HomeMy WebLinkAbout07-12-13 J 1505610143
REV-1500 EX`°,-,°, �`
OFFICIAL USE ONLY
PA Department of�Revenue pennsylvania co�mr coae vaa� File Number
Bureau of Individual Taxes °E°•"'"`NiOiPF"""`
Po sox2aosoi INHERITANCE TAX RETURN .21 12 1274
Harrisburg, PA 17128-0607 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
11 17 2012 07 19 1947
DecedenPs Last Name Suffix Decedent's First Name MI
DARR JANET M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M�
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Retum � 2. Supplemental ReNm � 3. Remaintler ReNm(tlate ot tleath
prior�o 72-13-82)
4. Limi[ed Estafe qa.Future Inlarest Compromise � 5. Fetleral Estate 7ax Retum Requiretl
❑ ❑ (tlateo(tleathaflerl2-12A2)
O 6 �ecetleM Died Tastate � �� �qpach Copy of�rusd�a Living Trust � 8. Total Number of Safe Deposii Boxes
(Attech Copy of Wili)
� 9. Litiga6on Proceetls Received � 14�betweenl2 31�J1 dnd�t�(aat�es�deam � 7�.Election to tax untler Sec.9173(A)
(Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
gRADI,EY L GRIFFIE 717 243 555'1
RE((S�TEOR OF WIIc.I.S US��Y
� � � �
First line of address r�i7 T G'> ' `-ry+. �
200 NORTH HANOVER STREE � � m rFV a �
D N � p p
Second line of address o � a —D '�'+ ,,.�
c� ° "*: � `� c�
�� �.�ATE FI f— fT7
City or Post Office State 21P Code '9 � � �N T '
�p�gi,Ig� PA 17013 m ca
CorrespondenYs e-maii address: bgriffie@griffielaw.com
It Isdtrue co�rreet ende�mpletle cDeclehration of preparer oah rthen me pe�rso�nalaepresentative Is besetl on aUll nforma on'of whlchhpreparelhas an�nowletlge belief,
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
1��� �'i/�'l�//� �r Merie E. Mixell,Jr. / d �3
A ESS � j�
�/
121 Steelstown ad Newville PA 17241
SIGNATUR R OTHERTHAN REPRESENTATNE DATE
Bradley L Griffie o �3
ADDRES
2 anover Street, Carlisle, PA
Side 1
� 1505610143 1505610143 J
_ _
PA Inheritance Tax Return
Signature of Additional Fiduciaries
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
Under penalties of perjury, I declare that I have examined this retum,including accompanying schedules and statements,and to the best of
my knowledge and belief,it is true,correct and complete. Declaration of preparer other than the personal representative is based on all
information of which preparer has any knowledge.
Signature#2 �(
Name Donald L.Mixel
Add�@551 262 West Penn Street
Address2
Clty, StBt@,Zlp . Carlisle PA 77013
Date � �-3
� 1505610243
REV-1500 EX
DecedenYs Social Securiry Number �
oa�ae^r�Name Darr, Janet M.
� RECAPITULATION
1. RealEstate(ScheduleA)....................................................................................... 1. 125 � �00 . �0
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporetion, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5� Cash,Bank Deposits&Miscellaneous Pereonal Property(Schedule E)............... 5. 1 J , 7 99 . 7 4
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous�nq-Probate Property
(Schedule G) U Separate Billinp Requested............ 7.
8. Total Gross Assets(total Lines 1-7)..................................................................... 8. 144 , 799 .74
9. Funeral Expenses&Administrative Costs(Schedule H)....................................... 9. 43 ,:133 . 75
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule I).............................. 10. 4 65 . 44
11. 7otal Deductions(total Lines s&10)................................................................... t 1. 43 , 59 9.19
12. Net Value of EsWte(Line 8 minus Line 11).......................................................... �Z, 101�200 . 55
�3. Charitable and Governmental Bequestsl5ec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subjectto�Tax(Line 12 minus Line 13)............................................... �4. 101,200 . 55
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9176
(a)(12)X.00 15. 0 . 0 0
16. Amount of Line 14 tazable 0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line 14 taxable �
atsiblingratex.tz 101�200 . 55 ��. 12 ,144 . 07
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 00
19. TaxDue.................................................................................................................. 19. 12 �144 . 07
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
L 1505610243 1505610243 J
REV-1500 EX Page 3 . File Number 21-12-1274
DecedenYs Complete Address:
DECEDENT'S NAME
Darr,Janet M.
STREETADDRESS
925 Greenspring Road
CITY STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Taz Due(Page 2, Line 19) (�) 12,144.07
2. CreditslPayments
A. Prior Payments
B. Discount 0.00
� Total Credits(A �+B) (2) 0.00
3. Interest (3�
q, If Line 2 is greater than�ine 1 +Line 3,enter the difference. This is the OVERPAYMENT. �q�
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) �'1���.�7
Make Check Pa able to: REGISTER OF WILLS, AGENT.
i3! .;t, � i _ m
2•
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:............................................................................... � �
b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ ❑x
c. retain a revereionary interest;or............................................................................................................... ❑ ❑x
d. receive the promise for life of either payments,benefits or care?............................................................ � �
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?.................................................................................................................... x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ �x
4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which
wntains a beneficiary designation?.................................................................................................................. ❑ ❑x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
..._:��. ,.
v ���� ,;,.;. .., ,.«t..._�r,__ _..__ . ...._..a_,. , _
.:I n! .��i... �u. �". .3� ��i ��� i: . . i c.' 'iS�' h ' � 3 .���� 'i;�;�9ii'i
For dates of death on or after July t, 1994 and before Jan. 1, 1995,the taz rate imposed on the net value of transfers to or for the use of lhe surviving
spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For tlates of tleath on or after January 1, 1995,the taz 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 taz 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)(12)].
.The tax rate imposed on the net value of transfers to or for the use of the tlecedent's lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116 12)[72 P.S.§9116Ia)(1)].
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blootl or adoption.
Rav-0502 EX«(11-08)
SCIiEDULE A
REAL ESTATE
COMMONWENLTIOFPENNSYLVANIA
INHERITANCETAXRETORN
RESIDENTDECEDEM
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
All real property owned solely or as a tenent in common must be reporfetl at falr market value.Fair market value is d�ned as the price et which pmpeny would be
axchangetl EeN�een a willing buyer and a willing seller,neither bemg mmpelletl to buy or sell,both having reasoneble knowletlge of iha relevant facts.
Raal pmParty which isjoinlly-ownetl with Mght of survivorship must Ge tllscloseE on sehetlule F.
Attach a capy of ihe settlement aheet if ihe property has been soltl
- Include a copy of Ne Eaed showing decetlenPe interest if ownetl as tenant in eommon.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Single Family Residence-925 Greenspring Road 125,000.00
Newville, Cumberland County, Pennsylvania
(See attached HUD-1 Settlement Statement)
TOTAL(Also enter on Line 1, Recapitulation) 125,000.00
Qf more space is neetled,additional pages of the same size)
Copyright(c)2009 torm software only The Lackner Group, Inc. Fortn PA-1500 Schedule A(Rev. 11-OS)
Rev�1508 E%*(6-98)
SCHEDUdE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEpLTHOF PENNSVLVRNIA
INNERITANCE TA%RETIIRN
RESIOENTpECEDEM
ESTATE OF FILE NUMBER
Darr, Janet M. 21-12-1274
Inclutle the proceetls of litigaban antl ihe date ihe procaeds were received by ihe estate.
All propertylointly-owned with ihe tlght of eurviwrship must be 0iscbsetl an schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
9 Personal property auctioned 438.00
2 ACNB Bank-Statement Savings Account No.XXX3072 12,482.53
(See attached statement)
3 ACNB Bank-Esteem Checking Account No.XX5193 4.379.35
(See attached statement)
4 1995 Chevrolet Blazer-(See attached Kelly Blue Book Value) 2,327.00
5 United Healthcare Insurance Co. -Premium refund 155.25
6 PPL Refund 23.61
TOTAL(Also enter on Line 5, Recapitulation) 19,799.74
pf more space is needed,atltlilional pages of the same size)
Copyright(c)2002 torm sofiware only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.6-98)
REV-1151 EX*(10-06)
SCHEDULE H
COMMONWqEAqL�TpHOFPENNTGpYLVANIA FUNERAL EXPENSES &
�RES�IDEN7E�ECEDENTR� ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION
MB AMOUNT
q, FUNERAL EXPENSES:
See continuation schedule�s) attached 4,880.e6
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
Ciry State Zio
Year(sl Commission oaid
2. Attornev's Fees Griffie &Associates, P.C. 6,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 315.50
5. Accountant's Fees
6. Tax Return Preparets Fees
7. Other Administrative Costs 31,937.39
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 43,133.75
Copyright(c)2009 fortn software only The Lackner Group, Inc. Fortn PA-1500 Schedule H(Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
ITEM `
NUMBER DESCRIPTION AMOUNT
Funeral Exoenses
�1 Egger Funerel Home, Inc. 4,880.86
H-A 4,880.86
Other Administrative Cost�
2 PPL Electric Utilities 445.97
3 The Sentinel(Advertising) 189.54
4 Cumberland Law Journal (Advertising) 75.00
5 Diversified Appraisal Services-(Real EsWte Appraisal) 350.00
6 AuctioneePs fee/costs-(See attached statement) 203.30
7 Real Estate Sale Costs-Realtor's Commission-$7,725.00 9,310.41
Realty Transfer Tax-$1,250.00
2013 County/Twp.Taxes-$330.41
Tax Certification-$5.00
8 Advanced Disposal (Trash/Dumpster) 390.42
9 Todd McKeone(repairs on real estate) 6,350.00
10 Donald Mixell,Jr. (trash removal) 210.00
11 Becky Mixell (trash removal/cleaning) 60.00
12 Blue Mountain Garege Door Service 1,100.00
13 Rosenberry Septic Service 287.40
Copyright(c)2002 fortn software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
ITEM
NUMBER DESCRIPTION AMOUNT '
14 Anthony Neil Contractor(repairs on real estate) 6.600.00
75 Shelly Patterson (cleaning) 120.00
16 Lowe's(home repair materials) 1,783.00
17 Brenda Etter-McCoy -(HOme Repair Materials) 103.00
78 Quigley Mechanical Services, Inc. -(Home repairs) 140.00
19 Rick Garman Remodeling -(Home repairs) 1,354.00
20 Lebo's Plumbing, Heating 8 Air Conditioning(Home repairs) 777:17
21 ShaffePs Concrete Constructin(Home repaire) 1,200.00
22 Shaffer's Lawn Care 150.00
23 E.E. Kough &Sons(Furnace repairs) 738.18
H-B7 .31,937.39
Copyright(c)2002 form so(tware only The Lackner Group, Inc. Fortn Pq-1500 Schetlule H(Rev.6-98)
Rev-757S E%+(72-0e)
SCNEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8� LIENS -
COMMONWEAITHOFPENNSYLVANIF
INHERIThNLETAXRETURN �
ltE51DENT�ECE�EM
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
Report tlebts incurretl by the Eecedent prior to death that remainetl unpaitl at Me tlate of tleath,inclutling unreimburmetl medieal expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Forrest Park Health Center 67.00
2 PPL Electric Utilities 220.26
3 Southampton Township(tresh billing) 98.53
4 Centurylink(phone) 79.65
TOTAL(Also enter on Line 10, Recapitulation) _ , 465.44
Qt more space is neetled,adtlitional pages of the same size)
Copyright(c)2009 form soflware only The Lackner Group, Inc. Fortn PA-7500 Schedule I(Rev. 12-08)
REV4571 E%��H-08)
SCHEDULE J
coMr�������'YANin BENEFICIARIES
ESTATE OF FILE NUMBER
Darr,Janet M. 21-12-1274
NAME AND ADDRESS OF REL4TIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER pERSON(Sl RECEIVING PROPERTY DECEDENT (yyords) (�$$)
I. TAXABLE DISTRIBUTIONS [include outright spousal
distnbutions,and transfers
under Sec.9116 a 12
Donald L. Mixell Brother Fifty percent
262 West Penn SVeet
Newville, PA 17241
Merle E. Mixell,Jr. Brother Fifty percent
121 Steelstown Road
Newville, PA 17241
Total
Enter dollar amounts for distnbutions shown above on lines 15 throu h 1 B on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
�• A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
6.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2009 fortn software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 11-OB)
OMB Approval No.2502-0265
������� ,A. Settlement Statement (HUD-1)
:`ilinlU f
1.Q FHA 2.�ftHS 3.Q Conv.Unins. �,Di;��umber: 978�oa5n Number: 8.Mortgage Insurance Case Number:
4.�VA S.QCOnv.lns.
G Note:T�is fortn is fumishetl to give you a statement of aclual selllemenl wsk.Amoun4s paiE ro and by[he settlement agenLS are shmvn Items marketl
"(p.o.c)"were paitl outside t�e Gwsing they are shovm here for informational purposes antl are not inclutletl in Ihe rotals.
D.Name 8 Address of Bortower: E.Name&Address of Selier: F.Name&Address of Lender:
Brenda G.Etter-MCCoy Estate M Janet M.Darr Comerstone Fedeal Credit Union
1125 Retlwoad Dnve,Cadisle,PA 17013 925 GreensD�ng Road,Nexville,PA 17241 5 Eastgale Dnve,Cadisle,PA 17015
G.Property Locatiort H.Serilement Agent I.Settlement Date:05123Y2013
925 Greenspring Road Pyrdmid Land Transfer LLC Disbursement Date:OS/2320i3
Newville,PA 17241 26 Wesl High Sireet,Cadisle,PA 17013
Parce13608A59S003,A,North Newlon
Township
Place of Settlement: TitleEzpress
2G West High Street,Cadisle,PA 17013 PriMed 05"27J2013 at 121 pm
by RLM
100. Gross Amounl Due from Bartower 400. 'Gross Amaunt Due to Seller ' ' � ' '
701. ContraQUlespnce 125,OOO.W 401. ConUaclsalespnce �z5,000.00
102. Persanal m 402. Personal r
103. Setllemen�charges to bortower(line 1400) 6,420.90 403.
1�. �.
105. 405.
Ad'ustrnentsforttems aidb sellerinadvance Ad'uslments(orilems aid6 sellerinadvance
706. CiNn�taxes to 406. Cityflown taxes to
107. Counry taxes 05232013 to 177d112013 197.83 4W. Counry t�es 0523R013 to 11J37I2013 197.83
108. Schrol Tazes 051232013 lo Ofi13012013 174.43 408. School Taxes 0.52312013�o Ofi130/2013 174.43
1a9. 409.
na. aio.
m. an.
»Z. a�z.
120. Gross Amaunt Due irom Borrower 717,793.76 410. rt',ross AmouM Due lo Seller 125,37216
Y00. AmouMS Paid b or in Behalf of Bortov.er 500. 'Reduclions In Amounl Due to Seller
201. Deposit or eamest money 1,400.00 501. :6ccess tleposit(see insimctions)
202. Pnndpal amount of new Iwn(s) 100,OW.00 502. ?SeNement cha�ges to seller Qine 1400) 9,310.41
2�3. Eeistin loa s takensu �ectto 503. ?5cis6n loa s Iakensu6'eclto
ppp 504. �Pa oRoffirstmort a eloan
205. 505. `P off of second mort a e loan
20fi. `�.
207. FA7.
208, `'�.
209. �.
Ad'ustmen4s for i[ems un aitl seller Ad'u3tments for ifems un aid b seller
210. City/townimces to 51�, Citytlowntaces to
211. Countytaxes to 511. Countylaxes to
� 212. SchoolTaxes to 512. SchwiTazes to
�I 213. 513.
214. 514.
215. 575.
216. 516.
217. 517.
218. 518.
219. 519.
1]0. 7ota1 Paid b r Borrower
1U1,000.00 520. 7��ReduclionAmauntDueSeller 9,370.41
700. GahatSeWementfromitoeorrovrer �BOO.��CashffiSettlementroHromSeller �
307. Grossamountduefrombortaxer(Iine120) 131)93.16 601. Grossamountauetoseller�line420) 125,37226
302. �-PSSamounispaitlbyflorhortower(Iine22U) 101,000.00 6�2. �reduc6onsinamountdueseller(line52�) 9,310.41
303. Cas� ❑X Fmm ❑ ToBortower 3�.�93•�6 607. Cash ❑X To ❑ FromSeller 776,061.85
uhu�pfqqs�pmrlryntl WBamdiurC�i.W miMnII�YY buavN:NkEY'luunYnu�tluM.T�6YCU9nM�epwtlelMp�IM�lo�PFdP1m.eM0m�ebnwl�MomulbnmOUFp W
Vrevious editions are obsolete 7age 1 of 4 HUD-]
T00. YofalRealEClateBrokerF¢es 57.725.00 � ' -Paid�From �Paid�F.rom;•
Olv�sbnormnumssion�ine7ao asknwrs: � --BOrrowers � �� �Seller's� ' .
701. 53750.00 to �DUSellDetwl�er Funds at. :Fands.at
1az. f3975.00 to HowardHanna Se[tlement 'Settlement��
703. Carmission C�d el uilkment 7.775.00
800. ttems hle In Connecllon.vMh Inan - ' - � � �
8111. Ouroriginalionc�a�ge (I�uOesOri�inatimPdn�O.WON,mS0.00) E1.4fi0.00 (franGFE#1) .
802. Your oetli�a Uimge(pdnis)la t�e spedf�c imerest rate chosen E1,682.00 (hom GFE tt2)
803. Your aCl���nation tliarges (GOm GFE A) 3.142.00
8U4. Apprasal fee to Canerstme Fedaral Credll Unbn � (�GFE A3) 375.00
�� �'�'eG� to Camerstpre Fetlerel�t Umon (�GFE t13) 56.00
806. Taservf[e � to fromGFEA3
807. Flaotl ceNfication In Cdnerstare FeOaal Cretlit Union (�GFE 0.i) 1950
�. ��9k�� to Camerslme Fetlerdl�1 Unian (�GFE t13) . 70.00
90�. Rems R uired Lenderto be Pald in AEranx � � � - � � �
907. Dallyinlerestchaigeshan hom0527I1073toIX'JJ72013�56.6000/0ay (fmmGFEC10) � 52.80
902. Morta Insurmae 'um monNS to fiom GFE A3
903. Hanevxnefs msurairoe monUS to fiom GFE ft11
BD4. manNs lo hom GFEl111
t000.Reserves�De sllMwltfiLenECr . ' . . . .
1001. Initial deposit ta ynur esarnv aosunl (Irom GFE A9)
1002. Hqreoxnefsinsurance rtpnlhs S hnonih
1003.Mort elnsu2(roe monNs 5 /monU
1004. lazes mm�ns E ImonN
700.5.Counry taes ' monNs S 26.98hnmlh �S
7006.Assessments rtronlh5 S 136.00/manN f
10W.Ag9regateAd'rystrn.mt S
NOO.TItIeCha es � �� • " - �- � .
1101.TNe seMces aM lerqefs Ii11e insursnce � (rom GFE itd 1.221.fi0..�.
1102.SetllprentwUOSngfae to S
1103.O�mefs tiUe insurarce from GFE A5 125.00
1106:lendela tltle mswance -f1.050.00
1705.1entlefsti�lepdiq6mf15100,000.00 LendefsPdiy
, 1106.OtmefsGUepdiqlim05175.OW.00 GmefsPoliry
7107.AgenfSpatianMNetotal�i�efnsurairceprerttium 51,021.25
1108.Undenrtltrls pption of Ure IMaI fAla insurawe preMUm 515375
1109.Closing PiMedian letter to Itl lanE Transfer LLC 575.00
7110.Atlomey Fee - to G'Mtie 8 Assodates POC SI
7200.GovemmeirtRecordln endTrenskrCha ea - � � -� � �
� 1207.Govemmenl remrtirg charpes b (hpn GFE#7) 169.00
1202.Oee0554.00 Mata SB6.OD Releaseb
12(13.T2miataxes S (franGFEAB) 1.750.00
1204.GN�ty�tamps peed8l .00 Mat eb
1205.SuteTadstamps peeEE1 .00 MM e5 1.250.00
��� Oeed S Mat e 5
7207.ParEICMifiWUon • .520.00
7208.FJec�micFllingFee f9.W - .
i�00.Add(tlonaiSettlemer�fCha es � - ' � - . -
1301.Re9uheE seMms Nat you can sMP for (han GFE k6).
1302. Jn
1303. to
1306.2013 CourityRwp Ta[es to Dailerre Pittrnan 33p.41
1305.TazCerlificationFee toDa�lenePltlman 5.
7306.Hpnpl�emulehNaler Inspeplms to Central PA Home I rons S A95.00 P.O.C.B'
"' � • � 6,420.90 9,310.41
'Paltl auls�Ee M dosl^9 M(Blmoxe�.(5)eller�(LlenOer�(qmmia.Bro(K�r.'Cred�by lender sliwun on page 1."'�t by sella sM�m on DaBe 1.
PfEVI0u5 EdltlOnS afE Ob501ete 7age 2 Of 4 HUD-]
Ca arison ot GooO FeHh Eatimate G end HU0.7 Cha ea Gaod FaNh Fsllmete HU0.1
Ch� esThBiCenrwtlncreane MU61l1neNum6er
a�ag�nauoncnarge e eoi i.�wom i.aco.ao
YaraetlilaMaigelDanLS)fanhespedfciMe�azlraletlbsen @ B02 7.68200 1,682.00
Yar adju5ted pigination cha�es p B03 3.74200 3,742.00
T2nskrta�es 2 1203 1,150.00 1,750.00
Gha esThatlnTotalCamrotinaeaseMoieTlianl0% Good"FaXh"Eetlmate HU61
Govemrtentrecwdmgtharges p 7201 169.00 769.00
Appalsalfee R �4 375.00 375.00
Cred�reD� p 805 56.00 56.00
FIODO aMifzatqn S BW 19.50 79.50
CorelogkGedco R.� 10.00 10.00
A
R
x -
629.50 629.W
� S 0.00 0.0000%
Cha ea That Gn Chan e ' Gaod'FeXli Es4matn :HUQt.
InNaltlepo6itforyaure5vvx�acouM � -�R 1001 - - 0.00 0.00
Dalrymte�astchaigesfian p:90t S6 52.Bf1 52.80
Homevimefsiiauram -� � :.R-903 . _ 0.00 0.00
TNB servioe5 antl IeMefSlitle in5u2nce � ' p 1101 1,111.60 1,721.60
Ownefs 61k Inw2xe �p 1103 � 725.00 125.00
HpmlrertnlldVlater•InspeGiptS .ffi 1306 r 530.00 395.00
p
Laan Terms
Your Wtial han anwnt Is ' . E10D,OOO.OD
Yprc ban Imm Is 15.yeas
Yarc InWal hAerest rate is 2.3750%
YaurinitlalmonNtyammloxealarpindpal,In�sl.antl�Y�9a9e Sfi60.93hdWes
InsuranCelS . QPNMpaI
px miear
❑�s�i��
Can yart Intmest rd(e ilse7 � : ❑X No. ❑Yes,ii can risa b a m�urtwm d X.The first�ange
wfll be an I I and an ctwMje again evey years aAer I l . Every
. change0ate,yourin�restralecaninaeaseadeaeaseby l6.Overthefded
� i1re ban,your Interesl rate is guarenteed Io never be loxer Ihan %v highv
Nan Ye.
Even If you make payments m time.wn your ban balarne Mse7 . ' ❑X No. ❑Yes,il an Ase to e m�dmum of b .
Even H you make paymenis m ime,.an yaur monNtyaimm�aved ta� ❑x No. ❑Yes,ihe firsl inaease pn be m I / aM Ihe maMty
pri�pal,hnerest,�and malgage Insurance rise7 amount oxe0 an risa to S .
- � ihertadmumnraneverriserotsb
Oces yaur ban have a qepaymeM penalyt ❑X No. ❑Yes,yptt^�atlmin^D�GaY���D��Y�S .
Wes�ywrlo�havea�halbonpaym.mf7 '� ❑7( No. ❑Yes,ynuAaveaCaMOOnpaymentd5 CueM
yea�sm I I
Tdal monOtly artnunt onBd�Mumn9 esaow eaaMlOaY��S � ❑X Ya Eo not hare e monlhly 85aox 7eY��fa I�ems,Suth a5 PW�Y tax6
aid Am�eamefs Insuranoe.Ya musl pay Nesa tterta dxettly your5elt.
❑Ya have an�6onal monNy escmw payrt�nt d b
Nal�esults ln a total Ini6al monU�ty anwnl oxed dS .This Nd�qi�Mpa�intaest
any rtqrt9age Insutarice xn0 anY items thedce0 belar.
' Q Pmpe�y tmes ❑Homeo.mefs Insuiawe
�FWOtl insurzxe ❑
❑ ❑
Note: If you have any questions a6oui�he Settlement Chafges and Loan Te�ms listed on Uis fortn,please conUd your lender.
Prevlou5 eEitlonS are ob501ete Page 3 of 4 HUD�7
HUD CERTIFICATON OF BUYER AND SELLER
I have lsmhly reviewetl the NUP1 Seltbment Statement¢M to lha best al my knowle0ga enE Coliaf,tt h a true enE acwreU atelertrent of ell recelpts aik
ElsEUrxrtrenis maEe on my eaount ar by me in Nis Iransaqiort I/uMer artHy that I have receive0 e copy of t�e HU67 Setllertrent StetemenL
�,�,� �-meC�u
BrenOa�.EtlaN.cCoy
�
I
I /J � � . . �� �
I
I
I /yJ / �yJ� ��( �
I %✓-`�" � .fi�"„7;'�I ♦� ��H�
ESTATE OF JANET M.�A 7
l
TOe HUOt SatOement Statement which I Aave prepared Is e inx and eamste e¢ount of t�h transacUOrt I�ava fausetl orw10 muse the NrMs to Oe
EiSburseE in aaoNance wtth t�h stetement �
1 � s�y�/� 3
SEffLEMENTAGENT DATE
I
I
(
�
I
WARNING R IS A CRIME TO KNOYVINGLY MAKE FALSE STATEMENTS TO THE UNfTED STATES ON T11S OR ANY SIMILAfi FORM PENALT7ES UPON
iONVICTION G4N INCLUDE A FINE AND IMPRISONMEM.FOR DEfA1LS SEE TfT7.E 10:U.S.COOE SECTION 1001 AND SECTION 1010.
irevious eCidans are obsolete Page 4 of 4 HUD]
I
L.�
__
BA�
December 28, 2012
Griffie&Associates PC
Attn: Bradley L Griffie
200 N Hanover St
Carlisle PA 17013
RE: Estate of Janet M Darr
Dear Mr. Griffie:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interestto Opened/Joint
D.O.D.
Statement 9613072 $12,482.53 $0.29 Individual 6/16/OS
Savings
Account
Este'em 115193 $4,39935 $0.17 Individual 1/22/SS
Checking
Account
Inquiries concerning ACNB Corporation stock inforrnation should be directed to the Registrar and Transfer Company
at 1-800-368-5948. Ifyou need any additional information, please contact me at(717)339-5122.
Sincerely,
�����
BarbaraJ Warner
ACNB Bank
Deposit Services Representative II
acnb.com •acnbbusiness.com• P.O.Box 3129,Gettysburg,PA 77325 •Phone 71 73343 7 67 •Toll Free 1.888334.ACN6(2262)
Kelley Blue Book Page 1 of 2
i �� i Ke��y P�ue Dflflk The Trvsied Resource'� �
� -
I • � � � ►
=`6el�iQuder'
aavemscnent whYaos?
i Your Blue Bookm Value
1995 Chevrolet Btazer
Sryle:Sport Utlliry 4D
Mileage:q1000
Private Party Value
Vehicle Highlights
Exceltent
S3'�2�' MPG:Ciry15/Hwy19 ;, MaxSeating:6
...__...__._.
Very Good
SZ 896 Doors:4 Engine:V6,High Output,4.3L
_...............____
� Drivetrain:4WD ���. Transmission:AUtomatic
Good
-�2.821 EPA Class:Sport Utiliry Vehicles i Botly Style:Sport Utiliry
_.._._....___.___.__....._.. ,,
Fair Country of Origin:United States ' Country of Assembry:United States
$2;321
Your Configured Options
__....... _..__ _._.... ..
Our prrselec�d optlons,bnsetl on typipl equlpment far this ar.
!Optlons Ma[you addetl whik conflBUrtn9�is mr. .
, E�ine BrekinpandTracLOn EnterbinmentanElnatruma�fion
" V6,Hlgh Ouqw4 43L ; A85(4Wheep AM/FM S�Ro
Trensmission '�, CqmfortantlCOnvenlence � WheeisantlTires
' Autr�matic � qirCOnditionlig ' SteelWheels
Drivetrain SCeerinB .
4WD . VowerSteerin9 :
:__. ........... ....._.. _.____._ ....._.. ................. __.._._ _._.. .......... _.___._. ...._...._�
Glossary of Terms
' Kelley Blue BookQ Trad<In Value-This Is tice amoun[you mn n,yec[ro recelve when you tratle In '�,
' your or ro a tlealer.iliis value I5 tle[ermined based on tlle styk,mndition,mllwge antl optlans '
i Indimted.
��. Kelley Blue BookO Private Parry Value-This is Me sbrtlng point kr negotlatlon of a used-mr sale
; beMreen a pnva[e buyer antl seller.This Is an"as is"value Mat dces no[intlude a�ry wartantles.The final �
; p�ice tlepends on ihe mYS acWal conEltlon an0 bol marke[facrors.
� Ezcellant Conditlon:3%of a0 mrs we value mee[Mls alteha.This rar looks new and Is in a�cellmt '
; mechaniql conditlon.It has never had palnt or botlywork a�lias an Interbr aM body iree of wear and '
�, visible tlefecls.The wr Is�usFfree and Oces no[rieed recoiMitioning.Its tl�n engine compartment Is '.
http://www.kbb.com/chevrolet/blazer/1995-chevrolet-blazer/sport-utility-4d/?vehicleid=73... 5/30/2013
Kelley Blue Book Page 2 of2
� (ree of flultl leaks.If also has a clean tltle histnry,has comqete an0 verifiaMe servire reroMS antl will '�,� . I
�� pass safecy an0 smog Inspection. ' i
: Very Gootl Cqntlitlon:13%o(all cars we ralue meet Mis ctl�na.This or has minor wear or vlsible �:
:: defetls on the body and intetlor but Is In eaellmt mechanical cantllbon,requlnng only minlmal '
I remndPoOning.It has IIMe[o no palnt and 6odywwk antl Is hee of rus[.ICS clean engine compartment Is
i hee of flultl leaks.The tlres mahh aiM have 75°/a or mare of Oeatl.l[also has a clean tltle hisrory,wIM ,
'�. mos[service records available,arM will pass safety aM smog Inspectlon. �'
; Good Conditlon:54Wo ot all ors we value meet Nis ulterla.ThIS wr Is free of mapr mechaniml
'�, pmblems bu[may neeA some reronditioning.Its palnt antl botlywoifc may repuire mi�ror rou[h-ups,with �,
! repai2de cosmetic tlefec[s,antl i[s engine compartment may have minor leaks.There are minor botly '
� 5[2trhes w tlings antl mirwr Interlor blemisha,but no rust.The tlres rtwCh aiM have 50%or mare of
; treatl.It alm has a tlean tltle hls[ory,wIM wme servire mcartts available,antl will pass safe[y antl smog '
; InspKtlon. "'.
j Feir Contlidon:18%af all cars we value mee[MIS crlRMa.ThI5 car ha5 wme methanical or msmetic �
; tleFectr a�needs servlcing,but is stltl In safe mnning contlition and haz a Uean tltle his[ory.The palnt, �
i body antl/or Intenor may neetl pro(rsslonal servltlng.The tires may neetl replanng and Nere may be
�.�wme repa�2ble mst Oamage.
�1995-1013 Ktlley Blue Brok Co.�,inc.All rights reservai.
�2013 K<Ihy BNe Bwk Co.�Inc NI tlgh6 rexned 5/24/2013-5/30/3013£tlNOn/ar F¢�nryNanN I]]91.]he spe 1/ICM/omutlon rtyulreO to -
tle[mnMe Ne value brMlsOaNrvlar vMltle ws suOV�Oy the person genvafln➢tNS rtport.VeNrM vNUatbras ere opinbns arb may vary Irom
veM1)tle fo vaYhM.AGUeI nlueHws xYll verybpsetl u0on maMef ron0/lbns,spetlflt�atbns,veFltle mMIWn or otlre�{arthuWr tlirums[enres pntlnenf
la Mk pfRlf�brvehkle arNe franID[tlon w Me paM'es ro Me banvttbn.This�epoK/s InfenOeElwMe lMlvlOVal use 0I Me person peneiatlnq t�it
rtpwt onty anO s�all iro(Ce sd0 w berttmlfRtl ro elroNe�party.KNky&ve BoaY assumes no respanLdllty Nr errvrs w wMSlons.(v.13050)
http://www.kbb.com/chevrolet/blazer/1995-chevrolet-blazer/sport-utility-4d/?vehicleid=73... 5/30/2013
ROWE'S AUCTION SERVICE �RH 79L>
2505 Ritner Highway • Carlisle,PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 674-1008 Dave Rowe (AU 2295L)
' Auction Is Action C¢Zl "Rowe" For Satisfaction
SELLERS NAME f'LS'7�r� o-�F �"JS�.x wl. �A.�..�..- DATE �� � 3
A'��R,ESS ��3�.�e l�-�., �. �a�s�.rE �5 � PHONE �'f'�-'�'� (
O'I`HER C.-�L+J=F-1 Fa.- $A-SS�.c.1.cR�S , I�.C.. AUCTIONEEIi % � S
AUCTION D.STE/LOCATION �..f�'`"^'`,��. l'�� 1�� �3 CLERI{ %�U���" �`��--���
DESCRIPTION OF MERCHANDISE
-Y'"�,`s`,�c. .. !?��e�-s,���-�-ed - (,�� n.��..... �. T�a ac ��J,caw e
,s,ys�is `,k=„-
, ; ..
. , w,< . . . .
aa„ �. '
,j
:^r.
. ...,y,..- -,.. . . _ . .,_..... . ... .._..... ._... . . .. ._. ........ . . .. . . �n.
- .. -.,v ���k�� .. . ... ,_...: . ... .. ... ...: . . . .._ ,. .-. ..,: ,_ .. .. ._..,.�
�S"S ��.f1`�c/t l�A'�-a-�-� . �0
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify.that I am the owner or authorized represen-
tative of the merchandiae,goods and or property and have good title and,the right to sell and that they are free
from all incumbrancea. I agree to accept all responsibility for providing merchantable title and for delivery of :
, , title.to the purchaser. I agree.to hold harmless the AucCioneers against.any claims of the nature referred to in .. T-''
this agreement. :�
L.�...�t......�-'--'-- /�'�_ �, r....� ,,,��y
AUCTION SIGNATURE SELLE IGNATURE
e
Total Sales (Clerking Tickets Attached) � �3� '
Less Sale Expense: '
� V
��% Commisaion Auctioneer $ f � 3
% Commission Clerks $ 4��!;>,;,
OTHER: �-�c,- �rz_ �` a �=�
3�_
TOTAL SALE EXPENSE DEDUCTED $ 2� 3
'l,d .
, � SELI„ERS,NET $ �-3 � ',