HomeMy WebLinkAbout11-30-11
],505610105
REV-1500 EX(g2 ,,,yyy
11)(FI) 1.~
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX z8o6o>. ~~~~~ ~~~' ~~~ INHERITANCE TAX RETURN County Code Year File Number
Harrisbur , PA 1 >z8-o6oi ~ I
RESIDENT pECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
172-16-7863 03 /06/2011 09/07/1919
Decedent's Last Name
GRAVER Suffix
Decedent's First Name MI
ROBERT A
(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 OVALS BELOW
OD 1. Original Return O 2. Supplemental Return
O 3. Remainder Return (Date of Death
O 4. Limited Estate
O Prior to 12-13-82)
4a. Future Interest Compromise (date of O 5
F
.
ederal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O
(Attach Copy of Will) 7. Decedent Maintained a Livin Trust
g 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Povert Credit Date of Death
y ( O 11. Election to Tax under Sec
9113(A)
B
t
.
e
ween 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED
A
Name .
LL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
DORIS JONES Daytime Telephone Number
(717) 243-4740
'
n '
REGISTER EtF. , LS USE I~jLY
First Line of Address t ~ r
~ ~ n
2071 NEWVILLE ROAD '~ r,_,'t ~ ~ , ,~
~ .. c_- '' c;;
-~
Second Line of Address -
-
_ _ . --~-{
' ~_~ ' '~
'i7 ' '~ f. ' ~ ;~-I
City or Post Office D ,. .. ~- `-~~
State ZIP Code DATE FILED T'
PLAINFIELD
PA 17081
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUR OF PERSON RESP IBLE FOR FILING RETURN
X ~ , ~ DATE
ADDRESS v~/~,~ ~~
/ / ~ ~ , ~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
~ DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
J 150561D205
REV-1500 EX (FI)
Decedent's Social Security Number
oecedenYs Name: ROBERT A GRAVER 172-16-7863
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1. 100,000.00
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D) .......................... .
4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
16,139.28
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ................ 116,139.28
............. 8.
9. Funeral Expenses and Administrative Costs (Schedule H) ..... .
• ~ ~ ~ s. 24,499.38
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............... 10.
11. Total Deductions (total Lines 9 and 10) ................................. 11.
24,499.38
12. Net Value of Estate (Line 8 minus Line 11) ..
13. ....... .
.................
Charitable and Governmental Bequests/Sec 9113 Trusts for which
... 12. 91,639.90
an election to tax has not been made (Schedule J) ........... , 13
14. Net Value Subject to Tax (Line 12 minus Line 13)
.......... .
..........
... 1a. 91,639.90
TAX CALCULATION -SEE INSTRUCT
IONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0
16.
Amount of Line 14 taxable 15.
at lineal rate X .0 45 4
123
79
17. ,
.
Amount of Line 14 taxable 16. 4,123.79
at sibling rate X .12
18.
Amount of Line 14 taxable 17.
at collateral rate X .15
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
I....._ Side 2
1505610205
4,123.79
1505610205
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
ROBERT A GRAVER
........_.._.....
_.
STREETADDRESS
2069 NEWVILLE ROAD
___._._._..
cirY
PLAINFIELD
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 5, 500.00
B. Discount __ _ 206.18
File Number
STATE Zip
PA 17081
(1) 4,123.79
3. Interest Total Credits (A + B) (2) 5, 706.18
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3)
Fill in oval on Page 2, Line 20 to request a refund.
(4) 1, 582 39
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A
"
"
N
X
IN THE APP ROPRIAT E BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred .......................
b Yes No
. retain the right to designate who shall use the property transferred or its income .....................................
i ....... ^ ^
c. reta
n a reversionary interest .....................................................................
d
. receive the promise for life of either payments, benefits or care? ..........................................................
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 beneficiary designation? .................................................................................................................. ...... ^
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 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)]. 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 an individual who has at least one parent in common with the decedent, whether by blood or adoption.
'REV-1502 ~X+ (11-08)
~ Pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RobertA Graver 2011-00328
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1' REAL ESTATE PROPERTY AT 2069 NEWVILLE ROAD PLAINFIELD PA 17081-0044 100,000.00
TOTAL (Also enter on Line 1, Recapitulation) I ~
If more space is needed, insert additional sheets of the same size.
100,000.00
REV-i5o8 EX+ (ii->o)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
tl^T~T.w w
SCHEDULE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
rv. r~.V Vr.
ROBERT A GRAVER
ITEM
JMBER
1. CD#4000003375
2 PERSONAL CHECKING ACCOUNT
3 INTEREST ON CD
4 COMCAST REFUND
5 HIGHMARK BLUESHIELD REFUND
6 CENTURY LINK REFUND
7 SPRINT NEXTEL REFUND
g THORNWALD HOME REFUND
g THORNWALD HOME REFUND
1 p ERIE INSURANCE REFUND
11 HOFFMAN ROTH VA REFUND
12 1990 LINCOLN TOWNCAR
13 PERSONAL ITEMS
14 FORD ESCORT
15 ERIE INSURANCE REFUND
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
TOTAL (Also enter on Line 5, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
FILE NUMBER:
2011-00328
VALUE AT DATE
5, 003.21
4,697.04
6.95
27.21
344.76
2.32
5.79
1, 975.00
833.00
163.00
100.00
1,495.00
494.00
975.00
17.00
16,139.28
=REV-IS~~ ~~. + t10-Q91
j i1 Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
CL~T1T!• w RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
~vl~Ir VI
ROBERT A GRAVER
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A• FUNERAL EXPENSES:
1' HOFFMAN ROTH FUNERAL HOME
2 BULLETINS FOR SERVICE
FILE NUMBER
2011-00328
e. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s),,,
_.
Street Address
__.
_._.....___..
City _ _ _ _.. State _ ZIP
Year(s) Commission Paid:
_.
Z• Attorney Fees:
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
__
__ .
_..
_.
_ _...
City _ _ _ _ State ZIP
......._......
Relationship of Claimant to Decedent
_._..
.
4• Probate Fees:
S• Accountant Fees:
6• Tax Return Preparer Fees:
~• PROPERTY SETTLEMENT COST
PROPERTY TAXES
PROPERTY UTILITIES
THORNWALD NURSING HOME
MEDICAL
REPAIRS/IMPROVEMENTS DONE TO PROPERTY TO SALE
TOTAL (Also enter on Line 9, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
739.02
122.96
275.00
319.50
15,250.69
316.96
551.22
5,403.02
228.74
1, 200.00
24,499.38
- _ -;~ ..
LA. sT wILL A:vD T~;sTA~~Fr?T ~~ :~ _.
.~ ~ _
I, ROBERT A. (;RAVER, of West pennsboro Township, Cumberland '
County, Pennsylvania, declare this instrument to be my last Wi11 And
Testament, hereby revoking all, Wills and Codicils heretofore made by me.
1. I direct my executrix to pay my debts, funeral and administrative
expenses as soon as may be done conveniently after my decease.
2. I authorize and empower my executri:~c to sell any realty owned
by me at my death, and not specifically devise ar bequeathed herein, at
either public or private sale, and to give good and sufficient deeds
therefor, in fee simple, as I could do if living.
3. I devise and bequeath all of my estate of every nature and
wherever situate to my wife, Martha B. Craver; providing she shall
survive me by sixty days.
4. Should the gift in Paragraph No 3 not take effect, I devise
and bequeath aLl of my estate of every nature and wherever situate to
my children, Doris (~. ,Tones, ,lames L. Craver, Robert A, Graver 11, and
Patricia K. McKeehan, to share and share alike, the child or children
of any deceased child taking the share their parent would have taken
if living.
S. I nominate and appoint "Martha B. Graver to be the executrix
of this my Last Will and Testament; she is to serve as such without
bond. Should she die before my death, renounce or refuse to serve for
any reason, or die leaving any of my estate unadministered, I nominate
and appoint Doris G. Jones and Patricia K. McKeehan, as substitute
executrices, also to serve as such without bond, with the same powers
as are given herein to my executrix.
page 1 of 2
TN WITNESS WHEREOF, I have set my hand and seal this Sixth
day of November lggg
r
G~~~_
Robert A. Graver
Signed, sealed, published and. declared by Robert ~. Graver, the
testator name above, as and for his Last Will anal Testament, in the
presence of us, who at his request, in his presence and in the
presence of each other have subscribed our names as witnesses hereto.
~, ,
,~
Subscribed, sworn to and acknowledged before me by the Testator
and the witnesses above named, this _ ~~-; 1'~ da of ~ ~ ,
y ~~C~~~ir k1N r
1989.
~~
Notarial Saa1 ~'
Barbara A. Day, Notary Public
Carlisle Borough, Cumberland Cou+ity
My Commission Expires Jon, 8, 1990
Member, Pennsylvania Association of Noiiries
M
N~
0
V
d
0
S
~~
0
a
x ,~
d N
v
r
V
to
v
d
L
V
N
d
t
V
N
ti ~
N Q
L M n
age,
o~~
y N N
C
n
L~
r0
n
is O
:a O
~, S ~ a
c o ~ a ~
`` c a "' "' o ,n ~ a,
~ ~ LL
o '" ~ a o a ~ c c ~ ~ F- a
1 ?_ _ _
C p C ~ G: ~ ~ ~ ~ ~ L ~ S.' C Lj G. C O ~ V u ,~ 'U ... ~
= c~ j ' '- c o- c a :' L~= 3= 3~ 3 m o= o
~- Z ti v`l a til vl ~ v~ ~ ~ w ~ v~'i ~ v o u c
ON O N rv > in ~ a N a ~ ~ vi w n. ~ ci
0 0 00 ~ B~~S°~~ X 8 8°~,8~8 S°~~ ~g
N M ~ O 00 ,-i .~. O O DO ill ql ~„+
N N p
~, l!1 N M ~ .N-1 .~. .Mi R "^ J "J N ~ lD lD .-r O :~ JO O N N
N N N ~~ tll ~~ N N u. lOi~ N ~. N ~ N rNil ~ ~ vai v'ai s
~ ~ GO
N
0
a
~:,
~~
~,
~ S g
o ~;
,~ :^
N
~n ,/i,
aS ~ N
° 8 ~ ~ .x
N Vr rx..
~n vi
+rl
~ ^"i t0 N C71 o
a ^~ ~ m n C~ 8 o
~ n b
N N M N N ~ M 8 O $ ~ O Q ry
N ~ ~ ^ ~ ~
~1 N N .-i N ~ N "My
N N
S o
8 g
N
N
v=
y 3
_ ~ ~ v a £
w O C - ~ G
n O ap ~ 7 ~ ~ ~ G~ Ca n O ~
oaThj ,s ~ C C ~ p c C+ ~ ¢ ~ ~ O O ~ 'C ,~: Cu
y 3= O c c, ~ m c y~ x= o n. ~ c_ ~- s ~+ ~ o~~ a a o
~ v Y ~ t U O O= ~ ~~~ G ~ ~~ w Q~ C~ -- .D T~ O -'i O O ~ ~' v_ O
u .. „' in 3 ,~ z Y T~~ a c o ~ = C a C ~ f0 ~ a
~~ ,~ .o a .`. a ~, c ~ ,, a 3 3~ ti °' ~ S' ~ c c ~ s ~ w 4 c in c~
v ~ %o o` ~ ~ o. ~ v o E ~ ° ~ ~ ~ ~ E '_ o` a a ,~ 3 _ E J ~ ~ ~ v ~ ~ ~ ~ a Y ° ~
o v a o ~:, v o ~ 3 ~L- ° w a y c. ~ .c° o a ~~ E T o w~ o a s ~. c ,- ~ a~ a ~, _ ~, ~
V x v vi a s .- F- S A O S\' u d~ a o rn a~~" d~ ° ? a n J .n oC
w 2 .. a s l~ ¢ O a ° ~ y o y i c,
Sl c 3 Q, S~ 3 a`. a ~., ~ t
.. r M v ~- p
~ ~~jj p gg
~ r, ~ "~ .~~.~ .M. 0 0 0 8 O O O O p~ .~-. .~. M C to
O O O ~~ ^ x
0 0 0 " O C O O
~ O O O
ry 0 0 0 0 0 0 0 0 0 0 0 0 0 p p q ~" ~~~ "' '" ~~ ~' "~' _ _
\\ --' ~~ ?~ w e ~ :; i;\,~ ~~<° o o a a o 0 0 0 0 0 0° ry o 0 0 0 0 0 0 o c> c o o p c, o 0 0
M M M M M M M M \. M ~ M N \ N \ N \ \ ^ ~ .,1 ill CG 4C' tlC '„^ \ \ \ \ \ \ N \ N f'v ~ N h ~ h N ` ry
M M rv` M M M ~ K ~"' `,f `. ',.' 4 Z p ~ .ti v1 L 71 1 '.U `iD l7 M \, y ~ ~ 1. \ M.. N 1 `t..
Tt ? .:'1 J J .a ~~ ~ N N
COMMONWEALTH OF PENNSYLVA""^
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I, GLENDA EARNER STRASBAUGH
Register for the Probate of Wi11s and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the Ilth day of March, Two Thousand and Eleven,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of ROBERT A GRA VER Ia to of WEST PENNSBORO TOWNSHIP
!first, MidWe Lastl ~
in said county, deceased, to DORIS GJONES
and
lFHSG Meddle, Lasrl
PA TRICIA NICKEEHAN
/First, Middle, last!
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office a t CARLISLE, PENNSYLVANIA, this I1 th day of March
Two Thousand and Eleven.
File No.
PA File No.
Date of Death
S.S. #
2011- 00328
21- 1 1- 0328
3/06/2011
172-16-7863
., ~ ,, /`
ifr i
~.,,;.
In ~ j
4- ~'.~_
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
r ORRSTOWN~ANK
. L Tradition of~Fxcellence
ORBS F O Fi<1X ~;i o .
S~uppensbur~~. Pa 1 r^~7
Temp-Return Service Requested I) a t e i. O i 3 i/ l i Fag e
Primary Accou:;t 103009805
Enclosures
.~ ~~r~~~~iir~~~~n~~~~~in~~~~~~i~~in~ii~u~~n~~~~i~~~n~~~~~~
007406 0.4500 AT 0.365 TR00028
~,~ Rabert A G~°aver Estate
.~.~ FO B o t; 5, ~,
Plainfield FA 17081-0096
C H E C K I N G A C C O U N T S
+,.; ou::t _ _ r. is Rcber _. A ,~ravfr Estate
F ee Chec};xng
Ac our:t Number Chec}; °a ~e}seeping
e~xous Ea lance 10.~u088b5
96 S a~emen t Dates 10/03.11 thru 1
0/31/1
Depo.sitsACredits ,3.51.4;;' La}'s In G
The Statement Period
Check.s;Debits .00
~, ~, A~.rerage Ledger ~
86
313
3
Sc-
~~ice Fee ,4~,
--~
Average ,
.
_
Collected, 86,312.31
.00
_..~~rest Paid
~.,rrent Ba'_an::e .,ib
_ . ~., .0
0
0
v
0
0
0
O
0
0
0
c
o ip
o cp
.-. `a$
0 0
0 0
N CO
G: O
-__ C H r K S UT~II~,,Ar~ ~ -
Da~e Checl "10 .,.taunt Lia ;
l; `, ~ =e ::heck Jo Amount
Fnotes m~s`_~'g one-.c}: n,.;m:~ers _. ~i:' __ _.._~ _50.00
Daily Balance Information
Date Balance Date 8-~-
,3 dance Date Ealance
;~ `v 86, ,,51.00 ~G: ~6 ,. :`1. u0 ? ~?y
'~~ 8e, 139. GO
T'rikNK YvU F1R EANKZNG WITH ;RRaT{4~LtTN BANK
~~
r
Pat McKeehan
44 Greenfield Drive
Carlisle, PA 17015
April 11, 2011
Statement of Funeral Expenses for Robert A. Graver
Date of Death: March 6, 2011
Account Id: 16184-059
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE
$ 4, 550.00
Sub Total: S 4,550.00
TOTAL FUNERAL HOME CHARGES:
CASH ADVANCES: S 4,550.00
5 Certified Death Certificates at $ 6
00
.
each
Newspaper Notice -Sentinel
$ 30.00
Newspaper Notice -Patriot $ 189.95
Clergy $ 170.07
Flowers $ 75.00
Honor Guard $ 159.00
$ 50.00
Sub Total: $ 674.02
Total Funeral Expense: $ 5,224.02
Payments Made: Total Payments Made: $ 5,224.02
PreNeed Disc Discount
Unity Financial Life Check
Estate Of Robert Graver Check
Reimb ToPat VA Benefit
Cumberland Cty VA Check
Cont/PreNeed Mar 25, 2011 206
36
23405 Mar 25, 2011 .
4
628.64
9 Apr 6, 2011 ,
389
02
H/R ck Apr 11, 2011 .
(100..00}
811466 Apr 11, 2011 100.00
Balance: ~.____ __0.00
Please return this portion with your Remittance.
Robert A. Graver
Service ID#: 16184-059
Amount Enclosed
.~,~ {,
• ~ r
~.
: _ r
`r
~' ~ ~ ~~' A.
B Typc olLoan
OMB Approval No. 2502-0265
Settlement Statement HUD-1
~ )
~
-
. '.. ~ RItS -r--- -..._
- r' Fne Nurw'nr:~
t :Oan Nurnhe• ~F Mra e r C L~S~u rr .• <;.r>e PJtrr••..brrr
1
177
^
'
ur+ 5 V Conv fns .
,,
,
;2ty/551p.
~ '
.. Note: ?his form +s Iumrshed 7o g+ve }rou a statement o1 ecetar settlement costs Amo±mts pard ro and by the seBJemrnt agent arc shown
';ems marked (p o c !' wer
d
e par
ou(srde the c7osrng; they are shown hone !or rnformationa+ purposes and are no! rncruded u, life fnrats
D Nan),' and Adorers of Borrowe+
E Name and Address of Seller
Bea,any :: Fcutz i
I
F Name and Address o} Lennnr
F?2 2ago Read Apt i. j WEi.!_5 FARGO f3APJK. N A
Dons G ,lanes
co-executrix ;tnd
_
-n~D^c~,sn.,;rq nA 1i7,` ~
,
161,55 Rocks~de Road tiurte 1 15
PatnC~aK M,:Keehan
ao-executrx iii
,
mdeaendenre. OH 44131
of thr. Estate of Rdoer, A Grave=
i
._ ---
G r~-nneny Location
fi.. ..Settlement A ent. -- - r- _......._-._..__..-.--
~.- .'i9 23-24023'6 ~ ---- --- -
?C55 Newvdie Road , I Srtdemen Date
PURITY ABSTRACT COMPANY
:;an~s4: PA t70t`'
' ~i 3329 MARKET STREET
vL r.c t?,r•rsboro TwC Cumberl July 25, :"d111
and Co CAMP HILL PA 1701 ?
p.
t 7 ~ )73 8'1`.9
--- --...._.-
~
----
Ptace of SCttfrmenl --.....__.- -----
~
CENTURY 2t A BETTER WAY
i
i 398E HIGH ST. CARLISLE., PA I
i J. Summary of Borrowers transaction K. Summary of SoNer's transaction
' :'~ Gross Amount Due from Borrower
t- --- _- 400 Gross Amount Due to Sever -
,.nhaU sales --.-` "~--.-
Pr~ce t OC OO,n, 00 40 ~. Contract sales Pace --~-"-"-
0
z ',cn ~,n@ 1 C ar, es o Borrn.,r I ,o --- -
_ - -- t02 Persona~a~rry- - _ ___
._ - ~__ _- ~~~ ~ 0653 X03 `- -
,:.t ~L`mdF WARi2ANTY r'1i1S - __ -- - 435 Oi;.. 404 ...._.-. _._...... -_.
_
f - --. .. _ _ _ .... _ _ ... .,
_ . -- ----- ----- ____ aas
- --
FA~ustments for items paid by Seller m advance
_.-_
_ Ad ustmenls for Ilems paid_h_y Seller in_advancc
~F OUNTY'rOWNSHIP r -" --~ - ~ -- 1 - ~ - -. _.
• ' 07!25 t to D' /0 r < 39 J ~ 406 COUNTV,?OWNSI uP 7 75" t -'
_ to ~._ _ .._ __ __ tr ~ ~.
tOH CttOOL TAX - ~- -'-"-- ._._, tJ7 .ITV TAX -- - -- - -_...
._.
t nQ - ______ --
to ao6 scHOUL rAZ... _... _ ~o
_ - _- _ s09 _ _ _ _ to
._ - - -
1 t ^ __ _..__ _ ... ._____ - _
- -----
410 -- _._.. - -
r -- --- _ .
. 41 1 ~ .._._.__.._ __~_
; .. 2 -. ___ ___ _
- _. ,.
4 t 2. _ -_......~. _.-_......- - -
- -_, .. _.
I t 20. Gross Amount Due from Borrower _ - ' t 0,;?80.84 420. Gross Amount Due to Sollar ~ _
200. Amounts Paid by or in Behalf of Borrower _ _ t 00 ' 35 3'
Oeposrt or gamest money 500. Reductions (n Amount Dua Seller:
_. ~-. cess de osrt sae ins r Cion 1
nc: a~ amoun; of new loan sl -- 500 00 50t. Ex ;" s
'--. -` _.
i ~ --" _~: _.- __ _03 626.00 502 ScttfemPnt char es to Seiler - - - - _
• _ 5 ~n~ bants] Taken subled to --~~- l ~ Iline t tOf}, --. fy 1y _
'-- ---
t'
_ I r D. i 8Y I ENDER ~ ---" "'- 503. ? xl5hn~ loan s) taken su_b_pect to ~ ~ ' "_
_.__ _
__ ----
- -- ------- 1.600.00 5(14 Payoff F-first Mortgage _ __._. _
- - ------
_-.
05 Pay'aft Seconr~ MoR a e -
~ ~ 6
- ----"-' --_._--- _._- 506 -'-_...._
_ --_ _..
------ 507 De osrt dish as roceedsl
._---
-~_- _. _ t_._L ._____._~-_______----
------- -_ -- '>08 _
'i S- Sf C.ER ASSIST - - -._._. ..--.-- _._ _
Ad ustmonts for items un aid h Sellar --'-- 5'000'00 X09 SELLER ASSISI -' -"' - - _
i Adjustments fnr (tams un aid b Sollor 7 1>00 OC
n G COUNTV,TOWNSHIP ~"-`-- - -' - ---"
to -- _.L
!:ITYTAX "-' to--~- 10 COUNTYTOW_N_SHiP -tta ---
_ SCHOOL TAX rJ7'^t,tt r --- )I1 r'ITY TAX _.. tc _.- -.. _ _._
` o )7125 __.. ,....__ - .,.
~__
- -....- ____,_, 3C 17 Str iCH00 IAY, `>ft t . __ t-~- ~ ~- _..
__-'_._._.-----... i .__..._ .-..--......_.__..
- - - . ._ - __- -_-.._ - .-_.--__ _._ at6 __.._ _... _._ _'---.__'
tti '. -.. ___. ... _._. _.- .._ .- '- - _.
-- _.-
_ _. _
,~.y --- ~t8 _..
_._ _...
519- ----" _
220. Total Pald b )for Borrower `-""-'-~--"'- __
]OO. Cash at Settlement from/to Borrower 110,816.17 520. Total ReaucUOO Amount Due Satlar ^
600. Cash at settlement lmfrom Seller t ~ 37F .)0
7J' Gross amoun! duo from Borrower ihne t101 "` ~ ""'-
~-` -t 10 280 64 bit ros.~ amoun) due to ~r_e~ has a2 ~~_
302 Less amount pard bylfor Borrower nine 2.'0; ~--- -- - -- _.
______-.__._ tall 119 ~~
1 t0.818.t7i 602. Less reductions due Seher (hne 520! - --
303. Cash 1~ From ~ To Borrower _ i ' > 128 00
535 33 603, Cash ~ Td jr- ~ From Seiler
.__. B48i1 ~~.
^d untlersrgned hereby aCXnowietlge recCipl of a completed copy of this statement 8 any attachments iTfenod t04he+ern ~`_
Bo^owe~ ~ ~ rt
_ Seaerr ~~
9etnanv FnurX~ ~ -'_..._-_
__~
r'atri ~~ K hac:KC eh r _.-ro-e%ecunix. _.._.
"]
, r ^.... .. ~a-y.. r.utpr ,t,
~ .,
, 5'1~~,r . 1....!'4C r
Page ~ a, 1 ,,,.,~r.. .., .. .~ . ~...,. , ,vi ., .~.. ..,; .~
!Al0-,
,r. n, ,,.nr ,,.r n,..-. ,.,
_'
1. SettlemetTt Charges
700. Total Real Estate Broker Fees S fi 000 00 .~~,;,..,,,,
_-- -_- l r: LrrT
Lv!Spn OI COmmr55rOn (qnP ? ,rq aS IRN(n 5 -.. - _._ _..--._.-..__.-__._.. __ __ _
...-_ _._
I ~-- c .•i/3Cr -o (ENTIFRV '..AHt-T-TER~JAv ..,___._ - ,.~
I ..._ -_ - _ __ _..
_.__- I .. I n- .
~ ~ to C FNTURY ~, A fiFT [ R'fJAY ----- ' ,. -....
h~.", r.,nssicn~aJat sctl~merrt. _... _._ _ -_. _ -... ,..: - --
._
---
1 -, RROKERAUE f"FE " _._ -_,-'- ,- --- ~. ~ DO_~_
. •n CE:NTUR4' 7t A RI 1"TER WAY -- --- 5 000 00
- _'
_ __ r-__.__--- _..__
800. Items Pa able in Connection with loan ~~ -
9C' Our ongmaeon charge _ - _~~ 495.00 tGom GFE # t'.
902 your credrl or charge (pants) for the speafic interest rate Gu7sc:n _ {from GFE #2 - -'-~` T~ ~ ~
_._-- _. _.-_. „vr~~ Marc wni i d95.00 _ ~
.._ _ -
nOa APPra~sal fee _ to RCt.S VAI-UATtON from GFE #3; 5400 PpC78~ _ 155 DO
~ ~G ~o-t Rec~rt _ c~ REI 5 (REDtT _~ _ - _ _.ifrom G _'.-----t- '
a0h Tax service _ r - __ _- _.- ~ FE #31 -_ _- 77 38
~ (from GFE d3) ---~"'-
30 c i cert treat cn -- '-- '- -- -
' t(rom GFE it$) . _^__ }_-°---
- --__ _ _ __ t rom GFE #?r --... t
~ 5 ~; - -- --- - - _ - 1 - -- -1
_ .-..__._ - -- _ from GFE #3d -`- .... .- ..
_-.. ..._- _ _.- _ iror t GFF #3'-.~ -. --
_ __ rttom GFE #31 -_- _ _ . --- -
3017. Items Required by Lender to Be Paid mAdvance --R_ -,~
,i H ~terest charges f on ,•N25+t o eOtOtrt I
- a } a9r)OfO,nay 'teem ('FE #t0l i ya
'_ _-__--
l ~. tt rgage msuran:F (` emw to ~nnlhs to WE(I 4 f ARl';O BANK N A _.- -- .....- .. _._ ..-__. 3 tt __43
--- -- from t Fe #31 X76 9a
73 Fro -ecnvners insurance fee ' 0 voars to FRI[. INSURANL,C~ --- -'-"-'-"-
9u4 ~ -- ` --` ---------..._._._ IlrOm GFE # T t j -.-_ . _~ -.._~_ 146 00
SOS --------~--.._-_.- - _ :from GFE #7 t,
_ rrrnrn GFE #+ ....-_-... _...~.-._-------._._..
7000. Reserves Da osited with Londer -~'-""` -------
^ lagial depostl for your escrow account -'-'-
y f om GFF #9;
~< OmeOwn '--'- ' S
ers nsurance a 64ri- -tonTtss C ' 7 _ Ot a2
--___ ~ . 8 8~ per n orit~ _. ~-_'~"S'} --------~----- ~.,,
--- ~},...^a a ^s;.rance ____ ---- - _.---'
i----~ ',Ontt15 (Q 't r e.~.. nOnt'1 _.._
...., . ... -...-.-.. .. j ~~ .
.. y .. -.._. .---.. ...
°•~oert axes _ -- 1~''
l ~. ... _...._ _ -.
_ ~JNTV FAX - _.._-___ _ -...._ -
rQrt(hS (7 K _-_.. .. .-.....- ~
I Y 7.:7 .._ .. PYtr menth `.. ...___.._ __
r lnth5 t.. _- ._ -.._ ._.--._
r--- _ -- - _ -_ C~' __ her month ---- ..-_..
o ,}FOOL TAX nanths ~ C --_-.__ .
~,_ .__-.-_ __ -_. - _ _..__._ 1 PPS manth _-.__-.__. ~_
ty: Tow axes _ -.._.___ ..
___- -. rr nnths a S Pgr rnantt '- "' ._
____._
S~e55ment5 manth5 7 ~+ Per monlh
r C05 ~GUNTY. FWI TAX. 5 00(` ~ nOnfhs to 5 2& U7 Per month -- _. -~- -"-
-_ 56 ~6
r goo scrlooL Tnx _ - _. .. _. _.- _._. ,
~ P
a nntt amhs ~ _.- .____- -
_-_
S • t? }0 nee month 449 JO -~ --- _•-" ---- '
_ _--
-- - --~.
,aoa --- --- --- _. _. -~
_ _____ t
'009 AGGREGATE ADJUSTMENT
7700. Title Char es - _-- -219 t5 -~--- - f--•-.~~
' '' a serv ces no :entlea bee msvrancc
- '!rom FE ftQ1
t S t 29~ , 155 r 5
'_ ae ! ment o 'os ^ tee _ _ - --- -
- L:. ..r Jne's rile nsusance to FIRST AMERICAN TITLE INS C.O ~ -~ `"' S -~- - - -~-
oe-s a surance to FIRST AM -- Itrom GFL #g} BASIC -'
' ERICAN TITLE INS GU _... ..... --- t -~-
._ ~ _r _.-...,
..-__ - ._ 5 t 028 75 "----_
- _ _ }..
:'t e a ~c~ .•m , _ -- --_ _-. -- _ _-.- n0 t _}a2-,J0298:6aP ~.._,..~.. ~
- rn noc, ~r, _,_.._.__
a0 1a42 002185 e
_.
~e 5 c it ,c o rite ~ , { t; ... I ,1FTI I v At 51 ftACT CUMPANV -... - -
_ , yr ~r, 5 n0 ~o r, 1nt - - - -..- _ B?4 a4 ..-~-.._....-.. ~.~
F-- -,- ,.. ~! a 4 ~y -i, niun 'r FIR 7 r1tWlFRlI AN 1'T1 E: sNS ,.O -.- 7
- ..., tv a v r er --. . - .... .__ ... 15a .. t
'' ~ tv rl uy C t rti .. __.. .. ._.-_ ...
_ ax Cer. ~ree ~- - -~ 7f21TY AR T kAC (')MPANY ~ ---~ -
't ~Ct SCHOOt Tnx is DFDOF2AHLti PIPER ErXCOLLECTUR - _ _
~ ~,^,
i t'? DC)C PREP FEE _ _ - ---- '_ t i4 51 • - - - -
to GItIFFI~ 8 ASSOCtA it„; ------__ .
t!!3 -_-._._._-.~-_ ------ f___ _' 30000
1200. Government Recording and Transtor Charges '
" a e 'nen e,.ord~no Gnaroes
-~- to HF_CURUf h Of pEE1l5 from GF_E #7
~-- 2ta 00
a rr tdon7atlr. S 90.00 Reicase .E._ ___ Other $__- -
- ___ _ .r
. s f..a to Rf CORUFH (Jf UECEI _ - ._ .~
-- ---- __.._. - .from GFF#81 "-- ~t,0004C --~~-
_ - __ t 000.00 S - - - ..-_.
"' . ~. i _ - -... -
=- __ _-. D00On S - ... _.. _- - _._ 0~ A
~ o. ~ ..- -...--
-._ _.
... ....,....-... .
_,.-
7300. Addrtronal Settlement Charges Y
3 Requrded services That you Gan shot for -~~--
.__ ..__.
_" `.DOD UFE Or LOAN CERT tOOD SVGS rhom GFE #6,' _' t9 00
'NAL SEWER BILL ---. -- --- --._. b.00
' to Vf fMA '--_.. _._
____ Hr f RI(. RIFF I NF3Al1(;H SI IRVF YINC _ ~ ~ -- '-
' 305 HOMEiPESTMJATER INSPS - - "'-"` -
- . «... ~2 a"s
_._
tc •..ENTRAI PA HOME (INSPECTIONS ~ - _ _ 2 86., ~.':~~
1400. Total Settlement Charges tenter on Ifnes 703, Section J an[I 502, 5ectforr K- ) -T - t't °FCt
I
y..a a.,..,,, • »n~~ rr.~,o•^M•, -, r~,o. r' rC5 53i 10.237 8w
i.a .so- x r:v ,nu~r,t, , ~rr~..x~r nr ;,~r;>.. .,r . r , ,~•
r:v).. s.. .. ,.
- =v!,IRITY ABS TRACT CUMPANV Sdttlement Agem, ~~-- "-
• Payc; 2 cf 3
1 IUU- •