HomeMy WebLinkAbout12-17-12 (2)
J
REV-1500 EX (01-10) 1505610140
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number q,(
PO BOX 280601 INHERITANCE TAX RETURN 1
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 2
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 9 7 2 2 6 4 3 9 0 1 0 9 2 0 1 2 0 5 0 3 2 0 2 3
Decedent's Last Name Suffix Decedent's First Name MI
G R I F F I E M A R L I N J
(if Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ❑X 2. Supplemental Return 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime TelephorM--Number
S E T H T M 0 S E B E Y 7=1o7 2 3 M93 4 1
.
nt I$$ERdFijVILL~S9'-`fW NLY
17
First line of address 2-1 C:3 y 'Y rF i
M A R T S 0 N L A W O F F I C E Sj T
Second line of address
1 0 E H I G H S T>
City or Post Office State ZIP Code DATE FILED
C A R L I S L E P A 1 7 0 1 3
Correspondent's e-mail address: SMOSEBEYa9MARTSONLAW • COM
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.
ySIGNA REOF PERS7ESPO IBLE OR FILING RETURN DATE
ADDRESS
89 BALL PARK ROAD GARDNERS PA 17324
SIGNA WREP~~ROT REPRESENTATIVE DATE
2
ADD S
10 E HIGH STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140 J V
1505610240
REV-1500 EX Decedent's Social Security Number
Decedent's Name: MARLIN J- G R I F F I E 1 9 7 2 2 6 4 3 9
RECAPITULATION
110000.00
1. Real Estate (Schedule A) 1
2. Stocks and Bonds (Schedule B) 2. 0 ' 0 0
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. 2 6 5 2 . 3 1
6. Jointly Owned Property (Schedule F) ❑ Separate Billing Requested 6. 0 • 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested 7. 0 . 0 0
8. Total Gross Assets (total Lines 1 through 7) 8. 1 1 2 6 5 2 . 3 1
9. Funeral Expenses and Administrative Costs (Schedule H) 9• 4 4 2 7 9 . 2 5
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) 10.
11. Total Deductions (total Lines 9 and 10) 11. 4 4 2 7 9 . 2 5
12. Net Value of Estate (Line 8 minus Line 11) 12. 6 8 3 7 3 . 0 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) 13. 0 . 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) 14. 6 8 3 7 3 . 0 6
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 _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 0. 0 0 16. 0. 0 0
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 6 8 3 7 3. 0 6 18. 1 0 2 5 5. 9 6
19. TAX DUE ......................................................19. 1 0 2 5 5. 9 6
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
1505610240 1505610240
REV-1 500 EX Page 3 File Number
Decedent's Complete Address: 21 12 0439
DECEDENT'S NAME
MARLIN J. GRIFFIE
STREET ADDRESS
604 Pine Road
CITY STATE ZIP
Carlisle ' PA __T17015
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 10,255.96
2. Credits/Payments
A. Prior Payments 6,834.12
B. Discount
Total Credits (A + B) (2) 6,834.12
3. Interest
(3)
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. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,421.84
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; ❑ x❑
b. retain the right to designate who shall use the property transferred or its income; ❑ x❑
c. retain a reversionary interest; or ❑ 0
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? ❑ ❑
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? El 0
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 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
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 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, undE
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 SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARLIN J. GRIFFIE 21 12 0439
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 that 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.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. "Real Estate located @ 604 Pine Rd., Dickinson Twp., Cumberland Co., PA, known as Tax 110,000.00
Parcel No. 08-30-2638-015, being described in Deed dated 4/12/59 & recorded in Cumberland Co
PA, Deed Bk "A", Vol 19, Pg 589,& being conveyed to Marlin J. Griffie & Deloris J. Grime, his
wife. Dorloris J. Griffie died on 8/15/2006 leaving title soley vested in Marlin J. Griffie.
2. "Real estate located at 602 Pine Rd., Dickinson Twp., Cumberland Co, PA, known as Tax Parcel
No. 08-30-2638-016, being described in Deed dated 5/27/1975, & recorded in Cumberland
Co., Deed Bk. "C", Vol 26, Pg 214, & being conveyed to Marlin J. Griffie & Deloris J. Grime, his
wife. Deloris J. Griffie died on 8/15/2006 leaving title soley vested in Marlin J. Griffie.
"The above properties were sold as one. See attached Settlement Statement
TOTAL (Also enter on Line 1, Recapitulation) $ 110,000.00
If more space is needed, use additional sheets of paper of the same size.
REV-1508,EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
MARLIN J. GRIFFIE 21 12 0439
Include 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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Tax proration 1,685.99
2. Donegal Insurance, refund of homeowner's insurance 376.00
3. Erie Insurance, refund of homeowner's insurance 479.00
4. First Energy, refund 111.32
TOTAL (Also enter on line 5, Recapitulation) $ 2,652.31
(If more space is needed, insert additional sheets of the same size)
REV-1511 £X+ (10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARLIN J. GRIFFIE 21 12 0439
Decedents debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) Diane L. Richwine 3,433.00
Street Address 89 Ball Park Road
City Gardners State PA ZIP 17324
Year(s) Commission Paid: 2013
2. Attorney Fees: Martson Law Offices (estimated) 6,256.00
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5 Accountant Fees:
6. Tax Return Preparer Fees:
7. Stella Richwine, property maintenance, February, March & Apr., pending sale of real estate 750.00
8. Diane Richwine, property maintenance, April through sale of real estae 1,435.00
10. Met-Ed, electric service pending sale of real estate 362.28
H. Century Link, phone service pending sale of real estate 25.33
12. Comcast, final bill 96.23
13. Realty transfer tax, 1% 1,100.00
14. Russell Shughart, Septic repair required for sale of real estate 15,000.00
15. Keller Williams of Central PA East, real estate commission 7,782.00
16. Paul Grothe, landscaping pending sale of real estate 550.00
17. Larry Peters, fee for no sale/real estate at auction 200.00
18. John Rhoades, water heater repair 95.00
19. Erie Insurance, homeowners insurance pending sale of real estate 653.00
TOTAL (Also enter on Line 9, Recapitulation) $ 44,279.25
If more space is needed, use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MARLIN J. GRIFFIE 21 12 0439
Decedent's Name Page 1 File Number
Schedule H - Funeral Expenses & Administrative Costs - B7.
ITEM
NUMBER DESCRIPTION AMOUNT
20. Carolyn McQuillen, school real estate taxes 2,526.70
21. Donegal Insurance, homeowners insurance pending sale of real estate 569.00
22. Carolyn McQuillen, county real estate taxes pending sale of real estate 456.73
23. McDannell Oil Service, fuel oil service pending sale of real estate 514.32
24. Amerigas, propane service pending sale of real estate 23.22
25. Jenny Steigleman, kitchen and microwave repair pending sale of real estate 250.00
26. Pecks Septic, perk test, labor, probe and septic system design, pending sale of real estate 1,045.00
27. KIP Technology, probe and perk test pending sale of real estate 500.00
28. Waste Management, trash service pending sale of real estate 43.44
29. Black's Water Conditioning, UV light installation required for sale of real estate 583.00
30. Borough of Carlisle, water quality test pending sale of real estate 20.00
31. Tax Certification 10.00
SUBTOTAL SCHEDULE H-137 6,541.41
REV-1513 EX+ (01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARLIN J. GRIFFIE 21 12 0439
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Diane Richwine Collateral 27,349.22
89 Ball Park Road
Gardners, PA 17324
2. Jason Richwine Collateral 27,349.22
1240 Goodyear Road
Gardners, PA 17324
3. Kimberly Larkin Collateral 13,674.62
31 Meadow Drive
West Warwick, RI
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 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. $ 0.00
If more space is needed, use additional sheets of paper of the same size.
OMB Approval No. 2502-0265
A. Settlement Statement (HUD-1) FINAL
. o
1. X❑ FHA 2. ❑ RHS 3. ❑ Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage insurance Case Number:
2012-192 7126300032
4. ❑ VA 5. ❑ Conv. Ins.
C. Note: This form 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 & Address of Lender:
Matthew A. Snyder The Estate of Marlin J. Griffie PHH Mortgage Corporation
P.O. Box 5954, Springfield, OH 45501
G. Property Location: H. Settlement Agent: I. Settlement Date: 1 V09/2012
602 & 604 Pine Road PA Real Estate Settlement Services, LLC Disbursement Date: 1 V09/2012
Carlisle, PA 17013 354 Alexander Spring Road, Carlisle, PA 17015
Dickinson Township
Telephone: 717-249-6333 Fax: 717-249-7334
Place of Settlement: TitleExpress
354 Alexander Spring Road, Carlisle, PA 17015 Printed 1109/2012 at 9:18 am
by KSC
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 sales price 110,000.00 401. Contract sales price 110,000.00
102. Personal property 402. Personal property
Settlement charges to borrower (line 1400) 7,743.58 403.
104. 404.
105. 405.
Adjustments for items aid b seller in advance Adjustments for items aid b seller in advance
106. Cityftown taxes to 406. City/town taxes to
107. County taxes 1110912012 to 12/3112012 45.77 407. County taxes 1110912012 to 12/3112012 45.77
108. Assessments 11/09/2012 to 06130/2013 1,096.02 408. Assessments 11/09/2012 to 06130/2013 1,096.02
109. County Taxes 1110912012 to 1213112012 20.36 409. County Taxes 11/0912012 to 1213112012 20.36
110. School Taxes 11/09/2012 to 06130/2013 523.84 410. School Taxes 1110912012 to 06/30/2013 523.84
111. 411.
112. 412.
120• Gross Amount Due from Borrower 119,429.57 420. Gross Amount Due to Seller 111,685.99
200. Amounts Paid b or in Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or earnest money 2,000.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) 108,007.00 502. Settlement charges to seller (line 1400) 9,077.00
203. Existing loa s taken subject to 503. Existing loa s taken subject to
204, 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. 506.
207. Seller Assistance 4,950.00 507. Seller Assistance 4,950.00
208. 508. Inheritance Tax Escrow 4,000.00
209. 509.
Adjustments for Items unpaid b seller Adjustments for items unpaid b seller
210. City/town taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. Total Paid by/for Borrower 114,957.00 520. Total Reduction Amount Due Seller 18,027.00
300. Cash at Settlement fromtto Borrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from borrower (line 120) 119,429.57 601, Gross amount due to seller (line 420) 111,685.99
302. Less amounts paid byflor borrower (line 220) 114,957.00 =603.Cash Ldctions in amount due seller (line 520) 18,027.00
301. Cash 0 From ❑ To Borrower 4,472.57 To From Seller 93,658.99
uency may na cn a s m ortne ,an, a, you ere no reewr a
n arena i e Ima a menu es peresponse ur wecap, rev lown. a n
mis loan, unless a isPlaYs • cunenlly -tw OMB'conlrel numon b ner. No canlMenVably Is aswre4 This disdasure Is mandatory. This a deslpned to preside the pelves to a RESPA covered Vansedlwr weh ImanN - dump IM
feVlemenl process.
Previous editions are obsolete Page 1 of 4 HUD-1
Com orison of Good Faith Estimate GF and HUD-1 Charges Good Faith Estimate HUD-1
Charges That Cannot Increase HUD-1 Line Number
Our origination charge # 801 460.00 460.00
Your credit or charge (points) for the specific interest rate chosen # 802 270.02 270.02
Your adjusted' origination charges # 803 730.02 730.02
Transfertaxes' # 1203 2,210.00 1,100.00
Charges That In Total Cannot Increase More Than 10% Good Faith Estimate HUD-1
Government recording charges # 1201 279.00 152.00
Appraisal fee # 804 465.00 465.00
Credit report # 805 6.20 6.20
Lender Inspection Fee # 806- 155.00 155.00
Scoring Fee - # 807 16.75 16.75
Mortgage insurance premium # 902 1,857.63 1,857.63
Flood Certification # 1304 19.50 19.50
2,799.08 2,672.08
Increase between GFE and HUD-11 Charges $ -127.00 or -4.5372%
Charges That Can'Change Good Faith Estimate HUD-1
Initial deposit for your escrow account # 1001 751.00 751.00
Daily interest; charges from # 901 $9.59001da 210.98 210.98
Homeowners Insurance- # 903 568.00 568.00
Title services and lender's I tle insurance _ # 1101 958.75 1,251.50
Owners title insurance ' # 1103 365.00 100.00
#
Loan Terms
Your initial loan amount is $108,007.00
Your loan term is 30. years
Your initial interest rate is 3.2500%
Your initial monthly amount owed for principal, interest, and any mortgage $579.62 includes
insurance is MX Principal
❑X Interest
X❑ Mortgage Insurance
Can your interest rate rise? ❑ No. ❑ Yes, it can rise to a maximum of The first change
will be on I I and can change again every years after 1 I . Every change
date, your interest rate can increase or decrease by Over the life of the loan, your
interest rate is guaranteed to never be lower than % or higher than
Even if you make payments on time, can your loan balance rise? X❑ No. ❑ Yes, it can rise to a maximum of $
Even if you make payments on time, can your monthly amount owed for ❑X No. ❑ Yes, the first increase can be on I I and the monthly
principal, interest, and mortgage insurance rise? amount owed can rise to $
The maximum it can ever rise to is $
Does your loan have aprepayment penalty? ❑ No. ❑ Yes, your maximum prepayment penalty is $
Does your loan have a balloon payment? X❑ No. ❑ Yes, you have a balloon payment of $ due in
years on I I
Total monthly amount owed including escrow account payments ❑ You do not have a monthly escrow payment for items, such as property taxes
and homeowner's insurance. You must pay these items directly yourself.
❑X You have an additional monthly escrow payment of $295.95
that results in a total initial monthly amount owed of $875.57. This includes principal, interest, any
mortgage insurance and any items checked below:
r'J Property taxes Q Homeowner's insurance
❑ Ftoodinsurance ❑
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender.
Previous editions are obsolete Page 3 of 4 HUD-1
L. Settlement Charges
700. Total Real Estate Broker Fees $ 7,782.00 Paid From Paid From
Division of commission line 700 as follows: Borrower's Seller's
701. $4,163.00 to Keller Williams of Central PA East Funds at Funds at
702. $3,619.00 to Century2l A Better Way Settlement Settlement
703, Commission paid at settlement 7,782.00
704. Broker Fee to Century 21 A Better Way 175.00
800. items Pa able in Connection with Loan
801. Our origination charge (Includes Origination Point 0.000% or $0.00) $460.00 (from GFE #1)
802. Your credit or charge (points) for the specific interest rate chosen $270.02 (from GFE #2)
803. Your adjusted origination charges (from GFE A) 730.02
804. Appraisal fee to STARS (from GFE #3) 465.00
805. Credit report to Innovis, Inc. (from GFE #3) 6.20
806. Lender Inspection Fee to STARS (from GFE #3) 155.00
807. Scoring Fee to FNMA (from GFE #3) 16.75
808. to
900. Items Required b Lender to be Paid In Advance
901. Daily interest charges from from 11/0912012 to 12101/2012 @ $9.5900/day (from GFE #10) 210.98
902. Mortgage insurance premium for months to Department of HUD (from GFE #3) 1,857.63
903. Homeowner's insurance for 1 ears to Donegal Mutual Insurance Company (from GFE #11) 568.00
904, months to from GFE #11
1000. Reserves Deposited with Lender
1001. Initial deposit for your escrow account (from GFE #9) 751.00
1002. Homeowner's insurance 3 months @_$ 47.33/month $141.99
1003. Mortgage insurance months $ 109.56/month $
1004. Property months $ /month
1005. County taxes 2 months $ 38.06/month $76.12
1006. School Taxes 6months $ 210.56/month $1,263.36
1007. Aggregate Adjustment $-730.47
1100. Title Charges
1101. Title services and lender's title insurance from GFE #4 1,251.50
1102. Settlement or closing fee to $
1103. Owner's title insurance from GFE #5 100.00
1104. Lender's title insurance $1,170.00
1105. Lender's title policy limit $108,007.00 Lender's Policy
1106. Owner's title policy limit $110,000.00 Owner's Policy
1107. Agent's portion of the total title insurance premium $1,038.25
1108. Underwriter's portion of the total title insurance premium $231.75
1109.
1200. Government Recording and Transfer Cha es
1201. Government recording charges $ (from GFE #7) 152.00
1202. Deed $72.00 Mortgage $80.00 Release $
1203. Transfer taxes $ (from GFE #8) 1,100.00
1204. City/County taxistamps Deed $1,100.00 Mortgage $
1205. State Tax/stamps Deed $1,100.00 Mortgage $ 1,100.00
1206. Deed $ Mortgage $
1300. Additional Settlement Charges
1301. Required services that you can shop for (from GFE #6) 204.50
1302. Tax Certifications to Carolyn McOuillen, Tax Collector 10.00
1303. Tax Service Fee to STARS $ $85.00 P.O.C. L'
1304. Flood Certification to STAS $19.50
1305. Septic Services to Pecks Septic $185,00 185.00
r r , r 7,743.58 9,077.00
'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.
Previous editions are obsolete Page 2 of 4 HUD-1
Signature Page
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 me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement.
Matthew A. Snyder
The Estate of Marlin J. Griffie
Settlement Agent
The HUD-1 Settlement Statement which 1 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.
SETT TAGENT 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 1001 AND SECTION 1010.
Previous editions are obsolete Page 4 of 4 HUD-1
Itemization of Lines 1101, 1103 and 1104
Name of Borrower: Name of Seiler: File Number
Matthew A. Snyder The Estate of Marlin J. Griffie 2012-192
TitleExpress
Prepared 11/09/2012 at 9:19 am
Note: This page is furnished to give you an itemization of the amounts shown on Paid From Paid From
Lines 1101, 1103 and 1104 of the Settlement Statement (HUD-1). This page Borrower's Seller's
accompanies but is not a part of the settlement statement. If a discrepancy Funds at Funds at
exists, the information shown on the Settlement Statement (HUD-1) applies. Settlement Settlement
1100. Title Gharges Amounts Included
in Line 1101
1101. Title services and lender's title insurance 1,251.50
a. Overnight Mail $ 20.50
b. Wire Fee 12.00
c. Processing Fee 49.00
81.50
1102. Settlement or closing fee
1103. Owner's title insurance (policy) $ 100.00 100.00
1104. Lender's title insurance (policy) 945.00 $ 1,170.00
a. Endorsement 900 EPL-Residential 50.00
b. Endorsement 100 No Violation) 50.00
c. Endorsement 300 Surve 50.00
d. Closing Service Letter 75.00
$ QO
(Total 1103 -1104)
1105. Lenders title' policy limit $108,007.00
1106. Owner's title policy limit $110,000.00
1107. Agent's portion of the total title insurance premium $ 1,038.25
1108. Underwriter's portion of the total title insurance rem. 231.75
(Total 1107 +11108),
1109.
1110.
1111.
1112.
Additional Information for Line 1101 Items
Total Borrower Borrower Seller
1100. Title Charges with Payee Charge POC or Credit Line 1101 Paid
1101. Title services and lender's title insurance $
a. Overnight Mail to Salzmann Hughes, P.C. 20.50 20.50
b. Wire Fee to PA Real Estate 12.00 12.00
c. Processing Fee to Salzmann Hughes, P.C. 49.00 49.00
1104. Lender's title insurance to Stewart Title Guaranty/PA RE SS 1,170.00 1,170.00
$ 1,251.50 1,251.50
THE E//S[[►►TATE OF MARLIN J. GRIFFIE
By DJ" yx, ate 11/9/12 Date 1119112
Matthew A. Sn