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J 1505610140 REV-1500 1 111-1111F'' PA Department of Revenue OFFICIAL USE ONLY Bureau of individual Taxes INHERITANCE TAX RETURN County/Code Year File Number PO BOX 260601 2 ], 1 3 0 6 9 8 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDOYYYY Data of Birth MMDDYYYY 0 6 1 7 2 0 1 3 0 1 0 6 1 9 2 8 Decedent's Last Name Suffix Decedents First Name MI H U B E R M A R Y E (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Secuuity Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Original Return 2.Supplemental Return 3.Remainder Return(Date of Death Prior to 12-13-82) n 4.Limited Estate [] 4a.Future Interest Compromise(date of [] 5.Federal Estate Tax Return Required death after 12.12-62) ® 6.Decadent Died Testate 0 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9.Litigation Proceeds Received 0 10.Spousal Poverty Credit(Date of Death [] 11.Election to Tax under Sec.9113(A) Between 12-31-91 and 14-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone NuM( #r S E T H T M 0 S E B E Y 7 1C7 4 C- 3 1 Rte *96 WIL SE 6)G r- rn rn First Line of Address = N _�K a C: 1 0 E A S T H I G H S T R E E T C) `; =` Second Line of Address ` r cn City or Post Office State ZIP Code DATE FLO C A R L I S L E P A 1 7 0 1 3 Correspondents e-mail address: SMOSEBEYC MARTSONLAW.COM Under penal of perjury,I declare that i have examined this retum,inducting accompanying schedules and stetenrerrts,and to the beat of my knowledge and beset, It is bm,,�jAndMmiplete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. I F SON E SI E F FILING REfUR 4LDA a o /ADD"S qe SPRINGERS LANE NEW CUMBERLAND PA 17017 SI E OF PREP R O ER THAN PPRESENTATIVE 3DA 2o)y J"07 P ADDRESS 10 EAST HIGH STREET 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 E . H U B E R RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . 1. 9 4 5 0 0 . 0 0 2. Stocks and Bonds(Schedule B) . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2• 0 • 0 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 1 0 0 0 . 0 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 4 8 6 9 . 0 0 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . . . . 7. 0 . 0 0 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 0 0 3 6 9 . 0 0 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . ... 9• 1 0 4 4 4 • 8 6 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . . . . . . 10. 1 5 6 3 . 1 3 11. Total Deductions(total Lines 9 and 10) . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . 11. 1 2 0 0 7 • 9 9 12. Net Value of Estate(Line 8 minus Line 11) . . . . . .. . . .. . . . . . . . . . . . . . . . . . 12. 8 8 3 6 1 . 0 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. 8 8 3 6 1 . 0 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.045 8 8 3 6 1 . 0 1 16. 3 9 7 6 . 2 5 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 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 9 7 6 • 2 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 REV-1500 EX(Fl) Page 3 File Number Decedent's Complete Address: 21 13 0698 DECEDENT'S NAME MARY E.I UBER STREET ADDRESS 3 PATRICIA DRIVE CITY STATE ZIP ENOLA PA 17025 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) (1) 3,976.25 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,976.25 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 ...................................................................... ❑ IZI b. retain the right to designate who shall use the property transferred or its income ............................... ❑ c. retain a reversionary interest ..................................................................................................... ❑ 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? ....................................................................................... El X❑ 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 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)]. • 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 REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARY E.HUBER 21 13 0698 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. One-half interest in real estate located at 3 Patricia Drive,Enola,Cumberland County,PA,known 94,500.00 as Tax Parcel No.09-14-0836&being described in deed dated 2/23/05&being recorded in Cum Co.,PA Deed Bk.,267,Page 4037,and being conveyed to Robert Dale Gottshall&Mary E. Huber,Decedent herein. See attached Settlement Statement and appraisal TOTAL(Also enter on Line 1,Recapitulation.) $ 94 500.00 If more space is needed,use additional sheets of paper 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 E.HUBER 21 13 0698 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. Personal property and household goods 1,000.00 TOTAL(Also enter on Line 5,Recapitulation) $ 1,000.00 If more space is needed,use additional sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARY E.HUBER 21 13 0698 If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.Phyllis E. Smith 12 Springers Lane Daughter New Cumberland,PA 17017 B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 4/2005 PNC Bank checking, 50-0442-5199 960.22 50. 480.11 See attached 2. A. 4/2005 Metro Bank Savings,626562185 8,777.77 50. 4,388.89 See attached TOTAL(Also enter on Line 6,Recapitulation) $ 4,869.00 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY E.HUBER 21 13 0698 Decedents debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Royers Flowers 381.60 2. First Church of God,Enola,PA,funeral luncheon 300.00 3. Ministerial Donation 100.00 4. Gingrich Memorial,gravemaker inscription 165.00 5. Funeral Supplies 26.34 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: Martson Law Offices 5,670.00 3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Cumberland County Register of Wills 338.50 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Postage 22.97 8. Cumberland Law Journal,advertising Letters Testamentary 75.00 9. The Sentinel,advertising Letters Testamentary 240.19 10. Short Certificate 5.00 11. Woof Appraisal Group,real estate appraisal fee 350.00 12. Debbie Lupold,2013 school real estate taxes,pending disposition of real estate 1,825.26 13. 1%Realty Transfer Tax 945.00 TOTAL(Also enter on Line 9,Recapitulation) $ 10 444.86 If more space is needed,use additional sheets of paper of the same size. 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 E.1 UBER 21 13 0698 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. Kinkora Pythian Home,account payable 450.00 2. Harrisburg Pharmacy,account payable 34.37 3. PAWC,water bill,account payable 50.19 4. PP&L,electric service,account payable 94.19 5. Holy Spirit Hospital,account payable 106.25 6. Duncannon Emergency Medical Service 75.00 7. Cumberland County Employees'Retirement System,reimbursement of benefit paid after 753.13 date of death TOTAL(Also enter on Line 10,Recapitulation) $ 1,563.13 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 RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARY E.HUBER 21 13 0698 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Phyllis E. Smith Lineal 16,796.43 12 Springers Lane 1/7th residue+Sch.F New Cumberland,PA 17017 Lines 1&2 2. Sheri Elaine Jacobson Lineal 11,927.43 909 Valley Road Enola,PA 17025 3. David Lash Lineal 11,927.43 670 Whistler Road Etters,PA 17319 4. Dianna G.Fetterman Lineal 11,927.43 3 Billman Road Catawissa,PA 17820 5. James Edward Gottshall Lineal 11,927.43 715 Sherman Street Catawissa,PA 17820 6. Robert Dale Gottshall Lineal 11,927.43 3 Patricia Drive Enola,PA 17025 7. Janice Kay Hevel Lineal 11,927.43 752 State Street Lemoyne,P A 17043 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. 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1, 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, . F TILMDATARMEslate Planning�l 1443 1 will.2005 LAST WILL AND TESTAMENT I, MARY ELLEN HUBER, of East Pennsboro Township, Cumberland County, Pennsylvania,being of sound and disposing mind and memory,do hereby make,publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me. 1. I direct that all my legally enforceable debts,funeral expenses,testamentary expenses and all death taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executrix shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 2. I make the following specific bequests: a. I give, devise and bequeath my diamond ring and my master bedroom suite unto SHERI ELAINE JACOBSON; b. I give, devise and bequeath my roll top desk unto ROBERT DALE GOTTSHALL; and C. I give, devise and bequeath any motor vehicle I might own at my death to JANICE KAY HEVEL. 3. I give such items of personalty as are itemized in a certain list, if any, attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof. [Initials] Page I of 4 Pages 4. I give, devise and bequeath all of the rest, remainder and residue of my estate, both real and personal property, unto PHYLLIS ELAINE SMITH, ROBERT DALE GOTTSHALL,SHERI ELAINE JACOBSON,JANICE KAY HEVEL,JAMES EDWARD GOTTSHALL, DAVID LASH and DIANE FETTERMAN, in equal shares, absolutely. 5. I nominate, constitute and appoint PHYLLIS ELAINE SMITH as Executrix of my estate. In the event she is unwilling or unable to so act, then I appoint DAVID LASH to serve in such capacity. 6. I direct that my Executrix, or her successor, shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 7. I authorize and empower my Executrix, or her successor, in their sole and absolute discretion,to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my Executrix, or her successor, considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; [Initials] Page 2 of 4 Pages and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my Executrix, or her successor, shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my state. IN WITNESS WHEREOF I have hereunto set my hand and seal this �'Z r day of (SEAL) ary 1 n Huber SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. z 14t4 Page 3 of 4 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, Mary Ellen Huber, (_ �(. , �.�-� and the Testatrix and the witnesses,respectively,whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. a 11 uber, Testatrix W� ss Wit ess Subscribed, sworn to and acknowledged before me by Ma Ellen Huber, the Testatrix,and subscribed and sworn to before me by T1,%C: y�. ,±_ and C' the witnesses, this 23'''day ofd,�� _/ , 2 0C . Notary Public NOTARIAL SEAL VICTORIA L. OTTO, NOTARY PUBLIC CARLISLE BORO CUMBERLA COUNTY MY COMMIISSIOA EXPIRES DEC. 2 006 Page 4 of 4 Pages fl-�' OMB Approval No.2502-0265 li, A.Settlement Statement(HUD-1) B.Type of Loan 1.� FHA 2.� RHS 3.❑x CONV.UNINS. 6.File Number. 7,Loan Number. a.Mortgage Inaunanoe Cese Number. ` 4.0 VA 5.D CONVANS. SW13-9323 0096205847 C.Note:This form Is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items marked"(p.o.c.)"were paid outside the dosing;they are shown hero for informational purposes and are not included in the totals. D.Name 6 Address of Borrower. I-Name b Address of Seller. F.Name d Addreea of Lander: Robert Dale Gottshall I Santander Bank,N.A. 3 Patricia Drive 824 North Market Street Enola,Pennsylvania 17025 Suite 100 Wilmington,Delaware 19801 0.Property Location: H.Settlement Agent: I.Settlement Data: 3 Patricia Drive Synergy Abstract January 2,2014 Enola,Pennsylvania 17025 1025 Berkshire Blvd. Disbursement Date:January 7,2014 Cumberland County,Pennsylvania Suite 600 Reading,PA 19610-1282 610-288-8200 fax:610-288-8202 Place of settlement ---_- Santander Bank Carlisle 17 West High Street Carlisle,Pennsylvania 17013 Phone:(717)243-2915 J. Summary of Borrowers Transaction K. Summary of Sellers Transaction 100.Gross Amount Due From Borrower. 400.Gross Amount Due To Seller: 101. Contract Sales Price 401. Contract Sales Price 102. Personal Property 402. Personal Property 103. Settlement Char es to Borrower line 1400 37 133.85 403. 104 Payout to Estate of ary E.Huber to Estate of 94,500.00 404. Mary E.Huber 105. Payoff to Santander 2,262.43 405. Adjustments for Items Paid by Seller in Advance: Adjustments for Items Paid by Seller in Advance: 106. City/Town Taxes 406. City/Town Taxes _ 107. County/Parish Taxes 407. County/Parish Taxes 108. School Taxes 408. School Taxes 120. Gross Amount Due from Borrower. 133 896.28 420. Gross Amount Due to Seller: 200. Amounts Paid by or in Behalf of Borrower: 500. Reductions in Amount Due to Seller:. _ 201. Deposit or Earnest Money 501. Excess Deposit see instructions) 202. Principal Amount of New Loan 133 600.00 502. Settlement Charges to Seller(Line 1400 203, Existing Loans taken subject to 503. Existing Loans taken subject to 204. Daily interest credit 504. Pa off of First Mortgage Loan 205. Application Fee $399.00 POC 399.00 505. Payoff of Second Mortgage Loan 206. 506. Purchase Mone Mort age Adjustments for Items Unpaid by Seller: Adjustments for items Unpaid by Seller: 210. C' /Town Taxes 510. Ci /Town Taxes _ 211. County/Parish Taxes 511. County/Parish Taxes 212. SchoolTaxss 512. School Taxes _ 220. Total Paid by/for Borrower: 133,999.00 520. Total Reductions In Amount Due Seller: 300. Cash at Settlement from/to Borrower: 600. Cash at Settlement to/from Seller: _ 301. Gross Amount due from Borrower line 120 133 896.28 601. Gross Amount due to Seller(line 420) 302. Less Amount Paid by/for Borrower line 220 133,999.00 602. Less Reductions Amount due Seller(line 520) 303. Cash To Borrower: $102.72 603. Cash From Seller: The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may not collect this information,and you are not required to complete this form,unless it displays a currently valid OMB control number.No confidentiality is assured;this disclosure is mandatory.This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. 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 disb emenis made on my account or by me in this transaction. I further certify that I have received a copy of HUD-1 Settlement Statement Borrower. ^'"r I&Wj Robert Dale Gottshall The HUD-1 Settlement Statemen hi ave prep red is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance wi h ctions he parties here o. BOLD SW13-9323 Settlement Agent: Date: January 2,2014 Luis odrigue WARNING: It is a crime to knowingly make false statements to the United States on this or any other 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 1 of 3 HUD-1 December 31,2013 12:56 PM File Number.SW13-9323 r Settlement Date:January 2,2014 Loan Number.0096205847 BOLD SW13-9323 L. Settlement Charges Paid from Paid from 700. Total Sales/Brokers Commission: Borrower's Seller's Division of Commission(line 700)as follows Funds at Funds at 701. Settlement Settlement 702. 703. Commission Paid at Settlement 800. Items Payable in Connection with Loan: 801. Our origination charge (from GFE#1) $998.00 - Loan Origination Fee to Santander Bank,N . $998.00 802. Your credit or charge(points)for the specific interest rate chosen (from GFE#2) to Santander Bank N.A. $167.00 803. Your adjusted origination charges (from GFE#A) I to Santander Bank,NA 1,165.00 I 804. Appraisal Fee (from GFE#3) to D.A Potts Appraisals _ 37.5.00_ 805. Credit Report (from GFE#3) to CBC Innovis 17.99 806. Tax Service (from GFE#3) to CoreLogic _ 63.00 807. Flood Certification (from GFE#3) to LIDS National Flood 5.75 900. Items Required by Lender to be Paid in Advance: 901 Daily interest charge from Jan 7,2014 to Feb 1,2014 @ 12.5250 1 day for 25 (from GFE#10) ) to Santander Bank NA 313.13 902. Mortgage Insurance Premium from GFE#3 903. Homeowner's Insurance (from GFE#11) to Allied Insurance 130.00 1000.Reserves Deposited with Lender. 1001. Initial deposit for your escrow account (from GFE#9) to Santander Bank NA 1.636.99 1002. Homeowners Insurance 1003. Mortgage Insurance 1004. Township Taxes 1005. County Taxes 12 months @$49.42 per month $593.04 1006. School Taxes 8 months @$155.21 per month $1,241.68 1099. Aggregate Adjustment $-197.73 1100.Title Charges: 1101. Title services and lender's title insurance (from GFE#4) 1,339.50 - Notary Fee to Luis Rodriguez $40.00 - Closing Service Letter Fee to Old Republic National Title Insurance Company. $75.00 1102. Settlement or Closing Fee $ 1103. Owner's Title Insurance Old Republic National Title Insurance Company.) from GFE#5 1104. Lender's Title Insurance(Old Republic National Title Insurance Company.) to Synergy Abstract - Lender's Premium $934.50 Endorsement 100 $50.00 Endorsement 300 $50.00 Alta 8.1 $50.00 1105. Lender's Title Policy Limit$133,600.00 1106. Owners Title Policy Limit 1107. Agent's Portion of the Total Title Insurance Premium $954.36 1108. Underwriter's Portion of the Total Title Insurance Premium $130.14 _ 1200.Government Recording and Transfer Charges: 1201. Government Recording Charges from GFE# 170.00 . 1202. Deed$67.00 Mort_me$103.00 Releases$0.00 _ 1203, Transfer Taxes (from GFE#8) 1204. City/Countytax/stamps Deed$0.00 Mortgage$0.00 1205. State tax/stamps Deed$945.00 Mortgage$0.00 1206. Other Tax 1 1207. Other Tax 2 1300.Additional Settlement Charges: 1301. Required services that you can shop for from GFE#6 1302. 2013 County/Township Taxes to Debbie Lupold,Tax Collector(poc$592.89 by Borrower 1303. 2013-2014 School Taxes to Debbie Lu old Tax Collector oc$1,862.51 by Borrower 1304. Payment to SUntrust -' to Suntrust 13 471.00 1305. Payment to Discover to Discover 5,333.00 1306. Payment to M&T Bank to M&T Bank 4,243.00 1307. Payment to Capital One --- to Capital One 4,036.74 1308. Payment to Sears to Sears 810.20 1309. Payment to Sears to SEARS 3,070.55 1310. Payment to Chase to Chase 560.00 1311. Payment to Bank Of America to Bank Of America 393.00 1400. Total Settlement Charges(Enter on line 103,Section J and line 502,Section K) $37,133.85 Previous editions are obsolete Page 2 of 3 i HUD-1 December 31,2013 12:56 PM File Number:SW13-9323 Settlement Date:January 2,2014 Loan Number:0096205847 BOLD SW13-9323 Com arison of Good Faith Estimate(GFE)and HUD Charges r HUD Line No. Good Faith HUD Charges That Cannot Increase Estimate Our origination char e #801 998.00 998.00 Your credit or charge(points)for the specific interest rate chosen #802 167.00 J_ 167.00 Your adjusted origination charges #803 1 165.00 1 1 165.00 Transfer taxes #1203 0.001__ 0.00 Charges That in Total Cannot Increase More Than 10% HUD Line No. Goad Faith HUD HUD Govemment Rewrding Charges __ #1201 230.00 __ 170.00 _A�praisal Fee #804 375.00 375.00 Credit Report #805 17.99 17.99 Tax Service #806 _63.00 63.00 Flood Certification _.__ #807 _ 5.75 5.75 Title services and lender's title insurance #1101 1,335.25 1,339.50 Total 2,026.99 1,971.24 Increase between GFE and HUD Charges -55.751 2.75% th Charges That Can Change HUD Line No. Good HUD Estinnate Initial de osit for our escrow account #1001 1,636.99 1,636.99 Gaily interest charge from Jan 7 2014 to Feb 1 2014 41 12.5250/day for 25 days #901 375.75 313.13 Loan Terms Your initial loan amount Is $133,600.00 Your loan term is 15 years Your initial interest rate is 3.375% Your initial monthly amount owed for principal,Interest,and $946.91 includes any mortgage Insurance is [X]Principal [X]Interest Mort a e Insurance Can your interest rate rise? [X 1 No. [ ]Yes,it can rise to a maximum of_%.The first change will be on and can change again every after . Every change date,your Interest rate can increase or decrease by_%.Over the life of the loan,your interest rate is guaranteed to never be LOWER than %or HIGHER than %. Even if you make payments on time,can your loan balance (X)No. [ ]Yes,it can rise to a maximum of$ rise? Even If you make payments on time,can your monthly [X]No. [ j Yes,the first increase can be on and the monthly amount owed for principal,Interest,and mortgage amount owed can rise to$ insurance rise? _ The maximum it can ever rise to is$ Does your loan have a re a ment penal T X No. Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? [X]No. [ ]Yes,you have a balloon payment of$ due in_ ears on Total monthly amount owed including escrow account [ ]You do not have a monthly escrow payment for items,such as property payments taxes and homeowner's insurance.You must pay these items directly yourself. [X]You have an additional monthly escrow payment of$204.63 that results in a total initial monthly amount owed of$1,151.54.This includes principal,interest, any mortgage insurance and any items checked below: [X]Property taxes [X]School taxes [ ]Flood insurance [ 1 X I Homeowner's insurance ( 1 __ 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 3 HUD-1 December 31,2013 12:56 PM Property Mapper Cumberland County, PA }.- , 159 r, R1 iWWC Rb's '�. � r �,rt,'• c, a,i1x1 +• , I1 " �,� _ 39.00 65Ac t �e ,, k . (9) 0 o) - " .� 47. 9 O . ,✓r� d M0.33Ac. r i i \v' Z - ---'_,;U�� �..._-`iloojf� '`� - � / �'� i_ .� i q• q q i i q � �Y ex Copyright 2011 Esri. All rights reserved. Thu Sep 19 2013 03:30:16 PM. 3 PATRICIA DRIVE PIN: 09-14-0836-181 Deedbook: 00267-04037 Owner: HUBER, MARY E Land Use Code: 101 Property Type: R Acreage: 0.39 Square Feet: 1638 Taxable Status: T Clean & Green Status: Land Assessed Value $: 52900 Building Assessed Value $: 130600 Total Assessed Value $: 183500 Sale Price $: 1 Sale Date: Wed Mar 2 2005 07:00:00 PM Year Built: 1969 Municipality: EAST PENNSBORO TWP Height in Stories: 1 Type of Dwelling: DETACH Primary Exterior: Brick Basement Percentage: Air Conditioning: AC Total Rooms: 5 Bedrooms: 3 Full Bath: 1 Half Bath: 2 7U/O RC BERT P. {IEGLER HjFAFILES\DATAFILE1Idee1 Estate\]1443-2.Dee&wpd f`_"' r�:.Uf?DER; iF DcFi.}S 2005 MH 3 Pn 4 02 Parcel No. DEED MADE THE c-�3ro( day of ,J4.11a1,t_ 2005 U BETWEEN MARY E. HUBER, of East Pennsboro Township, Cumberland County, Pennsylvania,hereinafter referred to as: Grantor, and MARY E.HUBER and ROBERT DALE GOTTSHALL,of Cumberland County, Pennsylvania, hereinafter referred to as: Grantees, In consideration of ONE AND 00/100 ($1.00) DOLLAR, the receipt whereof is hereby acknowledged, the Grantor does hereby grant and convey to the Grantees, their heirs and assigns: ALL THAT CERTAIN PIECE,parcel and lot of land situate in the Township of East Pennsboro,County ofCumberland and State ofPennsylvania,bounded and described as follows: BEGINNING at a point on the western line of Patricia Drive on the hereinafter mentioned Plan of Lots at the northeast corner of Lot No. 1 on said Plan; thence by the dividing line between Lots No.I and 9 on said Plan South 49 degrees 30 minutes West, one hundred twenty-six and eighty-eight one-hundredths (126.88) feet to a point; thence by the dividing line between Lots No. 8 and 9 on said Plan, North 32 degrees 54 minutes 40 seconds West, one hundred fifty-one and thirty-two one- hundredths (151.32) feet to a point on the southern line of the aforesaid Patricia Drive; thence by said Patricia Drive,North 49 degrees 30 minutes East, eighty-one and eighty-eight one-hundreds(81.88)feet to a point;thence by an arc or curve to the right with a radius of twenty-five(25)feet an arc distance of thirty-nine and twenty- seven one-hundredths (39.27) feet to a point; thence by the same South 40 degrees 30 minutes East, one hundred twenty-five (125) feet to a point; the place of BEGINNING. BEING Lot No. 9 in the Plan of Lots of Sherwood Park, Section 1,which Plan is of record in the Cumberland County Recorder's Office in Plan Book 12 at page 29. The f�r._ 49,37 e Plan of Sherwood Park is the same plan of lots laid out by Theodore E. Sgrignoli,et ux., and designated as Nola Acres, which Plan was not of record. HAVING thereon erected a one story ranch dwelling house known and numbered as 3 Patricia Drive. BEING the same premises which Mary E. Huber by her Deed dated December 7, 1999 and recorded December 13, 1999 in Cumberland County,Pennsylvania Deed Book 213, Page 20, granted and conveyed to Mary E. Huber and Michael A. Gottshall. The said Michael A.Gottshall died December 1,2004 where by operation of law title became vested solely in Mary E. Huber, Grantor herein. This conveyance is exempt from Realty Transfer Tax as this is a conveyance from mother to mother and son. AND the said Grantor hereby covenants and agrees that she will warrant specially the property hereby conveyed. IN WITNESS WHEREOF,said Grantor has hereunto set her hand and seal the day and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF Mary Hu COMMONWEALTH OF PENNSYLVANIA ) ): ss. COUNTY OF CUMBERLAND ) On this, the day of•'--2,Lc-n� 005, before me, the undersigned officer, personally appeared, MARY E. HUBER, known tdrme or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF,I hereunto set m7hand offic ial seal. 2c � d" (SEAL) Notary Public NOTARIAL SEAL VICTORIA L. OTTO, NOTARY PUBLIC CARLISLE BORON CUMBERLAND C ZUNTY [ r 1 I hereby certify that the precise residence and complete post office address of the within Grantees is 3 Patricia Drive,Enola, Pennsylvania 17025. Attorney for Gr tee MARTSON DEARDORFF WILLIAMS & OTTO M- 0 INFOLVArlox s ADVICE•ADVOCACY ATTORNEYS&COUNSELLORS AT LAW TEN EAST HIGH STREET 1 Certify this to be recorded CARLISLE,PENNSYLVANIA 17013 In Cumberland County PA TELEPHONE(717)243-3341 %? A. FACSIMILE(717)243-1850 Recorder of Deeds BOOK SUPERINTENDENT Fax 1177837185 Jul 1 2013 03:15 pm P003 OO4 Senior Checker Plan. Statement ...-PNCBANK PNC Bank Primary account number:50-0442-5199 Page 1 of 3 •175/2412_013 to 06/24/2013 Number of enclosu res:0 r OODS27 For 24-hour banking,and transaction or MARY E HUBER interest rate information,sign on to PHYLLIS E SMITH 1 PNG Bank Online Banking at pnc.com. i 3 PATRICIA DR '�' For customer service call 1-888-9NC-BANK EN©LA PA 17025-1931 ;` Monday-Friday: 7 AM-10 PM ET Saturday&Sunday: s AM-5 PM ET Para servicio en espafiiol,1-E66-KOLA-PNC M*wW. Please contact us at 1-888-PNC-SANK ®Write to.,Customer Service PO Box gno Pittsburgh PA 15230-9738 JqVisit us at pno.00m ® TDDtelrtinal:1-800-531-1648 For hearing impaired clients only Senor checking flan Mary Phyllis E Huber h Regadar ChecV=g Account Summary Aoconnt nun* r:50-0442-5199 avodraft Protection has not been established for this account. Please contact us if you would iilo to set up this service. Overdraft Coverage-Your account is currentlyepted-out. You or your joint owner may revolm your opt-in or opt-out choice at any time. To barn more about PNC Ovardraft Solutions visit us online at pne.00m/overdraftsolutions. Cell 1-577-558-3605,visit any branch,or sign onto PNC Oniine Banking,antl select:he'Overdreft solutions"link undertheAccount Servicesxetionto manage bothyour Ovordratt Coverage and Overdnaft Protection aMings. Sa9ance Summary eegrnning Deposits and Checks and other Ending balance otheraddttions deductions balance 1,528.93 1,710.28 2,613-24 620.98 Average monthly cnarges balan=2 and!9e: 1,588.61 .00 Transaetian Summary Checks paid/ Check Card POs Check Cardmankcard withdrawals signed transactions POS PIN transactions ;,7 0 0 Tots:Ai M PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Activity Detail Doposito and Other Additions There were 2 Deposits and Other Additions Date Arnount Description totaling$1,71023. 05,11 753.13 Direct Deposit-A,CH Credit PINK Bank XXXXXI174 06/03 957.10 Direct Deposit-X=Ret US Treasury 303 Waxw=82741 SUPERINTENDENT Fax 7177837185 Jul 1 2013 03:17pm P002/002 Senior Cheddng Plan Statement FQr the POri*di 05/=2013 to 0612412 013 For 24-hour information,sign on to PNC BankOniine Banking MARY E HUBER on pnc.com. Primary account,numher:50-0442-5199 Account number:5091442-5199-continued Page 2 of Checks and Substitute Checks Check Date Reference Check Date RafaMnce number Amount paid number number Amount paid number 4611 ;().35 05/28 OMM28a 4820 88.00 06/11 og451x834 4S1()* 19.5 00 05/28 0s;%W97 4W* 160.30 06/11 ORSt68793 4812 * 12.50 06/04 OU51164I 4824 '49,84 06/(:7 r,W)76179 4814:". 100.78 05/28 060Jd14S 4825 14£.63 W/11 otssOit6907 4815 03.7:, 05/30 6287.>969 4526 50().00 06/14 0811as6800 4816 210.()() 06/04 OS45116it 4WO* 170216 Go'/m, o&5)fA72s s X 4817 350.00 061/17 0&3888 N 710 0 /18 001667x3 4818 148.93 06/04 0S4624?7-i 4831 0.02 06/19 t ef5413f�f4 48141 ;5.00 ()6/06 sOlSis x Gap in check sequence There were 17 cbecics listed totaling $2x418,38. .0 nuae3 and Elecos®esie Saniidns Dech.-Ot icna There were 4 OR?ire or E!ec Ironic Banking Date Amount Description Deductions totaling$193,86, 06/04 8.79 Coi-wWed Check 8007457267 CVS Qwetlta-k 4821 06/07 7.49 Converted Check 8007467287 CNrS Caremw-k 4822 06/07 47.16 Dircct Payment-L'iec Scc Pp11;u XX.XX'.X'X200I s 06/17 130-42 Payment,-Ghecic Payments Veeizoii Finalicia 4828 Daily Balance [Detail Date Balance Date Balance Date Balance Date B;larce ()5/24 1,523.99 05/03 2,884.54 06/11 1,940.64 Orl19 620.08 05/26 1,X67.86 06/04 2,504-12 06/14 1440.64 -, 05/30 1,174.11 0(5/W 2,429.12 e06M ,��T 05/31 1,9`17.44 ()6/07 2,344.63 06/1 R 717V.t 1 f SUPERINTENDENT Fax 7177837185 Jul 1 2013 03:15pm P004/004 Signature- Servicing Page 1 of 1 Savings Account Inquiry -Prior Statement 12-TrenO erl3lys15(Analysis plane) ACCOunt Number I 62656218 MARY E HUBER Bel es ur 731 —77e56264 OR PHYLLIS E SMITH +Dep/CR 1 210. 3 PATRICIA DR -ChksIDR 6.000. ENOtA PA 17025 1 -SefvIce cnar9e �Interes:paid 6.1 j Cunelt balance 8.779.30 .. SQ Opt Pet Ot Sertal Number TC Description Amount Sub Balance Eft'Dt Str/RuNBaVSagk 042213 060 SAVINGS WITHDRA 1000.00 12562.64 043013 997 INTEREST PAYMEN 2.53 125a5,17 050313 011 SAVINGS DEPOSIT 210.50 12775.67 052813 060 SAVINGS WITHDRA 3000.00 9775.67 053113 997 INTEREST PAYMEN 2.10 9777.77 �- . 081713 060 SAVINGS WITHORA -1000.00 ""8777:77 ----- — 082813 997 INTEREST PAYMEN 1.53 8779.30 I I httol/10,209.22.60.32037/A1 Signature 90/entry;jsessionid=0000I4CHgevZVf8eVtlUw.- 6/29/2013 S I,LL F .&.r-Z