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HomeMy WebLinkAbout01-20-12J 1505610140 RE'1/-1500 ~` ro'~'°' PA DspaAment of Revenue Of'FICIAI. u8E ONLY Bureau of IndhAdual Tam PO Box 280801 INHERITANCE TAX RETURN Coungr Codo Year Fee Number HarrW~uao, PA 17128-0801 R ESIDENT DECEDENT ~ ~ 1 1 0 5 4 1 EN'1"ER DECEDENT INFORMATION BELOW Social Security Number Data of Death M)N~YYW Date of Birth AMMDDYYYY 1 8 3 1 2 1 2 7 3 0 4 2 4 2 0 1 1 0 1 2 9 1 9 2 2 Decedart's last Name Suflbc Decedent's First Name MI RUT H V I R G I N I A H (tf Applicable) Enter SuMving spoua's IrNartrratlon Below Spouse's last Name SuMbr Spouse's First Name MI Spouse's 8odal Security Number FILL IN APPROPRIATE OVALS BELOW TMIS RETURN MUST BE FlLED IN DUPLICATE WITH THE REGISTER OF WILLS ® 1.Orlpinal Return ~ 2. Supplemental Return ~ 3. Remainder Ratum (dabs of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Irthrest Compromise (date of ~ 8. Federal Estab Tax Ratum Required death aRer12-12.82} ® 8. Decedent Died Tsstabe ~ 7.Oscedart Maintalrted a LivNtp Tn~:t 1 8. Total Number of Safe Deposit Boxes (/attach Copy of Wpq (Attach Copy of Trust) 9. LIHgaHon Proceeds Raoehrod ~ 10. Spouse( Poverty CrsdR (date of death ~ 11. Elscdon to tax undx Sea 8113(A) between 12-31-91 and 1-1-9b) (Attach Sch. O) CORRESPONDENT - THIS 8ECT10N MUST 8E COUPLET®. ALL CORRESPONDENCE ANd CONFDENTW. TAX AiFORMItTION SHOULD BE DrtECTEp T0: Name Deytirne Tebphorre Number R OG E R M M 0 R GE NTH AL 71? 234 240]. First Nne of address 4 4 3 1 N F R O N T S T• Second Nne of address 3 R D F L O O R City or Post OHke State H A R R I S B U R G P A C.orrsspondsnt's e-mail address: RMORGENTHA Under penatdee or perJray, I daclsre qnt I haw exarrYrrcd tMS re4~Nn, i< a true, ocrrect era orrmplete. Dedaradon d prepanr otrer than tha SIQJiATUR1c OF PERSON RESP.QNI3181.E FOR FILJNt3 RETURN . r• a . ZIP Code REtitaTER Of YYILLS Ua~N.Y na c-.. x• .~ c', u~ ~ N __ ° ' ~ ~ FILED tV 1711D -- ectwtlrlee wind eleterr>enb, and to Ihs best ar ny a bead on ar Irrabnnatlon of which prepaer hoe (~ ~ OAT s. ~. Ib4Tlc ~_ t: T"1 ace and beMt, ~ewled0e. -n9 -~o la ~-z 4431 N• FRONT ST• HARRISBURG PA 17110 PLEASE USE ORIGINAL FORM ONLY Sibs 1 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number 1 8 3 1 2 1 2 7 3 Decedent's Name: VIRGINIA H• RUTH RECAPITULATION 8 9 9 0 0. 0 0 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 and Notes Receivable (Schedule D) ........................ .. 4. ' 2 6 9 4 2. 3 6 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. ' 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. g 1 1 6 8 4 2. 3 6 8. Total Gross Assets (total Lines 1 through 7) , 9 2 2 9 1 4 . 3 9 9. Funeral Expenses and Administrative Costs (Schedule H) . 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .... ....... .. 10. 1 5 5 7 . 8 0 11. Total Deductions (total Lines 9 and 10) ...................... ....... .. 11. 2 4 4 7 2 . 1 9 12. Net Value of Estate (Line 8 minus Line 11) ................... ....... .. 12• 9 2 3 7 0 . 1 7 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. 9 2 3 7 0 . 1 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0. 0 0 (a)(1.2) x .o _ . 16. Amount of Line 14 taxable 9 2 3 7 0 1 7 1 4 1 5 6. 6 6 . at lineal rate X .045 6. 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0 • 0 0 at collateral rate X .15 . 19 4 1 5 6. 6 6 19. ............................................ TAX DUE ........ . .. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 20 11 0541 DECEDENT'S NAME VIRGINIA H. RUTH STREET ADDRESS 17 TRINE AVENUE CITY MT. HOLLY SPRINGS STATE PA ZIP 17065 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 5,000.00 B. Discount 207.83 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) 4,156.66 Total Credits (A + B) (2) 5,207.83 (3) (4} 1,051.17 5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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 property transferred : ................................................................. i f ..... ^ ^ ^ ts income; .......................... erred or b, retain the right to designate who shall use the property trans ..... ^ c. retain a reversionary interest; or ........................................................................................... ..... ^ d. receive the promise for life of either payments, benefits or care7 .................................................. ..... 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. " " ..... ^ ^ 0 orpayable-upon-death bank account or security at his or her death? .... in trust for 3. Did decedent own an ..... 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................. ..... ^ 0 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)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(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)]. 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 EX+ (01-10) pennsylvania ~ SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: VIRGINIA H. RUTH 20 1 I 0541 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 jointlyowned 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. 17 TRINE AVENUE, MT. HOLLY SPRINGS, PA 17065 89,900.00 SEE ATTACHED HUD FOR SALE OF PROPERTY TOTAL (Also enter on Line 1, Recapitulation.) ~ E 89,900.00 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHER{TANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER VIRGINIA H. RUTH 20 11 0541 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty•owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M & T CHECKING ACCOUNT #xxxx3293 797.88 2. M & T SAVINGS ACCOUNT #xxxx4858 744.62 3. M & T CERTIFICATE OF DEPOSIT #XXX 1877 10,108.08 4. M & T CERTIFICATE OF DEPOSIT #XXX9012 10,105.33 5. 2004 FORD TAURUS - AS SOLD 4,200.00 6. M & T BANK SAFE DEPOSIT BOX 0.00 SEE ATTACHED SAFE DEPOSIT BOX INVENTORY 7. M & T BANK CHRISTMAS CLUB 300.04 8. LIBERTY MUTUAL INSURANCE -REFUND UNUSED CAR INSURANCE PREMIUM 120.86 9. THE SENTINEL -REFUND UNUSED NEWSPAPER SUBSCRIPTION 29.21 10. COMCAST -REFUND 15.19 11. CENTURY LINK -REFUND 21.15 12. PA 2010 PROPERTY TAX REBATE 500.00 TOTAL (Also enter on line 5, Recapitulation) I $ 26,9 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER VIRGINIA H. RUTH 20 11 0541 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME AND CREMATORY 9,630.55 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: SMIGEL, ANDERSON & SACKS, LLP 3, Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 5 Accountant Fees: 6. Tax Return Preparer Fees: FINAL FEDERAL AND STATE; FIDUCIARY RETURNS 7. THE SENTINEL -LEGAL ADVERTISEMENT 8. DAUPHIN COUNTY LEGAL JOURNAL - LEGAL ADVERTISEMENT 9. MISCELLANEOUS -PROPERTY MAINTENANCE 10. MED ED -ELECTRIC 11. BARBARA J. BOISE -TAX COLLECTOR (RE TAXES AND PER CAPITA TAX) 12. CENTURY LINK -PHONE BILL 13. POSTAGE, COPIES 14. MOUNT HOLLY -WATER, SEWER, TRASH 15. RUSSELL YINGST -REPAIR KITCHEN SINK IN REAL ESTATE 16. SELLING COSTS OF REAL ESTATE 17. 3ACQUELINE OGDEN -COSTS OF TRAVEL FOR FUNERAL 3,500.00 323.50 500.00 237.76 75.00 211.19 339.26 1,664.43 35.51 27.65 8b.70 50.00 6,232.84 TOTAL (Also enter on Line 9, Recapitulation)' ~ 22,914.39 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMI3tK VIRGINIA H. RUTH 20 11 0541 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. COMCAST -CHECK CLEARED AFTER DATE OF DEATH 67.31 2. FIRST ENERGY -CHECK CLEARED AFTER DATE OF DEATH 133.11 3. LIBERTY MUTUAL INSURANCE -CAR INSURANCE PAYMENT CHECK CLEARED 101.8b AFTER DATE OF DEATH 4. CENTURY LINK -CHECK CLEARED AFTER DATE OF DEATH 37.58 5. PARALYZED VETERANS OF AMERICA -CHECK CLEARED AFTER DATE OF DEATH 10.00 6. AMERICAN LEGION -CHECK CLEARED AFTER DATE OF DEATH 10.00 7. BOROUGH OF MT. HOLLY SPRINGS -CHECK CLEARED AFTER DATE OF DEATH 119.60 8. ATG -CHECK CLEARED AFTER DATE OF DEATH 50.00 9. SAFE DEPOSIT BOX ATM & T BANK- CHARGE CLEARED AFTER DATE OF DEATH 29.00 10. WEST SHORE EMS -AMBULANCE BILL 999.34 TOTAL (Also enter on Line 10, Recapitulation) I $ 1,557.8 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: VTR (3T1~TT D u R T TTT-T 2O 1 1 0541 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. SUSAN R. FAHNESTOCK Lineal 46,185.09 111 W. PINE ST. MT. HOLLY SPRINGS, PA 17065 2. JACQUELINE R. OGDEN Lineal 46,185.08 1336 S. MOUNTAINVIEW DR. COTTONWOOD AZ 86326 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: __ 5 000.00 Discount: 207.83 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1981 1982 1983 1984 1985 1986 1987 1988 throu h 1991 1992 1993 throu h 1994 1995 throw h 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: • ~ttst 3~iI1 ~n~ CSI. P~Y~mPrct OF VIRGINIA H. RUTH I, VIRGINIA H. RUTH, 17 Trine Avenue, Mt. Holly Springs, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, in manner and form following: 1. I hereby expressly revoke all Wills and Codicils heretofore made by me. 2. I hereby direct my Executor to pay all my just debts, i funeral and administrative expenses out of my estate, as soon as practicable after my death. 3. I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be paid out of my estate as a part of the administration of my estate. i 4. I give and bequeath such of my personal property as may be .listed ors ar. unsigned memorandum kept with my Will to the persons named thereon. In the event that no such memorandum is found with my Will, it shall be conclusively presumed that none was prepared and all my personal property shall be considered a part of the remainder of my estate. 1 5. Should my husband, James L. Ruth, survive me for a period of thirty days following my death, I devise and bequeath the remainder of my estate to James L. Ruth. 6. Should my husband, James L. Ruth, predecease me or. die on or before the thirtieth day following my death, I devise and bequeath the remainder of my estate to my issue living on the thirty-first day following my death, per stirpes. 7. I nominate and appoint CCNB Bank, N.A., Mt. Holly Springs, Pennsylvania, Trustee of the share of any beneficiary who may be under.the age of twenty years. The income and/or principal of said trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my Trustee in its sole discretion may determine; and my Trustee, in the expenditure of income and/or principal for such purposes, may, at its discretion, apply the same directly without the intervention of a guardian or pay the same to any person having the care or control of said beneficiary or with whom the beneficiary resides, without duty on the part of the Trustee to supervise or inquire into the application of the funds by any person to whom any payment is so made. The balance of such income and/or principal shall be paid to such beneficiary upon reaching the age of twenty years or to such beneficiary's estate in the event of death prior thereto. 2 8. I nominate and appoint my husband, James L. Ruth, ,as Executor of this my Last Will and Testament; and as substitute Executrices I nominate and appoint my daughters, Susan R. Fahnestock and Jacqueline R. Maddox. 9. I direct that my Executor and Trustee, as well as their successors, shall not be required to give bond for the performance of their duties in any jurisdiction. 10. In addition to the powers above provided for and those given by law, my personal representative and Trustee, without any order of court and in their sole discretion, may: A. Retain any property owned by me at my death and any form of life insurance, annuity or endowment policies; and in so doing they may act without restriction to so- called legal investments and without responsibility for diversification. B. Repair, alter, improve or lease, for any period of time, any property, and give options for leases. C. Sell at public or private sale, for cash or credit, with or without security, exchange or partition property and give options for sales or exchanges. D. Borrow money from any person; including my Executor or Trustee, and mortgage or pledge any property. E. Compromise claims. F. Pay premiums on any life insurance, annuity or endowment policies which may have been retained or purchased herein; and exercise any right, option or privilege thereunder. 3 G. Vary or retain investments, when deemed desirable by Trustee, and invest in such bonds, stocks (including bank stock of the CCNB Bank, N.A.), notes, real estate mortgages or securities, common or diversified trust funds, or in such other property, real or personal, as Trustee shall deem wise, without being restricted to so- called "legal investments." H. Place and carry any asset of the trust in the name of a nominee. I. Make distribution in cash or in kind or partly in each. J. Terminate said trust prior to the time designated herein, if, in the opinion of Trustee, the said trust res, together with accumulated interest, has diminished to the point that it is no longer economical or feasible to continue said trust. K. In the event that CCNB Bank, N.A., shall serve as Trustee, I direct that it shall be compensated for the services which it renders in accordance with its prevailing schedule of fees in effect during the time when said services are rendered. IN WITNESS WHEREOF, I have hereunto set my hand and seal ,r~ thi s ~ ! ~-~i day o f ~9~.~,,,,,~.(° ~ . , 19 8 9 . ,' ~,, -; ~..g .. f~ ~ L C r'ir .! : ~..r+"~. 7`' : ~ ~t l,', ,"ems'-".- -_. ( ) ~, ~ ~ f 6 t e i-/`1'~ yc.i SEAL Virginia H. Ruth WITNESS: ____. . _ ,~ ~- ~: l t ~ 4 ~;-. A. Settlement Statement (HUD-1) ~M° Approval No. 2502-0265 B. Type of Loan 1.^ FHA 2.^ RHS 3.^ Conv. Unins 4.^ VA 5.^ Conv. Ins 6. File Number: 7. Loan Number: RE 11-174 8. Mortgage Insurance Case Number: C. No[e; This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name 8 Address of Borrower: Gilbert S. Ramsey Lisa S. Ramsey 12 Westwood Drive Mt. Holly Spring=, pA 17065 E. Name & Address of Seller. Estate of Virginia H. Ruth 17 Trine Avenue Mt. Holly Springs, PA 17065 F. Name & Address of Lender Members 1st FCO ~I SD00 Louise Drive Mechanicsburg, PA !7055 G. Property Location: 17 Trinz Avenue Mt. Holly Spring= Borough Mt. Ho11y Springs, PA 17065 H. Settlement Agent: Duncan 6 Hartman, P.C. 1 Irvine Row Carlisle, PA ].7013 TIN: Phone: (717) 249-7780 Parcel: 23-32-2336- County: Cumberland Piace of Settlement: 1 Irvine Row Carlisle, PA 17013 I. Settlement Date: 11/23/2011 Funding Date: 11/23/2011 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contrail safes price 89, 9C0. 00 401. Contract sales price 89, 900.00 102. Personal property 402. Personal property 103. Settlement charge:: to borrower (line 1400) 3, 196.75 403. 1 ~ 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes: 406. City/town taxes: to to 107. County taxes:ll/:23/2011-12/31/2011 93.26 407. County taxes:ll/23/2011-12/31/2011 93.-'6 to to 106. Assessments: 408. Assessments: to to 109. 409. 110.SChoo1 Tax 11/23/2011-7/3/2021 1,189.91 410. School Tax 11/23/2011-7/3/2021 1,189.91 111. 411. 112. 412. 120. Gross Amount Due From Borrower 94, 329.92 420. Gross Amount Due To Seller 91, 132.67 200. Amounts Paid By Or In Behalf Of Borrower 50D. Reductions In Amount Due To SeNer 201. Deposit or earnest money 5, 000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 70, 700.00 502. Settlement charges to seller (line 1400) 6, 232.89 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. credit 597. So 504. Payoff of first mortgage loan from Alpha State 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. escrow for inheritance taxes 1,075.00 208. 508. 209. SD9. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. Ci[y/town taxes: 510. City/town taxes: to to 211. County taxes: 511. County taxes: to to 212. Assessments: 512. Assessments: to to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid By1For Borrower 76, 297.50 520. Total Reduction Amount Due Seller 7, 307.99 300. Cash At Settlement FromlTo Borrower 600. Cash At Settlement To/From Seller 301. Gross Amount due from borrower (line 120) 99, 329.92 601. Gross amount due to seller (line 420) 91, 132.67 302. Less amounts paid by/for borrower (line 220) 76, 297.50 602. Less reductions in amount due seller (line 520) 7, 307.89 303. Cash ®From ^ To Borrower 18, 081.92 603. Cash O To ^ From Seller 83, 824 .83 ~ ne r'uonc rcepomng ouraen ror mis correction or mrormation is estimated at 35 minutes per response for collecting, reviewing, and reporting the data. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. No confidentiality is assured; this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. © 2009-2011 Easy Soft. Previous editions are obsolete. Page 1 of 3 HUD-1 L. SettlemP_nt Charges Fle Number RElI-179 Loan Number: 700. To[al Real Estate Broker Fees Paid From Paid From Division of Commission (tine 700) as follows: Borrower's Seller's 701. S2, 29?. `~,_- to Century 21: A Better Way Funds at Funds at 702. $i,2b7.5 __ to Alpha State Realty Settlement Settlement 703. Commiission paid at settlement 9, 995.00 704.Discou:t f=_f to Century 21: A Better Way 250.00 800. Items Pa able In Connection With Loan 801. Our origination charge $700.00 (from GFE #1) 802. Your credit or charge (points) for the specific interest rate chosen $ (from GFE #2) 803. Your adjusted origination charges Members 1st FCU (from GFE A) 700.OD 804. Appraisal fee tc Members 1st FCd (from GFE #3) 375.00 805. Credit report to (from GFE #3) 806. Tax service to _ (from GFE #3) 807. Flood certification (from GFE #3) 808. Appircation fee to Members 1st FCU (from GFE #3) 100.00 809. _ 810. 811. 900. Items Re wired B Lender To Be Paid In Advance 901. Daily interest charges from 11!2312011 to 12/1/2011 @ S /day (from GFE #10) 902. Mortgage insurarn: premium for 0 months to (from GFE #3) 903. Homeowner's insurance for 0 years to (from GFE #11) 904. 905. 1000. Reserves De o:sited With Lender 1001. Initial de osit for our escrow account from GFE #9) 1002. Homeowner's insurance months @ per mo $ 1003. Mortgage insurance months @ per mo $ 1004. Property taxes months @ per mo $ 1005. School taxes months@ per mo S 1006. months @ per mo $ 1007. A re ate Ad~ustment S 0.0 0 1100. Title Char es 1101. Title services and lender's title insurance (from GFE #4) 889.75 1102. Settlement or closing fee5migel, Anderson & Sacks, LLP -atty fees 550.00 1103. Owner's title insurance Old Republic Title Co. (from GFE #5) 119 .00 1104. Lender's title insurance Old Republic Title Co. $689.75 1105. Lender's title policy limit 570, 700.00 1106. Owner's title policy limit $89, 900.00 1107. Agent's portion of the total insurance premium 5806.99 1108. Underwriter's portion of the total insurance premium 5192.31 1109. End. 100, 300, 8.1 to Old Republic Title Company $150.00 1110. Overnight/Wire to Duncan & Hartman, P.C. $30.00 1111. Notary to Cash $20.00 1200. Government Recordin and Transfer Char es 1201. Government recording charges Recorder of Deeds (from GFE #7 129.00 1202. Deed $62.00 Mortgage 562.00 Release S 1203. Transfer taxes (from GFE #8) 899.00 1204. City/County taxl:;tamps: peed S Mortgage 5899.00 1205. State tax/stamps: Deed $899.00 Mortgage S 899.00 1206. g 1207. $ 1300. Additional Settlement Char es 1301. Required servicr~s that you can shop for (from GFE #6) 1302. 1303. 1304. final water/sewer to Mt. Holl Springs 38.89. 1305. 130fi. 1307. 1308. 1400. Totat Settlement Char es enter on lines 103, Section J and 502, Section K 3, 196.75 6, 232.89, , dv - e wry ~evievveo one nuu-i aeniemenr araremem ono ro me oesr or my Knowteage ana beeei, rc is a true antl accurate statement of all receipts and disburse ents made~n my ac unt or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. 1 ~`1 _ Gi/SbeYt S. Ramse?i-~-,,, ` Buyer/Borrower Estate o Virginia H. Ruth ~ Seller r , l Lisa S. Ramsey The HUD-1 Settlement Statement which I disbursed in accordanre with this staterpt c Hartman, Buyer/Borrower Seller is a true and accurate account of this transaction. I have caused or will cause the funds to be 11/23/2011 Settlement Agent Date 11 Easy Soft~*Previous editions are obsolete. .'Comparison of Goodi=aith`F~timate'(GFEjandHUD-1 'Charges < - ` Charges That Cannot Increase HUD-1 Line Number Our origination charge #801 Your credit or charge (points) for the specific rate chosen #802 Your adjusted origination charges #803 Transfer taxes #1203 Charges That in TptaLCannot,Increase~More'Than'10°! - . Government recording charges #1201 Appraisal fee #804 Application fee #808 Good Faith'Estimate _ HUD-1 700.00 700.00 0.00 0.00 700.00 700.00 899.00 899.00 :Good Faitl`Estirriate> HUD-1 130.OD 129.00 375.00 375.00 100.OC 100.00 Total 605.00 599.00 Increase between GFE'and HUD-1 Cha es -6.00 of -0.998 Charges That Can Change Initial deposit for your escrow account #1001 Daily interest charges #901 Homeowner's insurance #903 Title services and lendar's title insurance #1101 Owner's title insurance #1103 Loan Terms GoodFaith'EStimate HUD-1 0.00 0.00 0.00 0.00 0.00 0.00 998.75 884.75 120.00 119.00 Your initial loan amount is $70, 700.00 Your loan term is 10 Years Your initial interest rate is 5.89% Your initial monthly amount owed for principal, interest, and $782.20 includes any mortgage insurance is Q Principal O Interest ^ Mortgage Insurance Can your interest rate rise? O No. ^ Yes, it can rise fo a maximum of J .The first change will be on and can change again every after Every change date, your interest rate can increase or decrease by °!o. Over the fife of the loan, your interest rate is guaranteed to never be lower than % or higher than %. Even if you make payments on time, can your loan balance rise? O No. ^ Yes, it can rise to a maximum of $ . Even if you make payments on time, can your monthly O No. ^ Yes, the first increase can be on and the monthly amount amount owed for principal, interest, and mortgage insurance rise? owed can rise to $ . The maximum it can ever rise to is $ . Does your loan have a prepayment penalty? O No. ^ Yes, your maximum prepayment penalty is $ . Does your loan have a balloon payment? O No. ^ Yes, you have a balloon payment of $ due in i years on Total monthly amount owed including escrow account payments O You do not have a monthly escrow payment for items, such as property taxes and homeowner's insurance. You must pay these items directly yourself. ^ You have an additional monthly escrow payment of $ that results in a total initial monthly amount owed of $ .This includes principal, interest, any mortgage insurance and any items checked below: ^ Property taxes ^ Homeowner's insurance ^ Flood insurance ^ ^ ^ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. ©2009-2011 Easy Soft. Previous editions are obsolete. Page 3 of 3 HUD-1 MBcTBank 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Smigel, Anderson and Sacks LLP 4431 North Front Street 3rd Floor Harrisburg, PA 17110-1778 Re: Estate of Virginia H Ruth Social Security: 183-12-1273 Date of Death: April 24, 2011 Se' w.. s _ Phone 888-502-4349 F ax (302) 934-2955 Tune 24, 2011 Dear Sir or Madam: Per your inquiry on June 3, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Savings Account Account Number 15004200924858 Ownership (Names o~ Virginia Ruth Susan Fahnestock (POA) Opening Date 06/09/88 Balance on Date of Death $744.61 Accrued Interest $ .01 Total $744.62 2. Type of Account Checking Account Account Number 2678073293 Ownership (Names oj~ Virginia Ruth Susan uh,«stock (P~ ~) Opening Date 02/08/85 Balance on Date of Death $797.88 Accrued Interest $ .01 _. _ _ _. Total $797.88 3. Type of Account Passbook Savings Account Number 25004920120330 Ownership (Names ofJ Virginia Ruth Susan Faltnestock (POA) Opening Date 10/04/83 Balance ort Date of Death $300.03 Accrued Interest $ .0] Total $300.04 4. Type of Account Certificate of Deposit Account Number 31003920291877 Ownership (Names o, fl Virginia Ruth Opening Date 04/30/10 Balance on Date of Death $10> 000.00 Accrued Interest $ 108.08 Total $10,108.08 5. Ti pe of Account Cernficate of Deposit Account Number 31003911879012 Ownership (Names o~ Virginia Ruth Susan Fahnestock (POA) Opening Date 01/13/04 Balance on Date of Death $10,099.37 Accrued Interest $ 5.96 Total $10,105.33 For any additional information on the above accounts, including ownership and any changes, closures andtor reimbursement of funds, pj~ace rsll thr Tvin~~nt 1_-Iolly Cnrin~.c ~('C At 1t717~tR( ,'1(t'iR_ We were unable to -ocate any safe deposit box for the above-mentioned decedent. This letter does not include any aawunts in whicl~ the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, Tammy Spencer Adjustment Services SAFE DEPOSIT BOX INVENTORY Page ~' of_ CX INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ITEM NO. ITEM DESCRIPTION J ss '- ° I 1`i l~~I ice' ~ . s-i ~a~ 7''; i ~ t :I ) ~~~ -- ~ S 3.i? '~ - ice., .1. 3, ~ i Y ~1i ~f ~_~ s ~ , r- 1 .. , ,~ I `;~ . ~tr_ c ~, .~~ . ~ t~3 , ire i r ~~ °~ . `.~ ~-~~~ ,% r ~. - -- __~ j) , `t ., ~', y ~ ... } _ t.: L l r ~ ' ! i.. ~, ? ~ ~ ~ I` 1 ~ 1 ~ I 4 ~ ' j i .a' ~ ~ 1 a ' ,.+,- ; ~ ' 3 ~ J r l t, : ~-- - ~, . -.~ ' .- r ,.y t 1j p 1 '~ 1.` 'y:~ ~\~ r ( ~ ~.~.. 'Y~~"4,ti .~ ;d'3 1`t ~-, tr~ ~ 3i ,~~ ~~,:~ ° 'j _.+J r :. r ` ~~ , _ ~ , , - ice} .. { r .. , *. _[7, .... I CERTYFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECENING COPY OF CORRECT AN PLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIGNATURE ~ , ~-~ ~ ~ " I ~ ~ ~~ ~ SIGNATURE - ~_ ~ I- ~. PRINT NAME ~ i PRINT NAME AN CHECK APPROPRIATE X BELOW: t., PRINT TITLE DATE CHECKAPPROPRI BOX: • y...r~r ~ : i ; -y: ~ _ ~" -~•-r, j. ` y ~f ;J j ~ Executor(Mx) ~ Administrator(trix) - t _ ^ Estate Representative ~ Joint owner of safe deposit box NOTE: Attach additional 8'/:" x 11" sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by law, 42 U.S.C. §405 (cj(2J(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities. The state law prohibits the Commonwealth's personnel from disdosing confidential tax informaton except for official purposes. ,~~ ~,~ ~~ . , _., ts. ~~~ Hollinger Funeral Home & Crematory, Inc. Eric L. Hollinger, Supervisor May 2, 2011 Susan R. Fahnestock 111 W. Pine St. Mt. Holly Springs, PA 17065 The Funeral Service for Virginia H. Ruth: We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Professional Service Graveside Service & Use of Funeral Home for Public Viewing $ 4425.00 Merchandise 18ga Silver, White Velvet Interior 2495.00 Continental Vault 1675.00 Memorial Package -Register Book, Memorial Folders, Acknowledgement Cards, Bookmarks Included AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. Cash Advances Newspaper- Patriot 322.49 Newspaper Notices -Sentinel 155.06 Grave Opening 700.00 Cemetery Equipment 325.00 Certified Copies of Death Certificate (15~a $6) 90.00 Clergy 125.00 Flowers 318.00 Engraving stone (Gift from Eric &Annan) Total Charges $10630.55 Discount for Family (Gift from Eric &Annan) - 1000.00 Current Balance: $ 9630.55 Sot NORTH BALTIMORE AVENUE • MOUNT HOLLY SPRINGS, PENNSYLVANIA 17065 • (717) 486-3433 • FAX (7 t 7) 486-3215 wvaw.hoIlingerfuneralhome.com ~. i~ t ~ .'~ f ~ S^ U ti ~~ ss 6 U F. ~~Q' p O N O ;'~0~-- I mONe- I~M~o l~:~aa P~ _' 1 I ~ N ~ N O ~1/Nf1 O o ~ Z N W 3 W H Z ~~ N ~ ~~ O ~ O iy d' avw .( O J ~~ ^~ ^ w U ~' C '' ~' a a r ~ w U o ~ ~ d ~ ~ :~ _ U1 ~ ~ M t. ~. aHcn~' ~, a z o 0 ~ ~ O ~ r lJl',, a W OQ,' C ~ ~a+ O z t., ~ _ .~ 1 / W n'4 ~ 4~ K i ` hao n : ~ ~~ H~~a ~j ~) cv C7 ~ W ~ WDZ~~ :; ~~ R;UOU .,_ U1 r~