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HomeMy WebLinkAbout08-09-12 (2)1505610143 ~ REV-1500 EX (01-10) ~i OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 2 1 11 0 0 3 19 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 173 14 1399 02 11 2011 Decedent's Last Name Suffix PINKO (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 4. Limited Estate ^ 6 Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received State ZIP Code PA 17043 Date of Birth 09 10 1921 Decedent's First Name MI MARY C Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 1 ~ Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number . , SAMUEL L ANDES 7 17 7 6 ~ 53 61 ~w.~' -,-~ First line of address 525 NORTH 12TH STREET Second line of address City or Post Office LEMOYNE Correspondent's a-mail address: l a w a n d e s@ a o l. c o m Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE -/~ _~ - _ ~ .~ _ /1 Bonnie J. Kundu -~_ ~ '~ . / '7 RESS 6343 Step ens Crossing, Mechanicsburg, PA 17050 SIGNPrTUR E A ER R THAN REPRESENTATIVE DATE Samuel LAndes / ~, ~aa s ~ 525 North 12th Street, Lemoyne, PA 17043 1505610143 ^ 3, Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) ~ ~ ~~~ REGISTER d~lL.LS USE~TaLY <_ I ~ ~_ - ~' .. ; 4 . ~'^~ 1 ~ .,.. = ~:. Op ; _, ~ L G.; DATE FILED Side 1 1505610143 J . :: J REV-1500 EX ~ecedent•s Name: P I N K O, MARY C. Decedent's Social Security Number 17 3 14 13 9 9 RECAPITULATION Real Estate Schedule A 1 14 2, 5 0 0. 0 0 1 ( ) .......................................................................................... 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 & Miscellaneous Personal Property (Schedule E) ................ 5. 4 4 , 14 7 . 0 6 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... g. 1 8 6, 6 4 7. 0 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 3 7 , 7 5 0 . 6 3 10. Debts of Decedent Mortgage Liabilities & Liens Schedule I 10. 6 5 3.10 11. Total Deductions (total Lines 9 & 10) .............................. ... ..................................... 11. 3 8 , 4 0 3 . 7 3 12. Net Value of Estate (Line 8 minus Line 11) 12. 14 8 , 2 4 3 . 3 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. I ( ) ................................................. Net Value Sub'ect to Tax Line 12 minus Line 13 14, 14 8 , 2 4 3 . 3 3 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 14 8, 2 4 3. 3 3 16. 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 6, 67 0.95 6, 670.95 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 11 - 00319 Pinko, Mary C. STREET ADDRESS 105 Salem Church Road CITY Mechanicsburg STATE PA ZI P 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 6,670.95 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 0.0 0 3. Interest (3) 148.24 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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) 6, 819.19 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 :.................................... ^ ^x c. retain a reversionary interest; or .................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ~ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ ^x 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 GIUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS P ART O F 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)]. 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 ears 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) (j .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) . A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bloo~ or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE FILE NUMBER ESTATE OF Pinko, Mary C. 21 - 11 - 00319 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 wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Single-family residence at 105 Salem Church Road, Mechanicsburg, PA. Value based upon 142,500.00 sale price. TOTAL (Also enter on Line 1, Recapitulation) ~ 142,500.00 - SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pinko, Ma C. FILE NUMBER ry 21 - 11 - 00319 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Savings account No. 1 1 1 200986 at Orrstown Bank 34,217.20 2 Checking account No. 1 1 1 000087 at Orrstown Bank 4,588.24 3 1998 Ford Van in fair condition 500.00 4 57 shares of Prudential Stock sold in May 2012 2,783.97 5 Real Estate tax rebate paid by Cumberland County 650.00 6 Miscellaneous items of household furnishings and tangible personal property 1,000.00 7 Stock dividend from Prudential 82.65 8 Supplemental Property Tax Rebate 325.00 TOTAL (Also enter on Line 5, Recapitulation) ~ 44,147.06 SCHEDULE H FUNERAL EXPE<VSES & COMMONWEALTH OF PENNSYLVANIA ~'N~~ INHERITANCE TAX RETURN R ESID ENT D ECED ENT ___ FILE NUMBER ESTATE OF Pinko, Mary C. 21 - 11 - 00319 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Malpezzio Funeral Home 9,108.74 2 West Shore Country Club (reception after funeral) 1,638.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 2 3 4. Street Address City State Zip Year(s) Commission paid Attorney's Fees 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 Probate Fees Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees Miller Dixon & Drake 7, Other Administrative Costs 1 Cumberland Law Journal (advertising) 362.00 150.00 75.00 TOTAL (Also enter on line 9, Recapitulation) 37,750.63 Sdiedule H ,. F E & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN Ac~nin~ C05~S continued RESIDENT DECEDENT ESTATE OF Pinko, Mary C. FILE NUMBER 21 - 11 - 00319 2 The Sentinel (advertising) 155.68 3 Costs incurred to maintain residence until sale (see Exhibit A) 5,251.24 4 Costs incurred to repair residence and prepare it for sale (see Exhibit B) 8,330.47 5 Costs incurred for sale of property (see Exhibit C) 11,160.00 6 Orrstown Bank (banking fee) 19.50 7 Reimbursement to Bonnie Kundu for postage, supplies, fuel, and related expenses 1,500.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LI ENS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Pinko, Mary C. 21 - 11 - 00319 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Crumay Barnes (physician's bill) 162.00 2 Camp Hill Emergency Ambulance Service 100.10 3 ~ Erie Insurance Group (homeowners insurance) ~ 391.00 ~ TOTAL (Also enter on Line 10, Recapitulation) ~ 653.10 REV-1513 EX+ (11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES I NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pinko, Mary C. FILE NUMBER 21 - 11 - 00319 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not Llst Trustee(s) I~ TAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Frederick L. Alleman Son 1,000.OC 219 Cockleys Drive Mechanicsburg, PA 17055 2 Bonnie J. Kundu Daughter 1/4 of residue 6343 Stephens Crossing Mechanicsburg, PA 17050 3 Cynthia I. Alleman Daughter 1/4 of residue 1019 Jenkins Grove Enola, PA 17025 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ 0.00 REV-1513 EX+ (9-00) _ ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pinko, Mary C. FILE NUMBER 21 - 11 - 00319 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 4 I. Timothy Alleman Son 1/4 of residue 5205 E. Willow Creek Road Castle Rock, CO 80104 5 Kathleen M. Harris Daughter 1/4 of residue 677 S. Chimazo Drive Pueblo West, CO 81007 Page 2 of Schedule J Exhibit A Estate of Pinko, Mary C. File No. 21-11-00319 Costs to maintain real estate 1. PPL (electric bills) $845.94 2. PAWC (water utility) $278.70 3. Buchanan Erb Fuel Oil 1,075.50 4. Hampden Township (sewer and refuse) $558.55 5. Just Lawn Cutters (lawn care) $1,637.63 6. Real estate taxes (less prorated portion received at settlement) 854.92 $5,251.24 Exhibit B Estate of Pinko, Mary C. File No. 21-11-00319 Costs incurred to repair residence and prepare it for sale 1. Mark Baumgarten (interior repairs) $1,192.00 2. Spangler Mills Contracting (chimney repair) $95.00 3. Jim Taylor (awning repair) $364.85 4. Lowe's (paint and wall plates) $129.62 5. Tom Strickler (painting) $925.00 6. Chimney Sweep System (chimney cleaning) $159.00 7. Snow removal $20.00 8. Environquest (radon mitigating system) $750.00 9. Fetrow Electric (electrical repairs) $1,020.00 10. Natasha Holmes (window replacements) $100.00 11. Elmwood Tree Service (tree and shrub removal -storm damage) $1,330.00 12. Norman Keck (fence repair following storm damage) $1,995.00 13. Dan Haring (disposal of remaining debris) 250.00 $8,330.47 Exhibit C Estate of Pinko, Mary C. File No. 21-11-00319 Costs incurred for sale of property 1. Jack Gaughen and Keller Williams (real estate sales commission) $7,220.00 2. Natasha Holmes (seller assistance) $2,000.00 3. T.A. of Central PA, LLC (certification, notary, and title fees) $55.00 4. Realty transfer tax $1,425.00 5. American Home Shield (home warranty) 460.00 $11,160.00 ;'lll~lll'= A• Settlement Statement (HUD-1} ~W ,„..~ R Tvnn of 1 nan OMB Approval No. 2502-0265 1. ~ FHA 2. ~ RHS 3. ~ CONV. UNINS. 6. File Number. 7. Loan Number. 8. Mortgage Insurance Case Number: a. ~ vA 5. ~ CoNV. INS. CEN154-308 5701331810 446-1102570-703 C. Note: This form is furnished to give you a statement of a ctual settlement costs. Amounts paid to and by the settlemen t 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. E. Name & Addresa of Seller: F. Name & Address or Lender. Natasha D. Holmes, a married woman Bonnie J. Kundu and I. Timothy Alleman, Co- Fulton Bank, N.A., ISAOA 106 West Clearview Drive Executors of the Estate of Mary C,. Pinko, One Penn Square Camp Hill, PA 17011 deceased Suite 304 6343 Stephens Crossing Lancaster, Pennsylvania 17602 Mechanicsburg, PA 17050 G. Property Location: H. Settlement Agent: I. Settlement Date: 105 Salem Church Rd T.A. of Central PA, LLC March 19, 2012 Mechanicsburg, Pennsylvania 17050 530 North Lockwiflow Avenue Lot 5, Salem Park, Book 11, Page 56, Harrisburg, Pennsylvania 17112 Cumberland County, Pennsylvania 717-724-3724 fax: 866-858-2780 Place of Settlement: T.A. of Central PA, LLC 530 North Lockwillow Avenue Harrisburg, Pennsylvania 17112 Phone: (717) 724-3724 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100_Gross Amount Due From Borrower: 400. G_ ross_Amount Due To_Seller: 101Contract Sales Price 142,500.00 401 Contract Sales Price 142.500.00 Adjustments_for Items Paid__by Seller in _Advance: 106. 2012 County & Township Taxes Mar 19, 2012 _ thru Dec 31 .2012 _ _107_CountY% Parish Taxes _108. Assessments 109. 2011-12 School Taxes Mar 19, 2012 thru Jun 30, 2_012 __ _ _ 110. Sewer ~ Trash (1st qtr) Mar 19, 2012 thru Mar 31, 2012 _ 120Gross Amount Due from Borrower: 149, _200. Amounts Paid_by or in_Behalf of Borrower: _201 _De~sit_or__Earnest. Money 3, 20.2. Princ~al_Amount of New Loan_ 138 203_ExistinQLoanL taken subject to 2012 County ~ Township Taxes Mar 19, 2012 224.21 406. thru Dec 31, 2012 224'21 315.26 409. 2011-12 School Taxes Mar 19, 2012 thru Jun 30, 315.26 2012 22.15 410. Sewer i;< Trash (1st qtr) Mar 19, 2012 thru Mar 31, 22,15 _ 2012_ _ 910.93 420. Gross Amount Due to Seller: 143,061.62 500. Reductions in Amount Due to Seller: Loan~sZtaken subject Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller: 210_Cty /Town Taxes 510_Cty% Town Taxes 2.11_ County /Parish Taxes 511. County /Parish Taxes 212. Assessments 512. Assessments 220. Total Paid by /for Borrower: 143,875.00 520. Total Reductions in Amount Due Seller: 21.062.93 300. Cash at Settlement from / to Borrower: 600. Cash at Settlement to /from Seller: -- - - - -- 301Gross Amt?unt due from Borrower {line 120) 149,910_93 601. Gross Amount due to Seller line 4.20) 143 061_62 303. Cash From Borrower: $6,035.93 ~ 603. Cash To Seller: $121,998.69 The Public Reporting Burden for this collection of information 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. Borrower Initials: ~~ Natasha D. Holmes Seller Initials: r` d' \ - Previous editions are obsolete Page 1 of 4 HUD-1 March 19, 2012 9:40 AM ~~`;iema.~t P;~te: March 19, 2012 Filc Number: CE1~1154-308 Loan Number: 5701331810 FA L-5012742-0014876E 0-5011442-0036347E L. Settlement Charges Paid from Paid from 700. Total Sales /Broker's Commission: $7,220.00 Division of Commission. line 700~as follows Borrower's Funds at Seller's Funds at 701_31707.50 to Jack Gaughen_Realtor ERAS 2.5%of $140 500 ±$195) 702_3,512_50 to Keller Williams of Central PA East ( (2.5% of 140 500 Settlement Settlement 3. Commission Paid at Settlement. _ 70 7 220.00 _ 704. Additional Commission to Keller Williams of Central PA East 250.00 800. Items Payable in Connection with Loan: 801. Our origination charge (from GFE #1) _ $695_00 802. Your credit or charge (points) for the specific interest rate chosen (from GFE #2) to Fulton Bank N__.A., ISAOA $_347_19 --- - 803_Youradjusted origination charges (from GFE #A 347.81 804. Appraisal Fee (from GFE #3) to.Mark_Heck_man Real Estate Appraisals ($450 POC by.Borrower oc X450.00 -25.00 805. Credit Report (from GFE #3) to Credstar 13.94 806. Tax Service 807 Flood Certification (from GFE #3) to CoreLogic Flood Services 11.50 808. Inspection Fee (from GFE #3) to Mark Heckman Real Estate Appraisals 100.00 _900. Items Required by Lender to be Paid in Advance: 901. Daily interest charge from Mar 19, 2012 to Apr 1, 2012 @ 14.2290 /day for 13 days (from GFE #10) to Fulton Bank, N•A.~I_SAOA __ 184.98 902. Mortgage Insurance Premium (from GFE #3) to Fulton Bank_ Life of_Loan_ 1 375.00 903. Homeowner's Insurance (from GFE #11) _ to Nationwide. 738.00 1000. R_ eserves Deposited with Lender: 1001. Initial deposit for your escrow account (from GFE #9) to Fulton Bank, N.A. ISAOA 771.96 1002. Homeowner's Insurance 3 months_~_$61,50per month $184.50 1003_Mortga_ge Insurance @130.67 p_er month 1004 _County_& Township. Property Taxes 2 months 24.23 per month $48.46 _ 1005. School Taxes 10 months Cc~ $94.34 per month $943.40 1099_A~gregate Adjustment $-404.40 1100_Title Charges: 1101_Title seryices_and lender's title insurance from GFE #4) 1 494.12 1102. Settlement or Closing Fee $ 1103. Owner's Title Insurance (First American Title Insurance Company) (from GFE #5) _ to T.A._of Central PA LLC Risk Rate Premium_$1 073.75) 20.00 1104. Lender's Title Insurance (First American Title Insurance Company) to T.A. of Central PA, LLC - Lender's Premium $1,053.75 - 900 Endorsement (ALTA 8.1) $50.00 - ALTA Short form loan policy (incl PA 100,300) $100.00 =ALTA 9 End~PA 1030) 105.37 1105_Lender's Title PolicyLimit_$138,875.00 1106Owner's Title Polic rLLimit~142 500_00 1107. Agents Portion of the Total Title Insurance Premium $1 129.75 1108. Underwriter's Portion of the Total Title Ins u_ra nce Premium $199.37 _ _ 1109. Reimbursement of tax certification fee to T.A. of Central PA, LLC 10.00 1110_Deed preparation fee estate attorne 1111. Notary fee to Abby F. Wendel 20.00 1200. Government Recording and Transfer C__ha_rges: 1201. Government Recording Charges (from GFE #7) 142.00 1202_Deed $62.00 Mort~age~80.00 Releases~0.00 1203. Transfer FE #8 Taxes (from G 1 425.00 _ _ 1204City_/Count~tax/stamps Deed $1 425.00 Mortgage $0.00 1205. State tax(_stamps Deed $1,425.00 Mortgage $0.00 1 425.00 1206. Other Tax 1 _ _ 1207. Other Tax 2 1300. Additional Settlement Charges: _1301. Re~c wired services that you can shop for (from GFE #6 _1.302Survey 1303. Home/PestlRadon Inspection to The Virtus_Group_(poc $425.00 by Borrower 425.00 1304. 2012 County & Township Taxes to__Michael_LanganLtreasurer _ 284.93_ 1305. 2011-12 School Taxes __ to _Michael.Langan~treasurer oc $1 109.46 by Seller 1306. Sewer & Trash (1st qtr) to Hampden Township~poc~155_05 b r~Seller 1307. Escrow for Inheritance Taxes due? to Title Alliance LTD 9 618.00 _ 1308. Fee for Escrow account Title Abstract Co of Pennsylvania to 25.00 _ 1309. Home Warranty to American Home Shield 460.00 1400. Total Settlement Charges (Enter on line 103, Section J and line 502, Section K) _- $6,849.31 $19,062.93 Borrower Initials: ~ Natasha D. Holmes Seller Initials: Previous editions are obsolete Page 2 of 4 HUD-1 March 1a ~n1~ a•an nnn CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) July 31, 2012 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Edgar A. Dilks No. 21-11-1121 Dear Register of Wills: TELEPHONE (717) 766-0209 FAX (717) 795-7473 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Edgar A. Dilks Estate as well as Check No. 106 in the amount of 588.78 for the Supplemental Inheritance Tax, Check No. 107 in the amount of $60.00 for additional Probate and Check No. 108 in the amount of $15.00 for the filing fee. Thank you for your kind attention to this matter. Very truly yours, ~ '~ ~' `~ Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures U ~~ C-,. ,. V = ~ ,~ . .A.a °•_~ ~~ ~z~{ r*~. ~, ~~ *-, x~ r r.~ ` . ~ '._ i .J l . ~- -t'; ' C-'r:. •/ ~~~~ ~ ~,. _ ,....r_. .'., t .- ~ .~~ -w.- ~ `'-~ r~..' • . ~ V f +....' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 016343 DILKS FREDA L 44 BLUE MOUNTAIN VISTA MECHANICSBURG, PA 17050 -------- fold ACN ASSESSMENT AMOUNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: SSN: 179-16-7382 FILE NUMBER: 211 1-1 121 DECEDENT NAME: DILKS EDGAR A DATE OF PAYMENT: 08/03/201 2 POSTMARK DATE: 08/03/2012 COUNTY: CUMBERLAND DATE OF DEATH: 10/01 /201 1 REMARKS: RECEIPT TO ATTY SEAL CHECK#106 101 $588.78 TOTAL AMOUNT PAID: 5588.78 INITIALS: HMW RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS