HomeMy WebLinkAbout12-30-13 (2) 1505610140
REV-1500 EX (02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 2 1 1 3 0 6 6 1
ENTER DECEDENT INFORMATION BELOW ^
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 5 2 7 2 0 1 3 0 7 3 1 1 9 1 8
Decedent's Last Name Suffix Decedent's First Name MI
F A G A N M A R Y K
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1.Original Return 2.Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
El 4. Limited Estate 4a.Future Interest Compromise(date of 5.Federal Estate Tax Return Required
death after 12-12-82)
QX 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
E] 9.Litigation Proceeds Received 10.Spousal Poverty Credit(Date of Death El 11.Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytim F3relephone Neer X
H U B E R T X - G I L R 0 Y 7 197;x° 2 4 7 32394 1
C-D cr,
RRr—GIATER"OF W L�,�yS USF�.t
M CZ)
First Line of Address
1 0 E A S T H I G H S T R E E T = c
Second Line of Address --I
L:7 Ct� T1
City or Post Office State ZIP Code DATE FILED
C A R L I S L E P A 17 0 1 3
Correspondent's e-mail address: HGILROY@MARTSONLAW.COM
Under penalties of perjury,I declare that 1 have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is tr e,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG TURE Py PERSO. SPO E FOR KING RETURN DATE
A RESS
3 8 OM AMOR-OAD NEW CUMBERLAND PA 17070
SIGNA R O R R OT R THAN REPRESENTATIVE AT
Q oo 13
ADD
10 EAST HIGH S EET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
1505610240
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: M A R Y K• F A G A N
RECAPITULATION
1. Real Estate(Schedule A) . .. . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . 1. 1 . 5 0 0 0 0 . 0 0
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . .. . . ... . . . . . .. .. . .. . . . . . .. 2. 6 8 4 8 5 3 . 7 5
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3.
4. Mortgages and Notes Receivable(Schedule D) . . ... . . .. .. . .. . .. . .. . . . . . . 4. ,
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 3 3 8 2 0 9 . 1 3
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .. . . . . 6. 0 . 0 0
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) b Separate Billing Requested . . . . . . . 7. 0 . 0 0
8. Total Gross Assets(total Lines 1 through 7) .. .. . . . . . .. .. .. . . .. . . ... . . . 8. 1 1 7 3 0 6 2 . 8 8
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . .. . . . . . . . . .. 9. 6 8 4 7 9 . 3 3
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .. . . ... . . . . . . 10. 5 2 8 . 4 4
11. Total Deductions(total Lines 9 and 10) . . . . . .. .. . .. . . . .. ... .. . . . .. . . . . 11. 6 9 0 0 7 . 7 7
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . ... . . . . . . ... . . . . . . 12. 1 1 0 4 0 5 5 . 1 1
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . ... . ... .. .. .. . ... . .. . 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) .. . . . .. . . . .. . .. . . . . . . . 14. 1 1 0 4 0 5 5 . 1 1
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X.0_ 0 . 0 0 16. 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate x.15 1 1 0 4 0 5 5 . 1 1 18. 1 6 5 6 0 8 . 2 7
19. TAX DUE . . . .... . . .. . . .. . . . . . . . . . . . . . .. . ... . . ... . . .. . . .. . . . . . .. 19. 1 6 5 6 0 8 . 2 7
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
1505610240 1505610240
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21 13 0661
DECEDENTS NAME
MARY K. FAGAN
STREET ADDRESS -----
1833 RIDGEVIEW DRIVE
CITY STATE I ZIP
CARLISLE PA 1 17013
Tax Payments and Credits:
I. Tax Due(Page 2,Line 19) (1) 165,608.27
2. Credits/Payments
A.Prior Payments 150,000.00
B.Discount 7,894.50
Total Credits(A+B) (2) 157,894.50
3. Interest
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. (3)
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 7,713,77
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 ...................................................................... ❑ Q
b. retain the right to designate who shall use the property transferred or its income ............................... ❑ 0
c. retain a reversionary interest ..................................................................................................... ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ Q
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ Q
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only 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)1.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY K. FAGAN 21 13 0661
All real property owned solely or as a tenant in common must be reported at fair market value Fair market vahie Is riefinedas the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
l. Real property located at 1833 Ridgeview Drive,North Middleton Township, 150,000.00
Cumberland County,PA,known as Tax Parcel No.29-17-1585-154,being described in Deed
dated November 20, 1959,and recorded in Cumberland County,PA, Book O,Volume 19,
Page 359,and being conveyed to Charles C. Fagan and Mary K.Fagan,his wife. Charles C.
Fagan died on June 8, 1990, leaving title solely vested in Mary K.Fagan.
See attached Settlement Sheet.
TOTAL(Also enter on Line 1,Recapitulation.) $ 150,000.00
If more space is needed,use additional sheets of paper of the same size.
REV-1503 EX+(8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY K. FAGAN 21 13 0661
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 6,400 shares Carlisle Corporation(CUSIP 142339100)($425,736.00+$1,280.00 dividend) 427,016.00
See attached valuation report.
2. 3,072 shares Dover Corporation(CUSIP 260003108) 243,525.12
See attached valuation report.
3. 35 shares Prudential Financial(CUSIP 744320102) 2,360.23
See attached valuation report.
4. 488 shares Flextronics International(CUSIP Y2573F102) 3,568.50
See attached valuation report.
5. 118 shares PNC Financial Corporation(CUSIP 693475105) 8,383.90
See attached valuation report.
TOTAL(Also enter on Line 2,Recapitulation) $ 684 853.75
If more space is needed,insert additional sheets of the same size
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
MARY K. FAGAN 21 13 0661
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M&T Bank,checking account no.411752 11,477.50
See attached.
2. M&T Bank,savings account no. 150004200020937 123,426.76
See attached.
3. M&T Bank,certificate of deposit account no. 31003912754958 106,035.00
See attached.
4. M&T Bank,certificate of deposit account no. 31003911160586 25,381.67
See attached.
5. M&T Bank,certificate of deposit account no. 31003911160578 20,080.33
See attached.
6. M&T Bank,certificate of deposit account no. 31003911160560 19,424.71
See attached.
7. M&T Bank,certificate of deposit account no. 31003910365830 8,240.78
See attached.
8. M&T Bank,certificate of deposit account no. 31003908159609 15,653.02
See attached.
9. Cash in home 1,985.00
10. Highmark Plan-refund 85.10
11. Carlisle Medical Center-refund 200.00
12. Thornwald Home-refund 336.92
13. Shipley Oil-refund 1,955.95
14. American Modern Insurance-refund from homeowner's insurance 76.31
15. PNC-stock dividend deposited after date of death 51.92
16. John Hancock -annuity payments for April and May not deposited until after date of death 404.30
TOTAL(Also enter on Line 5,Recapitulation) $ 338 209.13
If more space is needed, use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MARY K. FAGAN 21 13 0661
Decedent's Name Page 1 File Number
Schedule E -Cash, Bank Deposits, & Misc. Personal Property
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
17. Mass Mutual-annuity payments for April and May not deposited until after date of death 997.74
18. Personal property and household goods 1,000.00
19. County tax proration 62.67
20. School tax proration 1,333.45
SUBTOTAL SCHEDULE E 3,393.86
GRAND TOTAL SCHEDULE E $ 338,209.13
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT EDEN TURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY K. FAGAN 21 13 0661
Decedents debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Funeral Home 5,464.40
2. Westminster Cemetary-grave opening 1,021.00
3. Rustic Tavern-meal after memorial service 111.06
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Years)Commission Paid:
2. Attorney Fees: Martson Law Offices 37,171.00
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Register of Wills,Cumberland County 783.50
5 Accountant Fees:
6. Tax Return Preparer Fees:
7. M&T Bank,fee to order estate checks 13.49
8. Better Looking Landscaping-pending disposition of property 704.90
9. PPL-pending disposition of property 134.21
10. PPL-final invoice 37.50
IL Robin Sollenberger-school taxes pending disposition of property 2,138.91
12. North Middleton Water Authority-pending disposition of property 253.37
13. CenturyLink-pending disposition of property 180.30
14. CenturyLink-final invoice 165.58
15. York Waste Disposal-pending disposition of property 49.73
16. York Waste Disposal-final invoice 34.72
17. On the Level Remodeling-painting pending disposition of property 6,574.20
18. Gilbert Pro Pest Control-termite treatment pending disposition of property 1,637.70
TOTAL(Also enter on Line 9,Recapitulation) $ 68,479.33
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MARY K.FAGAN 21 13 0661
Decedent's Name Page 2 File Number
Schedule H - Funeral Expenses&Administrative Costs -67.
ITEM
NUMBER DESCRIPTION AMOUNT
19. American Modern Insurance-homeowner's insurance pending disposition of property 434.00
20. Postage 85.55
21. The Sentinel-legal advertising 200.16
22. Cumberland Law Journal- legal advertising 75.00
23. Stock evaluation report 7,75
24. Register of Wills-additional short certificate 5.00
25. Computershare-replacement fee for lost stock certificate 175.61
26. Real estate commission-sale of property 9,000:00
27. Title services and lender's title insurance-sale of property 25.00
28. Transfer tax-sale of property 1,500.00
29. North Middleton Authority-final sewer invoice 45.69
30. Sellers assistance-sale of property 350.00
31. Register of Wills-additional probate 100.00
SUBTOTAL SCHEDULE H-137 12,003.76
REV-1512 EX+(12-12)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES&LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY K. FAGAN 21 13 0661
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Quest Diagnostic-account payable 63.26
2. CenturyLink-account payable 58.51
3. Millennium Pharmacy Systems-account payable 11.43
4. Thornwald Home-account payable 357.74
5. Mobilex USA-account payable 37.50
TOTAL(Also enter on Line 10,Recapitulation) $ 528.44
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN BENEFICIARIES
fi G
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY K.FAGAN 21 13 0661
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).J
1. John O.Galvin Collateral 552,027.56
348 Old York Road 1/2 of residue
New Cumberland, PA 17070
2. James A.Galvin Collateral 552,027.55
910 South Street 1/2 of residue
Avoca,PA 18641
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
r
LAST WILL AND TESTAMENT OF
MAR'S K. FAGAN
1, MARY K. FAGAN, of Cumberland County, Pennsylvania, declare this to be my last will
and revoke any will previously made by me.
ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall
be paid from my residuary estate as soon as practicable after my decease as a part of the
expense of the administration of my estate.
ITEM TWO: I give, devise and bequeath my entire estate to my nephews, JOHN O.
GALVIN and JAMES A.GALVIN,share and share alike per stirpes.
I
ITEM THREE: I appoint JOHN O. GALVIN,Executor of this my last will. Should he fail to
qualify or cease to act as Executor, I appoint JAMES A. GALVIN to act as Executor with the
same rights, powers and duties.
ITEM FOUR: All estate, inheritance, succession and other taxes, imposed or payable by
reason of my death, and interest and penalties thereon, with respect to all property
comprising my gross estate for tax purposes, whether or not such property passes under this
will,shall be paid out of the principal of my residuary estate,without apportionment or right
of reimbursement.
ITEM FIVE: I direct that my personal representative or guardian shall not be required to
give bond for the faithful performance of their duties in any jurisdiction.
ITEM SIX: In addition to the rights and powers given to the fiduciaries by law or elsewhere
in this will, I give to my Executor during the full time necessary and for the administration of
my estate the following rights and powers to be exercised in his sole discretion.
A. To retain any real or personal property which may at any time form a part of my
estate so long as he or she deems it advisable.
B. To invest in any real or personal property without restrictions to legal investments.
r
MARY K. PAGAN
PAGE ONE OF THREE PAGES
C. To repair, alter, improve or lease for any period of time any real or personal property
and to give options for leases.
D. To sell at public or private sale, for cash or credit, with or without security, to
exchange or to partition real or personal property,and to give options for leases.
E. To make distribution in kind.
F. To compromise claims.
IN WITNESS WHEREOF, I have hereunto set my hand this ! day of
, 2003.
SIGNED �` a �{
MARY K. FA AN
The preceding instrument, consisting of this and two other typewritten pages each identified
by the signature of the Testatrix was on the day and date thereof signed, published and
declared by the Testatrix therein named as and for her last will, in the presence of us,who at
her request, in her presence and in the presence of each other have subscribed our names.
COMMONWEALTH OF OF PENNSYLVANIA
ss
COUNTY( OF CUMBERLAND
We /7(, [� 61�tv signed and
witnesses whosAnames a ned to the attached or foregoing instrument being duly
g
qualified according to law, do depose and say that we were present and sa.v the Testatrix sign
and execute the instrument as her last will; that she signed willingly and executed it as her
free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testarix signed the will as witnesses; and that to the best of our knowledge, the
Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or
undue influence.
PAGE TWO OF THREE PAGES
Sworn and subscribed to
before me this J��day
of HC , 2003.
1
Bridget Ann Corcoran.otarial Seal
Nota Public My Boro, CumberlanCounty
c
y Commission Expires June 10, 2006
Member,PennsylvanlaAssociatlpn,,t .p..�
COMMONWEALTH OF PENNSYLVANIA
: ss
COUNTY OF CUMBERLAND
I, Mary K. Fagan whose name is signed to the attached instrument, having been duly
qualified according to law, do hereby acknowledge that I signed and executed the instrument
as my last will; that I signed it as my free and voluntary act for the purposes therein
expressed.
� y
MARY K. FAGAN
Sworn and affirmed to and acknowledged before me this day of
2003.
Notary P lic
Notarial Seal
[:Carfi:�sleBoro,n Corcoran, Notary Public
Cumberland County
ion Expires June 10, 2006
Member,Pennsyivan iaAssociationofNotaries
PAGE THREE OF THREE PAGES
A. Settlement Statement (HUD-1) V V FINAL
IB.Type of Lwn
1.❑FHA 2.❑RHS 3.❑X Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
13.2124GC 1310215356
4.❑VA 5.❑Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Richard J.Juday,Allegra Marian Franklin The Estate of Mary K.Fagan USAA Federal Savings Bank
2107 Walnut Bottom Rd.,Carlisle,PA 17015 1833 Ridgeview Dr.,Carlisle,PA 17013 10750 McDermott Freeway,San Antonio,TX
78288
G.Property Location: H.Settlement Agent: I.Settlement Date:1 V20/2013
1833 Ridgeview Dr. Guardian Transfer Corporation Disbursement Date:1 V20/2O13
Carlisle,PA 17013 4075 Market St.,Camp Hill,PA 17011
North Middleton Township
717.9094700
Place of Settlement: TitleExpress
4075 Market Street,Camp Hill,PA 17011 Printed 1 V20/2013 at 1:37 pm
by JMG
J.Summary of Borrower's Transaction K Summary of Seller's Transaction
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales price 150,000.00 401. Contract sales price 150,000.00
102. Personal property 402. Personal property
103. Settlement charges to borrower(line 1400) 7,015.82 403.
104. 404,
105. 405.
Adjustments for items paid by seller in advance Adjustments for Items paid by seller in advance
106. Cityltown taxes to 406. City/town taxes to
107. County taxes 11/20/2013 to 12/31/2013 62.67 407. County taxes 1112012013 to 12131/2013 62.67
108. School taxes 11120/2013 to 06130/2014 1,333.45 408. School taxes 11120/2013 to 06130/2014 1,333.45
109, 409.
110. 410.
111. 411.
112. 412.
120• Gross Amount Due from Borrower 158,411.94 420. Gross Amount Due to Seller 151,396.12
200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due to Seller
201, Deposit or earnest money 1,000.00 501. Excess deposit(see instructions)
202. Principal amount of new loan(s) 112,500.00 502. Settlement charges to seller(line 1400) 10,570.69
203. Existing loos taken subject to 503. Existing loos taken subject to
204. 504. Payoff of first mortgage loan
205. Origination Charge Credit 350.00 505. Payoff of second mortgage loan
206. 506.
207. Sellers Assistance 350.00 507. Sellers Assistance 350.00
208. 508.
209. 509.
Adjustments for Items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to 510. Cityltown taxes to
211. County taxes to 511. County taxes to
212. School taxes to 512. School taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220• Total Paid by/for Borrower 114,200.00 520. Total Reduction Amount Due Seller 10,920.69
300. Cash at Settlement fromlto Borrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from borrower(line 120) 158,411.94 601. Gross amount due to seller(line 420) 151,396.12
302. Less amounts paid by/for borrower(line 220) 114,200.00 602. Less reductions in amount due seller(line 520) 10,920.69
303. Cash Q From ❑ To Borrower 44,211.94 603. Cash ❑X To ❑ From Seller 140,475.43
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Previous editions are obsolete Page 1 of 4 HUD-1
700. Total Real Estate Broker Fees $9,000.00 Paid From Paid From
Division of commission line 700 as follows: Borrower's Seller's
701. $4,500.00 to Century 21 A Better Way Funds at Funds at
702. $4,500.00 to Coldwell Banker Homestead Group Settlement Settlement
703. Commission paid at settlement 9,000.00
600. Items Payable In Connection with Loan
801. Our origination charge (Includes Origination Point 0.000%or$0.00) $685.00 (from GFE#1)
802. Your credit or charge(points)for the specific interest fate chosen $562.50 (from GFE#2)
803. Your adjusted origination charges (from GFE A) 1,247.50
804, Appraisal fee to Service Link (from GFE#3) 375.00
805. Credit report to Equifax Mortgage SOlutions (from GFE#3) 15.30
806. Tax service to Corelo is (from GFE#3) 80.00
807. Flood certification to Corelo is Flood Services (from GFE#3) 5.25
808. to
900. Items Required by Lender to be Paid in Advance
901. Daily interest charges from from 1112012013 to 12/0112013 @$13.67191day (from GFE#10) 150.39
902. Mortgage insurance premium for months to (from GFE#3)
903. Homeowners insurance for 1 ears to USAA (from GFE#11) 96932
904. months to from GFE#11
1000,Reseives Deposited with Lender
1001. Initial deposit for your escrow account (from GFE#9) 924.06
1002.Homeowner's insurance 3 months 0$ 80.78/month $242.34
1003.Mortgage insurance months 0$ 0.00/month $
1004.Property taxes months @$ 0.00/month $
1005.County taxes 10 months $ 45.39/month $453.90
1006.School taxes 6 months @$ 181.88/month $1,091.28
1007.Aggregate Adjustment $-863.46
1100.Title Charges
1101.Title services and lender's title insurance from GFE#4 1,287.00 25.00
1102. Settlement or closing fee to $
1103.Owners title insurance-First American Title Insurance Company $ from GFE#5 300.00
1104.Lender's title insurance-First American Title Insurance Company $965.00
1105. Lenders title policy limit$112,500.00 Lender's Policy
1106.Owner's title policy limit$150,000.00 Owner's Policy
1107.Agent's portion of the total title insurance premium $1,075.25
to Guardian Transfer Corporation
1108.Underwriter's portion of the total title insurance premium $189.75
to First American Title Insurance Company
1109. 100 No Vio11100 to First American Title $50.00
Insurance Company
1110.300 Survey1300 to First American Title $50.00
Insurance Company
1111.900 EPL-Res18.1 to First American Title $50.00
Insurance Company
1112.ClosingSvcLtACL to First American Title $75.00
Insurance Company
1200.Government Recording and Transfer Charges
1201.Government recording charges $ (from GFE#7) 162.00
1202•Deed$67.00 Mortgage$95.00 Release$
1203.Transfer taxes $ (from GFE#8) 1,500.00
1204.City/County tax/stamps Deed$1,500.00 Mortgage$
1205.StateTax/stamps Deed$1,500.00 Mortgage$ 1,500.00
1206. Deed$ Mortgage$
1207. $
1300.Additional Settlement Charges
1301.Required services that you can shop for (from GFE#6)
1302.Final Sewer to North Middleton Authority 45.69
1303. to $
1304. to
1305. to
r r r .MEE= 7,015.82 10,570.69
'Paid outside of closing by(B)orrower,(S)elier,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUD-1
Comparison of Good Faith Estimate(GFE)and HUD-11 Charges Good Faith Estimate HUM
Charges That Cannot Increase HUD-1 Line Number
Our origination charge. # 801. 685.00 685.00
Your credit Rcharge(points)for the specific Interest rate chosen # 802 1,200.00 562.50
Your adjusted origination charges # 803 1,885.00 1,247.50
Transfer taxes # 1203 3,000.001 1,500.00
Charges That In Total Cannot Increase Mote Than 10% • Good Faith Estimate, HUD-1
Government recording charges., # 1201 218.00 162.00
Appraisal fee . #804 375.00 375.00
Credit report # 805 . 15.30 15.30
Tax service # 806 80.00 80.00
Flood certification . # 807 5.25 5.25
# 1303 0.00 0.00
#
693.55 637.55
Increase between GFE and HUD-1 Charges $ -56.00 or -8.0744%
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account # 1001 1,697.00 924.06
Daily interest charges from # 90 $13.6719/day' 160.42 150.39
Homeowner's Insurance # 903 282.00 969.32
Title services and lender's title insurance• -# 1161 1,503.75 1,287.00
Owner's title insurance First American Title Insurance Company #,1103 0.00 300.00
#
Loan Terms
Your Initial loan amount Is $112,500.00
Your loan term is 30.years
Your IniFlal'interest rate Is ' 4.3750%
Your initial monthly amount owed for principal,Interest,and any mortgage $561.70 includes
insurance is ❑X Principal
X❑Interest
❑Mortgage Insurance
Can your Interest rate rise? X❑No. ❑Yes,it can rise to a maximum of %. The first change
will be on I I and can change again every years after I I . Every
change date,your interest rate can increase or decrease by %. Over the life of
1 the loan,your interest rate is guaranteed to never be lower than %or higher
than `9..
Even if you make payments on time,cah your roan balance rise? ❑X No. ❑Yes,it can rise to a maximum of$
Even N you make,paymenl"s an time,.can yourmoneily amount owed for No. ❑Yes,the first increase can be on I I and the monthly
principal',interest,and mortgage insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
Does your loan have a prepayment penalty? FA]No. ❑Yes,your maximum prepayment penalty is$
Does your low.have a balloon payment?; X❑No. ❑Yes,you have a balloon payment of$ due in
years on I 1
Total monthly amount owed Including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes
and homeowner's insurance. You must pay these items directly yourself.
X❑You have an additional monthly escrow payment of$308.05
that results in a total initial monthly amount owed of$869.75. This includes
principal,interest,any mortgage insurance and any items checked below:
Q Property taxes ❑X Homeowner's insurance
❑Flood insurance ❑X School Taxes
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
Previous editions are obsolete Page 3 of 4 HUD-1
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction I further certify that I have received a copy of the HUD-1 Settlement Statement.
0
Allegra Mari Franklin
THE ESTATE OF MARY K.FAGAN
Settlement gent
• ,cl
The HUD•1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be
disbursed in accordance with this statemenL
)Qi n ��riz-� -- U-30-13
S TTLEMEN A DATE
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
Previous editions are obsolete Page 4 of 4 HUD-1
Name of Borrower: Name of Seller: File Number:
Richard J.Juday - The Estate of Mary K.Fagan 13-2124GC
Allegra Marian Franklin
Prepared 1112012013 at 1:37 pm
Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 Settlement Statement.This page
accompanies but is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement
Statement applies.
1100.Title Charges Total Charge Borrower Seiler
1101.Title services and lender's title insurance to
Wire In to Guardian Transfer Corporation $ 12.00 12.00
Notary Fee-Purchasers to Guardian Transfer Corporation $ 35.00 35.00
Courier Fee-Purchase to Guardian Transfer Corporation $ 15.00 15.00
Electronic Document Fee to Guardian Transfer Corporation $ 35.00 35.00
Notary Fee-Sellers to Guardian Transfer Corporation $ 15.00 15.00
Tax Cert Reimbursement Fee to Guardian Transfer Corporation $ 10.00 10.00
1102.Settlement or closing fee to $ 0.00
1104.Lender's title insurance-First American Titto First American Title Insurance Cr$ 965.00 965.00
1109.100 No Vio11100 to First American Title Insurance G$ 50.00 50.00
1110.300 Survey1300 to First American Title Insurance Cr$ 50.00 50.00
1111.900 EPL-Res18.1 to First American Title Insurance Cr$ 50.00 50.00
1112.ClosingSvcLIrICL to First American Title Insurance G$ 75.00 75.00
Totals: $ 1,312.00 0.00 1,287.00 25.0
Seller/Lender credits shown on page i POC=Paid Outside Closing CR=Lender Credit
Previous editions are obsolete Page 1 of 1 HUD-1
15233.1 Estate Valuation
Date of Death: 05/27/2013 Estate of: Mary K. Fagan
Valuation Date: 05/27/2013 Account: Stocks
Processing Date: 06/24/2013 Report Type: Date of Death
Number of Securities: 5
File ID: 15233.1.fagan.stocks
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 6400 CARLISLE COS INC (142339100)
COM
New York Stock Exchange
05/24/2013 66.54500 65.21000 H/L
05/28/2013 67.68000 66.65000 H/L
66.521250 425,736.00
Div: 0.2 Ex: 05/16/2013 Rec: 05/20/2013 Pay: 06/01/2013 1,280.00
2) 3072 DOVER CORP (260003108)
COM
New York Stock Exchange
05/24/2013 79.51000 78.18000 H/L
05/28/2013 80.45000 78.95000 H/L
79.272500 243,525.12
3) 35 PRUDENTIAL FINL INC (744320102)
COM
New York Stock Exchange
05/24/2013 66.51000 65.54000 H/L
05/28/2013 68.79000 67.30000 H/L
67.035000
Div: 0.400000 Ex: 05/24/2013 Rec: 05/29/2013 Pay: 06/20/2013 + 0.400000
67.435000 2,360.23
4) 488 FLEXTRONICS INTL LTD (Y2573F102)
ORD
The NASDAQ Stock Market LLC
05/24/2013 7,44000 7.23000 H/L
05/28/2013 7.41000 7.17000 H/L
7.312500 3,568.50
5) 118 PNC FINL SVCS GROUP INC (693475105)
COM
New York Stock Exchange
05/24/2013 71.14000 70.07000 H/L
05/28/2013 72.22000 70.77000 H/L
71.050000 8,383.90
Total Value: $683,573.75
Total Accrual: $1,280.00
Total: $684,853.75
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.3.1)
p M&T Bank
499 Mitchell Road,Millsboro,DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
June 27,2013
Martson Deardorff Williams Otto Gilroy & Faller
Law Offices
10 East High Street
Carlisle, PA 17013
Re: Estate of Mary K. Fagan
Social Security: 203-05-7411
Date of Death: May 27, 2013
Dear Sir or Madam:
Per your inquiry on June 24,2013,please be advised that at the time of death,the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 411752
Ownership(Names qfi Mary K Fagan
John O.Galvin(POA)
Opening Date 0910111967
Balance on Date of Death $11,477.40
Accrued Interest $ .10
$ , __. - -_,�C i
Total 11 477.50__ - �--- ---- :f�4t tYl
2. Type of Account Savings Account
Account Number 15004200020937
Ownership(Names qf) Mary K Fagan
John O. Galvin(POA)
Opening Date 0711611984
Balance on Date of Death $123,420.68
Accrued Interest $ 608
Total $.123,426.76.............. .._........__G C-6.
3. Type of Account Certificate of Deposit
Account Number 31003912754958
Ownership(Names oj) Mary K. Fagan
Opening Date 1211012007
Balance on Date of Death $105,961.39
Accrued Interest $ 73.61
Total $106,035.00 )L IZ . t
4. Type of Account Certificate of Deposit
Account Number 31003911160586
Ownership(Names of) Mary K. Fagan
John O. Galvin(POA)
Opening Date 1110111991
Balance on Date of Death $25,359.98
Accrued Interest $ 21.69
_,.__ _._.
Total $25 381.67.
5. Type of Account Certificate of Deposit
Account Number 31003911160578
Ownership(Names q/) Mary K Fagan
John O. Galvin(POA)
Opening Date 0111111991
Balance on Date of Death S20,072.08
Accrued Interest $ 8.25 _
Total $20,080.33 S L�
6. Type of Account Certificate of Deposit
Account Number 31003911160560
Ownership(Names of) Mary K Fagan
John O. Galvin(POA)
Opening Date 0410511991
Balance on Date of Death $19,422.96
Accrued Interest $ 1.75
Total $19,4 24.71
7. Type of Account Certificate of Deposit
Account Number 31003910365830
Ownership(Names of) Mary K Fagan
John O. Galvin(POA)
Opening Date 0810411999
Balance on Date of Death $8,238.53
Accrued Interest $ 2.55
Total ._$8,_2 4 40..... 0...7.8
.............._..........._..._...... ..LJC 1l _.....'C
8. Type of Account Certificate of Deposit
Account Number 31003908159609
Ownership(Names of) Mary K. Fagan
John O. GaMn(POA)
Opening Date 0411112001
Balance on Date of Death $15,651.86
Accrued Interest $ 1.16
Total _.. 6'._..__...,..._...... .
$155,,653.02 '
For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds,
please call the High Street Carlisle at 717-240-4536.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers,
Representative Payee,or Trustee under a Written Agreement.
Sincerely,
Valarie Mercer
Adjustment Services