HomeMy WebLinkAbout09-20-12
1505610105
REY-1500 °`t~-ss'~`'
PA Department of Revenue P~~~ ~~~ uSE ONLY
Bureau of Individual Taxes °°""'"`"'° """~` County Code Year File Nunbe~r ~
PO BOxz8otioi INHERITANCE TAX RETURN ~ ~~ C~-,C.l~
Harrisburg, PA 178-o6oi RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
03/16/2012 08/31/1921
Decedent's Last Name Suffix Decedent's First Name MI
Fought viola A
(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
O1D 1. Original Retum O 2. Supplemental Retum O 3. Remainder Retum (Date of Death
Prior to 12-13.82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required
death after 12-122)
QD 6. Decedent Oied Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposk Boxes
(Attach Copy of III) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Ebction to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS BECTION MUST BE COMPLETED. ALL CORRE8PONDENCE AND CONFIDENTIAL TAX INFORMATION 8NOULD BE DIRECTED TO:
Name Daytime Telephone Number
Marlin L. Fought (717) 432-2594 ru
First Line of Address
198 Chain Saw Road
Second Line of Address
City or Post Office
Dilisburg
State ZIP Code
PA 17019
~2
REGISTER OF USE ONLY
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DATE FILED
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Correspondents e-mail address: fought198~comCeBt.net
Under penaMes of perjury, 1 dedare that I have examined this return, inducting acoornpanying schedules and staiemerrts, and ro the best of my krawledge and belief,
h is true. correct and complete. Decieretron of preparer other than the personal repreaerrtaUve is based on all infonnatlon of which
preparer hes any krgwledge.
SIGNATURE OF PERSON J2ES~QIOSIBLE FOR FILING RETURN DATE
ADDRESS
198 Chain Saw Road Isburg, PA 17019
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLt;~E UsE ORIGINAL FORM ONL7
Side 1
1505610105 1505610105 J
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1505610205
REV-1500 EX (FI)
Decedent's Soaal Security Number
Decede~es Nana: Viola A. Fought
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1. 149,000.00
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D) ........................... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5.
6. Jointty Owned Property (Schedule F) O Separate Bluing Requested ....... 6. 13,807.86
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 162,807.86
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 25,335.73
10. Debts of Decedent, Mortgage Liabilities and liens (Schedule I) ............... 10.
11. Total Deductions (total Lines 9 and 10) ................................. 11. 25,$$5.73
12. Nst Value of Estate (Line 8 minus Line 11) .............................. 12. 137,472.13
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. 137,472.13
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_ 15.
16. Amount of Line 14 taxable
at lineal rate x .0 ~5 137,472.13 18,
17. Amount of Line 14 taxable
at sibling rate X .12 17,
18. Amount of Line 14 taxable
at cdlateral rate X .15 18.
19. TAX DUE ..................................................... .... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1505610205
Side 2
1505610205
6,186.25
6,186.25
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
FIN Number
EDENTS NAME
Viola A. Fought
STREETADDRESS --- -- - - - -
Was living at Chapel Point at Carlisle Retirement Center
770 S. Hanover Street
CITY -- ~ STATE - - ----', ZIP -- -
Carfisle i PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments 10,500.00
B. Discount
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 6,188.25
Total Credits (A + B } (2) 10, 500.00
(3)
(4) 4,313.75
(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 incorr~ ............................................ ^
c. retain a reversionary interest .............................................................................................................................. ^
d. receive the promise for life of either payments, benefds or care? ...................................................................... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer propeAy within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an "in trust for" orpayable-upon~ieath bank account or security at his or her death? .............. ^
4. Did decedent own an individual retirement acwunt, annuity or other non-probate property, which
contains a beneficiary desi9natan? ........................................................................................................................ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
For da#es 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 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 benefclary.
For dates of death on or attar 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
adoptnre 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 beneticlaries is 4.5 percent, except as noted in [/2 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to a 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+ (11-OS)
pennsyivania SCHEDULE A
DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE 7AX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Viola A. Fought 21-12-0350
AN real property owned solely or as a tenant in common moat 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 wiling seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Rai property that hl ioindy-owned with right of survivorship must be dlackaed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
3 Bedroom Ranch House 502 S. Norway St. Mechanicsburg, PA 17055 ~ 149,000.00
TOTAL (Also enter on Line 1, Recapitulation.) ~ ~ 149,000.00
If more space is needed, insert additional sheets of the same size.
REV-i5og EX+ (oi-io)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEp1~LE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
Viola A. Fought 21-12-0350
If an asset became jointly owned within one year of the dtoedent's date of death, it must be reported on Schedule G.
SURVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A• Nancy E. Whittaker
200 Chain Saw Road
Dillsburg, PA 17019
Daughter
B.
C.
70INTLY OWNED PROPERTY:
TTEM
NUMBER UTTER
FDR MINI
TENMR DATE
MADE
MINI DESCRIPITON OF PROPERTY
INCLUDE NAME ~ FlNM!(]AL INSTITUTION MID BANK ACCOUNT NUMBER OR SIMILAR
IDENTIMNG NUMBER. ATTACH DEED Fqt MBVTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % of
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S BdIHtEST
1. A. ~~~ pNC Bank Checking Account X15070079116 26,612.93 50. 13,306.47
2. A. 04/22/09 PNC Bank Savings Account #5003634626 1,002.78 50. 501.39
TOTAL (Also enter on Line 6, Recapitulation) I $ 13,807.86
If more space is needed, use additional sheets of paper of tfie same size.
REV-1511 EX+ (10-09)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Vola A. Fought 21-12-0350
Ikcedent's debts moat be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B.
1
Complete Bunal Sernce C10
Myers-Buhrig Funeral Home
37 East Main Street Mechanicsburg, PA 17055
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address ------------__
City . - . ----------- -
Year{s) Commission Paid:
State 2IP
2. Attorney Fees:
3. Family Exemption: (!f decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address ._________ __ _
City __------------ - -------....---- State ---- 2IP
Relationship of Claimant to Decedent
4• Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
~• House Sale Closing/SeiUement CostslE~cpenses
$. House repairs and maintenance
s. House utilities
~o. House real estate taxes (net)
TOTAL (Also enter on Line 9, Recapitulation) I $
12,177.00
452.77
10,745.00
1,364.63
250.30
346.03
25.335.73
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EX+ (O1-10)
Pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE BENEFICIARIES
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Viola A. Fought 21-12-0350
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY f~ Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1 • Marlin L. Fought 198 Chain Saw Road Dillsburg, PA 17019 Son 25.0
2. Nancy E. Whittaker 200 Chain Saw Road Dillsburg, PA 17019 Daughter 25.0
3. Richard I. Reynolds 5184 Pond View Drive Jacksonville, FL 32258 Son 25.0
4. Donald E. Reynolds 610 Third Street New Cumberland, PA 17070 Son 25.0
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON L1NE5 15 THROUGH 18 Of 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:
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.
~~Cp. II, LViL II.UCniri ii~v .,, ~
`~
September 11, 2412
11!ixchael Woolums
pNC Banl~
Dillsburg Branch
ltE: viola A rauglrt . .
SSN: 204-03-5985
l7dD: 03/16/2012
Dear Sir>~ladam:
~ responsz to your request for Date of Death (DOD) balances for the customer noted above, our
records show the Following: .
Checking Account
Account ~ 5070079116 Established: 04,22,`2009
'4rlOLA A EOl_IGHT
NA'~1CY' E'V4'1~'1 TAKER
DOD balance: $26,612.$9 + 0.04 accrued interest
Savings A~ccau~nt .
Account # 5003634626 Established: 44/22,'2049
' ~~~rTOLAA(~(y)~"~O~~U~'''~Cr~y~T~yy
lYt~'VI..~YL'i WtI111A~r•1C
DOD balance: $1,002.7$ + 0.00 accrued interest
please note thalt this office protiides date of death balances for deposit accounts (IRAs, CDs, Checking and
Savings). Rye do not process any $nancial transactions ar. provide statements. if you need assistance with
any of these items, please call 1-888-pNGBANK (I.-88$762-2265) or stop by your Ioca] pNC dank biranch
office.
Sincerely,
Nataomall~inancial Services Center
pNC Bank, N.A.
Member FD1C
page 1 of 2
LAST WILL AND TESTAMENT OF VIOLA A. FOUGHT
I, VIOLA A. FOUGHT, of the Borough of Mechanicsburg, County
of Cumberland and State of Pennsylvania, being of sound and dis-
posing mind, memory and understanding, do make, publish and de-
clare this my Last Will and Testament, hereby revoking and making
void any and all prior Wills by me at any tine heretofore r=~~4e.
1.
I direct the payment of all my just debts and funeral expenses
as soon after my decease as the same can conveniently be done.
2.
I give, devise and bequeath all the rest, residue and remainder
of my estate, of whatsoever nature and wheresoever situate, to my
husband, Mervin J. Fought, absolutely and in fee simple.
3 . _:.; ;
In the event my husband should predecease me or should die
within thirty (30) days of the date of my death, I direct that my
entire estate be divided into four equal shares and one share paid
to each of the following: my son, Marlin L. Fought, my son Richard
I. Reynolds, my daughter, Nancy E. Whittaker and my son, Donald
E. Reynolds.
In the event any of th= conti_*~gent ber_efic~~ries predecease
*rle, hiS Cr her Share Shall T10t lapse " -., Sf':s11 gC i_T7.Stead tD ri8 Or
her issue .;
%: .
I nominate , c onstitute and ate--T_zt ~ ?~usb~zad, Mein. ~ . ?= 3:1gh v ,
to be the Executor of this my Last Will and Testament, and in the
event he should predecease me or for any reason be unwilling or
unable to act as such, I nominate, constitute and appoint my son,
Marlin L. Fought, Executor of this my Last Will and Testament,
and in the event my said son is unable or unwilling to serve in
such capacity, then I nominate, constitute and appoint my son,
Richard I. Reynolds,-Executor of this my Last`Will and Testament.
/I~N WITNESS WHEREOF, I have hereunto set my hand and seal this
~' J~~/~ day of August, 1973.
~_, ~ . ~~.
~ ~'i ' ~zc- '~ ( SEAL )
Vio a A. ou "t
Signed, sealed, published and declared by the above named
Viola A. Fought, as and for her Last Will and Testament, in the
presence of us who have subscribed our names hereto as witnesses,
at the request of said testatrix, in her presence and in the
presence of each other.
~.; .
`, .
__
SEi`iLEiv1EN-I J7AitnnEN-i
-; . ~-Lea~o .,,
LIBERTY LAND TRANSFER, INC. % f NI c ~ ~
~"
B. TYPE OF LOAN
4660 Trindle Road, Suite 201
Camp Hill, PA 17011 ~ 1. FHA ~ 2. RHS ~ 3. CONV.UNINS.
~ 4. VA 5. CONY. INS.
Phone:717-975-9915 FAX:717-763-7460 6. FILE NUMBER:
95937 7. LOAN NUMBER:
MORT. INS. CASE NO.:
C. NOTE: This form is furnished to give you a statement of actual settlement coats. Amounts paid to and by the settlement agent ere shown.
Items marked "(p.o.c.)" were paid outside the Dosing; they ere shown here for inforrrtatfon purposes and are not inWuded in the totals.
D. NAME AND ADDRESS OF BORROWER:
R. William Hain
B. Elizabeth Hain E. NAME AND ADDRESS OF SELLER:
Viola A. Fought Estate F. NAME AND ADDRESS OF LENDER
G. PROPERTY LOCATION:
502 Norway Street
Mechanicsburg, PA 17055 H. SETTLEMENT AGENT: Liberty Land Transfer I. SETTLEMENT DATE:
Jun 29 2012
Friday
Mechanicsburg Borough
Cumberland County, PA PLACE OF SETTLEMENT: 1068 Harrisburg Pike
Carlisle, PA 17015
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. Gross Amount Due From Borrower 400. Gross Amount Due to Seller
101. Contract sake price 149,000.00 401. ContreG sales price 149,000.00
102. Personal Properly 402. Personal Property
103. Settlement Charges (line 1400) 2,850.75 403.
104. 404.
105. 405.
Adjustments for items paid in advance by seller(s) Adjustments for items paid in advance by seller(s)
106. Cityfrown tax to 406. Cityfrown tax to
107. County/City tax 6/29/2012 to 12/31/2012 358.15 407. County/City tax 6/29/2012 to 12/31/2012 358.15
108. Assessments to 408. Assessments to
109. School Tax 6/29/2012 to 6/30/2012 4.76 409. SehoolTax 6/29/2012 to 6/30/2012 4.76
110. Sewer 6/298D12 to 6130/2012 0.93 410. Sewer 6/298012 to 6/308012 0.93
111. Trash 6898012 to 6/308012 0.48 411. Trash 6/298012 to 6/308012 0.48
112. to 412. to
120. Gross Amount Due from Borrower 152,215.07 420. Gross Amount Due to Seller 149,364.32
00. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller
201. Deposit or earnest money 5,000.00 501. Excess deposit (see instructions)
02. Principal Amount of new loan(s) 502. Settlement charges to seller (line 1400) 22,215.00
03. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
04. 504. Payoff of First Mortgage Loan
O5. 505. Payoff of Second Mortgage Loan
O6. 506.
07. 507.
08. 508.
09. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
10. Citylrowntax to 510. City/Towntax to
11. County/City tax to 511. County/City tax to
12. Assessments to 512. Assessments to
13. School Tax to 513. School Tax to
214. to 514. to
15. to 515. to
216. to 576. to
17. 517.
18. 518.
19. 519.
220. Total Paid by/for Borrower 5,000.00 520. Total Reduction in Amount Due Seller 22,215.00
300. CASH AT SETTLEMENT From/To BORROWER 600. CASH AT SETTLEMENT TolFrom SELLER
301. Gross amount due from borrower (line 120) 152,215.07 601. Gross Amount due Seller (line 420) 149,364.32
302. Less amounts paid by/for borrower (line 220) 5,000.00 602. Less reduction in amt. due seller (line- 520) 22,215.00
i
303. Cash ®FROM ^ TO Borrower
147,215.07
603. Cash ~j TO ^ FROM Seller
127,149.32
Buyer or Bo is Signature Sellers Signature
HUD-1
i L. st I o LcfsREiJ'i CHARGES Case ii 9li9:f7
700. Total Reai Estate Broker Fees $ 9,330.00 Paid From Paid From
Division of commission (line 700) as follows: Borrower's Seller's
701. 8,212.50 to ERA NRT, LLC funds At Funds At
702. 1,117.50 to Keller Williams Settlement Settlement
703. Commission paid at Settlement 195.00 9,135.00
704. to
800. Items Payable in Connection Wlth Loan
801. Our origination charge (from (GFE #1)
802. Your credit or charge (points) for the interest rate chosen $ (from (GFE #2)
803. Your adjusted origination charges to (from (GFE A) 0.00 0.00
804. Appraisal Fee to (from (GFE #3)
805. Credit Report to (from (GFE #3)
806. Tax Service to (from (GFE #3)
807. Flood certification to (from (GFE #3)
808. to
809. to
810. to
811. to
812. to
813. to
814. to
900. Items Required by Lender to Be Paid in Advance
901. Dairy interest charges from to ~ $ 0.0000 lday (from (GFE #10)
902. Mortgage insurance promiurt for 0 months to (from (GFE #3)
903. HometnvneYS insurance premium fo0 years to (from (GFE #11)
904. to
1000. Reserves Depoalted with Lender
1001. Initial deposR for your escrow acwunt (from (GFE #9) 0.00 0.00
1002. Homeowner's insurance 0 Months ~ $ /Month
1003. Mortgage Insurance 0 Months ~ $ /Month
1004. Property taxes 0 Months ~ $ /Month
1005. 0 Months ~ E /Month
1006. 0 Months ~ $ Mlonth
1007. Aggregate Adjustment -
1100. TIUe Charges
1101. Title services and lendefs tRle insurance (from (GFE #4) 0.00 0.00
1102. Settlement or closing fee to Liberty Land Transfer
1103. Owner's title insurance to Liberty Land Transfer (from (GFE #5) 1,103.75
1104. Lenders title insurance
1105. LendeYS title policy limit $
1106. Owner's title policy limft S 149,000.00
1107. Agent's portion of the total title insurance premium 938.19
1108. Underwriters portion of the total tkle insurance promium 185.56
1109. Tax Cert. to Liberty Land Transfer 10.00
1110. Notary to Hoity Keller 10.00
1111. Deed Prep. to Liberty Land Transfer 100.00
1200. GovemmsM Recording and Transfer Charges
1201. Government recording charges
(from (GFE #7)
62.00
1202. Deed $ 62.00 Mortgage $ Recorder of Deeds
1203. Transfer taxes (from (GFE #8) 1,490.OD
1204. City/County tax/stamps Deed $1,490.00 Mortgage $ Recorder of Deeds
1205. State tax/stamps Deed E 1,490.00 Mortgage $ Recorder of Deeds 1,490.00
1206. to
1300. Additional Settlement Charges
1301. Required services that you can shop for (from (GFE #6) 0.00
1302. to
1303. to
1304. to
1305. to
1306. Inheritance Tax Escrow to Liberty Land Transfer 10,500.00
1307.
ldnn Electrical Repair to Brian Bronneman
Twlsl a~Ml~.~~~ f.t-~~ i--~--~- ~.--_ inn n_~,___ , __~ ~..- .._ _
... .-. 970.00
--- ----~°-°- -••-•_-- ~-..._. _......-- ~--~ _.,...._,.o .. o.,......~, .,o..~.,~~~ ~f 1 z tfou. rb ~ 22 215 DO
Parties agree that no liabildy is assumed by Settlement Agent for the acaracy o1 infortnatlon furnished by others as shown on the HUD-1 Settlement Statement.
HUD CERTIFICATION OF BUYERS AND SELLERS
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
dis/b/ur~s~ements m/ode on my account b/y me In this transaction. I further certify that I hav~eyreyceive~d a copy of UD-1 Settlement Statement.
Buyer or Bor~ Signature Sellers Sgnature
Buyers Address 8 Phone: Sellers New Address 8 Phone:
The HUD-1 ettlement Statement which I have prepared is a We and accurate account of this trensachon. I have caused or will cause the funds to be disbursed in accordance with this
stat¢ment
Settlement A ~o .~ g ~ Cl /~
Date
WARNING: I s a crime to know(ngty make false statements to the Untted States on this or any sim(lar forth. Penalties upon conviction can include a fine and imprisonment. For details
see Trite 1 e: U.S. Code Section 1001 antl Section 1 Dt o.
ESCROW AGREEMENT
RE: CASE #95937
SELLER: Estate of Viola A. Fought
BUYER: R. William Hain & B. Elizabeth Hain
PROPERTY: 502 Norway Street, Mechanicsburg, PA 17055
On this, the day of June 2012, the undersigned
hereby appoint(s) LIBERTY LAND TRANSFER, INC. ("Escrow Agent") as
Escrow Agent and direct Escrow Agent to withhold from the net
proceeds due to Seller at the settlement the sum of $10500.00
Escrow Agent will release funds upon the following conditions:
Upon receipt of the Inheritance Tax Return in the Estate of Viola
A. Fought, listing the subject premises on Schedule A, Escrow
Agent will disburse a check for the tax amount due, payable to
Register of Wills Agent; and
Upon receipt of the acceptance of the Inheritance Tax Return in
the Estate of Viola A. Fought, by the Commonwealth of
Pennsylvania, all remaining funds will be disbursed to Estate of
Viola A. Fought.
It is agreed and understood that the Seller has 180
days from the date hereof to satisfy such conditions. It is
agreed and understood that if the Seller has not produced in hand
to Escrow Agent such satisfaction of conditions, Escrow Agent is
authorized to pay out such amounts as are necessary to satisfy
such conditions without further liability, in Escrow Agents sole
discretion.
Escrow Agent shall hold the monies in escrow, separate and
apart from its own funds, and shall invest the same in a federally
insured Bank. It is hereby agreed and understood that Liberty
Land Transfer, Inc. will pay no interest on funds escrowed. The
Escrow Agent shall not be liable for any mistake of fact or error
of judgment or any acts of omission of any kind unless caused by
.its willful misconduct. or gross negligence. The parties hereto
each release the Escrow Agent from any act done or omitted to be
done by the Escrow Agent in good faith in a performance of its
obligations and duties hereunder.
The undersigned hereby jointly and severally indemnify the
Escrow Agent and hold it harmless against any loss, liability or
expenses incurred without negligence or bad faith, on the part of
the Escrow Agent, arising out of or in connection with the
acceptance of, or the performance of its duties under this
agreement, as well as the costs and expenses of defending against
any claim or liability arising under this Agreement.