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HomeMy WebLinkAbout07-31-12 1SDS61118D -•-~ REV-1500 Extoz.tt,IFi1 pennsytvania OFFICIAL USE ONLY PA Department of Revenue c~p~x+ircvTCS«s.ex~:t County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisbur~c. PA t7128-0601 RESIDENT DECEDENT ~ ` ~ ~ ` (~ ENTER DECEDENT INFORMATION BELOW Saeial Security Number Data of Death fviMDDYYYY Date of Birth b1MDDYYYY , 1D1$2D11 11161925 Decedent's Last Name Suffix Decedent's First Name MI GIBBON ~ LOIS R (If Applicable) Enter.e~urviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name toil Spouse's Social Security Number THIS RETURN MUST 8E FILEO IN DUPLICATE WITH THE REGISTER 0~ WILLS FILL IN APPROPRl,ATE BOXES BELOW [] 1. Original Return [~,] 2, SuppiemenW) Return [~ 3. Remair~ler Return (Date of Death Prior to 12-13.82} d. Limited Estate [] aa. Future Interest Compromise (date of Q 5. Federal Estate Tax Return Required death alter 12-12.82} [~ &. Decedent Died Tostaie Q 7. Decedent Maintained a Living Trust 8.7ot;al Number a1 Sate Deposit Boxes (Attach Copy of Will} (Attach Ccpy of Trust} Q 9. Liitgatian Proceeds Received Q 10. Spousal Poverty Credit (Date of Death [~ 11. Election to Tax under Sec. 9173(A} 9etween 12.31.91 and 1-i-95) (Attach Schedule O) CORRESPDNDENT -THIS SECTtDN MUST eE COMPLETED. ALL CDRRtcSPONDEHC£ AND COHFIDEHTIAL TAX INFDRMATIQN SHOUID 6E DIRECTED TD: Name Daytime Telephone Number ROBERT G. FREY 71 h~ 72435838n© N .~~; r-,, ~ REGISTER O t USE Ot X S.i~ rn ~ -Tt ~." _ ~n ._ ~ ~ .__. ~ ~ First Line of Address ~~ } `~-~ C: ~ C C-,, _• ,, ,..~ Wit,. s --r-r 5 S HANOVER ST n~-=~'-'' =~ •~" -r' Second tine of Address ~ '~? r-rn D G3 y `n ~Fij G~: i P ff s DATE FtLEo ty or o C t O tca State ZIP Gode CARLISLE PA 17013 Correspondent'se-mail address: RFREYb1F'REYTILEY.COM Under penalties of per;ury, i declare that i hava exarrair~ed ihds return, inctudtng ac cmpsnying schtdu€es and statements. and tc the best o! my kr~ricdge arsd t:elei, FtItNG RETURN qAT OF PREF/ARt~IE OTHF,jt TNAt~REPRESENTATNE DATE S SOUTH HANOVER STREE'i';' CARLISLE, PA 27013 PLEASE USE ORIGINAL FORM ONLY Side 1 15OS611180 3,505611180 f`~ J 15n~611280 REV-1500 EX (FI) Decedent's Social Security Number ~ecedent'sName: LOIS R GIBBON RECAPITULATION 1. Real Estate (Schedule A) ........................................ . 1. 110 0 0 O . 0 0 2. Stocks and Bonds (Schedule B) ................................... . 2. 2 2 810.0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . 3. N 0 N E 4. Mortgages and Notes Receivable (Schedule D) ....................... . 4. N 0 N E 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ... . 5. 5 2 5 3 5 . O O 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ..... .. 6. N 0 N E 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ..... .. 7. 3 7 0 7 0. 0 0 8. Total Gross Assets (total Lines 1 through 7) ........................ .. 8. 2 2 2 415.0 0 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .. 9. 2 5 5 7 5 . 0 0 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........... . 10. 1228.00 11. Total Deductions (total Lines 9 and 10) ............................ . 11. 2 6 8 0 3 . 0 O 12. Net Value of Estate (Line 8 minus Line 11) .......................... . 12. 19 5 612.0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0 . 0 O 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 19 5 612 . O O TAX CALCULATION -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 .0 O 15. O.O O 16. Amount of Line 14 taxable at linealratex.o 45 195612.00 16. 8802.54 17. Amount of Line 14 taxable at sibling rate X . 12 17. O . 0 0 18. Amount of Line 14 taxable at collateral rate X .15 18. 0 . 0 0 19. TAX DUE ....................................................... 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 8802.54 L 1505611280 1505611280 REV-1500 EX (FI) Page 3 File Number 162-22-4271 Decedent's Complete Address: DECEDENT'S NAME LOTS R GIBBON STREET ADDRESS CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 8802.54 A. Prior Payments 9307.22 B. Discount 465.36 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. Total Credits (A + B) (2) 9772.58 (3) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (a) 970.04 (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 ....................................................................................... ^ 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? .................................................................. ^ 2. If death occurred after Dec. 12, 1982, did decedent Vansfer property within one year of death without receiving adequate consideration? .......................................................................................................... ^ 3. Did decedent own an "in trust for" orpayable-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 ftom 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)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)]. 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 SCHEaULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Lois R Gibson 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. If more space is needed, use additional sheets of paper of the same size. REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHED~ILE B STOCKS & BONDS FILE NUMBER Lois R Gibson All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MTB Strategic Allocation Fd, ARBAX, 2621.798 sh @ $8.70 22,810 TOTAL (Also enter on line 2, Reca (If more space is needed, insert additional sheets of the same size) REV-1508 EX+(„-,o' SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Lois R Gibson InGude 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. If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(OS-os> SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Lois R Gibson 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 yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED fOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Lincoln National IRA 37,070 100.00% 37,070 TOTAL Also enter on Line 7, Reca itulation $ 37,070 If more space is needed, use additional sheets of paper 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 Lois R Gibson Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Rice Memorial Works 195 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Mary Gibson and Katherine Nasser Street Address City State ZIP Year(s) Commission Paid: 2012 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. 7. 8. SVeet Address City State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Expenses in connection with real estate sold Auctioneer fee TOTAL (Also enter on Line 9, Re If more space is needed, use additional sheets of paper of the same size. ZIP 3 6,600 5,250 13,380 150 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 NUMBER Lois R Gibson Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. REV-1513 FJC+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Lois R G ibson 21-11-1111 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [Include outright spousal distributions and Vansfers under Sec. 9116 (a) (1.2).] 1 ~ Mary Gibson 2 Jane Lane, Carlisle, PA 17013 Daughter 1/4 of Remainder 2 Katherine Nasser 214 W[Ilis Road, Bunker Hill, WV25413 Daughter 1/4 of Remainder 3 Phillip A. Gibson 1313 Nottingham Drive, Union City, TN 38261 Son 1/4 of Remainder 4. William W. Gibson, Jr. Son 1/4 of Remainder 260 Crain's Gap Road, Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. 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. ~,r,~ 1 w tL1, AND TESTAMENT y `' <7 LOIS RICE GIBBON ~- -~ .>~,, ~r'l ~ ..~_~ i I, LOIS RICE GIBBON, widow, of North Middleton Township (mailing address. 1~3 Pheasant Drive South, Carlisle, Pennsylvania 17013), Cumberland County, pennsylvania~eing of sound and disposing mind, memory and understanding, do hereby make, publish and declare x' ~~ this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter-named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I duect that my funeral services be conducted by Nickel Funeral Home, Loysville, Pennsylvania 17047, in a manner '`; substantially similar to the arrangements made by me for the services for my husband, William ~ ~' ~'i'. Gibson, and that my body be cremated and my ashes be interred beside his on my burial lot which is Lot No. 69 in Landisburg Cemetery which had belonged to my grandfather, M. L. °~ Koller, located neaz the Borough of Landisbur m P g ~ erry County, Pennsylvania. 2. I give and bequeath various items of personal properties to the persons named in a writing which I intend to prepare and keep with this Last Will and Testament. 3. All of the rest, residue and remainder of my estate, personal, and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shazes as follows: ~ a) One (I) share to my daughter, Mary R. Gibson, her heirs and assigns, provided ~~ she shall survive me by a period of ninety (90) days, but should she fail to so survive me then to such of her issue as shall survive me by a period of ninety (9p) days, per stirpes, and if there be ~? no such issue the same shall lapse and be added to the other s ~~ hares, r s ' . pe topes; b) One (1) shaze to my daughter, Katherine G. Nasser, her heirs and assigns, provided she shall survive me by a period of ninety (90) days, but should she fail to so survive me then [o such of her issue as shall survive me by a period of ninety (90) days, per slopes, and if there be no such issue the same shall lapse and be added to the other shares, per stirpes; c) One (1) share to my son, Phillip A. Gibson, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me [hen to such of his legitimate issue as may hereafter be born to him who shall survive me by a period of ninety (90) days, per stirpes, and if there be no such legitimate issue the same shall lapse and be added to the other shazes, per slopes; d) One (1) share to my son, William W. Gibson, Jr., his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me then the same shall lapse and be added to the shares of my other three children, their heirs and assigns, as hereinabove provided. 4. I hereby nominate, constitute and appoint my two daughters, Mary R. Gibson and Katherine G. Nasser, or either of them, as co-Executrices of this my Last Will and Testament, and I further d~rec[ that neither of them shall be requued to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania. or in any other jurisdiction. 5. In addition to the powers conferred by law, my hereinbefore named Executrices, and their successors, are empowered: a. To invest any part of the [rust corpus in such securities, investments, or other property as may be deemed advisable and proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b. With respect to any corporation, the stocks, bonds, or other securities of which may be held, to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale of the property of any such corporations; to make any sun-ender, exchange or substitution of -f~~ -~ r~ L .~.i -. _ 'i'. ~~ O -z-~ such stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of such corporations either for the conversion of the same into other securities or for the purchase of additional securities, and to make any and all necessary payments which may be required in connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which sepazate shares shall have undivided interests. d. To sell at public or private sale for cash or upon credit, or partly for cash and partly on credit, and upon such terms and conditions as shall be deemed proper, any part or parts of the [rust estate, and no purchaser at any such sale shall be bound to inquire into the expediency or propriety of any such sale or to see to the application of the purchase moneys arising therefrom. e. To keep on hand and uninvested such money as may be deemed proper and for such period as may be found expedient. f. To compromise, settle or arbitrate any claim or demand in favor of or against the trust estate. g. And authorized in the discharge of fiduciary duties, to employ counsel and to determine and to pay such counsel reasonable compensation which shall be charged against the principal or income of the trust fund, and shall further be entitled to chazge against the principal or income such other reasonable expenses and chazges as may be necessary and proper to incur for the proper dischazge of fiduciary duties and for the proper management and administration of the trust estate. h. In making any division of property into shares for the purpose of any distribution thereof duected by the provisions of the trust, to make such division or distribution, either in cash or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to any one or more of such shares, and to that end may appraise any or all of the property so to be allotted and the judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. Authorized to register any shares of stock or other assets of any trust in [heir own names or in the name of a nominee. j. To retain any investments or mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, irrespective of whether the same aze authorized for the investment of trust funds under the laws of any governing jurisdiction. k. 'To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as maybe deemed advisable or proper, irrespective of whether the same aze authorized for the investment of trust funds under the laws of any governing jurisdiction. 1. To determine from time to time whether all or some portion of realized capital gains shall be treated as ordinary income for distribution to a beneficiary or treated as principal to be retained as part of the corpus, and such designation need not be consistent from one yeaz to another. ~' ~~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on three (3) pages, this 24thlldaDDy of February, 2005 OS/`z~ /~.lC''rL (SEAL) Lois Rice Gibson Signed, sealed, published and declared by LOIS RICE GIBBON, the Testatrix above- named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. S ~ 'Q. Real Estate Expenses North Middleton Authority 82 PPL 33 PPL 39 North Middleton Authority 82 PPL 67 North Middleton Authority 82 Stanley Steamer, cleaning 105 Robin Sollenberger Tax Collector 356 North Middleton Authority 82 PPL 26 PPL 14 North Middleton Authority 82 PPL 48 Expenses from HUD-1 Settlement Statement, line 1400 9,860 Seller Assistance 2,400 PPL 22 Total Real Estate Expenses 13.380 r var++v,. - ~~~ OMB Approval No. 2502-0265 yoe o`p ~'~= A. Settlement Statement (HUD-1) +aN oeJa B T of Loan YP 1. ~ FHA 2. ~ RHS 3. Q Conv. Unins. 4. Q VA 5. ~ Conv. Ins. 6. File Number: 12102-097 7. Loan Number: 5701417210 8. Mortgage Insurance Case Number: C. Note: This form is famished ro give you a statement of actual settlement wets. Amounts paid ro and by the settlement agent are shown. !tams marked "(p.o. c.)' were paid outside the Goring; they are shown here rorinformational purposes and era not inGuded in the rotate. D. Name and Address of Borrower: Renee G. Foley 36 Courtyard Drive Carlisle, PA 17013 E. Name and Address of Seller: Estate of Lois R. Gibson 1413 Pheasant Drive S Carlise, PA 17013 F. Name and Address of Lender: Fulton Bank, N.A. One Penn Square Lancaster, PA 17602 G. Property Location: 1413 Pheasant Drive South Carlisle, PA 17013 Cumberland County, Pennsylvania H. Settlement Agent: Residential-Commercial Abstract, Inc. 3621 North Front Street Harrisburg, PA 17110 Ph. (717)901-8926 I. Settlement Date: Jury 31, 2012 Place of Settlement: 3621 North Front Street Harrisbu , PA 17110 J. Summary of Borrowers transaction K. Summary of Seller's transaction 100. Gross Amount Due from Borrower: 400. Gross Amount Due to Seller. 101. Contrail sales rice 110000.00 401. Canttact sales rice 110,000.00 102. Personal roe 402. Personal ro 103. Settlement Char es to Borrower Line 1400 6,513.84 403. 104. 404. 105. 405. Ad ustments for items aid b Seller in advance 106. Ci !Town Taxes to 107. Coun Taxes 08/01/12 to 01!01!13 108. Assessments 08l01I12 to 07/01/13 149.02 1 295.73 Ad ustments for kema aid b Seller in advance 406. Ci !town Taxes to 407. Coun Taxes 08101/12 to 01/01/13 408. Assessments 08/01112 to 07/01/13 149.02 1 295.73 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 117,958.59 420. Gross Amount Due to Seller 111,444.75 200. Amounts Paid or in Behalf of Borrower 500. Reductions in Amount Ous Seller. 201. De osit or earnest mono 202. Princi al amount of new loans 1 000.00 108,007.00 501. Excess de osit see instructions 502. Settlement rho es to Seler Line 1400 11,966.60 203. Existin loan s taken sub'ect to 503. Existin loans taken sub'ect to 204. CCHRA Grant 5,000.00 504. Payoff First Mortga e 209 505. Pao Sawnd Mort a e 206 506. P07 507. De osit disb. as roceeds 208. `~8~ 209. Seller Assist 2 400.00 509. Soler Assist 2,400.00 Ad ustmants for kerns un aid b Seller Ad ustments for items un aid b Seller 210. C' !Town Taxes to 510. C' !Town Taxes to 211. Coun Taxes to 511. Coun Taxes to 212. Assessments l0 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid b Jfor Borrower 116,407.00 520. Total Reduction Amount Due Seller 14,366.60 300. Cash at Settlement fromko Borrower 600. Cash at aettlsment toHrom Seller 301. Gross amount due from Borrower line 120 302. Less amount paid b/for Borrower (line 220) 117 958.59 ( 116,407.00) 601. Gross amount due to Seller line 420 602. Less reductions due Seller (line 520) 111 444.75 ( 14,366.60 303. Cash X^ From ~ To Borrower 1,551.59 603. Cash X^ To ~ From Seller e 97,078.15 • PaiO owitls ar doainy by nonowerte), ae4a(S), lentlsr(L), a sYre-p-Mtn The undersigned her~a cnowledge receipt f a completed copy of this statement & any attachments referred to herein ~ Seller Borrower C.. Estate L 's R.Gi o Rene G. Foley BY: M fbson, Co-Execut/ri~x BY: ~ ~~~0'~2 ~ c,~'@ Katherine G. Nasser, C Executrix Tne Puck Rspw9np Burtlen for Inia wtlecWrl or Inlortnalion is aawneW x135 mirwtes per nepaue br coeegin0, nvlevAnp, antl reportlrq Na tlw. rns agency may nor mead this intormalion, antl you era not rsquiretl b compNU Wa form, uMaaa it olaplaye a C rtently valk OMe mnUd number. Nc mnlltlentlWlly u ueuretl; tlee obtlown b mentlalory. This is tleaipnatl to provia Ne panlsa to a RESPA wvaatl uanaecaon vAm nrormstion Page 1 of 3 HUD-1 (FOLEY, RENEE G..PFD/12102-097/33) .e oroKer Feeg $6,825.00. Paid From Paid From Division of commission (line 700) as fo/lows: Borrowers Senors 701. $ 3,525.00 to Prudential Home Sale Services Funds at Funds at 702. $ 3,300.00 to Hooke, Hooke & Eckman Realtors, LLC Settlement Settlement 703. Commission aid at settlement 6 825.00 704. 705. 800. Items Payable in Cpnnectlon with Loan 801. Our on ination cha e $ 695.00 from GFE #1 802. Your creditor char a Dints for the s ecific interest rate cho en fro F #2 803. Your ad' sled on ination char es from GFE #A 695.00 804. A rai I fee to Central nn A rai ors Inc. from GFE #3 400.00 805. Credit Re ort to Credstar, A First Advanta a Com an from GFE #3 13.94 806. Tax service to fr m FE #3 607. Flood cert~wtion to CoreL is Flood ervices from GFE #3 11.50 606 from GFE # 809 from FE #3 610 from GFE #3 611 (from GFE #3) 900. Items Required by Lender to Be Paid Iri Advance ' 901. Dai interest cha es from 07131!12 to 08!01112 1 $10.697400Poa 902. Mortgage insurance premium for months to Fu0on Bank Life of Loan from GFE #10 (from GFE #3) 10.70 1,857.63 903. Homeowners insurance for 1.0 years to USAA (from GFE #11) 670.10 gOq (from GFE #11) 905 (from GFE #11) :_:. 1000. Reserves De Ited with Lender , 1001. Initial deposit for your escrow account (from GFE #9) 412.97 1002. Homeowners insurance 3.000 months ~ $ 55.64 par month S 167.52 1003. Mort a e insurance 0.00 months $ 109.63 er month $ 1004. Pro taxes S 422.26 Assessments months $ r month School Taxes 2.000 months $ 120.41 - er month County Taxes 6.000 months $ 30.24 per month 1005. 1006. months $ per month $ 1007. Aggre ate Adjustment months $ per month $ -176.81 1008. $ 1009. $ 1100. Tice. Charges ~ _ 1101. Title services and lenders title insurance (from GFE #4) 1,190.00 1102. Settlement or ctosin fee $ 1103. Owners title insurance to Old Republic National Title Ina. Co. (from GFE #5) 10.00 1104. Lender's title insurance to Old Republic National Title Ins. Co. $ 1,095.00 1105. Lenders title policy limit $ 108,007.00 1106. Owners title policy limit $ 110,000.00 1107. Agents portion of total title insurance premium to Residential-Commercial Abstract $ 950.30 1108. Undelwrtters portion of total title insurance premium to Ok1 Republic National Title Ins. Co. $ 154.70 1109. Closing Protection Letter to Old Republic National Title Insurance Compily 75.00 1110. Tax Certification to Residential-Commercial Abstract, Inc. $ 5.00 1111. $ 1112. $ 1113. $ 1200. Gavemment Recordin and Transfer Cha es 1201. Government recordin char es to Cumberland Coun Recorder of Deeds from GFE #7 142.00 1202. Deed $ 62.00 Mort a e E 80.00 Releases $ Other $ 1203. Transfer taxes to Cumberland Coun Recorder of Deeds (from GFE #8) 1,100.00 7204. Ci /Coun tax/stam s $ 1 100.00 $ 1205. Stale taz/stam s $ 1,100.00 $ 1,100.00 1206. 1207. 1300. Additlonal Settlement Charges ~ 7301. Required services that you can shop for GFE #6) (from 1302. 2012/13 School Taxes to Robin K. Sollenberger, Tax Collector S 1,415.99 1303. Electrical Work to Marshall Electric $ 126.75 1304. Estate Charge to Register of Wills, Agent $ 2,107.22 1305. Attorney Fees to Frey 8 Tiley $ 334.50 1306. Final Sewer to North Middleton Township $ 52.14 1400. Total SettlemenFChargas (ertter on Qnes 103„ Section J and'502, Section K) 6,513.84 11,966.60 Pea o„ls~ae or aor~ry oy oonmranel, rawnsl, ~enaer(L), or n:a-p.m(17 By s~yninp pays / of Nu sUtemenl, Cw aignaWnes atlotowNOge recoipl D<a completed Copy or pspa 2 6 3 of Inis Vuae papa s1alMMnt Residential-Commercial Abstract, Inc., Settlement Agent Certified to be a true copy. Page 2 of 3 HUD-1 (FOLEY, RENEE G..PFD/12102-097!33) a~~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302)934-2955 [November 2, 201 I Frey and Tiley 5 South Hanover Street Carlisle, PA 17013 Re: Estate of Lois R Gibson Social Securi~!; 162-22-4271_ Date of Death: October 18.2011 Dear Sir or Madam: Per your inquiry on October 25 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 Account Number Ownership (Names o, fl Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total Savings Account 15004221128215 Lois R Gibson 09/08/09 $8,328.26 $ .38 $8,328.64._ _ _ __ Checking Account 9852795989 Lois R Gibson 0623/11 $28,350.80 $ 1.99 $28,352.79 For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the High Street Carlisle Office at #717-2A0^1536. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not indude any aocounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, 4. Tammy Spencer Adjustment Services ~~ ~