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HomeMy WebLinkAbout06-27-121505610143 REV-1500 ~`(°'-'°' PA De artment of Revenue y OFFICIAL USE ONLY P Penns Ivania County Code Year File Number Bureau of Individual Taxes e~^~^"oF~,eE Po Box.2soso~ INHERITANCE TAX RETURN 21 12 0310 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 02 16 2012 05 14 1927 Decedent's Last Name Suffix Decedent's First Name MI TAYLOR JAMES B (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 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 6 Decedent Died Testate ^ (Attach Copy of W II) ~ Decedent Maintained a Living Trust 0_ 8. Total Number of Safe De Slt BOXeS (Attach Copy of Trust) ~ 9. Litigation Proceeds Received ~ 1 p. Spousal Povert~Creditl(date of death ~ 11. Election to tax under Sec. 9113(A) b t 12 31 1 d 1 95 e ween - - an - - ) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDMUND G MYERS (717) 761 4540 First line of address 301 MARKET STREET Second line of address PO BOX 109 City or Post Office LEMOYNE State ZIP Code PA 17043 .~-a REGISTER OS USE IZBILY `~ ~~' ~.. C~ - ? t t=t ; ca r,=- _. ;~.; , c c7 C. = ~ ' C~t = ::- .t ~ _ DA'~ FILED ~ ~ ` n >~ Correspondent's a-mail address: egll'1t~dSW.COm Under penalties of perju Clare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct a~d'fort~e~~ De~taration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. 6 Fairfield Lane. Mechanicsburg. PA 17050 SIGNA E OF PREPARER OTHER THAN REPRESENTATIVE DATE ~~~~0~~/1.( ,~j ~~ EDMUND G. MYERS (P~y~,~~v ADDRESS 301 MARKET STREET, Lemoyne, PA 17043 Side 1 1505610143 1505610143 J~~% REV-1500 EX Decedent's Name: TayiOr, James B Decedent's Social Security Number RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 12 3, 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... . 4. 5• Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) .............. . 5. 19 , 321.4 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8~ Miscellaneous ~ nq Probate Property (Schedule G) u Separate Billing Requested............ 7. 1 , 025.00 8. Total Gross Assets (total Lines 1-7) .................................................................... . g. 143 , 346.47 9. Funeral Expenses & Administrative Costs (Schedule H) ............................... ........ 9. 6 , 241.67 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...................... ........ 10. 7 , 220.88 11. Total Deductions (total Lines 9 & 10) ........................................................... ........ 11. 13 , 4 62.55 12. Net Value of Estate (Line 8 minus Line 11) .................................................. ........ 12. 12 9 , 8 8 3.92 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. 12 9 , 8 83.92 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 12 9 8 83.92 ~ 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ................................................. ............................................:................... . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505612243 1505610243 1505610243 0.00 5,844.78 0.00 0.00 5,844.78 REV-1500 EX Page 3 File Number 21-12-0310 ................. __. .r•--- - ---- --- DECEDENT'SNAME Taylor, James B STREET ADDRESS 520 Old Orchard Lane CITY STATE ZIP PA 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 5,000.00 zs3.1 s 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 5,844.78 5,263.16 (3) (4) (5) 581.62 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 :............................................................................... ^ 0 b. retain the right to designate who shall use the property transferred or its income :.................................. ^ c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ^ ^ receiving adequate consideration? .................................................................................................................... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a} (1.1) (ii)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)J. . The tax rate imposed on the net. value of transfers to or for the use of the decedent's siblings is 12 percent [72 P S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. (1) Total Credits (A + B) (2) Rev-1502 EX+(~~-08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Taylor, James B 21-12-0310 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 which 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 Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Real Estate located at 520 Old Orchard Lane, Camp Hill, Wormleysburg Boro, Cumberland I 123,000.00 County, PA -Property sold on April 24, 2012. A copy of the HUD-1 Settlement Sheet is attached to this Return TOTAL (Also enter on Line 1, Recapitulation) I 123,000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1508 FJt+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF I FILE NUMBER Taylor, James B 21-12-0310 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Boscovs Department Store -Final Paychecks 903.94 2 Fulton Bank Checking Account No. 1068-32944 4,711.26 3 Fulton Bank Savings Account No. 1371-02709 103.26 4 2005 Toyota Camry -Price received for sale of Automobile 8,800.00 5 Sale Price of Bedroom Furniture (2) -Floor Lamp -Table Lamp 445.00 6 Sale Price of Bedroom Furniture and Recliner Chair 200.00 7 Sale Price of Books 40.00 8 Sale Price of Decorative Pieces -Sofa - Chair 8r Table -Coffee Table 350.00 9 Sale Price of Dining Room Fixtures 675.00 10 Sale Price of Remaining Furniture 53.00 11 Sale Price of Wall Lamps -End Table 120.00 12 Highmark -Refund on Account 502.85 13 Homeowners Insurance -Refund on Account 182.00 14 Real Estate located at 520 Old Orchard Lane, Camp Hill, PA -Reimbursements of County and 986.16 School taxes at time of Closing. HUD-1 Settlement Sheet is attached to this Return. 15 U.S. Treasury -Refund of 2011 Personal Income Taxes 1,249.00 TOTAL (Also enter on Line 5, Recapitulation) 19,321.47 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+(6-98) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMON4VE4LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF r, James B FILE NUMBER 21-12-0310 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFER.SATfACIiTAOOPY OF TIRE DEIED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET ~ OF DECD'S INTEREST Excl_usloN (IF APPLICABLE) TAXABLE VALUE 1 Wells Fargo _ 401 K Retirement Account - 1,025.00 1,025.00 Beneficiaries: Pamela Merrow, Craig A. Taylor and David W. Taylor TOTAL (Also enter on Line 7, Recapitulation) I 1,025.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+(10-06) COM INNER 7ANCE T~ REiUYRN ANIA RESIDENT DE EDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Taylor, James B 21-12-0310 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 1,903.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Yearfsl Commission Daid 2. Attorney's Fees JOHNSON DUFFIE 3,500.00 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 379.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 10.00 7. Other Administrative Costs 449.17 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 6,241.67 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Taylor, James B 21-12-0310 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Cost of Opening Grave 1.620.00 2 Paxton Cemetery -Inscription on Gravemarker 283.00 H-A 1.903.00 Other Administrative Costs 3 Cumberland County Register of Wills -Filing Fees for Inheritance Tax Return and Inventory 30.00 4 Reserves: Miscellaneous Out of Pocket Expenses 200.00 5 The Cumberland Law Journal -Notice of Estate Administration 75.00 6 The Patriot News Co. -Notice of Estate Administration 144.17 H-B7 449.17 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 Ex+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Taylor, James B 21-12-0310 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 Alma Berrsford, Tax Collector -Per Capita Tax 9.80 2 Comcast Cable g,97 3 Cumberland County Tax Bureau -Local Income Tax 27.00 4 Donegal Mutual Insurance Company -Homeowners Insurance 303.50 5 Donegal Mutual Insurance Company 27.00 6 Family First -Additional Settlement costs on sale of Decedent's Real Estate 143.03 7 Fulton Bank Installment Loan Account No. 0221411437 1,267.35 8 PA American Water Co. 271.60 9 Pennsylvania Power 8r, Light 138.77 10 Real Estate located at 520 Old Orchard Lane, Camp Hill, PA -Settlement Charges. A copy of 3,676.19 the HUD-1 Settlement Sheet is attached 11 Verizon 29.89 12 W.C. Eshenaur and Sons, Inc. -Oil for heatlFinal payment 707.20 13 W.C. Eshenaur and Sons, Inc. -Oil for heat 363.60 14 W.C. Eshenaur and Sons, Inc. -Oil for heat 166.59 15 West Shore EMS 80.39 TOTAL (Also enter on Line 10, Recapitulation) 7,220.8$ (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+111-08) EE SCHEDULE J COMINHRE IS DE ITEDE~ DEN~RNANIA BENEFICIARIES ESTATE OF FILE NUMBER Ta lor, James B 21-12-0310 RELATIONSHIP TO NAME AND ADDRESS OF SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY ,DECEDENT 0 of 'st (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)1 Pamela L Merrow 48 North Conley Lane Etters, PA 17319 Craig A Taylor 6 Fairfield Lane Mechanicsburg, PA 17050 David W Taylor 503 Porsha Terrace Camp Hill, PA 17011 Daughter Son Son 1/3rd of Estate 1/3rd of Estate 1/3rd of Estate ~ ~ Total ~ Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet, as a ro i NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ESTATE OF JAMES B. TAYLOR SCHEI3 ULE OF EXHIBITS EXHIBIT A Last Will and Testament for James B. Taylor signed and dated on March 2, 1977 EXHIBIT B HUD-1 Settlement Sheet for the sale of Decedent's residence located at 520 Olde Orchard Lane, Camp Hill, PA on April 24, 2012 EXHIBIT C Fulton Bank ~ Date of Death Letter on Accounts EXHIBIT D Copy of check received for Sale of Decedent's Automobile soaosr ~CL~~ ~l ~n~ ~P~kc~11~1~~ I, JAMES B. TAYLOR, of the .Borough .of Wormleysbuxg, Cumber- land County, Pennsylvania, make, publish .and declare this to. be~ my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. 1. I direct the payment of my just debts and funeral expenses as soon after my death as maybe convenient to my Exe- cutrix hereinafter named. 2. I give, devise and bequeath all the rest, residue and remainder of my estate unto. my wife, Joanne ~. Taylor, pro- vided she survives me by a period of thirty. (3~) days. 3: Should my wife, JoannelJ;. Taylor, not be living on the thirty-first (3lst) day following my death,'. then 2 give, devise and bequeath all the rest,. residue and remainder of my estate unto. my children, Craig A. Taylor, David W. Taylor and Pamela L. Merrow, in equal shares. 4.. I name, constitute and appoint my wife; Joanne D. Taylor, to be the Executrix of this,' my Will. In the :edent my said wife shall fail to. survive me, or fail 'for any reason to. complete the administration of my estate, I appoint my children,, Craig A. Taylor, David W. Taylor and Pamela L. Merrow,. to: be the Executors of this Will, and I request .that .they be excused from entering security in any jurisdiction in which they may be called upon to. act.. IN WITNESS WHEREOF, .I have hereunto. set my hand and seal, this a ~ day of March,. ,1977•: ,. (SEAL) ames. B.. Taylo " ®1 Q JA J J Q ... Signed, ,sealed,.publishe.d and d.eclare.d by. the above=named Testator, as and for hi.s Last .Will and Testamerit,.in the presence of us, whd, at hi.s request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. -. ~2 :- .. ACKNO.WLEDGMENT.. COMMONWEALTH OF PENNSYLVANIA ) - ~ ) SS. COUNTY OF CUMBERLAND ) I, JAMES B. TAYLOR, Testator, whose name is signed to. the foregoing instrument, having been duly qualified according to. law, do hereby acknowledge that .I signed and executed the instrument as my Last Will and Testament;. thafa:2 signed it willingly; and that I signed it as my free and volun- tary act .for the purposes therein expressed. .James 'B. Taylo Sworn or affirmed to. and acknowledged before~~/m,/e//-;-b_y/ JAMES B. TAYLOR, Testator, this ~i~2,pL~ day of ~ l ~^~-- , 1977. Not Pu. is My Commissi Expires.:' . ~~ ,.., r- AFFIDAVIT . COMMONWEALTH OF PENNSXLVANIA ) ) SS. COUNTY OF CUMBERLAND. ) We. 7t7"U__~1;6-~1~~.~ and ~,CZam ~~-2~r~~ the witnesses who. names. are signed to. the. foregoing instrument; being duly qualified according to. law, do depose and say that we were present and saw the. Testator sign and execute the foregoing instrument as his Last Will and Testament;. that he signed willingly and that he executed it as his free and voluntary act .for the pur- poses therein expressed; that .each of us in the hearing and sight of the Testator signed the. Will as witness'e's.;' and that to the best of our knowledge, the Testator was at that time .18 or more years of age, of sound mind and under no constraint ~r undue influence. Sworn or affirmed to and subscribed ta.before me 'by. • ~ ~ ~r~. and rr ~~,' , wi.t- nesses,~ ,thi. ~~`~ day of C~.~CN , 1977.• No.tar Fubl'c My Commission E~pires:r . t3~r ~~ nue ~~n o r A• j B. T.. _OAN: - n U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 1.QFHA 20FmHA 3. QCONV`UNINS. 4. QVA 5. QCONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: FFF.52D 7. LOAN NUMBER: I B. MORTGAGE INS CASE NUMBER: C. NOTE: Thk farm is furnished to grva you a~slatertrent of actual sef0emen! costs. Amourtls paid ro and by the setUamertt agent are shown. items marked'7POCJ' were paid odtslde the closing; they are shown hen: for informetionel purposes end am not included in the totals. 1.0 3188 IFFFSZO.PFOIFFF.530rJ2) D. NAME AND ADDRESS OF BORROWER: ~ Family Firs/ Financial, LLC ; j j E. NA:JIE AND ADDRESS OF SELLER: Craig A. Taylor, Executor of the Estate of James B. Taylor F. NAME AND ADDRESS OF LENDER METRO BANK 3601 PAXTON STREET HARRISBURG, PA 17111 : G. PROPERTY LOCATION: i 520 Old Orchard Lane I Camp HIII, PA 17011 I H. SETTLEMENT AGENT: 23-2402316 PURITY ABSTRACT COMPANY I. SETTLEMENT DATE: A rll 24 2012 Wormleysburg Baro, Cumberland County ~ PLACE OF SETTLEMENT Century 21 Realty Services 3315 Markel St, Camp Hill, PA 17011 p , J. SUMMARY OF BORROWER'S TRANSACTION 700. GROSS AMOUNT DUE FROM BORROWER: 101. Contract Sales Price I 123,000.00 K. SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract Sales Price t 23,000.00 102. Personal Pm I q02. Personal Pro e 103. Settlement Char es to Bortower Llne 1400 3,531.44 403. 104. 404, 105. i 405.. Ad'ustments For items Paid 8 Seller in advance A 'ustments Forltems Paid B Seller in advance 10fi. Coun /Born Taxes D6/01/12 to 011,01/13 674.09 406. Coun /Boro Taxes 06/01712 to 01/01/13 674.04 107. C' Tax to i 407. CI Taz to 108. School Tax 06!01/12 to 07N1/i2 312.07 q08. School Tax 06/01/12 to 07/01/12 312.07 109. 409. 110. 410. 111. 411. , 112. I 412. 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 127,517,60 420. GRO55 AMOUNT DUE TO SELLER 500, REDUCTIONS IN AMOUNT DUE TO SELLER: 123,986.16 201. De osit or earnest move 202. Princi al Amount of New Loans i 203. Existi loans taken sub act to I 20,000.00 95,000.00 501. Excess D osri See Instructions 502. 5e01ement Cha es to Seller Line 1400 I 503. Exisfi loans taken sub ct to I 2 733.28 204. i 504.' Payoff of first Mortgage to FULTON 942.91 205. i 505. Pa Hof second Mort a e 206. I I 506. ~ 207• 507. De osil disb. as roceeds ~ 208. 508. 209. ' 509. ~ Ad'ustmenfs For Nems Un id B Seller A usfinents For Items Un ald B Seller 210. Coun /Born Taxes to 510. Count /6oro Taxes to ~ 211. C Tax to ~ 511. C Tax to 212. School Tax to I 512. School Tax to I 213, 513. 214. I 51q. I 215. I 515. ~ 216. 516. ~ 217. ! 517. INHERITANCE TAX ESCROW to PURITY ABSTRACT ~ 5,427.22 218. 518. ~ 219. 519. 220. TOTAL PAID BY/FDR BORROWER ~ 300. CASH AT SEfTLEMF~IT FROMITO BORROWER: 115,000.00 520. TOTAL REDUCTIONAMOUNT DUE SELLER I 600. CASH AT SETTLEMENT TO6=ROM SELLER: 9,103.41 301. Gross Amount Due From Bonower Line 120 127,517.60 601. Gross Amount Due To Seiler Line 420 123,986.16 302. Less Amount Paid BylFor Borrower (Line 220) ( 115,000.00 602. Less Reductions Due Seller (Line 5201 I( 9,103.41 303. CASH (X FROMJ ( TO) BORROWER ~ 12,517.60 603. CASH (X TO) ( FROM) SEVER 114,882.75 The undersigned hereby acknowledge receipt o(a completed copy of pages 182 of this statement 8 any attachments referred to herein. Y Borrower Family t F' nda, LL ' Sal _ G BY:•~ i - ~/ Cra A. Taylor, Execul J Q r~ Wa J f.. H J J Q Page 2 ~ L. SETTLEMENT CHARGES _ 7011. TOTAL COMMISSION Based on Price j r$ °/a Pg1DPROM PAID FROM Division of Commission !!ne 700 85 Fol%ws: nORROWER'5 SELLER'S 701. $ IO FUNDS 0.T FUNDS AT 702.5 to SETTLEMENT SETTLEMENT 743. Commission Paid at Settlement 704. BROKER FEE ! to CENTURY 21 REALTY SERVICES 295.00 800. ITEMS PAYABLE W CONNECTION WITH LOAN 601. Loan Ori ination Fee % Ito ~ 602. Loan Discount % Ito 803. Appraisal Fee Ito 804. Credit Report Ito 805. Lender's InspeUion Fee ho 806. Flood Cart Fee Ito METRO BANK 7.00 807. Tax/Judgmenl Search Ito METRO BANK 225.00 809. Document Prep Fee 809. COMMI MEhtT FEE Itc METRO BANK 610. I 475.00 611. I 900. ITEMS REQUIRED BY LENDER TO BE PATD IN ADVANCE 901. Interest From to I ~ $ /day ( days %) 902. Mon a e insurance Premium for months to 903. Hazard Insurance Premium for ears to 904. I 905. 1000. RESERVES DEPOSITED tfy1TH LENDER I, 1001. Hazard Insurance months S er month 1002. Mon a e Insurance I months $ er month 1003. Coun /Boro Taxes I months $ er month 1004. Ci Tax months $ er month 1005. School Tax i months @ $ par month 1006. I months $ er month 1007. ' months S er'month 1008. AGGREGATE ADJUSTMENT months $ r month O.OD 11 OD. TITLE CHARGES j 1101. Settlement or Closin Fee jto 1102. Abstract or TiDe Search I.to 1103. Title Examination Ito 1104. TiDe Insurance Btnder I[o 1105. Document Pre oration Ito PURITY ABSTRACT COMPANY DEED 150.00 1106. Note Feas Ito NOTARY CLERK 30.00 10.00 1107. Mlomey's Fees No includes above ifem numbers: I 1108. Title Vnsurance Ito PURITY ABSTRACT COMPANY Includes above item numbers.1101, 1103 -BASIC RATE 973.75 1109. tender's Coverage ?$ 9 , .00 626.75 1110, Owner's Coverage j$ 123,000.00 145.00 1111. PA ENDS 1 OD, 300, 900 !to PURITY ABSTRACT COMPANY 200.00 1112 CPL Itc PURITY AB5 CT COMPANY 75.00 1113. I 1114. Payoff outgoing wire fee Ito PURITY ABSTRACT COMPANY 12.00 1115. Tax Certifiglion Fee Ito PURI ABSTRAC OMPANY 10.00 1116. I 1117. 1118. j 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed S 63.00; Mortgage $ 78.00; Releases $ 1202 Cif /Coun TaxlStam s: Deed i. 1,230.40• Mort a e 1203. State Tax/Stam s: Revenue Stam s! 1230.00; Mort a e 141.00 1.230.00 1,230.00 1204. RECORD ASSIGNMEPI't OF RENTS Ito RECORDER OF DEEDS 35.00 1205. I RECORDER OF DEEDS 1300. ADDITIONAL SETTLEMENT CHARGES. I 1301. Surve Ito 1302. Pest Ins ction Ito WAIVED 1303. 2012 COUNTY100ROUGH TAX Ito ALMA BERRESFORD, TAX COLLECTOR 1304. SEWER & REFUSE Ito BOROUGH OF WORMLEYSBURG 139.69 979.03 47.25 1305. 1400. TOTAL SETTLEMENT CHARGES nter!on Lanes 103, Section J and 502, Section 31.44 2,733.26 ar b10M0 p@ge 1 Or Wb ibl@Tarll, @I@ e19DalOneb aCIQ10W1e0D@ RC@Ipl d @ mlllPln@p L9pyW page [ o~ Tls oho page a®isn,arn / / - Certified to be a Vue copy. / .. __~. PURI R/jC~T:Vt~PANY Se I ant A enf- ~ - (FFF.SZD/FFF520/3?) F'ultanBank LISTENING IS JUST THE BEGINNING April 6, 2012 Law Offices Johnson Duffie 301 Market Street P.O. Box 109 Lemoyne, PA 17043 Dear Ms. Wiesman, This intor~atios' `~: as x ,~^::~~+~ ~ ~itSi ,~~~; oc;:.. ~. s~~~ in arta~wer to your i~4dry, ~,~.s E~~ V~~ ~.r~t>~~';?c":r u>z: only. Tha bank ~~mishir:~ t'~s ir•:~rE~a:s<:~n ~:.~~N. ^~~. =,:~-~~r°nt or ~iU~6lRtt"~ei ii1@ ~f~if2iG„ G,,1ii~,r~~`!t',:~ li' ....'.<~:~i5+ t?` i1 lRIOR'+'I~t1C1R (Nv':'E,4seuv~, t,~i3 ~'8~r'X~fcB:~ '•.;tV `r ~v;3u i:~? v'y' tn~ ~k ~ 3R9f +~ ~ U4, @: C,){ ~'~c. a`;±?V ~;ii~iGn hef6in ax;~r~seetf ~ s!s-c~ t~ ch~~r~;~- ~-y,f:~+.;t n:.±ice RE: James B. Taylor, deceased February 16, 2012 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking #1068-32944 Savings #1371-02709 Installment Loan #0221411437 Date of death balance $4,711.26, opened 10/1/68, titled in his name alone Date of death balance $103.25 plus $0.01 accrued interest, opened 10/22/01, titled in his name alone Date of death principal balance owing $1,267.35, opened 11/10/07, secured, held in his name alone If you require loan payoff information, please fax your request to our Direct Banking Center at (717) 569-6316. If you have any other questions, please feel free to contact me at (717) 327-2497. Sincerely, E~~ Joshua A. Groff Credit Confirmation Processor 1.800.FULTON.4 fultonbank.com Fulton Bank, N.A. Member FDIC. Member of the Fulton Financial Family. ^ J Q W J F H J ~_ J Q Bobby TOYOTA ~~ ~ 6711 Carlisle Pike MECHANICSBURG, PA. 17050 717-691-0500 PAY ~~~`EIGHT THOUSAND EIGHT HUNDRED DOLLARS AND 00/100~~ TO THE ORDER JAMES B TAYLOR 520 OLD ORCHARD LN OF CAMP HILL PA 17011-1828 ©M&TBank Buffalo. NY 14240-0767 so-2ss CHECK# 92778 'c~13 927~~8 DATE i' ~ AMOUNT ! 03/14/12 $8,800.00. BOBBY RAHALTOY®TA 8 I Ivr SIGNATURE ~~'092778i~' ~:03~302955~: 33398739~~' NAME NUMBER JAMES B TAYLOR 91876 PURCHASE OF 06 CAMRY(642969) DATE CTRL# ACCT# AMOUNT DESC 03/14/12 TP5198 T308 8800.00 642969 03/14/12 Q U U U a y a REMITTANCE ADVICE DETACH AND RETAIN BOBBY RAHAL TOYOTA CHECK NO. 6711 Carlisle Pike 92778 Mechanicsburg, Pa. 17050 NET AMOUNT E U a w J W Q H V) J J Q