HomeMy WebLinkAbout02-01-13 (2)ESTATE OF JAMES E. JOHNSTON
FILE NO. 21-11-12$6
FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE
IN THE ESTATE OF JAMES E. JOHNSTON
KNOW ALL MEN BY THESE PRESENTS, that, WHEREAS, James E. Johnston, late of
Cumberland County, Pennsylvania, died testate on November 7, 2011, having first made his last will
and testament duly executed on October 8, 2004;
WHEREAS, the said James E. Johnston, by the aforesaid last will and testament, named Jean
Bartley, Executrix of said last will;
WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the
Register of Wills of Cumberland County, Pennsylvania, to the said Executrix, Jean Bartley,
hereinafter called the personal representative.
WHEREAS, the personal representative has gathered the assets of the estate of the said
decedent and the assets consist of personal and real property, to a total value as set forth in Exhibit
"A", a copy of the Pennsylvania Inheritance Tax Return filed by said personal representative, and
which has been provided to each heir;
WHEREAS, the debts and deductions, including the payment of inheritance tax in the said
estate, are $15,240.18, as further referenced in Exhibit "A";
WHEREAS, a balance for distribution exists;
WHEREAS, the balance for distribution has been reduced to cash and/or is held in kind and
is available for distribution in accordance with the terms of the last will and testament of the said
decedent.
NOW, THEREFORE, KNOW YE, that I, being the named beneficiary of the will of said
decedent, do hereby acknowledge that I have this day had and received from the aforesaid personal
representative, in full satisfaction and payment of all sum or sums of money, legacies, b~q~ests, a
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devised as are given, devised and bequeathed to each of us respectively by tl~s~d will af~Tarr~s
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Johnston in the amounts due me under said will, which amounts I have recepve~ t~ns day. ~
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AND. I do hereby stipulate that in order to avoid the expense and time involved in the filing
of a formal account and schedule of distribution, I agree that no account is necessary and I do hereby
agree and consent to distribution being made without the filing of an account and schedule of
distribution, the same to be with the same force and effect as if they had been filed and confirmed
by the Orphans' Court Division of the Court of Cumberland County.
THEREFORE, I do hereby remise, release, quitclaim and forever discharge the said personal
representative, heirs, executor, and administrators and assigns of and from the said estate and from
all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason
thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said
decedent, and each of us do further hereby covenant and agree with each other and the aforesaid
personal representative, that we will contribute pro-rata, our share of the estate to satisfy any and all
claims, demands, suits, or causes of action which may be successfully prosecuted against the said
estate or aforesaid personal representative after the signing, sealing and delivery of this family
settlement agreement and final release.
IN WITNESS WHEREOF, and intending to be legally bound hereby, we have hereunto set
our hands and seals on the dates below indicated.
WITNESS:
` ~, I
COMMONWEALTH OF PENNSYLVANIA
Jean Bartley
COUNTY OF CUMBERLAND
SS.
AND NOW, this ~ ~ ~ day of , 2013, before me, the undersigned
officer, personally appeared Jean Bartley, kn to me r satisfactorily proven) to be the person
whose name is subscribed to the within instrument, and acknowledged that she executed same for
the purposes therein contained.
IN ~~'dti~li~-~° ' C~~ eunto set my hand and official seal.
Notarial Seal public
Jennifer s. lindsaY~ Notary
Carlisle Boro, Cum ~rla~ 9~ ~ 15 '
My Commission ~xP TION OF NOYARIES
MEMBER, PENNSYLVAN[A A550~
arv 1
1505610105
REV-1500 ex cot-11, ~~, !~-
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
~~*~~~~~ Cowty Cade Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN I i ~ -
PO BOX 28o6oa.
Harrisburg, PA i~iz8-o6o1 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
196-14-2910 ~ 111/07/2011 ~ 11/09/1925 -~
Decedent's Last Name Suffix Decedent's First Name
Johnston -~ ~ ~ James
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
__ _ __
,. --------...--------_ _ _ ------ -- ------- THIS RETURN M
Spouse's Social Security Number
UST BE FILED IN DUPLICATE WRH THE
REGISTER OF WILLS
MI
MI
FILL IN APPROPRIATE OVALS BELOW
m 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
death after 12-12-82)
O>D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death
Between 12-31-91 and 1-1-95)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENT
Name
David A. Baric, Esquire
First Line of Address
Baric Scherer LLC
Second Line of Address
19 West South Street
City or Post O(fice
O 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
O 11. Election to Tax under Sec. 9113(A)
(Attach Schedule 0)
AL TAX INFORMATION SHOULD BE DIRECTED T0:
Daytime Telephone Number
(717) 249-6873
State ZIP Code
REGISTER OF WILLS USE ONLY
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'Carlisle ~ PA ~ 17013 ~^ ~~.~ ~'
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Correspondent's a-mail address: dbaric@baricscherer.com ~ -.-.-
Underpenalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the hest of my knowledge and belief,
it is true, correct and complete. Dadaretion of preparer other than the personal representative is based on all information of which
preparer has any knowledge.
SIGJ~1~~ PEA ON ~PONSI FOR FILING RETURN ~~~ `~~
1
17257
19 West South Street, Carlisle, Pennsylvania 17013
PLEASE USE ORIGINAL FORM ONLY
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Side 1
L 1505610105 150561015 J
1505610205
REV-1500 EX (FI) Decedent's Social Security Number
Decedent's Name: James E. Johnston 196-14-2910
RECAPITULATION
1.
Real Estate (Schedule A) ........................................... 1
.. 62,750.00
_ .
2. Stocks and Bonds (Schedule B) 2, 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00
4.
9 9 ( ) .........................
Mort a es and k~otes Receivable Schedule D 4,
.. 0.00
5. Cash, Bank Depos :s and Miscellaneous Personal Property (Schedule E)..... .. 5. 250.00
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
00
0
(Schedule G) O Separate Billing Requested...... .. 7. .
8.
( 9 ) ...........................
Total Gross Assets total Lines 1 throw h 7 8.
.. 63,000.00
9. Funeral Expenses and Administrative Costs (Schedule H) ............. ....... 9. 15,240.18
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 0.00
11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 15,240.18
12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 47,759.82
13. Charitable and Go~~emmental Bequests/Sec 9113 Trusts for which
00
0
an election to tax I-'3s not been made (Schedule J) .................. ...... 13. .
14. Net Value Subject to Tax (Line 12 minus Line 13) .................. ...... 14. 47,759.82
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 I
at lineal rate X .0 _. 16. I
17. Amount of Line 14 taxable
at sibling rate X .12 !, 17.
18. Amount of L ine 14 taxable
82
47
759
,
.
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
1505610205 1505610205
7,163.97 .
7,163.97
O
J
REV-1500 EX (FI) Page 3
npr_prlant'c Celmnlete Address:
File Number
DECEDENTS NAME
James E. Johnston
STREETADDRE55
152 Neil Road
CITY
Shippensburg STATE
PA ZIP
17257
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + B) (2)
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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
(1)
0.00
7,163.97
Make check payable to: REGISTER OF WILLS, AGENT.
s '.~T.s r..,.....e. t.f v 1.. ~i:s
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 ri;tht to designate who shall use the property transferred or its income ...................................... ...... ^
c. retain a rev;rsionary interest ........................................................................................................................ ...... ^
d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................................................................................................ ...... ^
3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ........ ...... ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? .................................................................................................................. ...... ^
iF TFiE ANSWER TO ANY OF ~'HE ABO'JE QiiEST[ONS iS Y'cS, YOi1 iWUS T CGS"rLE i E S~NEDUi.E G ANC FILE IT AS PART OF Ti'E 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 Jai. 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 st~:tute 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 'I , 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)j.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
7.163.97
REV-1502 EX+ (01-10) ~
~i 'pennsylvania SCHEDULE A
~ DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
James E. Johnston 21-11-1286
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, bath having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disdosed 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• 152 Neil Road, Shippensburg, Pennsylvania 17257 62,750.00
mobile home on real property
(HUD-1 from sale attached)
TOTAL (Also enter on Line 1, Recapitulation.)
If more space is needed, use additional sheets of paper of the same site.
62,750.00
REV-15o8 EX+ (a8-iz)
pennsyLvania SCNEptILE E
DEpARTMENTOFREVENUE CASH BANK DEPOSITS 8F MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
James E. Johnston 21-11-1286
Include the proceeds of litigation and the date the proceeds were received by the estate.
au mm~erw inintly ewn~ with rioht of survivorship mutt bH disclosed On Schedule F.
If more space is needed, use additional sneers Dr paper or me same size,
REV-1511 EX+ (10-09)
Pennsylvania
OEPANTMENT OF REVENUE
SCHEDULE H
FUNERAL EXPENSES AND
ESTATE OF FILE NUMBER
James E. Johnston _- 21-11-1286
Decedent's debts must be reported on Schedule I.
ITEM AMOUNT
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1' permit 600.00
.marker 450.00
burial service 7,005.00
B. ADMINISTRATNE COSTS:
i. Personal Representative Commissions:
Name(s) of Personal Representative(s) __-__ _ -_- -___
Street Address
City _ State ZIP
Year(s) Commission Paid:
5,500.00
i. AttomeyFees.: Boric Scherer LLC
3. Family Exemptio~i; (If decedent's address is not the same as claimant's, attach explanation,)
Claimant None
------------- ---- - ------~-
-- --------
Street Address
City _ State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 186.50
5. Accountant Fees:
6. Tax Retum Preparer Fees:
~~ __ _.....
Adam's Electric;
321.00
B. CFJMA 291.00
s. water bill 114.00
~ o. homeowner's insurance 341.00
~ 1. The Sentinel (legal advertising) 157.68
~2. Cumberland I_aw Journal 75.00
13. Real estate taxes 199.00
TOTAL (Also enter on Line 9, Recapitulation) ~- 15 , 240.18
If more space is needed, use additional sheets of paper of the same site.
REV-1513 EX+ (01-10)
Pennsylvania
DEPARTMENT OF REVENUE
SCHEDULE ~
BENEFICIARIES
ESTATE OF: FILE NUMBER:
James E. Johnston 21-11-1286
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(5j RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).)
i. Jean E. Bartley none
201 Neil Road
Shippensburg, Pennsylvania 17257
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 ANU GOVERNMENTAL DISTRIBUTIONS:
1.
100%
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1900 COVER SHEET. $
If mare space is needed, use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
JAMES E. JOHNSTON
I, JAMES E. JOHNSTON, currently of 152 Neil Road, Shippensburg, Cumberland
County, Pennsylvania, revoke any prior Wills and Codicils and declare this to be my Will.
ITEM 1. I give my furniture, household and personal effects, and other tangible
personalty of like nature, other than cash or securities, together with any existing insurance thereon,
to my neighbor, JEAN BARTLEY, if she survives me by thirty days. If JEAN BARTLEY is not
living on the thirty first day following my death, then this gift shall lapse and I give my furniture,
household and personal effects, and other tangible personalty of like nature, other than cash or
securities, together with any existing insurance thereon, to my neighbor, LARRY McLAUGHLIN,
if he survives me by thirty days.
ITEM 2. I give the rest, residue and remainder of my estate to my neighbor, JEAN
BARLTEY, if she survives me by thirty days. If JEAN BARTLEY is not living on the thirty first
day following my death, then this gift shall lapse and I give the rest, residue and remainder of my
estate, to my neighbor, LARRY McLAUGHLIN, if he survives me by thirty days.
ITEM 3. If neither JEAN BARTLEY nor LARRY ivIcLAUGHLIN are living on the
thirty-first day following my death, then all gifts to either of them shall lapse and I give my
entire estate to my heirs at law in such proportions as is provided for under the Pennsylvania
Probate, Estates and Fiduciary Code or its successive legislation as is in force at the time of my
death.
Document #3/1313.1
Page 1 of ~
ITEM 4. I direct that all my just debts and the expenses of my last illness and
disposition of my remains shall be paid from my residuary estate as soon as practicable after my
death and as part of the expense of the administration of my estate.
ITEM S. In addition to the powers conferred by the common law, by statute, or by any
other provisions hereby, my Personal Representatives are hereby empowered as follows:
(a) Subject to the gifts made in Item 1 of this Will, to sell at public or
private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or
otherwise dispose of, or grant options with respect to, any and all property, real, personal, or
mixed, at any time forming a part of my probate or trust estates, in such manner, at such
time or times, for such purposes, for such price or prices, and upon such terms, credits, and
conditions as shall be deemed advisable or necessary under the circumstances.
(b) To assent to, join in, and vote in favor of any merger, reorganization,
voting trust, plan, lease, mortgage, consolidation, exchange, foreclosure of any corporation
or other investment in which the probate estate or trusts may hold stock, bonds, investments,
or an interest;
(c) To vote in person or by general or limited proxy with respect to any
share of stock or other investment held by the probate estate or trusts;
(d) To make distribution in division of the probate estate in cash, in kind,
or partly in both;
(e) To distribute articles to a minor or to her or his guardian or to any
person taking care of the minor to hold for the minor within the limits authorized by statute
or rule of law;
(f) To compromise any claim or controversy;
Document #31?313 ,'
Page ? of
(g) To apportion between principal and income any receipts and
disbursements and to ascertain income and principal in accordance with the statutes and
rules of :law of the Commonwealth of Pennsylvania;
(h) To keep property in the name of a nominee with or without
disclosure of any fiduciary relationship;
(i) To employ attorneys, auditors, depositories and proxies with or
without discretionary power.
(j) To make, execute, acknowledge, and deliver any and all instruments
which maybe deemed advisable or necessary to carry out any of the powers herein granted
or provided by law;
(k) To invest and reinvest the principal of the trusts, together with any
accumulated income thereon whenever such accumulation has been permitted by the terms
hereof, in all forms of property, real, personal, or mixed, including but not limited to stocks,
bonds, common trust funds, mortgage, investment funds, insurance policies, and annuities,
without being limited by any statute or rule of law concerning investments by fiduciaries;
(1) To join with my spouse, if I am married at the time of my death, in
filing any federal income tax returns for any year in which such joinder is permitted by law
and to pay all or such ratable share of any taxes due thereon as my fiduciaries shall deem
proper, and to join or consent to any gifts made by my spouse during my lifetime as having
been made one-half by me for the purpose of any federal gift tax law;
(m) To carry out the terms of any agreement I may have entered into to
sell all or. any part of any property or any interest I may own in any business at the time of
my death;
Document X311313.
Pale 3 of ~ ~V
(n) To exercise any law-given option to treat administrative expenses
either as income tax or as estate tax deductions, without regard to whether the expenses were
paid from principal or income;
(o) To disclaim inheritances and interests in property.
(p) To apportion tax basis among bequests in accordance with the
Internal Revenue Code, applicable regulations and other state or federal laws.
ITEM 6. No bond shall be required of my Personal Representatives or Trustees but if
bond is nevertheless required, it shall be without surety.
ITEM 7. I appoint my neighbor, JEAN BARTLEY, Executrix. If JEAN BARTLEY
fails to qualify or ceases to act, I appoint my neighbor, LARRY McLAUGHLIN, Executor.
ITEM 8. I note to my Executors that I have retained the services of David H.
Martineau, Esquire, and the firm of Metzger, Wickersham, Knauss & Erb, P.C., in connection with
the writing of this Will.
Executed on ~F~~ ,~`- l` ~ .- ~ 2004.
ames E. Johnst
In our presence, JAMES E. JOHNSTON signed this Will and declared it to be his Will, and
now at his request, in his presence, and in the presence of each other, we sign as witnesses:
Document #31?3! 3.!
Residence
~~~~ ~~
Residence
Page ~ of ~~
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF i,~ rl~i~'1a }:.-yL
We, JAMES E. JOHNSTON, and I~r,~,~~ ~ il'~1<<~ ~;r~a~t~' ,and
/~ 4`,~~~ L~ , ,,~ . , the Testator and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testator signed and executed the instrument as his last Will and
that he had signed willingly (or willingly directed another to sign for him), and that he executed it as
his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the Testator, signed the Will as witness and that to the best of our
knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no
constraint or undue influence.
estator
`_~
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SWORN to or affirmed and acknowledged before me by the above named Testator and witnesses
this :f day of (~r~~~r~'~~~ - 2004.
//~`
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Notary Publlic
My Commission Expires:
(SEAL)
Notarial Seal
Angela M. Miller, Notary Public
City of Harrisburg, Dauphin County
My Commission Expires Oct. 15, 2006
Document ~3l23/3 !
Page ~ of ~
rremaus eanions are oasorete
form HUD-~ ;3lB6~. •er'riandbnoN 430'.<'
A. Settlement Statement U.S. Department of Housing and Urhan Development
C. 1 e or t_oan -- -- -- - - ---
1. ^P'tiA 2. ~FmHA 3. ~Conv. Unins. 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number
4. ^vA 5. Conv.lns. 2012-351MILLHOU
rs rm is give you ^ a an p y e sa an a an are s own.
Note: Hams marked'(P~o.aJ" wer^ w~ cuteiw ~^ t~ahty; ~^Y ors sh^wn hen for inramation purposes and an not indudad in the !dots. TitleE%preSS Settlement System
C
.
WARNING: Il is a crime to knawklglY make tales alatemama bt the UNYa Stales on this or any othr srmdar term. Penalties upon
eonvidion nn include a fins and i sonment. For detatls aaa: Title 1tl LL 8. Cade Ssdbn 1001 and Section 1010. -
D. NAME OF BORROWER: Angela Hillhouse and Faye Hillhouse
ADDRESS:
E. NAME OF SELLER: James E Johnston
ADDRESS: clo Jean E. Bart) Executrix
F. NAME OF LENDER:
ADDRESS:
G. PROPERTY ADDRESS: 152 Neil Road, Shippensburg, PA 17257
Southam on Townshi
H. SETTLEMENT AGEIJT: Bark Scherer LLC, Telephone: 717.249-6873 Fax: 717.249.5755
PLACE OF SETTLEMENT: 19 West South Carlisl PA 17013
I. SETTLEMENT DATE: 09H4120'12
J. SUMMARY OF BORROVYER'S RANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
GROSS AMOUNT DUE FROM BORROWER
100 400. GROSS AMOUNT OUE TO SELLER
.
101. Contract sales rice 83 000.00 401. Contract sales rice 63 000.00
102. Personal ro 402. Personal ro e
103. Settlement ch es to bomower line 1400 1398.50 403.
104. ~~
105. ~`•
Ad'ustments for items aid setler i n advance Ad'ustments for items aid seller in advance
Ci /town taxes
106 406. Ci ftotxn taxes
.
Count taxes 09114112 12131112
t07 39.68 407. Coun taxes 09114112to12131112 39.68
.
108. School Tax 09/14112to06130113 408.62 408. School Tax 09114112to08130113 408.62
109. 4~'
110. 410.
111. 411.
112 412.
.
120. GROSS AMOUNT DUE FROM BORROWER 846.80 420. GROSS AMOUNT DUE TO SELLER 63 448.30
200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
D sit or earnest moos
201 501. Excess osit see instructions
.
202. Princi al amount of new loans 502. Settlement cha es to seller line 1400 24 597.35
203. Existin loan s taken sub'ect to 503. Existin loan s tak n su ~ t to
204. 504. P off of First M Loan
205. 505. Pa off of second mort a e loan
206. 506.
207. 50T
208. ~•
209. 5~'
Ad'ustments for items un aid b seller Ad'ustmeftts for items un aid b seller
210. Ci /town taxes 510. C' flown taxes
211. Coun taxes 511. Coun taxes
212. School Tax 512. School Tax
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218 518.
219 519.
220. TOTAL PAID BYIFOR 80RROWER 520. TOTAL REDUCTION AttOUNT DUE SELLER 24 597.35
300. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLE R
301. Gross amount due from borrower line 120 64846.80 601. Gross amount due to seller the 420 63 448.30
302. Less amounts b Ifor borrower line 220 602. Leas reduction anrount due seller line 520 24 597.35
303. CASH FROM BORROWER 64 846.80 603. CASH TO SELLER 38 850.95
corm ~ _ _ ,^In°, .^, "e^d~w~ n_e5 2
E•'Uy cU,S I DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 2012.351N11LLHOU =Ai1E 2
nrrrl GaC\IT CTATCIIACAIT T:11.. G......... O..NI.....eanl Quclem
NVI IJrVIe1L„1\1 v~Il~r•~~r.~. „u,.rn ,a..a.a vv.uv,i.~,.._ _._... ___ .._
L. SETTLEMENT CHARGES ~ PAID FROn~ PAID F IoM
700. °i OTAL SALES/BROKER'S COMMISSION based on rice $63 000.00 = ' BORROWER'S SELL.FR'S
Division of commission (line 7001 as follows: _ _ ~ FUNDS AT FUNCS AT'
701 $ tD ~ SET-TLEMEPJT '' SETTLEMENT
702. $ t0 ~
1
703. Commission aid at Settlement -
~
~_
800. ITEMS PAYABLE IN CONNECTION WRH LOAN
801. Loan 0 ' ination Fee ~
802. Loan Discount °6
803. A raisal Fee
804. Credit Re ort
805.
806.
807.
808.
809.
810.
811.
900. ITEMS REQUIRED BY LENDER TO 8E PAID IN ADVANCE
901. Interest From to $ Ida
902. Mort a Insurance Premium far to
903. Hazard Insurance Premium for to
904.
905.
1000. RESERVES DEPOSRED WRH LENDER FOR
1001. Hazard Insurance mo. Imo
1002. Mort a Insurance mo. Ire
1003. Ci Pro Tax mo. Imo
1004. Coun Pro rt Tax mo. Imo
1005. School Tax mo. $ Imo
1009. A ate Anal Ad'ustment 0.00 0.00
1100. TREE CHARGES
1101. Settlement or Closin Fee
1102. Abstract or Title Search
1103. Title Examination
1104. TiBelnsurance Binder
1105. Document P aratlon
1106. Nota Fees to Cesh 10.00 10.00
1107. Altome 's fees
includes above items No:
1108. Title Insurance to Boric Scherer LLC 696.50
includes above items No:
1109. Lender's Poli
t 110. Owner's Poli 83 000.00 •896.50
111E
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordin Fees Deed $ 62.00 ~ Mo e $ ~ Release $ 62.00
1202. Ci !Coun taxlstam s Deed ,00 ~ M a e 630.00
1203. State Taxlstam s Deed 630.00 Mo a e $ 6~•~
1204. Deed ~ Mo a e
1205.
1300. AODRIONAL SETTLEMENT CHARGES
1301. Final Water/Sewer to eorou h of Shi s6u 57.35
1302. Motor Vehicle TiNe Escrow to Bane Scherer LLC 23 900.00
1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 1 398.50 24 597.35
HUO CERTIFICATION OF BUYER ANO SELLER
I have caralWly revlswetl VIN NUO.1 SNVlemanl $taumenl sntl la the baEl01 my knowlatlge and 6aliN, it is a Inge antl aceurne sWlament of all neepts antl OiEDutsemeMS matle On my acwunt
or oy ma in this eansaeuon. I fwthx cerVy thN I nave nsesivM a copy N the HUD-1 SNdemanl Stalamnl
,~~ m~
nga a use Faye Duos ~~~~
a s ..lonnston
+ ~ ~ ~ J
y: can ey, a ns
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE TM HUO-1 SaVlemeM vMitll 1 plc le account M Nis
UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION tranaaellen. I have or funds ed ~ tlance um This sWemeM.
CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 10: 1
U. S. CODE SECTION tpV1 AND SECTION 7010.
SETTLEMENT AG _ DATE: _