HomeMy WebLinkAbout06-24-13 (2) ,lun, 14. �Q13 ?:3bPM No, �15$ P. 1
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PA Department of Revsnue p���n�� ���-USE�NLY
Bureau of individuai'faxea ��TM"'rcxR�v�►r ���� �� F���
P�BOX,28C�601 1NHERiTANCE TA�(RETE�RN � 1 12 0 0 9��
WarrisSurg,PA t 7128-0607 RESIDEt�tT DECEDENT
ENTER aECEDENT IMFORMATiON�tEi,b1M
Soc:iaf Security Number pate of Death I�te of$irth
4$ �A �012 09 21 1924
Decedent's l.ast Name Suffix Decedent's First Name Mf
FIFE R�78ERT
{If App�cabk)Errter Snrviving Spouse's Info�metion Be[aw
Spo�se's L.ast Natr� Suf�x Spaur�'�Fir�t Name Mi
Spouse's SSc�cial Securty Number TH1$�ETURN MIi�T B��tL�D IIV DUPU�ATE WlTH THE
RECI�TER�F WILL�
FlLL.1N AP�I�pREATE OVALS BELOW
� 1.OriQirt�!Ftdtum Q 2. Sup�pk�trlent�l Retum ❑ 3,Remeinder Retum(Oate of Death
Priorto 92-13-8�2)
[j 4.Lim�ed Eatete � 4a.�"�"��"tQ��°"'� � �. Fede�l Eslaiie Tax Retum Requoed
{dao�d deat�aioe��2-12�
� �, oeoedeK o�tesmae � �, De�er►c Meir�inea s�ivir�Tn�sc _� _. 8, Tota1 Number o#9afe Depoalt 6amces
Umarch CaN of wiQ G°� G°P�'�T'�tl
� 9.l,.�igatiorr Prooeeds Rece;ved ❑ 90.Spous�l Par Cred'R(Date of Qe,�th p 1 t.Eiedbn�t�oc under�ec.9113(A)
b�n�et�i2�3�1 and 9-1A� {Astach Sc�edule�)
CORRE�PONDENT-Tti1S SECTION MUS7 BE CCMpLETED.ALL t�RRE3PONDEN�Af�4"QNFIDEN7#AL TAX IM�RMA110N ShlOU�D BE DI��TED TQ:
Nanra Daypme 1�;pho�t�Num� �
�
RaBERT G FRE� 717 �4�' �8�8 ►?'x �
n� `�° c � �,'
....,, �
R�GIS��LLS��.9E 01��ff
� �!'j �D � Ca
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First Ur�e of Address � Q � � .� �
5 �OUTH HANC�'VE R STREE T �" � � �, °; �
-u `.� c� r�"'.- rri
Stcond une of address �. 0 �,� �,
- �'I '�"t .
DAT�FI�ED
City or Post Office State ZIP Code
CARLISLE �.A 17013
carre.sQandent's e�nail address: rf te y�f reyti le y.c o m
U�ler per�kies of perjuryt,I deder�a thst I have examir�ed this retam.induding aocomperryin8 sdiedufes snd dalemertts,end to the 1�est of my lmor+de�e and belief,
It ls atue�oor�and compiete.Decfer�mn of preperer other thsn!he persone[r+epreaentstive ia besed on sA i�fiormation a�which prepsrer has sny knoNUled�e.
SIG OF P'�RSDrt I�ESPbN518tE F fit�t4 RETIIRN D�TE
� ` Jenni�r His�r� Cv r�O• I
16��ourt Street,Fairtaw�,�M 44333
sIGtV� OF SHER T EZEP ATlVE TE
Robsrt O Frey �L �
�
Fr+ey an�Yitey
5 Soulh Ffanaver Stre�,Carlisle,PA 17fi1�
.. , , ..,�.
Si�e 1
�
'I�Obfi1 b�43 �16066'!0�43 �
� 1505610243
R EV-1500 EX
Decedent's Social Security Number
oe���SNa�: FIFE� ROBERT
RECAPITULATION
1. Real Estate Schedule A .......,.. �. 9 0 , 0 0 0 . 0 0
( )...............................................................................
2. Stocks and Bonds(Schedule B)............................. 1 , 4 4 3 , 7 9 7 . 5 0
.................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mo�tgages 8 Notes Receivable(Schedule D).......................................................... 4.
5• Cash,Bank Depasits&Miscellaneous Personaf Property(Schedule E)................ 5. 3 3 , 8 7 2 . 9 0
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
Transfers 8 Miscellaneous Non-P obate Property
� u G) �Separate Billing Requested............. 7. 3 9 , 919 . 0 0
g, Total Gross Assets(total Lines 1 through�.......................................................... g. 1 , 6 0 7 , 5 8 9 . 4 0
9. Funerai Ex enses and Administrative Costs Schedule H s. 119 , 0 2 5 . 4 9
p � )....................................
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 1 7 , 5 5 2 . 3 5
11. Total Deductions(total Lines 9 and 10).................................................................. ��, 13 6 , 5 7 7 . 8 4
�2• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 , 4 7 1 , 0 1 1 . 5 6
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J}................................................. 13, 5 , 0 0 0 . 0 0
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14, 1 , 4 6 6 , 0 1 1 . 5 6
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 713 , 0 4 6 . 2 8 1 s. 3 2 , 0 8 7 . 0 8
17. Amount of Line 14 taxable
at sibling rate X .�2 7 13 , 0 4 6 . 2 8 ��� 8 5 , 5 6 5 . 5 5
18. Amount of Line 14 taxable
at collateral rate X .15 3 9 , 91 9 . 0 0 �$• 5 , 9 8 7 . 8 5
19. TAX DUE................................................................................................................... 19. 12 3 , 6 4 0 . 4 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Slde 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File N�unber 21 - 1 2 - 0 0 9 3 8
Decedent's Complete Address:
Fife, Robert
STREET ADDRESS
442 Walnut Bottom Road
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,�ine 19) (1) 12 3,64 0.4 8
2. CreditsJPayments
A• Prior Payments 100,000.00
B. Discount 5,263.16
Total Credits(A +B) (2) 10 5,2 6 3.16
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �4�
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) �$,$7 7.$2
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.................................................................................................................. x
d. receive the promise for life of either payments,benefits or care?.............................................................. X
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receivingadequate consideration?....................................................................................................................... ❑ 0
3. Did decedent own an"in trust fo�' 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?............................................................................
.......................................... a ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Fo�dates of death on or after Jul 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 percerrt[72 P.S.§91�6(a)(1.1)(i)]. :
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The stafute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax refum 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(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)1. A
sibling is deflned under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption.
`� pennsytvania
DEPARTMENT OF REVENUE SC H E D U LE A
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
F1LE NUMBER
ESTATE OF Fife, Robert 2� - 12-00938
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 wil(ing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
NUM ER DESCRIPTION VAL-UE�AET�DHTE OF
1 17 Abbey Court, Carlisle, Pennsylvania. See HUD-1 settlement statement attached 90,000.00
TOTAL(Also enter on Line 1, Recapitulation) 90,000.00
REV-1303 D(+(g.gg)
SCHEDULE B
con,�aHw�u,ni oF a�Nmv,o►,��a STOCKS & BON DS
NHERRANCE TAX REiURN
RESIDBVT DECEDBJT
ESTATE OF Fife, Robert FILE NUMBER
21 - 12-00938
All property jantly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF
DEATH
1 Stocks and mutual funds, itemization attached 1,443,797.50
TOTAL(Aiso enter on line 2, Recapitulation) 1,443,797.50
� pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC.
INHERITANCE TAX RETURN �
RESIDENT DECEDENT P E RSO NAL P RO P E RTY
FiLE NUMBER
ESTATE OF Fife, Robert 21 - 12-00938
Indude the proceeds of litigation and the date the proceeds were received by the estate.Ail property jointly-owned with the right of
survivorship must be disclosed on schedule F.
NUM ER DESCRIPTION v�U DEATHTE OF
1 Metro Bank Account No. 513230383 31,267.65
2 Real Estate Tax and Homeowners Assoc. proration from HUD-1 sett{ement statement 507.63
3 Thornwald Nursing Home refund 2,097.62
TOTAL(Also enter on Line 5, Recapitulation) 33,872.90
Rev-,s,o ac+�oe-os� SEPARATE BiLLING REQUESTED
. '� , pennsylvania
DEPARTMEM'OFREVENUE SCHEDULE G
INHERITANCETAXRETURN INTER-VIVOS TRANSFERS &
RESJDEM'DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Fife, Robert FILE NUMBER
21 - 12-00938
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPER7Y DATE OF DEATH �'� EXCLUSION
NUMBER Indude the name d the transUeree,their relationship to decedent VALUE OF ASSET °��S (IF APPLICABL� TAXABLE VALUE
and the date d transfer. Attach a copy of the deed for r�l estate. I MEREST
1 IRA with T. Rowe Price 39,s�s.00 100% 0.00 39,919.00
TOTAL{Also enter on line 7, Recapitulation) 39,919.00
REV-1 S11 EX+(10-09)
� pennsylvania 9(�EDULE H
DEPARTMEM'OF REVENUE ����w„D
��"�1\
fRESIDENT DECEDENT URN �w�w��
��.��rv'1
ESTATE OF Fife, Robert FILE NUMBER
21 - 12-00938
Decedent's debts must be reported on Schedule L
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
�►. 1 Ewing Brothers Funeral Home 2,717.00
2 Lawson Vault and Monument 275.60 :
3 Jennifer Hissem, reimbursement for payment to Ewing Brothers Funeral Home 1,378.57
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Jennifer Hissem 48,000.00
Street Address 164 Court Street
city Fairlawn state OH zip 44333
Year(s)Commission Paid 2012-2013
2. Attorney's Fees Frey&Tiley 48,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
C�Y State Zip
Relationship of Claimant to Decedent
4. Probate Fees Frey&Tiley, reimbursement for Probate and advertising 1,314.66
Additional Probate
5. Accountant's Fees
6. Tax Retum Preparer's Fees Included with Attomey fees
7. Other Administrative Costs
1 Expenses of maintaining real estate sold,see itemization attached 9,418.26
TOTA�(Also enter on line 9, Recapitulation) 119,02b.49
Sct�edWe H
COMMONWEALTH OF PENNSI�LVANIA ,���w���
INHERITANCE TAX RETURN � C��,'S
RESIDENfr DECEDENT
FiLE NUMBER
ESTATE OF Fife, Robert
21 - 12-00938
2 Closing costs for sale of real estate, HUD-1 settlement statement attached 7,669.87
3 Misceilaneous fees and charges, see itemization attached 251.53
Page 2 of Schedule H
'� pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT MORTGAGE
INHERITANCE TAX REfURN �
RESIDEIYT DECEDENT LIABI LIT!ES & LI ENS
FILE NUMBER
ESTATE OF Fjfg, Robert 21 - 12-00938
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTfON AMOUNT
1 Millenium Pharmacy Systems 81.00
2 Frey 8�Tiley, attomey's fees owed at time of death 500.00
3 Jennifer Hissem, mileage and travel reimbursements owed at time of death 16,971.35
TOTAL(Also enter on Line 10,Recapitulation� 17,b52.35
REV-1 S7 3 EX+(p�-10)
� ' pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN ' BENEFICIARIES
RESIDENT DEC�DEPIT
ESTATE OF FILE NUMBER
Fife, Robert
21 - 12-00938
NAME AND ADDRESS OF PERSON S RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER RECEIVING PROPERTY � � DECEDENT (Words) ($$$�
Do Nat List Trustee(s}
I� TAXABLE DISTRiBUTIONS[indude outright ousal
distributions and�ransfers
under Sec.�116(a)(1.2)j
1 Terrence C. Fife Son 1/2 of remainder :
2 Rosalie Wilson Sister 1/2 of remainder
3 Susan Spurlock Niece
Errter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II� NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAI�N
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Hillsdale College 5,000.00
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DtSTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET b,000.00
�''°�,a OMB Approval No.2502-0265
``• ��`�� A. Settlement Statement (HUD-1)
4. �C���,:�.�
..,,,F:...
: .- . .
1.Q FHA 2.Q RHS 3. X�Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
13064 6401020011
4.Q VA 5.Q 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 ciosing they are shown here for informational purposes and are not included in the totals.
D.Name 8�Address of Borrower: E.Name&Address of Seller: F.Name 8 Address of Lender:
Beverly D.Lins Estate of RobeR W.Fife Foote Capital Mortgage Company
65 Nelson Drive,Carlisle,PA 17015 5 South Hanover Street,Carlisle,PA 17013 3 East Mulberry Avenue,Carlisle,Pa 17013
G.Property Location: H.Settlement Agent: I.Settlement Date:04N 6J2013
17 Abbey Court Keystone land Transfer,Ltd Disbursement Date:04/16/2013
Carlisle,PA 17015 3421 Market Street,Camp Hill,PA 17011
South Middleton Township
Telephone:717-731-4200 Fax:717-731-1799 �
Place of Settlement: TitleExpress
3421 Market Street,Camp Hill,PA 17011 Printed OM16/2013 at 9:14 am
by KS
. :. . . . .
100. Gross Amount Due irom Borrower �00. Gross Amount Due to Seller
101. Contract sales price 90,000.00 401. Contract sales price ' 90,000.00
102. Pe�sonal ro 402. Personal ro
103. Settlement charges to borrower(line 1400) 7,365.37 403.
104. 404• '
105. �•
Ad ustments for items id b aeller in�vance Ad uatments for items id seller in advance
106. CityKovm taxes to 406. CityRown taxes b
107. Counry taxes 04116I2013 to 1?J3112013 215.31 407. County taxes 04/16/2013 to 12/31/2013 215.31
108. School Tax 04I16/2013 to 06I30/2013 229.82 408. School Tax 04h6I2013 to 06/30/2013 229.82
109. HOA 04116/2013 to 04130I2013 62.50 409. HOA 0411612013 to 0413012013 62.50
110. 410.
111. 41L
112. 412.
12�• Gross Amount Due from Borrowar 97,873.00 420. Gross AmouM Due to Seller 90,507.63
200. Amounts Paid b or in Behatf of Borrower 500. Reducdons In Amount Due M Seller
201. Deposit or eamest money 1,000.00 501. Encess deposit(see instructions)
202. Principa!amount of new loan(s) 67,5U0.00 502. Settlement charges to seller(line 1400) 13,467.87
203. Existin loa s taken sub'ect to 503. Enisti loa s taken sub'ect to
2p4, 504. Pa off of first mort e loan
205. 505. Pa off of second mo�t e loan
206. •`�•
207. 507.
208. ��
209. �•
Ad ustments for items un id seller Ad ustments for items un aid b seller
210. City/town taxes to 510. Cityftovm taxes to
211. County taxes to 511. County taxes to
212. School Tax to 512. School Tax to
213. 513.
214. 514.
215. 515.
216. - 516.
217. 517.
218. 518. '
219. 519. �
��• Total Paid ifor Borrower
68,300.00 520. Total Reductlon Amount Dua Seller 13,467.8T
300. Cash at Settlement fromlto Borrower 600. Caah at Setdement tolfrom Setler
30�. Gross amount due from borrower(line 120) 97,873.00 gp�, Gross amount due to seller(line 420) 90,507.63
" 302. Less amounts paid by/for borrower(line 220) 6g,50p,p0 6p2. Less reducctiions in artrount due seller(line 520) 13,467.87
303. Cash QX From ❑ To Borrower ��373•� 603.� Caah QX To ❑ From Seller 77,039.76
this tortn uN�ss d Oiy�ys a ear�wrly vNld OMB comrol mn�bsr.No contld�miaWy is aasund this dhcbsun Is maWatory.This is dulOned ro provW�tM W�s to a RESPA oov�nd trans�abn wNh bfartnallon Curkq tM atlNmaM .
�Procsas. � . .
See attached addendum for additional information � '
Previous editions are obsolete Page 1 0 4 HUD-1
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.
Corr� arison of Good Faith Estimate GF and HUD-1 Cha es Good Faith Estimate HUD-1
Cha That Cannot increase HUD-1 Line Number
Ouroriginationcharge # �� 1.221.00 1,181.25
Your credit or charge(points)for the specific interest rate chosen # 802 2,193.75 2,193.75
Your adjusted origina6on charges # 803 3,414.75 3,375.00
Transfer taxes # 1203 �•� �•�
Cha ea That in Total Cannot Increase More Than 1096 Good Faith Estlmate HUD-1
Govemment recording charges # 1201 150•00 164•00
Appraisal fee # � 675.00 550.00
Credit repoR # �5 50.00 23.87
Flood certification # �7 8.00 8.00
# 1311 0.00 0.00
#
#
#
. 883.00 745.87
. -.• - . . � .- S -137.13 � -15.5300%
Cha es That Can Chan e Good Faith Estlmate HUD-1
Ini6al deposit for your escrow account # 1001 1,518.30 953.24
Daily interest charges from # 901 �6.9349/da 112.50 104•02
Homeowners insurance # �3 �•� �•�
Title services and lenders tide insurance # 1101 1,130.00 1,106.00
Owner's tide insurance-First American Title Insurance Company # 1103 100.00 121.00
#
#
Loan Terms
Your initial loan amount is �s�,�•�
Your loan term is 30.years
Your initial interest rate is 3.7500�0
Your inidal monthly amount owed for principal,interest,and any mortgage $312.60 includes
insurance is XQ Principal
❑X Interest
❑Mo�tgage Insurance
Can your interest rate rise? XQ No. ❑Yes,it can rise to a maximum of %.The first change
will be on 1 I and can change again every years after l l ..Every change
date,your inte�est rate can increase or decrease by %. Over the I'rfe of the loan,your .
interest rate is guaranteed to never be lower than 96 or higher than 96.
Even if you make payments on time,can your loan balance rise? OX No. ❑Yes,it can rise to a maximum of$
Even'rf you make payments on time,can your monthly amount owed for QX No. ❑Yes,the first increase can be on / I and the monthly
principal,interest,and mortgage insurance rise? amount owed can rise to$ .
The manimum it can ever rise to is$ .
Does'your loan have a prepayment penalty? QX No. ❑Yes,your maximum prepayment penalty is$ .
Dces your loan have a balloon payment? QX 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 homeowners insurance. You must pay these items directly yourself.
XQ You have an additional monthly escrow payment of a150.50
that results in a total initial monthly amount owed of$463.10. This includes principa�inte�est,any
mortgage insurance and any items checked below:
QX Property taxea �Homeawners insurance
�Flood insurance . ❑X Misc.Impound
❑ �
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
See attached addendum for additional information
Previous editions are obsolete Page 3 of 4 HUD-i
T-df1H ti�o�a6ed a�a�osqo a�e suoiaipa snoina�d
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2131�3S aN`d 2l3Af19�O NOI1V�1�112i3�af1H
..•, . .
• • • •. • • • ��
Name of Borrower: Name of Seller: File Number:
Beverty D.Lins Estate of Robert W.Fife 13064_ '
Prepared 04/16/2013 at 9:14 am
Note:This page displays an itemlzation of the adjusted origination charges shown in section 800 of the HUD-1 Settlement Statemen
This page accompanles but is not a part of the HUD-1 Settlement Statement If a discrepancy exists,the infortnation on the HUD-1
Settlement Statement applies. ,
Your Loan Origination Charges Borrpwer Seller
801. Our originaUon charge (Includes Origination Point 0.000%or$0.00)
Administration Fee to Foote Ca ital Mort a e Com an$ �.���•25
Wire Fee to Foote Ca ital Mort a e Com ana 10•�
802. Your credit or cha�ge(points)for the specific interest rate chosen
Loan Discount to Foote Ca ital Mort a e Com an$ 2,193.75
803. Your adjusted origination charges 3,375.00 0.00
. . �
Name of Borrower: Name of Seller: File Number.
Beverly D.Lins Estate of Robert W.Fife 13064
Prepared 04116/2013 at 9:14 am
Note:This page displays an itemizatlon of the charges shown on line 1101 of the HUD-1 Settlement Statement.Thls page
accompanies but ia not a part of the HUD-1 Settlement Statement If a dlscrepancy exista,the information on the HUD-1 Settlement
Statement applies.
1100.Tide Charges Total Charge Borrower Seller
1�p�,Title services and lender's title insurance to
Ovemight Delivery Fee-Package to Ke stone Land Transfer,Ltd $ 25•� 25.00
Emai110oc Copy Fee to Ke stone land Transfer,Ltd $ �•� �'�
Wire In Fee to Ke stone Land Transfer,.Ltd $ 12�� �2'00
Notary Fee to Kristen D.Shive $ �•� 35.00
1102.Setdement or closing fee to $ - 0.�
1104.Lenders title insurance-First American Titto First American Title Insurance G$ �•� �'�
Totals: S 1,106.00 ' 0.00 1,106.00 0.0
SelledLender credits shown on e 1 POC=Paid Outaide Closin CR=Lender Credit
See attached addendum for additional information
Previous editions are obsolete Page 1 of 1 HUD-1
Stock Shares High Low Average Value
Comcast 438 34.15 33.66 33.905 $ 14,850.39
Buckeye Partners 476 49.55 48.00 48.775 $ 23,216.90
Bank of America 912 8.21 8.03 8.12 $ 7,405.44
Northeast Utilities 2170.07398 38.OZ 37.63 37.825 $ 82,083.05
AT&T 1051.03984 37.04 36.45 36.745 $ 38,620.46
0 $ -
T. Rowe Price Account: � $ _
0 $ -
Alcatel Lucent 390 1.18 1.16 i.17 $ 456.30
Alcoa 1000 8.68 8.55 8.615 $ 8,615.00
America Movil 10012 25.68 24.73 25.205 $ 252,352.46
Amerigas 711.7679 40.98 40.29 40.635 $ 28,922.69
Apache 206 87.75 86.35 87.05 $ 17,932.30
AT&T 440 37.04 36.45 36.745 $ 16,167.80
Bank of America 1000 34.15 33.66 33.905 $ 33,905.00
Buckeye Partners 1000 49.55 48.00 48.775 $ 48,775.00
China Mobile 517.7571 53.68 53.11 53.395 $ 27,645.64
Cisco Systems 500 19.24 18.93 19.085 $ 9,542.50
Corning 707.7802 11.53 11.34 11.435 $ 8,093.47
Covidien 317.3448 55.76 54.86 55.31 $ 17,552.34
Dominion Resources 1840 53.56 53.00 53.28 $ 98,035.20
Duke Energy 368 66.57 65.09 65.83 $ 24,225.44
Dynegy 101 p $ _
FirstEnergy 518 45.10 44.65 44.875 $ 23,245.25
Fiserv 300 71.00 70.37 70.685 $ 21,205.50
General Electric 1000 20.90 20.55 20.725 $ 20,725.00
Hecla Mining 300 22.93 22.65 22.79 $ 6,837.00
Hewlett Packard 481.9485 17.74 17.50 17.62 $ 8,491.93
Koninkujke Philips 300 22.93 22.65 22.79 $ 6,837.00
Mexico Fund 3469.1665 25.20 24.80 25 $ 86,729.16
Microsoft 471.0498 30.63 30.18 30.405 $ 14,322.27
Myrexis 450 2.55 2.51 2.53 $ 1,138.50
Myriad Genetics 1800 25.20 24.78 24.99 $ 44,982.00
NCR 589.315 22.25 21.65 21.95 $ 12,935.46
Nokia 400 2.55 2.51 2.53 $ 1,012.00
Rite Aid 2708.3637 1.23 1.20 1.215 $ 3,290.66
Spectra Energy 534 28.90 28.70 28.8 $ 15,379.20
Tata Motors 1700 22.24 21.90 22.07 $ 37,519.0�
TE Connectivity 319.6158 35.15 34.85 35 $ 11,186.55
Tyco International 320.2035 56.79 55.97 56.38 $ 18,053.07
WR Grace 600 59.01 57.80 58.405 $ 35,043.00
T Rowe Price Mutual Funds:
Health Sciences 962.152 41.87 $ 40,285.30
Capital Appreciation 1273.186 22.82 $ 29,054.10
G N MA 5892.151 10.13 $ 59,687.49
International Growth & Income 950.142 12.31 $ 11,696.25
Latin America 4028.208 39.58 $ 159,436.47
Science and Technology 595.615 27.38 $ 16,307.94
Prime Reserve Money Fund $ _
Total $ 1,443,797.50
BA N K 3801 Paxton Street 888.937.0004
Harrisburg, PA 17111 mymetrobank.com :
September 8, 2012
Robert G. Frey
5 South Hanover Street
Carlisle PA 17013
RE: Estate of: Robert Fife
Tax Identification Number:
Date of Death: August 24, 2012
To Whom It May Concern:
This letter is in reference to decedent account information you requested for the
individual listed above.
We are able to provide the following:
Account Type:Checking
Account Number: 513230383
Date Opened: 09/14/2000
Primary Owner: Robert Fife
Date of Death Balance: $31,267.65
Please feel free to contact me at (717) 412-6127 if I may be of further assistance.
Sincerely, ��_..�.--�---_._.�_,........_.
Jennifer Jacobs
Research Associate
Metro Bank
STAT E M E N T ;
Thornwald Home Statement Date: 11/01/2012
442 Walnut Bottom Road
Carlisle, PA 17013 _ Due Date: 11/25/2012
Telephone: 1717) 249-4118 - -
Amount Enclosed $
Amount Due: $ .00
Account #: 1148
RE: Robert W Fife
Robert Frey �
5 South Hanover Street
.�,,� Carlisle, PA 17Q�.3
a �� � �3i:�� �
` ; , ,;� '.. ,� ��a; y
I ,<: ��� .':;.:. .::?: , . : ' .`>.. .��`� �, Y �� �� ..,a.��a`��4�
�,� ; ���
� _ � ��:�.
.�: ;,
; , . ..�.
Balance B/F -2,097.62 -2,097.62
10/17/12 RESIDENT REFUND -2,097.62 .00
Current 31-60 Days 61-90 Days Over 90 Days Amount Due
.00 .00 .00 .00 ' .�� '
Payments MUST be received BY the 25th of each month. .
Wishing you and your family a most blessed Thanksgiving. '
Statement Date: 11/01/2012
_ Due Date: i l/�5J2012. . ,
- Robert W Fife-Account #: 1148
Thornwald Home
442 Walnut Bottom Road
Carlisle, PA 17013
Telephone: (717) 249-4118
10/09/2012 23:08 3306665210 HISSEM PAGE 12
, Septem ber 2012 . � . . . � , � e: �
� M�utual Fund Statement � � �TC�'e��
. . ' ' INVEST WITH CONF,(D$MGE �
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9/1 Begi�ning Balance � � � � . � � � � �
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' '9/30 � Endingealance , � � '— `
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. . . . .�..■
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This dividend is For 27 da s vs.34 da s(ast month. � � ' � � �
. . . . ., Y Y , Taxable Dividends , � • • . �$22.76
, � � . . . - __ -�---�. _�.�._ �
� ; . , � � � . Purchases � � � � � � ' � �.$44,6od.40
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(n an et�or[to tnatntain�a zero or positive netyleld forSummit�ash Reserves Fund,:T.Rowe Price hasvotuntarily wa(ve�d all or�a portion of
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r.Rowe Prlce inutual Fund accounts are maln�sthed and serviced byT.Rowe Drlce Seivlce$,Inc. , � •� � Dage 8 of 10
Ewing Brothers Funeral Home, Inc.
630 South Hanover Street
Carlisle,PA 17013-
(717)243-2421
August 28, 2012
Jennifer L. Hissem
163 Court Dr.
Akron, OH 44333
The Funeral Service for Robert W. Fife
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF TH�SERVICES,FACILITIES,AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES
Basic Services of Funeral Director/Staff , , , , , , , , , , , , , , , , , $1200.00
2. FACILITIES/SERVICES/STAFF/EQUIPMENT
Basic Use of Facility, , , , , , , , , , , , , , , , , , , , , , , $200.00
Document Prep/Permanent Recording)(Disc) , , , , , , , , , , , , , , , $200.00
3. AUTOMOTIVE EQUIPMENT
Vehicle to transfer remains to Funeral Home, , , , , , , , , , , , , , , , $295.00
Utility Car , , , , , , , , . . . . . . . . . . . . . . . . . $135.00
C. SPECIAL CHARGES
Direct Cremation , , , , , , , , , , , , , , . . . . . , . . $345.00
FUNERAL HOME SERVICE CHARGES . . . . . . . . . . . . $2375.00
THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE
THAT YOU HAVE SELECTED , , , , , , , , , , , , , , , $2375.00
Cash Advances
Certified Copies of Death Certificate , , , , , , , , , , , , , , , , , , $72.00
2 Days refrigeration , , , , , , , , , , , , , , , , , , , , , , , $75.00
Black swirl cultured marble urn, , , , , , , , , , , , , , , , , , , , $195.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES . . . . . . . . $342.00
Total
Total Cost , . . . . . . . . . . . . . . . . . . . . . . . . . $2717.00
SUB-TOTAL $2717.00
INITIAL PAYMENT/DISCOUNT/CREDITS 0.00
TOTAL AMOLTNT DUE $2717.00
The unpaid balance over 30 days is subjected to a 1.50%service charge per month-18.0000%per annum.
Heck Fune ral Home Statement of Funeral Goods and Services Selected
Chnrgea aro ony for Maae Nems thet you aebded or that are required.H we are
1007 Smith Street-Milton W"V 25541 ���a�a�erya�mat«,,��8e�,,,��,,�,���,,�
(304)743-4141 '°a'°'�"'""�'°b°'°"".
www.hecl�uneralhome.com ff''°"'°�ted e'"�'a"�`"'ey�`""�'"�'°,"'�'e°e��'""""""'°"""°,
you mey hsve W pey for embalmirp.You do not have to pay for ert�alminp you did nW
approve if you aeleded artangemerHs such as a direc.t cremaafi�on or irtimediate burisl.K
Contract Number. 1458 we a�ed for embar�rrp,we wrp exaain wny beww.
Date of Death: 8/24/2012 Fuli Name of Deceased: Robert Wallace Fife
Date of Service: 9/10/2012 Cemetery/Crematory: Milton Cemetery
- : � ►•
- - •- •-
Professional Sarvices ❑ Interment Fee y 500.00
Baaic Ssrvicea of Funeral Diroctor ❑ Cemetery Equipment 3 �.�0
and Statf: (non-dedinable)�fte E 0.�� �Crematory Charges • : 0.��
Embalming Fees: y 0.00
❑ Final Date Charge s O.00
Other Preparation or Care:
N/A g �.00 ❑ Clergy Honorarium S�-
❑ Musician Honorerium E �.�0
FaciliWs,Equipmerrt,and Staff: ❑ Soloist Honorarium a 0.00
use a faci�wes,ey��prt,ent,a�d starr 0.00 ocitua�es:
for�liewiny,Visitati�on,or Wak� $ ❑ Obituaries g 248.00
use a raainies,ea��r�,e�,and sran ❑ wA a 0.00
for Funeral Service: y 0.00 Certified Death Certificates:
Use oi Sta}f andlor Equipment for Service � 0 � 0.00 a 0.�0
in Church or ofher locatlon or faciidy: S 0.00 � o � o.00 s 0.00
Other use of Funeral Home faalities
and/or Sta}f(describe:) ❑ Permk t �.0�
Use for Memorial Service s 450.00 ❑ Hairstyling/Barber Charges S 0.00
Ha�aaynnreokena s�rc.nar�« a 0.00 ❑ Florist�ta�es s 0.00
Automotive Equipment(35 Mile Radius) ❑ Transportation(name tl►e carrier:)
Transfer to Funeral Home S O.00 N/A y O.00
Hearse(F�nera�coacn): a 0.00 O Esoorts s 0.00
Family VehiGe(s): S 0.�0 �'
F�ower/other Vehide: S 0.00 � �A i 0.00
Transfer to Crematory/Cemetery S 125.00 � N�A S 0.00
WA S 0.00 TOTAL OF CASH ADVANCES: OO 748.00
We charpe you for our servicea in obtaininy:(the items above marked with an�
Special Charges: nnr es�irna�ed a�arfles wiu be K,dieated win,a�E :
Cemetery Senrice by Funeral Home S 0.00 _
Other Special Charges: _ • . •- : -•
. •-
N/A i 0_0� TaxableAmount s�
�UA S 0_00 State s
N/A s 0.00 E 0_00
s 0.00 a 55.57
Total Tax:
a 0.00
a 0.00
TOTAL OF OTHER � y 55.57
CHARGES�CREDITS:
- •• • ` -
TOTAL OF SERVICES: � s 575.00 �� I �"
TOTAL CHARGES&CREDITS(A+g+C): a 1378.57
� � _ . �_ Payments S 0.00
a 0.00 _
ce��c wA : 0.00 a 0.00
o.s.c. wA s 0.00 a 0.00
Um N�A S_�_00. UNPAID BALANCE(Due by 9/1012012) S 1,378.57
Clothing wA S 0_�0 Insurance Assignments or Other Pendinp Credits:
Flowen (from Funeral Homel S 0.0� (S 0.0� )
Memorial Monument S 0_00 �y 0.00 �
Temporary Grave AAarker 3 �.0� (S �.�� 1
N/A 3 �.� ��v.�r,.r�,,,,,,,d,;...ro.a.ea..rr w vre eo w�+ww�eo d.w a n.a.r a w.�a.a.uvo�r�r wro m•w rae
M R)�Y�0�wWll noYO�Mt ny maiM tIM 1�tlN ri��pmwll�a)Aw�JWtl tlow hM rot y�t Mw�pWl b yotl�r -
Memorial Repister Book s �.� w�+.a.rW�.,�o+.w.e.rr.�w+�.�+rN s.owi ey�.r.r..
PAY�ffM TERMS:I utlo�Y�wl ro alnrfa�d a+At wlj�C b NOr��ntl WM ad[Wdo��Yrhlnwrt rMS.a otlr �
ACknOVrledQement Cerds S �.�� anwnw a�Q MMiMS Y mMnpYbd!y Yis Cant�el I Ir�ne hM b atr PMn�Y d�N r'wut dw uitlrt 1!r Cort�ct I
�pN Ilr[1 rn O�rY Y6M lar P�1*MR d tlr p�fe�hY e�lro Au�Yqwn�bwe M Ilr A�Y YiBelW E�lev.&c�pryr�t .
MemOfiel FOIdeB/Prdye�Cerds j�.�� .�e.mw.ey�.e rW.e rr.atr..s..�an�n.car.a n waren..rr nwo.r w.�re a.+pa..n v.rcw I�ex)v«
Y8 ....e�>.r is eu niyu.c r.r o«nr.a uar.ovk.w rw�r w dro.a.na s.m n.vo.e wi..:.aan n.a.e.a
e.cort.a�.won e.ar.pia.rw'an waa an*wt ae w.�r.aroa r reu v.r n.«�w eww...,u wnn roo�d.r.
Other Merchandise: rr.»ar..ro.�n...n.r.c�„nar�cra�.e.ti u�a wro�.v,ono,2
N/A 0.00 "°Tx�:
s To e�+.�coe�s«aa.�sw a w.�r.a��da�r r.m�s.k+wro a.�.:�■.�wrt.,r...�d r��a�.m.a...
O.oo hl w V�d Ys ea6ae[rd in Ympn�YA Maln M edwMO.Do M qi Yr eentst E�kn fW mtl k v M M caWnt rry ,
TOTAL OF MERCHANDISE• 2Q3 ��ro�.�xn.�.ao.r.wacd.omawvyati.eam.�cw.pw.o�a�ceRa.aro�r�eornrer
TOTAL OF SERV.8 MERCH.(1.+2): 0 s 5� Buyer Name: Jennifer Hissem
IdantlNcation and Doscriptlon of Mandatory ltems and Address: 163 Court Drive
Explanation of Embaiming Charge: City. Fairlawn State:Qli 21P: 44333 Date:
ReasonslwEmbalminp: phone: Relationahip:Niece
❑Exprssaly Approved ❑Fwieral with Public Yiewinp
11 any kw,amsMry,a asmefory isqwsments have requ�sd the purc�ase of any SIGNED:
ofher kams tisted sbors,tNe law a�eQuirement ia exphined bebw: (Signature of Buyer)
�Outer buri�l oontainsr roquirW by cemetery
� p�(���: Co-Buyer Name:
We apree to rondar the tsrvicsa�d iumish�e rtierc�andise indicated abow. AddreSs
ACCEP SELLER• Jason Thomason City. Stete: ZIP: Date:
4i aa� umba: � 3 9 Phone: Relationship:
SIGNED
gy; SIGNED:
Sipnature nsed u 1 Director) (Signature of Co-Buyer)
1458 le Numsric Sequencx ' File Buyer
While C Yellow Copy PiNc Copy Gold Copy
Jason Thompson-Licensee In Charge
CFS Fam M01 RwY�A(12N5)a000
Wednesday, June 19, 2013 Page: 1
CHECKINGFIFE.qdfm - Checking
Category Detail Report
1/1/12 through 6/19/13
Date Num Payee Memo Category C I r Amount
Income/Expenses
Expenses
�
9/5/12 CHECK/ACC. DELUXE CHECK PPD Misc R -1 5.75
9/13/12 105 Vitai Records Death Cert Misc R -90.00
9/14/12 charge back of comcast check M i s c R -4 9.2 8
9/14/12 Fee for charge back Misc R -1 4.00
12/27/12 wire fee to Orrstown Bank wiring fee for Rosalie's funds Misc R -20.00
2/11/13 129 Matthias Hasenbrink translation Misc R -62.50
Total Misc �
Real Estate
9/10/12 101 The Villas H.A. Real Estate R -12 5.00
9/26/12 107 Met Ed Real Estate R -2 7.9 3
9/26/12 108 Met Ed Real Estate R -42.40
9/26/12 109 Met Ed Real Estate R -30.88
9/26/12 1 10 Met Ed Real Estate R -50.31
9/26/12 1 1 1 Met Ed Real Estate R -1 1 5.81
9/26/12 1 12 The Villas H.A. Real Estate R -375.00
9/2 6/12 1 15 Foremost Ins. Co. Homeowners Ins. Real Estate R -1 ,2 2 6.2 S
1 1/21/12 121 MOUNTAINVIEW REMODELING 17 ABBEY Real Estate R -2,3 2 9.0 7 '
1 1/23/12 1 18 Frey & Tiley painting house Real Estate R -4,321 .00
12/7/12 123 The Villas H.A. Jan/Feb/March Real Estate R -375.00
2/15/13 130 Met Ed Real Estate R -85.66
3/6/13 131 The Villas H.A. April Real Estate R -125.00
3/6/13 132 Met Ed Electric Real Estate R -123.08
3/6/13 134 Met Ed Real Estate R -45.79
3/6/13 135 Met Ed Final Met Ed Bill Real Estate R -20.08
Total Real Estate � i
Total Expenses -9,6 6 9.7 9
Total Income/Expenses -9,fi fi 9.7 9
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