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Home My WebLink About11-10-111505611185 REV-1500 EX t°Z-", tF'> PA Departrnent d Revenue OFFICIAL USE ONLY Bureau d Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 y y y 0 5 4 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDOYYYY Date of Birth MMDDYYYY 180-22-7434 04282011 09011924 Decedent's Last Name Suffix Decedent's First Name MI BRYAN ELEANOR C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number - - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE t30XE3 BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death ^ ^ Prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required ® death after 12-12-82) 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Bones ^ (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death ^ 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD C- SNELBAKER 717-697-8528 First Line of Address 44 WEST MAIN STREET Second Line of Address City or Post Office MECHANICSBURG CorreapondenCs e-mail address: State ZIP Code PA 17055 REGISTER OF WILLS USE ONLY r-.,. C ~ -~--~ . ,- O ,.. ~ i.. ~ _ ~ t . r- ~'' f,'1 - r„, .~ cli n - -- ,y -; ^~i ~ , `_~' '~ ' ~:. ~ r FILED '- rn ~ --i .. `n r-~ r -~ T G~ Under penalties of perjury, I declare that I hove examined this return, including accompanying schedules and statements, and to the best d my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the peroonal representative is based on all informal d which preparer has eny knou4edge. SIGNATUR_E.O/F_PE-R`SO-N RESPONS-I7B~LE FOR FILING RETURN ~ DATE ADDRESS a~ ~ ~ t t i ~ i t l BARB~iA E. BRYAN, ~XJ~CUTRICE ~DIANNE C BRYAN, E'XECUTRICE SIG O~PREP7~yER OTHER TH N REPRESENTATIVE _ . __ RICHARD C- SNELBAKER 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA 17055 Side 1 L 1505611185 1505611185 OM4847 3.000 ~~ 1505611285 REV-15DD EX (FI) Decedent's Social Security Number 180-22-7434 Decedent's Name• BRYAN I F A N A R RECAPITULATION 1. Real Estate (schedule A) .. .. .. .. .. .. .. ... 1 ], 2 5 , 9 31 • 8 5 2. Stocks and Bonds (Schedule B) . 2 0 • 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3 0 • 0 0 4. Mortgages and Notes Receivable (Schedule D) 4 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) g . 4 , ? 9 9.41 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6 0 • 0 0 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 9 2 3, 8 9 5. 9 4 8. Total Gross Assets (total Lines 1 through 7) 8 1, 0 5 4 , 6 2 7.2 0 9. Funeral Expenses and Administrative Costs (Schedule H). g _ 18 , 8 0 8.0 5 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) t0 776.02 . 11. Total Deductions (total Lines 9 and 10) , t 1 19 , 5 8 4 •0 7 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12 1 , 0 3 5 , 0 4 3.13 an election to tax has not been made (Schedule J) , _ 13 , . 0.00 14. Nat Value Subject to Tax (Line 12 minus Line 13) , TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 14, 1, 0 3 5 , 0 4 3.13 15. Amount of Line 14 taxable at the spousal tax rate, ar transfers unfjer Sec. 9116 (a>(1.2>x.o_ 0.0D ts. 0.00 16. Amount of Line 14 xable o 4~ at linealratex 17. . 1,035,043.13 Amount of Line 14 taxable 16. 46,576.94 at sibling rate X .12 0 • 0 0 18. Amount of Line 14 taxable 17, 0 ' 0 0 at collateral rate x .15 0. 0 0 18 0. 0 0 19. TAxDUE 19. 46,576.94 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 J OM4848 3.000 REV-1500 EX (FO Pege 3 File Numb•r Total Credits (A + g) (2) 3. Interest 4 8 , 3 0 0 • ^ 0 4. If Line 2 is greater than Line 1 + Llne 3, enter the difference. This is the OVERPAYMENT. (3) ~ ~ ~ Fill in box on Page 2, Line 20 to request a refund. (4) 1, 7 2 3.0 6 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ^ 0 O Make check payable 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 properly transferred .. .. ^ .. b. retain the right to designate who shall use the property transferred or its income ^ :::: c. retain a reversionary interest .. .. .. ^ (~ d. receive the promise for life of either payments, benefits or care? ^ L~'~'f 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .... .. .. 3. Did decedent own an "in trust for" or payable-upon•death bank account or security at his or her death? ^ 4. Did decedent own an individual retirement account, annuity, or other non probate property, which contains a beneficiarydesignation? .. ..... .. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS P ART 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 Jan. 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)J. 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 years 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(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)]. Asibling is defined, under Section 9102, as en individual who has at least one parent in common with the decedent, whether by blood or adoption. OM4671 2.000 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 46,576.94 2. Credits/Payments A. Prior Payments 4 6, 0 0 ~• 0 ~ B. Discount _ 2 , ~ ^ ^ ^ ^ REV-1502 EX « (01-10) Pennsylvania DEPARTM£Ni OF REVENUE INHERITANCE TN( RETURN ESTATE SCHEDULE A REAL ESTATE FILE NUMBER: Eleanor C. Bryan 2111 0549 All real properly owned solely or as a tenant in common must be reported at fair market value. Falr market value Is defined as the price d which propeny would be exchanged between a willing buyer and a willing seller, neither bring compoled to buy or aril, both having reasonable knowledge of the relevant facts, Real properly that isjointty-owned with rlgM of survivorship must be disclosed on Schedule F. Attach a copy aT the settlement shed if the property has txen arid. ITEM Include a copy of the deed showing decedent's interestd owned as tenant in common. VALUE AT DATE NUMBER DESCRIP170N O F DEATH 1. Property known and numbered 125,931.85 as 3531 Green Street, Hampden Township, Cumberland County, Camp Hill, PA. Sale value (see attached settlement sheet) TOTAL (Also enter on Llne 1, Recapitulation.) 8 125,931.85 swaess z.ooo If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARiMENiOF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Eleanor C. B an 21 11 0549 Include the proceeds of litigation and the date the pra»eds were received by the estate. All ro olntl owned with ri ht of survivorshl must b® disclosed on Schedule F. ITEM NUMBER VALU E AT DATE DESCRIPTION OF DEATH ~• Burial benefit from Cumberland County 100.00 2 Cumberland Crossings refund due the decedent on nursing home care 765.00 3 Erie Insurance refund due the decedent on homeowner's insurance 50.00 4 Household goods retained by family 200.00 5 Household goods, sale value 50.00 6 PNC Bank checking account #5070077313 3,612.91 7 Verizon refund due the decedent 21.50 TOTAL (Also enter on line 5, Recapitulation 5 4 , 799.41 aw48AO 2.000 It more space is needed, use adddionaf sheets d paper oFthe same size. REV-1510 EX+(08-09) Pennsylvania DEPARTMENiQFREVENUE INHERITANCE TAX RETURN RESIDEPIT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY r~~.~ ~~umocrt Eleanor C. B an 21 11 0549 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is ves D ~ I~ RR U N O E D P ~Tp ITEM NUMBS riL~ETFENNAEO F ~p FER E,T E F ~R FI AT I 7ooECEOExrAw TF DATE OF DEATH %OFDECD'S EXCLUSION EMTEOFiRM$ER,ATTpI]IgpppypFT1EDEEDFORREALE6TATE. VALUE OF ASSET INTEREST TAXABLE ~ Di IFPPPLICABLE VALUE anne C. Bryan 13,000.00 100.0000 3,000.00 10 000 00 gift made by the decedent on , . March 3, 2011 2 Roger F. Strand 13,000.00 100.0000 3,000.00 10 000 00 gift made by the decedent on , . March 3, 2011 3 Barbara E. Bryan 13,000.00 100.0000 3,000.00 10 000 00 gift made by the decedent on , . March 3, 2011 4 Anthony F. Kren 13,000.00 100.0000 3,000.00 10 000 00 gift made by the decedent on , . March 3, 2011 5 Lincoln Financial Group 58,485.23 100.0000 0.00 58 485 23 account #97-5244438. , . beneficiaries are decedent's children in equal shares 6 Vanguard 825,410.71 100.0000 0.00 825 410 71 investment account. , . Beneficiaries are decedent's children in equal shares TOTAL (Also enter on line 7, Recapitulation) $ 923 895 94 If more s eed pace is n ed, use addttlonal sheets or paper of the same size. BW46AF 2.000 REV-1571 EX• (1609) Pennsylvania OEPNtTA£Ni OF REVENUE NHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Eleanor C Brvan 21 11 549 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: ~. Funeral Luncheon, obituary guest book and flowers B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address city Year(s) Commission Paid: State ZIP 2. Attorney Fees: Snelbaker & Brenneman, P. C. 3,752.50 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address 4. 5. 6. 7. 1 2 9W48AG 2.000 City State ZIP _ Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Cumberland Law Journal Advertising Executrices Notice Hampden Township sewer/refuse service Total from continuation schedules TOTAL (Also enter on Line 9, Recapit If more space is needed, use additlonal sheets of paper of the same size. AMOUNT 1,103.61 727.50 75.00 105.75 13,043.69 80 Estate of: Eleanor C. Bryan 21 11 0549 Schedule H Part 7 (Page 2) 3 Michael Langan, Tax Collector 2011-2012 school taxes l,olo.ea 4 Pennsylvania American Water water service 59.49 5 PNC Bank check printing fee 4.50 6 PPL Electric electric service 72.42 7 Ralph Daywalt financial work for estate 210.00 8 Register of Wills filing fee for Inheritance Tax Return 15.00 9 Repairs to Green Steet property in order to prepare property for sale and siding repair discovered on settlement day. 550.00 10 Settlement costs associated with the sale of Green Street property a. Realtors Commission $7,500.00 b. Title services $15.00 c. Real estate transfer taxes $1,250.00 d. Hampden Township, sewer $150.00 e. Home warranty $399.00 9,314.00 11 The Sentinel advertise Executrices Notice 219.40 12 UGI gas service 88.04 13 Reserve for filing fees, accountant fees and other costs associated with the administration of the decedent's estate 1,500.00 Total (Carry forward to main schedule) 13,043.69 REV-7572 EX F (12-OBJ Pennsylvania SCHEDULE I OEPPF27MENr OF REVENUE DEBTS OF DECEDENT roRIET~C~~T ~NTTURN MORTGAGE LIABILITIES $ LIENS ESTATE OF FILE NUMBER Eleanor C. B an 21 11 0549 Report debts Incurred by the decedent prior to death that remained unpaid at the data of death, including unreimbursed medical expenses. ITEM PAIMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Continued Care RX medical expenses 469.12 2 Cumberland Crossing nursing homo care 120.00 3 Hampden Township seweer/refuse service 150.00 4 Pennsylvania American Water water service 19.00 5 PPL Electric electric service 17.90 TOTAL Also enter on Line 10, Reca itulatfon j 776.02 ewasnrl 2.00o If more space is needed, insert additional sheets of the same size. REV-1573 EX+(01-10) Pennsylvania OEPPRTMENi OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT 1 SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [Indude auldght spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Roger F. Strand 69 Dirbyshire Drive Carlisle, PA 17015 Roger F. Strand Inventory Value: 10,000.00 2 (Anthony F. Kren 1026 Country Club Road Camp Hill, PA 17011 Anthony F. Kren Inventory Value: 10,000.00 RELATIONSHIP TO DECEDENT DO Not List Trustee(s) Son-in-law Son-in-law ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SF~WN ABOVE ON LINE515 THROUGH 18 OF REV•1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: FILE NUMBER: 1~1--05-4.-9 I ~~.xJNT OR SHARE OF ESTATE 10,000.00 10,000.00 TOTAL OF PART II • ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET I Z 0 0 9wesni z.ooo If more space is needed, use addltlonal sheets of paper of the same size. Estate of: Eleanor C. Bryan Schedule J Part 1 (Page 2) Item No. Description 3 Barbara E. Bryan 1026 Country Club Road Camp Hill, PA 17011 One Half of Residue: 507,521.57 4 Dianne C. Bryan 69 Derbyshire Drive Carlisle, PA 17015 One Half of Residue: 507,521.57 Relation Daughter Daughter 21 11 0549 Amount 507,521.57 507,521.57 ~`xltM{xt(A Y ~9 ~~ A. Settlement Statement (HUD-1) ~+N o~ie~ B. Type of Loan OMB Approval No. 2602A2s8 1. ^ FHA 2. Q RHS 3. QX Conv. Unins 6. Flle Number. 11-382 7. Loan Number: 8. Mortgage Insurance Casa Number: . 240921039 4. Q VA 5. Q Conv. Ins. C. Note: 7hls fomt is fumished to glue you a statement ofadua/ s at t ement cows. Amounts paW to and 6y the setdemenl agent are shown. Items marked'(p.o.c.)' were pald outride the closlrrg; txy are shown hers forin/ormaflonal Purposes end are notlnd d d I D. Name and Addross of Bonower: u e n tre totals. E. Name and Address of Seller: Dean LC. Foote Estate of Eleanor C Br F. Name end Address of Lender. an 1112 Wansford Road . y BANK OF AMERICA, N.A Medumlcsburg, PA 17050 ATTN: Enterprise Cbeing Protectlon Dept MS:TX2-972.04-02, 8400 Legacy Dr. Plano, TX 73024 G. Property Location: 3531 Green Street H. Settlement Agent: 25-1867112 I. Settlement Date: Camp Hill PA 17011 Midstab Abstract Company , Cumbedand County, Pennsylvania 2331 AAarket Street Camp HIII PA 17011 October 8, 2071 , Ph. (717)763.1383 Place of SePoement 2331 Market Street Cam HIII, PA 17011 J. Summa of BonowMS tnnsaetlon K. Summa d Seller's trsnsaetlon 100, Oross Amount Dus from Borrower . 101. Contrad setae rice 400. Gross Amount Due to Seller. 102. Personal roe 125 000.00 401. Contract sales rice 125 000 00 103. Settlement Cha ea td eonowar Line 1400 4 832 59 . 402. Personal ro 403 104. . . 105. 404. 405 Ad uatmenb for items old b Seller In advance . 106. Ci /Town Taxes tO Ad usbnenb for Items id b Salbr In advance 107. Coun Taxes 10/06/11 to 01!01/12 66 78 406. CI /Town Taxes to 407 C T 108. Sdrool Taxes 10108/11 to 07/01/12 109. 4th Qtr. Sewer 10!06/11 to 01/01/72 . 758.10 106 97 . oun axes 10/06!11 to 01/01/12 408. School Taxes 10I08l11 1p 07/01112 409 4th S 66.76 758.10 110. . . qtr. ewer 10/06!11 to 01101/12 106 97 111. 410. 411 . 112. . 412. 120. Gross Amount Due from Borrower 130,584.44 420. Gross Amount Dw to Seller 200. Amounb Paid b or In Bshelf oT Borrower 300 725,931.85 201. ^ sit or earnest mon . Reductlons In Amount Dus SNlsr: 202. Pdnd al amount of new bans 1 000.00 100 000 00 . 501. Excess de it see IrtsWCtlons 502 203. Exiatln loans taken sub act l0 . . Settlement cha es to Seller Line 1400 9 314.00 204. 503. Existln loans taken sub'ect to , 205. 504• Payoff First Mortgage 505 P 208 . a nd Mo e 207. ~~ 507 D i 208. . e a l disb. as roceeds 209. 309. 509 Ad uatmenb for items un aid b Ssller . ' 210. G /sown Taxes t Ad ustmsnb for kerns un old b Seller o 211. Coun Taxes to 510. Ci /Town Taxes to 511 C 212. School Taxes to . oun Taxes to 213 512. School Taxes to 214 613. 215. 514. 218. 515. 516 217. . 218. 517. 219 518. 519. 220. Total Pald b /for Borrower 300. Cash at t8sttbmsM fromlto Borrower 101.000.00 520. Total Reduction Amount Due Selbr 9,314.00 301. Gross amount due from Borrower Ilne 120 800. Cash at saKlemeM to/from Seller 302. Less amount id b /for Borrower Ilne 220 ( 130 564.44 101 000 00 601. Gross amount due td Seller line 420 802 125,931.85 303. Cash X^ From ~ To Borrower , . . Less reduc8ons due Seller line 520 ( 9'314'00 Th~.,..aa,....W ~ 29,584.44 803. Cash Q To ~ From Ssller 118,617.85 . _.e..__ .._....., o,,,,,,,,.,,a„y®, ew,pc or acompleted copy of this statement 8 any attachments referred 1o herein Borrower OV.O,rPI,~'G/~~~~ II Seller Estate of Eleanor C. Bryan Dean LC. Foote - n BY: LIAX9atd- ~ /i , renbYM MY /wpm, M~~ ~ailb~Otb~wnholb ~~rrbwM~er,lbloxxybrrurW~tlilr~wnY~^~MaY. 7hbbM Wh. Thbaprbymryrbr axMCllMahMr,ram, mU you mnotrpuwEb ~M1q M naer,wx tlWpIM b Pru"b~ M Wrtlw b ~ RESPA WwM barn~wbn Wm NAxm~EOn Page 1 of 3 HUD-1 (FOOTE.DEAN.PFD/11-362/8) L. 3ettiemeat Charoas - 700. Total Rul Estate Broker Fua $ 7 500 00 , . DlNSlon commission Inc 700 es folbws: Pete FO11 gb Frem 701 3 7 Cddwell B nker H d Pmf I ecrtowere scars e 702 B n H el ro ions - ,usa.x ~dter 7 la on ement satlsmait Sxaxrant 704, 7 705. 800. Items Pa bls In Connectbn wRh Loan 801.Our inatlon ch a Inductee inatlon Pdnt 96 or 590.00 802. Your credit a charge (poinb) for the s edfl i t from GFE #t ~~~,~`~" >• ~ ~~~ ~ ~ ~ ~~ p c n erest rata chosen $ 803. Your adJustad o irtatlon cha es (from GFE #2) ~ ` :~ ~ '^ ;, ~ , 804. relsel fse W LarWSafe relael Services, Inc. from GFE #A frorrr GFE #3 44 890.00 .~' sr ~ ~: ' ~ 805. Credit R ort to LandSak Credit Inc 0.00 POC q 00 a ~, =~e ~ : ~ ~ . 8. ax service b BA ax Services Co retlon ffrom G~ ~ 35.00 1J " ':: "t 807. Fkz1d cerdftcatlon b Land fe Flood Determinatlon Inc 89. ~~ , v~.;. , . 808. mGFE fl3), . 28.00. ~„,, ..~ 809. from FE 3) G „y„ . 1~"M r'7" 610. F S3 k'> i r,a,~r 811. from F 3) v11..n~P%'a.~...t 900. Ibms Re aired b Lender to Bs Pald In Advanu m E ip ~~~"' ,., 907. Dail interest charges from 10/08/11 t 11/ o 01/11 28 ~ $11.300000/da 902 M from GFE #10 r . e e Insurance remium for months to f 293.80 + 4a~. ""r;J ,.^; 903. Homeowne/s Insurance for 1.0 an to USAA rom GFE #3 904. 908, from GF 11 from GFE #11 351.61 ~ ~ a . 1000. Raserws De oaited wkh Lander (from GFE #11) .., ,,, 1001. Initlal deposit for your esvow account omeowners insurance mon s (from GFE #9) 547 43 d ~ ~> ` 1003. Mort e e insurance ~ mon months 4 ' '~ ~ er month 1004. Properly fazes $ ,,. A' 3 ' Coun Taxes 9.000 monhs 23.35 er mon $ 631.36 ~ : i;~"'yam . ,~,. r ~: 1,,'„fit, ' Assessments 5.000 months S 84.24 month `i i° ~-~ 7005. 1006. months ~ $ per month $ ~ ~ ~ ~ a p 1007. months Q $ per month 1006. $ $ e 1009. Aggregate Adjustment 1100. Title Char es $ -207.16 i '. ............... ~ 1101. Title services and lender's tltle insurance 1102. Settlement or dosin fee (from E #4) 1,168.7 5 15.00 1103. Owner's tltle Insurance to Midsfate Abstract Com any Insurance Acct $ „. " ~~ s '~ "5 "' " . 1704. Lender's tltle insurance to Midstate Abstract Compan Insurance Acct from GFE #5 125.00 . 1105. Lender's tltle oli limit $ 100 000 00 $ 858.75 s,; re ~ c Y,, ^, .. ,...... , . 1106. Owne's tltle oli limit $ 125,000.00 ' +""'r . ,.,: ,., ~°~,~ + 1107, ant s ortlon of the total tltle Insurance remium to Midstate AbstraG Com an _~ t ~w ~ s car. 1108, Underwriter's oNon of the total tltle insurance re i $ 685 7 ° a ~ ~ '~' m um to Midstate Abstract Com a 1109. n Insurance Ac $ 178,p ~ ~ ; - 1110. 1111. 1112. 1113. 1200. Govemment Recording and Transfer Ch arges 1201. Govemment racordin cha es to Recorder of Deeds Office from GFE #7 1202. Deed $ 82.00 Mortg e $ 90.00 Releases $ Other $ 152.00 p _ 7203. Transfer taxes to Recorder of Deeds Offic '' ~ ~ ,.•,~ e 1204 Ci /C {from GFE #8) 1 250 00 s ~ . ty oun tax/stamps $ 1 250 00 , . ~ ;; ~, ~~ , . 1205. Stets tex/stam s $ $ .-. i, ',_ 1208. $ -=~'-i:.... ... _,... ~. 1 250.00 1207. 1300. Additional Settlement Char es 1307. R aired services that u ran sho for 1302. from GFE #8 e a'"~'z}?~4' 1303. 1304. 1305. See addil'I distr. exhibit to 1400. Total Settlement Char es enter on lines 103, SacOon J and 502 SlteBo K 649.00 , n Byslpnb9 p,pe t xxu sblanur,4 the &pne6xies aCknoMlpge rscepl Of a eamol,nE wov W nape 2 of tlw Ne,,un..r. 4 632.59 9 314.00 Certlfled to be a true copy. 1 Midstate pl ompan , ettlement Agent Papa 2 of 3 HUD-7 (FOpTE.DFJ W.PFD/11-382/6) of Good Fsifh Esumats (GFE) antl NUD-1 for Loan Terms Your Initial loan amount la loan tsnn is Your Initial interest rate is Your inttfal monthly amount owed /or principal, Interest and any mortgage insurance is Can your interest rate rise? Even If you make payments on time, can your loan balance riser Even I/ you make payments on time, can your monthly amount owed for principal, Inlareat, and mortgage Inauance rise? Dose your loan have a prepayment penalry7 Does your loan have a balloon paymeml Total monthly amount owed Including escrow account payments Good Faith Estimste I HUD-1 # 802 #1203 $ 700,000.00 30 years 4.125D 1,250.00 $ 484.65 includes ^X Prinrtipal 0 Interest ^ Mortgage Insurance ^X No ^ Yes, it can dse ro a maximum of % . The Orst change will be on and can change again every_ months after . Every change date, your Interest rate can increase or decrease by %. Over the life of the loan, your interest rate Is guaranteed to never be lower than °~ or higher than %. ^X No ^ Yes, it can rise ro a maximum of $ Q No ^ Yes, the first increase can be on amount owed can dse ro $ and the monthly The maximum it ran ever rise to is $ ^X No ^ Yes, your maximum prepayment penalty is $ ^X No ^ Yes, you have a balloon payment of $ due In _ years on ^ You do not have a monthly escow payment for items, such as property taxes and homeowners insurance. You must pay these Items directly yourself. ^X You have an additional monthly escrow payment of $136.90 that results in a total ini8al monthly amount owed of $621.55. This includes principal, interest, any mortgage Insurance and any Items checked below: ^X Property }axes ^X Homeowner's insurance ^ Flood insurance I"I Note: If yvu have any questions about the Settlement Charges and Loan Terms listed on this form, lease contact I__I P your lender. Page 3 of 3 HUD-1 (FOOTE.DEAN.PFD/11-382/8) HUD-1 Addendum Borrower(s): Dean L.C. Foote Ballet(s): Estate of Eleanor C. Bryan 1112 Wansford Road Mechanicsburg, PA 17050 Lender: BANK OF AMERICA, N.A. ATTN: Enterprise Closing Protection Dept. Settlement Agent: Midstate Abstract Company (717)763-1383 Place of Settlement: 2331 Market Street Camp Hill, PA 17011 Settlement Date: October 6, 2011 Property Location: 3531 Green Street Camp HIII, PA 17011 Cumberland County, Pennsylvania Additional Adjustments For-items Paid By Seller In Advance (Borrower Debit) Descri lion Amount From/1'hrou h 4th Qtr. Sewer 150.00 09/01/11 through 12/31/11 Prorated Amount 106.97 Total Line 109/409 106.97 Additional Disbursements Payee/Description Note/Ref No. Borrower Seller Hampden Township 4th Qtr. Sewer 150.00 rst American Home Buyers Home Warranty Total Additional Disbursements shown on Line 1305 Adjusted Origination Charge Details Origination Charge Origination Charge to BANK OF AMERICA, N.A. ATTN: Enterprise Closing Pro Origination Credit/Charge (points) for the specific interest rate chosen $ 0.00 $ 549.00 590.00 Total $ 590.00 Total $ Adjusted Origination Charges $ 590.00 Reserves Deposited with Lender Homeowner's Insurance 4.000 at 29.31 per month County Taxes 9.000 at 23.35 per month Assessments 5.000 at 84.24 per month Aggregate Adjustment month 117.24 210.15 421.20 -201.16 Total 547.43 WARNING: It Ia a crime to knowingly make falp statements to the United Stsus on tMs or any similar form. Penakiss upon ccmrictlon can include a floe and ImprlsomrpnL For details tee: Tkle 18 U.S. Code section 7001 and Section 1070. (FOOTE.DElW.PFDl11-3tr2le) HUD-1 Addendum - Continued Title Services and Lender's Title Insurance Details BORROWER SELLER Closing Service Letter Midstate Abstract Company Electronic Doc. Preparation Midstate Abstract Company Wire Fee Midstate Abstract Company Notary Fee Midstate Abstract Company Overnight Fees Midstate Abstract Company End. 100 300 & 8.1 Midstate Abstract Company Tax Cert. Michael Langan Owner's Title Insurance Owner's Policy Premium to Midstate Abstract Company Insurance Acct. Lender's Title Insurance Lender's Policy Premium to Midstate Abstract Company Insurance Acct. 75.00 50.00 10.00 10.00 15.00 1 50.00 5.00 10.00 Total $ 310.00 $ 15.00 BORROWER SELLER 983.75 Total $ 125.00 $ BORROWER SELLER 858.75 Total $ 858.75 $ WARNING: It Is a crime to knowingly make (else statemems to the Untied Slatp on this or any similar form. Panahlas upon eonvktion can IneluM • ftn. and imprlaonmsnt. For dataile sae; Tkla 18 U.S. Code Sacdon 1001 and Section 1818. (FOOTE.DEAN.PFD/1 ~-362/6) LAST WILT, AND TESTAMENT uw orrm[[ II SNELBAKER. MCGLP-0 R EC7CKER I, ELEANOR C. BRYAN, of the Township of Monroe, County of CumbexJ;and and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare-this as and for my Last W11 and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. RIRST. I order and direct that all my just debts and funeral expenses be paid Yay my Executor, Executrices or Executrix, as the case may be, hereinafter named, as soon as copveniently may be done after my decease. "SECOND, I give, devise. and bequeath all the. rest; residue. and remainder of my Estate, real, personal and mixed, whatsoever, and wheresoever situated, unto my husband, bONALD E. BRXAN,.absalutely and in. fee. simple, if he survives me by as manx.as sixty .(60) days, THIRp, If my husband, DONALD E. BRYAN, does not survive me. by: as matey as. sixty .(60} days, then and in that event, I give, devise. and bequeath ail the rest, residue and. remainder of my Estate,.zeal, persona],: and mixed, whatsoever. and. wheresoever situated, in equal. shares unto my daughters, namely, BARBARA E. BRYAN and DIANNE C, BRXAN,,share and share alike, absolute],y and in. fee. simple, If either of mX said daughters. shall predecease me, I order, and direct that. the. foregoing 'residuary disposition shal3,.be distributed unto my surviving daughter, I+F~STtiY, I nominates constitute and appoint ,my husband, DONP,Lp E, BRYAN, to be the. Executor of this, iny,Last Will and Testament, but. if for anX.reason he should. fail to qualify as such Executor or cease so to serve, then and in that event, I nominate, constitute and appoint my daughters, namely, BARBARA E, BRYAN and DIANNE C. BRYAN (or either of them singularly if one should €ail to qualify or cease so to serve), to be the Executrices of this, my Last Will and Testament, each and both to serve without bond or other security as a condition of I qualification hereunder. IN WITNESS WHEREOF, I, ELEANOR C. BRYAN, have hereunto set my hand and seal to this, my Last Wili and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this ~~~ day of A.D., One. Thousand Nine Hundred Eighty-five (198 . ~~'~`~~'~ ~ (SEAL) U The pzeceding instrument, consisting of this and one (1) other typewritten page,. each identified by the signature of the Testatrix,. was on the date t#~ereof signed, sealed, published and declared. by ELEANOR C, BRYAN; the Testatrix. therein named, as an ~oz.hez Last Will, azid Testament, in the presence of us, who, at her. request, in.hex'presenee,..and in the presence o~ each other, have subscribed our names. as wit ess h eto ~,e~ uwomco 3N EL94KER. OLEO ~ EpCKCR COMMONWEALTH OF PENNSXLVANIA ) COUNTY SS. Ok' CUMBERLAND ) We, ELEANOR C. BRYAN, RICHARD C. SNELBARER and JANET M. FORF the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she execute it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the. presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 8 11 .~~ 'Gi~c.'~'rrrc~LJ ,~j ness f ~ .~+ 7`"' Ill ~„_ Witness Subscribed, sworn to and acknowledged before me by ELEANOR C. BRYAN, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET M. FORRY, witnesses, this //~' day of ~L d~e~ , 1985. / / ~ Notary Public ` FLORENCE 6. IUSCHER. NOTARY PUBLIC HIECHRHlCSBURG BIIRO, CUSRBERlAH9 COUHTY FdY IAAtYtSSION EXPIRES APRIL 6, 19Bb MEmper, Pennsylvania Association at Notaries t~ uw ornccc 6N P.LBAKER: ALES 6 ELICKF'j=