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Home My WebLink About08-14-121505610143 RSV-1500 Ex(o,_,o> PA De artment of Revenue OFFICIAL USE ONLY P Pennsylvania County Code Year File Number Bureau of Individual Taxes UEGA0.TMENT OF REVENUE PO Box.2aoso~ INHERITANCE TAX RETURN 21 12 0068 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 05 2375 12 30 2011 09 29 1920 Decedent's Last Name MONISMITH Suffix Decedent's First Name SR. HARRY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name 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 ^ qa Future Interest Compromise 5. Federal Estate Tax Return Re wired (date of death after t2-12-82) ^ q a g Decedent Died Testate ~ Decedent Maintained a Living Trust 0 (Attach Copy of will) ^ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes MI F MI 9. Litigation Proceeds Received ^ t D. Spousal Poverty_ Credit (date of death 1 t .Election to tax under Sec. 9113 A between 12-31-land 1-t-95) ^ (Attach SCh. O) ( ) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D HUGHES ESQ 717 249 6333 First line of address 354 ALEXANDER SPRING RO Second line of address City or Post Office State ZIP Code CARLISLE PA 17015 Correspondent's a-mail address: jhugheS@SalZmanrlhugheS.COm REGISTER OF~AtIL`TLS USE 01dL'Y rrl -i- , -~ ~:..~ -. t ~,, . .~ t=J £-1 •' J rJ; -. .~. ~,~ DATL~FILED ... C' CG `_J ~, C'% r, ") _...:i ~ _.t,i C•T7 unaer 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, comet and complete. Declaration of preparer utter than the personal representative is based on all information of which preparer has any knowledge. Vickie E. Boyles / f ADDR S 391 Peter r le PA 17015 SIGNATUR PREPARE N EPRESENTATIVE ATE ^ James D. Hughes Esq. ~~(~ ~~ f L Road, Suite 1, Carlisle. PA Side 1 L, 1505610143 1505610143 J PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF I FILE NUMBER Monismith, Harry F. Sr. 21-12-0068 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 #2 Name Address1 Address2 City, State, Zip Date Bonita M. Wise 9 Channel Drive Carlisle, PA 17013 ~'.32o~z J 1505610243 REV-1500 EX Decedent's Social Security Number oe~ede^~'SName: Monismith, Harry F. Sr. 174 05 2375 RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... .. 1. 8 9, 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 8~ Notes Receivable (Schedule D) ....................................................... . 4. 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) .............. . 5. 2 9 , 054.66 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous ~ nq Probate Property (Schedule G) U Separate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1-7) .................................................................... . 8. 118 , 054.66 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 32 , 54 0 . 0 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10. 353 , 38 11. Total Deductions (total Lines 9 & 10) .................................................................. . 11. 32 , 893.47 12. Net Value of Estate (Line 8 minus Line 11) ........................................................ . 12. 85 , 161.19 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. $ 5 , 161.19 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. 0 . 0 0 16. Amount of Line 14 taxable $5 161.19 at lineal rate X .045 ~ 16. 3 , 832 .25 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0, 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due ................................................................................................................. . 19. 3 , 832.25 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Monismith, Harry F. Sr. STREET ADDRESS 1515 Longs Gap Road File Number 21-12-0068 CITY STATE ZIP Carlisle PA ~ 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 3,832.25 2. Credits/Payments A. Prior Payments 4,500.00 B. Discount 191.61 Total Credits (A + B) (2) 4,691.61 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 859.36 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) 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; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ O 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?....... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ^ ^x 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)]. . 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. Rev-1502 EX+(~f•08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Monismith, Harry F. Sr. FILE NUMBER 21-12-0068 ESTATE OF 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 1 Real estate located at 1515 Longs Gap Road, Carlisle, Cumberland County, PA - at proceeds 89,000.00 of sale (See HUD-1 attached) TOTAL (Also enter on Line 1, Recapitulation) I 89,000.00 (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) Rev1508 EX« (6.98) COMMONWEALTH CF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Monismith, Harry F. Sr. Include the proceeds of litigation and the date the proceeds were received by fhe estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. FILE NUMBER 21-12-0068 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Members 1st Federal Credit Union, Checking Account No. 279197-11 1,443.55 2 Members 1st Federal Credit Union, Savings Account No. 279197-00 21,316.69 Accrued interest on Item 2 through date of death 4 28 3 1990 Pontiac Sedan -VIN 1G2NE54D3L212853 325.00 4 Coal 300.00 5 Coins - at proceeds of sale (See attached) 294.00 6 Household Goods - at proceeds of sale (See attached) 4,587.00 7 Capital Blue Cross -refund of unused premium 626.07 8 Centurytel, Inc. -refund 9 78 9 Comcast -refund 74 29 10 State Farm Insurance Company -refund cancelation of automobile insurance 66.00 11 U.S. Treasury -refund 8.00 TOTAL (Also enter on Line 5, Recapitulation) I 29,054.66 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, lnc. Form PA-1500 Schedule E (Rev. 6-98) REV•1151 EX+110-06) '~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEGENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Monismith, Harry F. Sr. 21-12 0068 Debts of decedent must be reported on Schedule 1. ITEM N R DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,461.66 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(sl Commission paid 2. Attorney's Fees Salzmann Hughes, P.C. 6,470.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 269.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 20,338.93 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 32,540.09 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 Monismith, Harry F, Sr. 21-12-0068 ITEM NUMBER DESCRIPTION Funeral Ex en nses 1 Ewing Brothers Funeral Home, Inc. -funeral services 2 Georges' Flowers -funeral flowers AMOUNT 5,142.60 319.06 H-A 5,461.66 Other Administrative Costs 3 ERA-NRT, LLC -commission paid to sell real estate in order to administer the estate 5,535.00 4 Kevin Wickard, Auctioneer -reimbursement for advertisement and commission paid for sale 1,395.65 of household goods 5 PPL Electric Utilities -electric service 11.95 6 PPL Electric Utilities -electric service 10.23 7 PPL Electric Utilities -electric service 12.12 8 PPL Electric Utilities -electric service 11.71 9 PPL Electric Utilities -electric service 13.13 10 PPL Electric Utilities -final electric service 21 87 11 Register of Deeds - 1% realty transfer tax paid to sell real estate in order to administer the 890.00 estate 12 Register of Wills -filing fees 30.00 13 Robert Kovanic -reimbursement for stones to fill in the holes on the drive way to sell real 180.18 estate in order to administer the estate Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Monismith, Har F. Sr. 21-12-0068 ITEM NUMBER DESCRIPTION AMOUNT 14 Salzmann Hughes, P.C. -reimbursement for payment to Cumberland Law Journal for legal 75.00 advertising 15 Salzmann Hughes, P.C. -Attorney's fees closing costs and final fees for income tax 850.00 preparation, postage and miscellaneous contingencies in order to administer the estate 16 Swenson's Fuels, Inc. -propane delivery 78.03 17 Swenson's Fuels, Inc. -propane delivery 283 22 18 Swenson's Fuels, Inc. -propane delivery 216.75 19 Swenson's Fuels, Inc. -propane delivery 63.58 20 The Sentinel -Legal advertising 210.78 21 Todd D. Heister -seller assistance paid to sell real estate in order to administer the estate 4,000.00 22 Wes's -install furnace to sell real estate in order to administer the estate 5,000.00 23 William Heister -remove and replace chimney to sell real estate in order to administer the 1,400.00 estate 24 York Waste Disposal #611 -refuse service from 411112 to 6/30112 49.73 H-B7 20,338.93 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 CF?ENNSVLVANIA INHERITANCE TAX RETURN RESICENT DECEDENT ESTATE OF FILE NUMBER Monismith, Har F. Sr. 21-12-0068 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Allied Waste Service -refuse service 49.73 2 Century Link -phone service 42.05 3 Comcast -check written prior to death clearing after death , 74.29 4 Department of Veterans Affairs -balance due on account for RX prescription 8.00 5 PPL Electric Utilities -electric service 59.90 6 PPL Electric Utilities -check written prior to death, clearing after death 63.41 7 Veterans Affairs -balance due for medical care 56.00 TOTAL (Also enter on Line 10, Recapitulation) I 353.38 (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 EXt (11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Monismith, Har F. Sr. 21-12-0068 NUMBER NAME AND ADDRESS OF PERSON(Sl RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE Oo Not ist Trustees (Words) g$$ ( ) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a) 1.2 1 Harry F. Monismith, Jr. Son 1/5th Residue 17 032 24 257 S. West Street , . Carlisle, PA 17013 2 Bonita Wise Daughter 1/5th Residue 17 032 24 9 Channel Drive , . Carlisle, PA 17013 3 Dixie Heister Daughter 1/5th Residue 17 032.24 1 Penny Lane , Carlisle, PA 17013 4 Vickie Boyles Daughter 1/5th Residue 17 032.24 391 Petersburg Road , Carlisle, PA 17015 5 Brenda Kovanic Daughter 1/5th Residue 17 032.23 524 Springfield Road , Shippensburg, PA 17257 II. I ~ Total Enter dollar amounts for distributions shown__above on lines 15 through 18 on Rev 1500 cover sheet as appropi NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 85,161.19 ate. 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) LAST WILL AND TESTA-IV~EN~' I, HARRY' F. 1~IO~iIS~I1TH SR., of forth Middleton Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last ~~'ill and Testament, hereby revoking all ~~'ills and Codicils heretofore made by me. O~1E. I direct my Executor or Executrix, as the case may be, to pay all of my ~_ debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, ~. I direct that all state, inheritance, succession and other death taxes imposed or payable by reason ~~~ of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid t by the Executor or Executrix of my estate. Further, to the extent that sufficient assets exist in my ~ estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable benel"iciaries, shall be paid by my Executor or Executrix from the residuary' of my estate. TWO. My Executor or Executrix may, at his or her discretion, compromise claims, borrow money, retain property for such length of time as he or she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he or she may _ deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or saps and to ~~ive good and sufficient deeds and/or bills of sale therefor, in foe simple, as I could do if living. ~Iy Executor or Executrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor or Executrix. THREE. I give, devise and bequeath all of my estate of ~vhate~er nature and wherever situate to my children, HARRY F. i~IONIS~tITH JR., BO~iITA i~1. WISE, DIXIE L. HEISTER, VIC[tIE E. BO~'LES and BRENDA h. KOVAvIC, per stirpes, which provides that the child or children of any deceased beneficiary shall take the share their parent would have taken if living. FOUR. If, under any of the provisions of this Will, any principal becomes vested in a minor, my Executor or Executrix, as the case may be, inciuding any administrator e.t.a., snail have the discretion either to pay over such principal or any part thereof to any parent of such minor, any guardian of the person or estate of such minor, or any person with whom such minor resides, or to retain the same as trustee of a power in trust for the benefit of such minor during his or her minority. Any of the principal thus retained, and any of the income therefrom, including the whole thereof, may be paid to or applied for the benefit of such minor from time to time in the discretion of the trustee of such power. When such minor reaches majority, the funds so held shall be paid over to such person, or, if he or she shall sooner die, to his or her legal representatives. In so holding any principal or income for any minor, the trustee of such power shall have all the rights, powers, duties and discretions conferred or imposed upon my fiduciaries acting under this Will. I further direct that no bond shall be required from any person receiving a payment hereunder and receipt from such person shall be a full discharge to the trustee of such power who shall not be bound to see to the application or use of such payment. The trustee of such power shall be entitled to commissions at the rates and in the manner payable to a testamentary trustee. FIVE. I hereby nominate and appoint BONI'I'A I~1. ~l'ISE and VICKIE E. BOYLES, or the survivor of the two of them, to be the Co-Executrices of this my Last Will and Testament. hl the event both of them have predeceased me, failed to qualify, or are not able or ~7 ~~ does not serve for whatever reason. [then appoint BREND.-~ h. KOV\tiIC, to serve as substitute Executrix of this my Last ~~~ill and Testament, ~vherebv the said substitute personal representati~~es shall have the same powers as are given to the original Co-Executrices hereunder. SIt. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SEVEN. No Executrix, Executor or Guardian acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. EIGHT. No beneficiary may assign, anticipate or pledge his or her interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. NINE. If any person or institution entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such person or institution shall forfeit his, her or its entire interest inherited hereunder and all provisions in favor of such person or institution shall be declared void and of no effect. The share of such person or institution so forfeited shall be distributed as part of the residue pursuant to Paragraph Three hereof except that if such person or institution is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary distributees. ~~ ~~ `~ ~~ IN WITNESS w'HEREOF, I have hereunto set my' hand and seal this 11 ``' day of ti1a`~, 2006. s~, HAR&' F. ~IO~~'IS:bIITH SR. Signed, sealed, published and declared by the above-named person as and for a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. 4 ACKNOWLEDGMENT AND AFFIDAVIT W'E, HARRY F. i~10NISi`IITH SR., JAMES D. HliGHES, and JENNIFER ~I. NEGLEI', the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last `Vill, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ C `~,~-~,.~ it ~~~r~,.tiwc~1;~`'~ ~~ HARRY' .~-I-@~`IS~IITH SR. JA~IES,D. HUGHES i / ~~ ,,, , , . '~~,1 '~' ~ NNIF ~ R l~I. NEGL COivIN10N~VEALTH OF PENNSYLVANIA . SS: COUNTY OF CLI~IBERLAND Subscribed, sworn to and acknowledged before me by HARRY F. IvIONIS~IITH SR., the testator herein, and subscribed and swo n to before me by J 1v1ES D. HUGHES and JENNIFER 1~1. NEGLEh', witnesses, this ~ day ^f ~1ay,~2006.~ ~ COt~1".iOt•14VEAt_T~-! OF PENNSYLVANIAI Notarial Seal ~~ Public Jacqueline L. Drawbaug . Carlisle Bono, Cum ~ ~~n~ My Commission. Ex~ 14, 2607 Member. Fer.rsyivaria 45.'x::~5rn C~f Netares ,~~ OMB Approval No. 2502-0265 ~~,- ~((~n~~~ A. Settlement Statement (HUD-1) .- . .. 1. X^ FHA 2. ^ RHS 3. ^Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4. ^ VA 5. ^Conv. Ins. 2012-137 /124976007 446-1273555-703 C. Note: This farm is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents 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 & Address of Borrower:. E. Name & Address of Seller: F. Name 8 Address of Lender: Todd D. Heisler The Estate of Harry F. Monismith ERA Home Loans 102 Shaffer Road, Canisle, PA 1 1013 1 Mortgage Way, MOUNT LAUREL, NJ 08054 G. Property Location: H. Settlement Agent: I. Settlement Date: 07/06/2012 1515 Longs Gap Road PA Real Estate Settlement Services, LLC Disbursement Date: 07/06/2012 Carlisle, PA 17013 354 Alexander Spring Road, Carlisle, PA 17015 North Middleton Township Telephone: 717-249-6333 Fax:717-249-7334 Place of Settlement: TitleExpress 354 Alexander Spring Road, Carlisle, PA 17015 Printed 07/09/2012 at 4:41 pm by KSC :. 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contrac( sales price 89.000.00 401. Contract sales price ao nnn nn 102. Personal property 103. Settlement Charges to borrower (line 104. 105. AOjustments for items paid by seller in advance 106. Cilyltown taxes to 107. County taxes 0110 612 0 1 2 to 12!31/2012 108. Assessments 07!06/2012 !0 0613012013 109. 110. 111. 112. 120• Gross Amount Due from Borrower 200. Amounts Paid by or in Behalf of Borrower 201. Deposit or earnest money 202. Principal amount of new loan(s) 203. Existinq loan(s) taken subiecl to 205. 206. 207. Seller Assistance Ad•ustments for items un aid by seller 210. City/town taxes to 211. County taxes to 212. Assessments to 213. 214. 215. 216. 217. 218. 219. 220• Total Paid h Ifor Borrower 300. Cash at Settlement fromlto Borrower 301. Gross amount due from borrower (line 120) 302. Less amounts paid by/for borrower (line 220) 303. Cash ^X From ^ To Borrower a--i~ r ~-ar-s~a Ift,e /orT u I 1 Crapleya a nlly valid OM9 1 I mMr. No wnfiEs eeltlemenl procea9. 402. Personal 6,326.75 403. 404. Ad'ustments for items paid b seller in advance 406, City/town taxes to 203.75 407. Coun(ytaxes 07/06/2012 to 12/3112012 1,494.87 408. Assessments 07/06/2012 to 06/30/2013 409. 410. 411. 412. 97,025.37 420. Gross Amount Due to Seller 500. Reductions In Amount Due to Seller 500.00 501. Excess deposit (see instructions) 87,387.00 502. Settlement charges to seller (line 1400) 503. Existinq IoaMs) taken subiecl to 203.75 1,494,87 90,698.62 7,940.63 ~ 504. Payoff of first mortgage loan 505. Payoff of second mortgage loan 506. 4,000.00 507. Seller Assistance 4,000.00 509. Ad'ustments for items un aid b seller 510. City/town Coxes to 511. County taxes to 512. Assessments to 513. 514. 515. 516. 517. 519. 91,887.00 520. Total Reduction Amount Due Seller 600. Cash at Settlement tolfrom Seller 97,025.37 801. Gross amount due to seller (line 420) 91,887.00 602. Less reductions in amount due seller (line 520) 5,138.37 603. Cash ^X To ^ From Seller as ~e~ reap~^ee pr ~ y~e . a a . .a.n ^,ma re ^~ la a ed, ih,e Eiagosure is maraalory Tl,ia a Eeagned to pmvitle iM pari as toe ESPA ccvereC Vanaecti n vnl~ Informal 11,940.63 90,698.62 11,940.63 78,757.99 700. Total ReaLEstate Broker Fees $'5,535.00 Peid'-'From Paid From' Division of commission line 700 as follows.. Borrower's . `~. Seller's 701. 55,535.00 to ERA-NRT, LLC Funds at ~ Fu~nd~.at, ` 702. $0.00 to `Settlement ; , :Settlemernt i 703. Commission pall at settlement 5 55.00 8.00. Items Pa .atile,iri Connection:with'I:oan' 801. Our origination charge (Includes Origination Point 0.000% or $0.00) $710.00 (from GFE #1) 802. Your credit or charge (points) for the specific interest rate chosen $-900.00 (from G"rE #2) 803. Your adjusted origination charges (from GFE A) -190.00 804. Appraisal fee to Stars (from GFE #3) 465.00 805. Credit report to CBC Innovis (from GFE #3) 6.20 806. Tax service to (from GFE #3) 807, Flood certification to from GFE #3 808. Scoring Fee to FNMA (from GFE #3) 15.95 900.,:'ItemsrRe• cared li'~Lentlerto.'be,Paid,iri:Advance,.:~ ' - v -,~_;; _ s '(;;p • ~ °_= 901. Daily interest charges from from 07/06/2012 to 08/01/2012 @ $9.7400Iday (from GFE #10) 253.24 _ 902. Mortgage insurance premium for months fo De artment of HUD (from GFE #3) 1,502.99 903. Homeowner's insurance for ears to Allstate (from GFE #11) 1,386.59 904. months to from GFE #11 1'000.:'Reserves.De osited with'Lender - °-* ".; 1, 1001. Initial deposit for your escrow account (from GFE #9) 590.33 1002. Homeowner's insurance 3 months $ 115.55/month $346.65 1003. Mortgage insurance months $ 88.76/month $ 1004. Pro ert taxes months $ /month 1005. County taxes 6 months $ 34.72/month $208.32 1006. Assessments 2 months $ 144.89/month $289.78 1007. Aggregate Adjustment $-254.42 1100: Title Char es:' "- ~ . ,. .:. ,.. , ;: _ x ~~ r _. ~- 1101 Title services and lender's title insurance c q from GFE # 1 155 50 1102. Settlement or closing lee to $ 1103. Owner's title insurance w e ea E tote from GFE #5 89.45 1104. Lender's title insurance Stewart Title PA Real Es. $1,059.00 1105. Lender's title policy limit $87,387.00 Lender's Policy 1106. Owner's title policy limit $89,000.00 Owner's Policy 1107, Agent's portion of the total title insurance premium $934.93 1108. Underwriter's portion of the total title insurance premium $213.52 1109. Attorney Fees (POC) -SELLER to <7200:' Government Record'in and.:T.ransferCFier es - '; ` ~ ;. 1201. Government recording charges $ (from GFE #7) 142.00 1202. Deed $62.00 Mort a e $80.00 Release $ 1203. Transfer taxes $ (from GFE #8) 890.00 1204. CitylCounty tax/stamps Deed $890.00 Mart a e $ 1205. State Taxlstamps Deed $890.00 Mart a e $ 890.00 1206. Deed $ Mort a e $ 1300:: Additional Settlement Char es ' - - , 1301. R wired services that ou can sho for eq y p (from GFE #6) 19.50 1302. 2012-13 School Taxes to Robin Sollenber er, Tax Collector 1,515,63 1303. Tax Service Fee to Stars $ $85.00 P.O.C. L' 1304. Flood Certification to Stars $19.50 1305. to '' r r r 6,326.75 7,940.63 'Paid outside of closing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bro(K)er. "Credit by lender shown on page 1."'Credit by seller shown on page 1. 710.00 710.00 -900.00 -900.00 -190.00 -190.00 1,790.00 890.00 G A.drF,ait ;ima~ y 279.00 ~'` ..,.1~. 14200 465.00 465.00 6.20 6.20 15.95 15.95 1,502.99 1,502.99 19.50 19.50 2,288.64 2,151.64 $ -137.00 or -5.9861% P+"~,'~GoQd',F itle ~"~~~`_ ~~ 4:~HUD 1 362.14 590.33 253.24 253.24 282.84 1,386.59 365.00 1,155.50 858.75 89.45 Loan Terms $87,387.00 30. years 4.0800°% $510.00 includes Q Principal Q Interest Q Mortgage Insurance Q No. ^ Yes, it can rise to a maximum of will be on 1 I and can change again every date, your interest rate can increase or decrease by interest rate is guaranteed to never be lower than %. The first change years after / / .Every change %. Over the life of the loan, your or higherthan %. No. ^ Yes, it can rise to a maximum of $ Q No ^ Yes, the first increase can be on / I and the monthly amount owed can rise to $ The maximum it can ever rise to is $ 0 No. ^ Yes, your maximum prepayment penalty is $ Q No. ^ Yes, you have a balloon payment of $ due in _,_,.,, years on / / Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your fender. HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by mein this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Todd D. Heisler ~~~~ I T Estate of Harry F. Monismith ~ ~~ The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. `~~ ~~ ~,~_ Cam" _ ~ ~ ~ Z- SET CEMENT AGENT DATE WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 100t AND SECTION 1010. 'ftemizatien of Lines 1101', 1103 and 1104 Name of Borrower: Name of Seller: File Number Todd D. Heister The Estate of Harry F. Monismith 2012-137 TitleExpress Prepared 07/06/2012 at 1:41 pm ~ Note: This page is furnished to give you an itemization of the amounts shown on W~ Lines 1101, 1103 and 1104 of the Settlement Statement (HUD-1 ). This page I~ accompanies but is not a part of the settlement statement. If a discrepancy exists, the information shown on the Settlement Statement (HUD-1) applies. 1101. Title services and lender's title insurance 1,155.50 a. Overnight Mail $ 20.50 b. Wire Fee 12.00 ~ c. Processin Fee 49.00 d. Notary Fee 15.00 $ 96.50 1102. Settlement or closing fee 1103. Owner's title insurance (policy} $ 89.45 89.45 1104. Lender's title insurance (policy) 834.00 $ 1,059.00 a. Endorsement 900 EPL-Residential 50.00 b. Endorsement 100 (No Violation) 50.00 c. Endorsement 300 Survey 50.00 d. Closing Service Letter 75.00 (Total 1103 + 1104) 1109. 1110. 1111. 1112. THE ES TE OF HARRY F. MONISMITH r ~' By Date 716!12 ~~ ~ /ate 7;6112 Todd D. Heister Additional Information for Line 1101 Items MEMBERS ls` FEDER:IL CREDIT L'YION SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Accrued Interest from 1/1/11 to Date of Death Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Accrued Interest from 1/1/11 to Date of Death Name of Joint Owner 279197-00 01131 /2006 $21,316.69 $4.28 $21,320.97 $57.44 None 279197-11 01/31 /2006 $1,443.55 $0.00 $1,443.55 $.83 None MEMBERS 1ST FEDERAL CREDIT UNION ~,~,t ' W' ""- ~~ Le~~h-P(nne Stallin s 9 9 Lending Insurance Support Specialist January 31, 2012 Estate of: Harry F. Monismith Date of Death: 12/30/2011 Social Security Number: 174-05-2375 cnnn r ,.,,:..e r~.-;,,,~ P(~. Rc~s 40 l~fechanicsburg, Pennsyl~-ania 17053 (800) 283-2328 u~~w:memberslst.org 3R Arecious Metals / Marjorie's Gems 21 West Pomfret Street, Carlisle, PA 17013 (717)816-4767 or (717)329-7917 or (717)701-8148 (shop Name ~2~; ~/, ~~ l ~ l ~~5e~ Address Date ~- u ~ I City/State 1 ~L:~, l.~_ ~,~~ <•~ ~~ , j- ~i7~~%. S~rj~ ~~i DR Lic# -~ ~_ ~_ s f- --~- ~-_- •7u . ~~- ~- -~ Price -^~"r"---> "~ iy ~` LAG-1r- <7 ' ~~ t ~' ~~ _~/O /S . o!o ~ .17 r' ~?~, ~' ~~ _~O- ~ ~ zs`'~ . 7 _3 t ~ '3 ~.., _-, ,, -'~.•1~.,'.~~~ ~i~ ~,.- -• -e ,r J Total Purchase of Sale Cash or C~ ~ ~ ZZ~ I certify that I am the legal owner of the above materials or have been author d t act on behalf of the legal owner and I am at least 18 years old. ~. Signature ~~~ ~~ ~~~~~ ~ Ci rl~ ~=. SETTLEMENT .~ NAME ~ J 5 I ~~ DRESS ~ATION OF SALE CTIONEER I ~ ~- ~ `~ r-~-~ S i ii ~ i iii r_ ~~`~ ~ ~ ~ DATE OF SALE ~~ ~ ~{ r ~ ~ ~ <~ ~ / ~'~ ~ C k c~. ~ ~~- SELLER'S EXPENSES PHONE zIP ~ ~~ ~' ~--~ PHONE ~ ~ ~ _! ~ ~ _ .5 RECEIPTS y' r, _ ,UCTIONEER $_ ~ t~ . l1 ~ CASH ~ _ $~ ~, U/ LERK ` ~ !C1 $ CHECKS $~~~-~~ 15 ASHIER $ OTHER RECEIPTS OTHER EXPENSES $ $ $ (~ $ $ $ $ $ $ $ TOTAL RECEIPTS $ ~ ~~~~ ~ ~'~ $ LESS TOTAL EXPENSES $ ~ ~ -~ /' ~ < ~~' TOTAL EXPENSES $ ~ 1 ~ ~ ~~ NET PROCEEDS PAYABLE TO SELLER $ 3 1 ~ C, J ^ ~Ct ~ ~ C_. ~l t~ C ~° C ~ CL` I ~' T D'. ('~ ~' v' ~ n M . I~t i ~ k ~c r~ I (or we), the seller, accept this settlement and acknowledge receipt of the above specified net proceeds from the auction of my goods and property sold on the above date. I accept all responsibility for providing merchantable title to all goods, and property sold, and for delivery of title to the purchaser. ~ ' ~ ~J ~ - Date - <,s, , irtL~. ~ ~ Auctioneer or Cashier's Signature `f (Seller's Signati~ . s 1 7 ° t: ~' ! ~ Date (Seller's Signature) Date L~,,~r~<