cash Q To ^ From Setler 120,288.58
aiu: ~i ..n.n.a,.,.r..o,,.eca,o.q„e... n.mmo..,.+r..w..a.,...oe...e.,.e..v- n,.e~a,.eco,wn.o.wm..w.,~av.m~.a u...ao„en.ramm,a.,.v n,.
~~
See attached addendum for additional information
Previous editions are obsolete Page 1 4 HUD-1
700. Total Real Estate Broker Fees 7,600.00 Paid From Paid From
Oivisbndcenmiission 8ne700 asidbws: Borrower's Seller's
701• $3,900.00 to Wotle&Canpany Funds at Funds at
702• $3,900.00 to Help-USeBDdwiler Realty Settlement Settlement
703. Commission paid al settlement 7,gOp.00
800. kerra ble In Coenecfbn whir Loan
801. Our aigina8an charge (Irrckrdes Origination Paint 0.000X, err $0.00) ,366.25 (from GFE #1)
802. Your aedil a charge (pdnls) far the spedfic interest rate chosen $-1,557.92 (from GFE #2)
803. Your adusted aiginatlon charges (from GFE A) 1,8013.33
804. Appraisal fee to Dart sisals $325.00 P.O.C. B (~ 6FE.113)
805. Credit report to Credit Plus lion GFE #3) 50.00
806. Tax service to from GFE #3
807• Flood certification to is Fkrod Services (from GFE #3) 11.00
808• to
900. tterm ked Lander f4 be Paid in Advance
901. Daly interest charges from fran 0727J201110 08/0112011 ~ 11.2192/day (from GFE #10) 112.19
~2• ~9a9e lce• P'~~ months to (from GFE #3)
903. Homeowner's insurance for 12 months to JP Wotle InslErielns $323.00 P.O.C. 8 (~ GFc^#t 1)
904. months to from GFE i!'rt
1000. Reserves wlllr Lender
1001. Initial deposit far your esaow account (trap GFE #9)
1002. tfonreox~rrers insurance months a o.oonrradh $ to Cole T Bank
1003. Mortgage Ir>surance rtanihs $ O.OI)hnonth S to
1004. City Property Tau madhs $ O.OOhrronth $ to
1005. County Property T~ nanths $ O.OOlrranth $ to Cole T Bank
1006. Scholl Property Tax months $ 0.001nanih $ to
1007. Aggregate Adjustment $ to
1100. Title Cho
1101. Title services and lender's title insurance from GFE f14 1 A94.75
1102. Selllanent a dosing ice to $
1103. Owner's title insurance from GFE #5 204.00
1104. Lender's tills irrsuranoe $1,029.75
1105. Lenders title policy firtril $91,000.00 Lenders Pdicy
1106. Owner's title policy limit $130,000.00 Owners Policy
1107. Agent's patios d the trial title insurance premium $984.94
1108. Underwriters potion d the idol title insurance premium $248.81
1109. E-0oc Delivery Fee to Cormerstone land Transfer $25.00
1110. CourierlYYre Fee to Cornerstone Land Transfer 515.00
1111. Notary Fee to Pudic $25.00 20.00
1112. Reimbrxse for Tax Certfic~on to Cormerstone Land Transfer S 10.00
1200. Government Record and Transfer Cha
1201. Government recalling charges S (from GFE#:') 152.00
1202• Deed $62.00 Mat 590.00 Release $ to Cumberland Recorder
1203. Transfer taxes $ (from GFE #8) 1,300.00
1204. City/Camty tax/stamps Deed $1,300.00 $ to Cumberland Cam Recorder
1205. Stale Taxlstamps Aced $1,300.00 Mort $ to Cumberland Coup Recorder 1,300.00
1~• Deed i $ ro
1207. $ to
1300. Additional lietllemerd C
1301. Required services that Yce can ~P ~ (from GFE if6)
1302. 2011-12 Scholl Tax to Carlisle Tax Accarnt 2,048.6
1303. Atlaney Fees to Michael 840.
1304. Final Wafer/Sewer to d Carisle 51.84
1305. to
' r r ' • r ~ r 4, .227 12,070.46
'Paid outside d dosing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bra(K~r• "Credit by lender shown on page 1. "'Cred'it oy seller shown on page 1.
See attached addendum for additional information
Previous editions are obsolete Page 2 of 4 HUD-1
of Good Faith Estimate GF. and HUD-1 C
C That Camrot Increase HUD•1 Line Number
Our origination charge #801
Your aedd ar charge (points) (ar the sped8c interest rate chosen #802
Your adjusted origination chaPges # ~3
7raruler lazes # 1203
C That CsrrChan a
Initial deposit for your escrow account # 1001
pally interest charges from #901 11:21
liorr>eornrers kinsurance #
Title services s tide ir>surance # 101
Owners title insurarae # 1103.
#'
.. T.
Good Faith Estimate HUD-1
3,366.25 3,366.25
-1,557.92 -1,557.92
1,808.33 1,808.33
1,300.00 1,300.00
Good Faith Estimate tiUD-1
190.00 152.00
390.00 325.00
50.00 50.00
11.00 11.00
641.00 538.00
-103.00 or -16.0666%
Good Faith Estimate NUD-1
0.00 0.00
224.38 112.19
420.00 323.00
1,146.75 1,094.75
204.00 204.00
Your kddal loan amount is 591,000.00
Your loan tens is 30. years
Your initial interest rate is 4•`~%
Your initial monthly amount awed roc pdndpal, interest, and any mortgage 5461.06 includes
..
insurance is ^X Prindpnt ,
^X Interest
^ Mortgage Insurance
Can your interest rate rise? 0 No. ^ Yes, it can rise !o a maximum of r °L. The first change
will be on 1 l and can change again eve,y years after I 1 .Every change
date, Your interest rate Can increase or decease t:y 96. Over the life of the ban, Your
` interest rMe is guaranteed to never be lower than . 96 or higher than 96.
Even d you make payments on lime, canyourban balance rise? ^X No. ^ Yes, it can dse to a maximum of 5
Even d you make payments on f)me,-can your rnoMhiy amountowed for . ^X No. ^ Yes, the first increase can be on I I and the monthly
principal, interest and rrartgageinsurance dse? amount owed can rise to 5
The maximum A can eve dse to is S
Does your ban have a prepayment penady9 ^X No. ^ Yes, your maximum prepayment penalty is S
Does your banhave a baloon payment? Q No. ^ Yes, You have a balloon payment of S due in
years on / 1
Total monthly amormtowed inducting escow account payments ^X Yau do not have a monthly escrow payment for items, such as properly taxes
and homeowner's insurarroe. You must pay these items directly yoursed.
^ You have an additional rtanthty escrow pay~x;nt M S
that results b a total initial monthly amount owed of S .This includes prinapat interest,
any nartgage insurance and any items d>edcer' ~elow:
^ Property taxes ^ Homeowners insurance
^ Food insurance ' ^
^ ^
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please co~a~:t your lender.
See attached addendum for additional information
Previous editions are obsolete Page 3 of 4 HUo-l
.,
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully revrewed the HUD~1 Settlement Statement and to the best of my knovNedge and belief, k is a true and accurate statement of atl receipts and
disbursements made on my account or by me in this transaction 1 further certify that I have received a copy of the HUD-1 Settlement Statement
y G. SeibEat itre`y A. Laugh
LE.'
Estate . Mich
The HUD-1 Settlement Statement vfikh I have prepared is a true and accurate axount of this trsnaadion 1 have caused or will cause the funds to be
disbursed in accordance with this statement.
,7/~a-~~
SETTLEMEN AGENT DATE
WARNING: R IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS CrR ANY SIMILAR FORM PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTIC~M 1001 AND SECt10N 1010.
See attached addendum for additional information
Previous editions are obsolete Page 4 of 4 HUD-1
. e .
Name of Barower:
Andxxry G. Seibert
Shirley A. Laughnan Name of Seller:
Estate of Nelson L. Minich File Nu^+her:
CL113^?
Pre'areKb712112011 at 4:06 pm
Note: This page displays an itemization of the adjusted origination charges shown in section $ri3.of the HU0.1 Settlement Statemen
This page accompanies trot is not a part of the HU0.1 Settlement Statement If a diacrepancy.~xbats, the information on the HU0.1
Settlement Statement applies
Your Loan Origination Charges ~~~ Seller
801. Our origination charge (Itxludes lhigination Point 0.0()(196 or .00)
Org Fee to Finanaal Servicci 2,616.25 __
Admin Fee to Cde T or Bank t 750.00
802. Your aedil a charge (pdnls) fa the spedfic interest rNe dx>sen
YSP to Cole Ta kx Bank E -1,557.92
803. Your adNsted origination charges ,: ~: 1,808.33 0.00
. r
Name of Borrower.
Andxrny G. Seibert
Shirley A. Loughman Name of Seller:
Estate of Nelson L Minich File Nuinher.
CL1130'
Prepares o7n112011 ai a:o6 pm
Note: This page displays an itemization of the charges shown on line 1101 of fhe HU0.1 Settler?rent Statement This page
accompanies but is not s part of the HU0.1 Settlement Statement H a discrepancy exist, the i.^1`onnation on the HU0.1 Settlement
Statement applies
1100. Title Charges Bonovver Seller
7101. Tide services and lender's title insurance to 1, 94.75 0.00
Subtotal S 0.00
1102. Settlement a dosing fee to S 0.00 Borrower
1104. leaders tide insurance to Cornerstone land Transfer = 1,029.75 Borrower `- ~"'
1109. E-Dac Delivery Fee to Cornerstone Land Transfer S 25.00 Borrower
1110. CounerAMre Fee to Comerstare Land Transfer 15.00 Borrower
~~
1111. Notary Fee to N Pubdc j 25.00 Manual 20.00
1112. Reimburse for Tax Cerliflcation to Cornerstone Land Transfer S 0.00 Seller 10.00
SetlarlLender credits shown on oaae 1 POC a Paid Outside Goring
See attached addendum for additional information
Previous editions are otuolete Page 1 of 1 HUD-1