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HomeMy WebLinkAbout02-20-14 (2) 1505610140 REV-1500 EX (01.10) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO sox 280601 INHERITANCE TAX RETURN 2 1 1 3 0 3 7 2 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 3 1 7 2 0 1 3 Decedent's Last Name Suffix Decedent's First Name MI S A L I S B U R Y H E L E N I (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) 4.Limited Estate 4a. Future Interest Compromise(date of 5.Federal Estate Tax Return Required death after 12-12-82) 0 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) 9.Litigation Proceeds Received 10.Spousal Poverty Credit(date of death 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number W I L L I A M A D U N C A N 7 1 7 2 4 9 7 7 8 0 REGISTER OF WILLS USE ONLY n 10 `C First line of address CT C' tTt O N E I R V I N E R 0 W ' r %T-1 Second line of address C7 c City or Post Office State ZIP Code 6ATeTILED — D (—n C A R L I S L E P A 1 7 0 1 3 Cl) Correspondent's e-mail address: b i l l a@ d U n c a n h a i t m a h l a W•c o m Under penalties of perjury,I declare that I have examined this return,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 OF PERSON RESPONSIBLE FOR FILING LING�E�URN ATE �� ADDRESS ��'C A 1060 ROCKLEDGE DRIVE CARLISLE PA 17015 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J J 1505610240 i I REV-1500 EX Decedent's Social Security Number Decedent's Name: HELEN I• SALISBURY RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . .. . . .... .... . . . . ... 1. 1 2 0 0 0 0 . 0 0 2. Stocks and Bonds(Schedule B) . . . . .. . . .. .. . .. . . .. .. .... .. . ... . .. .. . . 2• 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 1 6 7 5 3 . 6 1 P p rty(Schedule E). . . . .. . 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . .. . . 6. 7. Inter-Vivos Transfers&Miscellaneous N -Probate Property (Schedule G) 5 Separate Billing Requested ... . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . .. . . .. . . .... . . .. .... .. . 8. 1 3 6 7 5 3 . 6 1 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . .. .... 9. 2 0 1 6 3 . 4 4 10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 2 4 1 4 9 . 8 6 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . .. . . . ... .. . . . . . . . . 11. 4 4 3 1 3 . 3 0 12. Net Value of Estate(Line 8 minus Line 11) . . .. .. . . . .. .. .. . .. ... . . . . . . . 12. 9 2 4 4 0 . 3 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. 9 2 4 4 0 . 3 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 9 2 4 4 0 . 3 1 18. 1 3 8 6 6 . 0 5 19. TAX DUE .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . . . .. .. . . . . . . .. .. 19. 1 3 8 6 6 . 0 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 13 0372 DECEDENT'S NAME HELEN I• SALISBURY STREET ADDRESS 103 BURGNERS ROAD CITY STATE ZIP CARLISLE I PA 117015 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) (1) 13,866 - 05 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0 . 00 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) 131866 - 05 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; ...................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑X c. retain a reversionary interest;or ................................................................................................ ❑ 0 d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ Q 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? ......... ❑ 0 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 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(1.2)[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,unde Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1502 EX+(01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: HELEN I . SALISBURY 21 13 0372 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 • 103 BURGNERS ROAD 120,000 . 00 CARLISLE, PA 17013 ESEE HUD SHEET ATTACHED] TOTAL(Also enter on Line 1,Recapitulation.) $ 120,000 - 00 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX+(8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERANC RESIrDE T TAX EDECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER HELEN I. SALISBURY 21 13 0372 Include the proceeds of litgation and the date the proceeds were received by the estate. All property intly-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 # 1145800 15,245. 93 [SEE DOD LETTER ATTACHED] 2 CARLISLE REGIONAL. MEDICAL CENTER REFUND 147.00 3• COMCAST REFUND 5. 42 4 • D.E.W. & SONS SERVICES — SEPTIC BILL REFUND 495.00 5• STATE ,FARM INSURANCE REFUND 313.74 I i 6• SCHOOL TAXES CREDIT — REAL ESTATE 546. 52 [SEE HUD ATTACHED] TOTAL(Also enter online 5,Recapitulation) $ 16-.753-61 (If more space is needed,Insert additional sheets of the same size) 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 HELEN I . SALISBURY 21 13 0372 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME 5,290 . 66 2 - ST. PAUL ' S EVANGELICAL CHURCH — FUNERAL LUNCHEON 200 . 00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) N A N C Y L - E W A N E K 61837 - 68 Street Address 1060 ROCKLEDGE DRIVE City CARLISLE state PA zip 17015 Years)Commission Paid: 2 014 2, AttomeyFees: DUNCAN & HARTMAN, PC 6,837 . 68 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: REGISTER OF WILLS 243 . 50 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. CUMBERLAND LAW JOURNAL — LEGAL NOTICE 75 . 00 8- THE SENTINEL — LEGAL AD 178 . 92 9 - HELD IN RESERVE 500 . 00 TOTAL(Also enter on Line 9,Recapitulation) $ 201163- 44 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-08) pennsylvania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES &LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER HELEN I. SALISBURY 21 13 0372 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. CUMBERLAND GOODWILL FIRE RESCUE EMS 88 . 23 2• PPL 43 . 59 3 . PAMELA BURKHOLDER, TAX COLLECTOR - PERSONAL TAX 9 . 80 4 • PAMELA BURKHOLDER, TAX COLLECTOR - REAL ESTATE TAXES 274 . 63 5 • PPL 67 . 23 6 • CENTURYLINK 46 . 99 7 . STATE FARM HOMEOWNERS INSURANCE 700 . 00 8 . PPL 1 . 83 9 • PEERLESS CREDIT SERVICES 60 .67 10• DURHAM & DUNHAM - CARLISLE PHYSICANS 102 . 37 11• PPL 30.05 12. PPL 71 . 78 13. PPL 16. 33 14. GILBERT'S PEST CONTROL 805.60 [TREATMENT REQUIRED SALE OF HOUSE] 15. WASHINGER'S ELECTRIC 1,925. 00 [REPAIRS REQUIRED SALE OF HOUSE] TOTAL(Also enter on Line 10,Recapitulation) $ 24,149- 86 If more space is needed,insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent HELEN I. SALISBURY 21 13 0372 Decedent's Name Page 1 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, &Liens ITEM NUMBER DESCRIPTION AMOUNT 16, PPL 26 . 77 17. D .E.W. & SONS SEPTIC SERVICES 960 .00 [REPAIRS REQUIRED SALE OF HOUSE] 18. KOUGHrS OIL SERVICE 525. 35 19. PPL 34 -23 20. KOUGHIS OIL SERVICE 577 . 50 SELLER CLOSING CREDITS AS PER CONTRACT VV/BUYER#21-33 [SEE ATTACHED CONTRACT] 21. ORIGINATION FEE - REAL ESTATE 1,211 . 00 ESEE ATTACHED HUD] 22. APPRAISAL FEE - REAL ESTATE 505 .00 ESEE ATTACHED HUD] 23. CREDIT REPORT - REAL ESTATE 30. 52 ESEE ATTACHED HUD] 24. FLOOD CERTIFICATION - REAL ESTATE 8 . 00 ESEE ATTACHED HUD] 25. FINAL INSPECTION - REAL ESTATE 175. 00 ESEE ATTACHED HUD] i 26. DAILY INTEREST - REAL ESTATE 392. 50 ESEE ATTACHED HUD] 27. HOMEOWNER INSURANCE - REAL ESTATE 537. 00 ESEE ATTACHED HUD] 28. INITIAL ESCROW DEPOSIT - REAL ESTATE 884 .21 ESEE ATTACHED HUD] 29. TITLE SERVICES - REAL ESTATE 1,345. 73 ESEE ATTACHED HUD] SUBTOTAL SCHEDULE 1 7,212-81 Continuation of REV-1500 Inheritance Tax Return Resident Decedent HELEN I. SALISBURY 21 13 0372 Decedent's Name Page 2 File Number Schedule I -Debts of Decedent, Mortgage Liabilities,&Liens ITEM NUMBER DESCRIPTION AMOUNT 30. RECORDING FEES - REAL ESTATE 162 . 00 [SEE ATTACHED HUD] 31. CITY/COUNTY TAX/STAMPS 1,200 . 00 [SEE ATTACHED HUD] 32. HOME INSPECTION - REAL ESTATE 295. 00 [SEE ATTACHED HUD] 33. SEPTIC INSPECTION - REAL ESTATE 454 . 00 [SEE ATTACHED HUD] 34. REAL ESTATE COMMISSION JACK GAUGHAN & HOWARD HANNA 61963-00 [SEE ATTACHED HUD] 35. ESCROW FEE BARRISTER LAND ABSTRACT 25.00 [SEE ATTACHED HUD] 36. TRANSFER TAX 1,200.00 [SEE ATTACHED HUD] 37. TAX CERTIFICATION 10.92 [SEE ATTACHED HUD] 38. HOME WARRANTY 435.00 [SEE ATTACHED HUD] 39. 2013 SCHOOL REAL ESTATE TAX 1,512-73 [SEE ATTACHED HUD] 40. SUSAN J. HARTMAN, ESQ. -SETTLEMENT FEE 350.00 [SEE ATTACHED HUD] 41. SELLER SCHOOL TAX 2014 25.34 [SEE ATTACHED HUD] 42. STATE FARM HOMEOWNERS INSURANCE 37.33 43. PPL 20.09 44. PPL 2.54 SUBTOTAL SCHEDULE 1 12,692 - 95 Continuation of REV-1600 Inheritance Tax Return Resident Decedent HELEN I. SALISBURY 21 13 0372 Decedent's Name Page 3 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, &Lions ITEM NUMBER DESCRIPTION AMOUNT SUBTOTAL SCHEDULE I GRAND TOTAL SCHEDULE 1 $ 24,149,86 REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: HELEN I. SALISBURY 21 13 0372 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. DONALD E. MACKEY Collateral 130 BURGNER ROAD 50% SHARE CARLISLE, PA 17015 2 - BOBBI JO MYERS 1208 EGRET COURT 16.66% SHARE MECHANICSBURG, PA 17050 3 - ROBERT E . KEITER 80 FARM ROAD 16.66% SHARE NEWVILLE, PA 17241 4 - MICHAEL A. KEITER 80 FARM ROAD 16 .66% SHARE NEWVILLE, PA 17241 i I 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. I 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, LAST WILL TESTAMENT OF I, HELEN I. SALISBURY, of 103 Burgner Road, Carlisle, Lower Frankford Township, Cumberland County, Pennsylvania,being of sound and disposing mind,memory and understanding, do hereby make,publish and declare this as and for my Last Will and Testament,hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot located within Westminster Cemetery Carlisle,beside my beloved husband, Edgar M. Salisbury, in accord with my expressed wishes. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give,devise and bequeath all of my estate of whatever nature,be it real, personal or mixed, and wherever situate unto my nephew, DONALD MACKEY, and my niece, DORIS KEITER, in equal shares,per stirpes. FIFTH. I direct that any and all Inheritance,Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. SIXTH I hereby nominate,constitute and appoint BARBARA BISTLINE and NANCY EWANEK as Co- Executors of this my Last Will and Testament. I hereby relieve my Co- Executors from the necessity of posting security in connection with their duties, as such, in any jurisdiction in which they may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Co-Executors, in their absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of one typewritten page this day of 2006. HELEN 1. SALISBURY i i t. Signed,sealed published and declared by the above named Testatrix HELEN 1. SALISBURY as and for her Last Will and'Testament,in the presence of us'who, at her request,in her sight and presence.and in the-sib t ai}c pretence o e h,other,have.hereunto subscribed our names as witnesses. , . . + ,r . �. ; 4•: LMi C!/A M'01Yii E L VS. MIv : • , • SS. COUNTY OF CUM$F.RL,4NDt '• 1,HELEN I. SALISBURY;Testatrix whose name is signed to the attached or foregoing insttwrrl 4baviug-been duly qualified according to law,do hereby.-acknowledge that I signed, and,executed tho'his#unmt as m'Last.Will;that.I.signed itwillingly; and diati.signed.it as my free and voluntary act for.the purposes:therein expressed.. . HELEN 1. SALISBURY* Sworn or aframed ta.and acknowledged before me,by HELEN I. &gSBURY day of C ? S ,2006. lit No Pub iVOTAft14R 4 Kathy L Mmmsrtf Notary puWjc,. 13orough of Cartisie,Cum4ertapd Co.,pA My'COmmistOn E3cptces Aug.7f,2007 COMMONWEALTH OFFENNSYLYANL4 : :SS . COUNTY OF CUMBERLAND ; We, W itI(cx%NA b-t( x -\ and 'TC-Xo(\ (-UoLMS the witnesses whose names are signed to,the attached or foregoing instrument,being duly qualified according to law, do'depose and say that we were present and saw HELEN 1. SALISBURY sign and execute the instrument as her Last Will;that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge,the Testatrix was at that time eighteen(18)or more years of age,of sound mind and under no constraint or undue influence. I - } Sworn or affirmed to and ' -subscri-bed before me by 1 I cCJ1YYl Ai tNvvicafZ and Pc6ms witnesses, this c day of j45 , 2006. Notary bli NOTARIAL SEAL t Kathy L.Mummert,Notary Public Borough of Cariislo,Cumberland Co.,PA My Commission Expires Aug.11,2007 j I i �`t} 'rP,.tk �'�1 �•Y:"1 t ?{s-. 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Re Ee ofn ISaltsbtir� t 7 ire r r 'J oneSOC13�SCCUCIt�!.' AN te of Death 'N1at+ch?17,-2013- ,C'3 .Y'-0SK;n�.w. +� � i ,1�3r� }a�'b.. kk4 r; ,,.tr ;{�t�,aft p 4�' •,y1wf7:� 4t"t'4 y. Y e4� I .rya N' 1is v �' ?' {,a .r ,, } r 1l i '},t��•�r`7. ( y h' e'ir^ yD,t.'aa . '1•, '-; "• t + k`' x( `G '+•"'i ii .. \t S'.:}iytS ^4.�, _•" y �$ f 1. 1r y 1 'q�'F. •1� t 'W x�m ,> � �t. t j1� t 1#'� �l}S,{ y:r Dear Str or Madam „y ,� 'y` i, ` {. , A. .!'r 'r'j 'n:t rl" y:! * ,x' r ,. _ kr Ar,�'r '« trkM; ,r,�y 5+ `*. N' YT Y at tr •tu q }� t rV 1J � s' i! rE. ,ICrY � .'Y'tf.•rr: l�t.' +�5'.y. �; Fft T,t} ;Per.yotir mqu on June=1 ease be advt ofd 1 u}' seta that at the time eath;" y� p }� dei»eden#had an { -J"Sf +Aa t"d- } -S'a••i'r 'Y� -.5. .1,✓* f( ?, X q r q, rwb^ the-above i#eposrt with tits bank the followin ' �ti � " a� w�)w pN • 4P y, t tiY �/ r r x ro s kA 1J a y i Jr "r Gfi Y{a,. 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T y ..Ir } r,• 1}''#3�, 1 'S. f t�{}Jy,3�� tr .f R x .t i t l '+ rb�'r-. .. .«W�°.� _�L 't.t '4•x ;c:� �' •'. �!i Date,, 07/09/1992 tE1I7J8 + • `l tt��#', f rr� �,'_.Y�J' � ''k4, �;ii��`�' 1 t Batmtce o�hate 5,245.91�y v +YF l r .:� r„+.V,� �� ��.,; ddyy' T .twA.+f° . +F{ '��� " l �1 r} `. ..� ..5,.k iG ' ���¢q•,a'm '.¢. t �"wbt!t, t 1'"<+ # I' Cq x ti ;< ,#'.' .t••plr. 7}. .r trM4r;' < �CC7TlBtll)Jt � 4r1 # far Y /� {y i k ; i y ' V2'.S' •t ,i { pit,• ?.i`t4 rBAC.KCMb' :.�.{r,a}s r L+P.k,. lsrr w ri,:Jn•S n s ctr .,Y,t 11 . r� ca '1 t `r 4Y +�'� 4 a �iQ•`-,+'�.`y+.".� t'w_-, ,c K --�� 4�'- � ?t'Sjt. h+ti�: '>'r{ t 1'Yt �SjS "'' q• iil'L'' ;•,nr,'t.�F 1 .INi' is;n Total .. 245 93 `�f .1 rd + F f r C � fq�tt 7 ? r�t J ::: +,.;i J►M ,,T �5r 1k_ �': )�r , ;,+ a�" :y r }'' F' '4 4 i -:r"f'+2 # � t .'J- � r��r.4'>+, {��,l t' !r �.. '�rF��•}/,,i,�+ rf t � 9 'A"*�ttc #�? r i"�h1f ',��' t" :�` t d b ,� i r •`,yti r� ,� x t. • •. i• ..b r 1 w t�.•=S`""r'7-S-xY"'7r•t t- ..'ti wi.a-a*» �^r: . ... +.k"'•r i. }+�i:. .rt7..ti. r tti iii.x For my additional information on the above accounts,includiai ownership and any changes,closures and/or reioibursement of foods, , ptwe caG the Hig!►3tiYet G1tWe at 717-244.p453V z v .,. ,'t'i. • "i-.[jtR*�t'` a S Ii , r fi il :,'S'•,w 5,' ,�?`'yr e '` :;r, K°`' ,� ` ', ;'q + � } Y tr :,K;•i<+. 4r f ..,+ "ir Jy w •+'� �';; r, t'., Ml '�,. f 3,,. r•'a it c�k 1 h ,fs•. ,�S,,ryr .i f y iM �. �S }6�J4Sx�r r '`t'b`-. +rnir'r•t .Y'Qi 4i.. r 4i^i t 4 4 . ,We were !!Sble to locate toy safe deposit bo:for the abare•meotioned decedent: t 1t�"ex 't•i{ fi.Ty.yf.�I" rt'.r --iF�yr�i3II.T.9.r lr,dt,.. 'p•+•"'Ki ¢1t- r{ fi f, `;'u�"Ct (H�' _1 .tY'Y''""" `ryY ky(. ,- }YJ.9-g_• t ' i rft..t.t >rL r a -et br' 'Fri'.yVxS I� r r• a i 1 .. r, �• 'i �fi(' s r 1�k><•ry,,, 4Pt V a vt 3: .� "k,•q,yy< a Yeti1�i� ii'y4n4 Ali{." ° 'd i"y i4-t,'' t k t. } ,ir •`••r"�7 11 U� —f}Cia i!f!!r dolt not�DttfidC tom+ i!1 Xifitb 11St dtidlEtl my,hm*bCe� # p�� +..- rS• h :.< f F' sY 4*Y .,a., .Eds^ �j WRi[to rVnR"�1� � {4"'�..•".`. itep exeuEStive 1'ayttw or Trmlle undls a Written Apetment 1 r;% "' JL �y ' °". " ,{._-w '!�.;T,1 !t:.l, Y t r t ,•x `"- N.r' '.ice ..,,. ;.. ryi It .. y.N ir7Mi` i hA c9A+: !- '�!Sr '•¢ �'i1a� ;w� '.,, '$ d 1 �, � •.<. �� orh 4: u.Mft4 ,� W' ,. S6vices it 1 •i, IIY 1 rrev ous editions are o sa ete Page i of 4 µ HUD-1 HUD CERTIFICATION OF BUYER AND SELLER I have carefutly 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 oerttry that 1 have received a copy of the HUD-1 Settlement Statement Penny W.Den 1 T OF HELEN I.SALIS9U N Ewartak, ecvMx The HUD-1 Settlement Statement which 1 have prepared Is a true and accurate account of this transaction I here caused or will cause the funds to be disbursed in accordance with this statement. I I II I SEThf&fENT XGENT DATt i �i I� ARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON NVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 1S:U.S.CODE SECTION 1001 AND SECTION 1010. revious editions are obsolete Page 4 of HUD-1 Itemization of /1,1103 and 1104 Name of Borrower. Name of Seller. File Number Penny W.Derr Estate of Helen I.Salisbury 13.01-31518 TRIeExpress Prepared 0113112014 at 8:39 pm I y.r Note: This page is furnished to give you an itemization of the amounts shown on :_Fuld:Frorrl ;'Paf ; rom Lines 1101, 1103 and 1104 of the Settlement Statement(HUD-1).This page Bd'6\i6e, ,::,jSe11er's.x: accompanies but is not a part of the settlement statement if a discrepancy '=Ft?fi(*;.t k Utrtif � exists,the Information shown on the Settlement Statement(HUD-1)applies. Settlemt3nt;. ',' etti8mt3T1t'.- Ib duct1100.'Ttle Chsrgea M In'Une1101 ;. 1101. Title services and lender's title insurance 1,345.13 :.•, a.Notary Fees 30.00 b.Wire Fee 5.00 c. Ovemi ht Fee 2 25.73 d. Electronic Doc Transmittal Fee 45.00 105.73 1102. Settlement or dosing fee 1101 Owner's title Insurance 1104. Lender's tte insurance 1,015.00 $ 1,240.00 a. Endorsement 900 EPL-Residential 50.00 b.Closing Semce Letter 75.00 c. ALTA Short Form Loan 100.00 (Total 1103+1104) 1105. Lender's Utle policy limit$122,448.00 •_ 1106. Owner's rite policy llmlt$120,000.00 1107. Agents portion of the total title Insurance premium $ 990.25 1108. Underwriter's portlon of the total title Insurance prem. 249.75 .(Total 1107+1108) 1109. 1110. 1111. 1112. Additional 4 u rT.tom: �TOte1J` r 'w t1301fo1Yef^Y w•„.90PrOWEfti S411sr, 1100. Tlde Chem"with.P ee. � "�' Ch'a e' ` �P,OCdremdil PUnb11013i�t:in�:�Pald. 1101. Title services and lender's title Insurance ;~ -105.73 10533 a.Notary Fees to Joyce Ehdch 30.00 30.00 b.Wire Fee to Barristers Land Abstract Wire-Hbg 5.00 5.00 c. Ovemight Fee 2 to Barristers Land Abstract Postage-Hbg 25.73 25.73 d.Electronic Doc Transmittal Fee to Barristers Land Abstract General-Hbg 45.00 45.00 1104. Lender's title insurance to Barristers Land Abstract Company 1,240.00 1,240.00 $ar:1345.7 - 105.73 '.1;34&73 a -- II L.Settlement Charges 700. Total!teal Estate Broker Fees 7,1882 Paid From Paid From Division of commission fine 700 as follows: Borrower's Seller's 701. $3,579.00 to JaxdC Gahg w ERA Funds at Funds at 702. $3609.00 to Howard Panne Camp Hill Settlement Settlement 703. Commission paid at settlement 225.00 963. 000. Items le In Connection with Loan 801. Ouroriginationchatge (includes Origination Point 0.000%or ,00) $1,211.00 (from FE 1) BD 2: Your credit or charge(points)for the speck Interest rate 9;9F---f- (from GFE#2) M. Your adjusted origination charges (from GFE A) 1,211. 804. Appraisal fee to StredUnks $505.00 P.O.C.B (from GFE#3) W. Credit report to Foote Capital FBO Credit Plus GFE ) 30.52 M. Tax service to from GFE#3 807, Flood certification to Foote Capital FBO CBC Innovis (from GFE#3) 8.00 808. "Une 801 Admit Fes$1,211 to Final Inspection Fee to ShWUnks $175.00 P.O.0 B (from GFE#3) 900. Items utred b Lender to be Paid In Advance 90, interest charges from from 0ZWM14 to 112014� 15. day from GFE#10) 392.W. age ltts.Premium for months to (from GFE#3} 903. ownees insurance or 12 months to Penn National Insurance $537.00 P.O.C.B (from GFE#11) 904, Rural Development Guarantee Fe fa months to Rural Housing from GFE#3) 2,448.96 1001.Initial deposit for your escrow account (from GFE#9) 884.21 1002.Homeowners insurance 3 morbs S 44.75towth 313425 1003.Mortgage Insurance months O.Oft nth $ 106+1.City Property Tax months 0$ 0,00/month $ 1005.County Property Tax 13 months 23.35b=M $303.55 1006.Solmol Taxes 9 months 3 112.Mmonth $1,010.88 1007.USDA Annual Fee 2 months 40.52/month $81.04 I 1008,Aggregate Adjustment $.845.51 #100.Title Charges lot,Tide services and enders tl e insurance from GFE 94 1,34533 1102.Settlement or dosing fee to $ 1103.Owner's title Insurance-Stewart This Guaranty Company $ from GFE#5 1104.LaxWs this insurance-Stewart Title Guaranty Company $1,240.00 1105.Lender's due policy limit$122,448.00 Lender's Polo 1106.Owners title policy limit$120,000.00 Owner's Policy 1 W.Agent's portion of the total He Insurance premium $990.25 1108.Underwrttars portion of the total titte Insurance premium 324915 1109,Escrow Fee for Inheritance Tax to Barristers land Abstract 25.00 General-Hbg 1200.Government Recording and Transfer Charges 1201.Government recording charges $ (from GFE#T) 162.00 1202.Deed$S7.00 M $95.00 Release 1203.Transfer taxes $ (from GFE#B) 1,200.00 I 1264.Clty/Cwnty taxistamps Deed$1,200.00 Mort $ 1205.State Tax/stamps Deed$1,200.00 M 1,200.00 1206. Deed$ E 1207. $ i 1100.AddWwW Settlement Charges t equ red services that you can strop FE ) i .Survey 10 303.Home Inspediori to Inspection Center by Mike Bloc* 295.00 P.O.C.B 1304.Tax Cert Reimbursement to Banisters Land Abstract Cost-Hbg 1 305.Inheritance Tax Escrow to Banisters Land Abstract Escrow-Hbg 27.0000 1306.Home Warranty to HSA Howie Warranty 130 .Pest Treatment to Gilbert's $805.60 P.O.C.S 1308.Electrical Repairs to Washi %Electric $1,925.00 P.O.C.S 1309.Septic Inspection to D.E.W.&Sons Servi s% $495.00 P.O.C.B 1310.Septic Pu Test to D.EW.&Sons Service's $465.00 P.O.C.S 11311.Ddkqmd 2013 Scrod Taxes to Cumrbedand county To Claim Bureau 1,512. iM Pest Inspection to Inspection Center by Mike Biechle .00 P.O,C.B 131 .Water Test to Inspection Center by Mike Biadtle 185.00 P.O.C.B 314,Attomney Fee to Duncan 8 Hartman P.C. 1111MOTIR11161 =Mnm r r 7,907.92 .65 outside of dosing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er,"Credit by fernier stem on page 1.-Credit by seller shown on page 1. I lous editions are obsolete Page 2 of 4 HUB71 I i of Good Fatth Estlrnate and HUNI C Good FoM Edbnafe HUD�i MUM That Cannot Increase HUD-1 Ursa Number ' OurwItifnationchaw 801 1,211,00 1, 11.00 Your craft or charge{points}for the specific interest rafa Fhosen #. 802. 0.00 0. Your ad} charges it 1,211.00 1,211,00 taxes 1,200.00 t Chwen _afth Estimate HUD-111 ;. Gwemrrne t neco"ft trtcrease tiro re3han 101G=` F 1 Guod F_ _160.00 16 Appraisal fee'r" �. W5.OD .�.,_.._._. . cmcuff, ort #. # 7 6.00 8. Fire!Inspection Fee # 175.W 75. Guarantee Fee #9D4 2,448.96 2,446. ,356.98 3, .48 or CMmes,Thd Can Cliange Good NO Ettlnnate HU11-1 InItial-deposit for you escrow account # 1 1 1,878.60 _ 884.21 arms from #.901 15. 392,50 r—X92.50 tr # 7.00 Insurance. a title Irnmanot # 110i 1,250.00 1,345.73 MR; insurance # 0.00 0. #. #71 575.00 495.00 Pest #1 1 45.OD Water Test # 1313 -. 135.00 185.00 Loan Terms Yaui Idtla�iosit:amcwnt is. $122,446.00 You load term:l3 �: .... 30.years Your bdtibt interast•rste is 4.5000% Your tnitlel inontldy amount owed for Interest auxi any matgepa $620.43 Includes inso��ncekf'- ©Prinr� Q Interest ❑Mortgage Insurance 1 Gan you;(rntst rate rise? []X No. ❑Yes,R can rise to a maximum of %.The first change ' vrid be on t i and can change again every years after 1 ! . Every change date,your interest rate can increase or decrease by %. Over the we of the loan,your interest rate Is guaranteed to never be lower than %or higher Olen %. Evers y«t make payrnents on thne,can ycu r bar balancs lis? �X No. ❑Yes N Carr the to a maximum of$ 1i Even ; r pr y @R19i t�rn,y :rrlcnanfY a+tn9uRttivredfor [&o. ❑Yes,the first Increase can be on t I arnd the monthly 1 putt pal,&tleies4 arnd rtnorlgage nsurancs rlse? amount owed can rise to$ The ma dmurn it can ever rise to is$ Oohs yore ban fnavis a prepayrrn6nt pnmafq/1"'. ©No, ❑Yes,your madmum prepayment penalty is$ Does'yoru ban have a balloon payment? ©No. ❑Yes,you have a balloon payment of$ due In years on ! i Total mo tiny Www owed including escrow socount pay Irl®Ms?:.' ,' ❑You do not have a rnonbiy escrow payment for sterns,such as property taxes W4 horneowners Insurance.You moxg pay""fiems direclty yourself. r ©You have ar add9onal monNy escrow payment of$220.94 that results In a total WM nwd ty amount owed of$841.37. This Includes prirdpal,Woest,any mortgage insurance end any itarn&**ad bebw: QX Property taxes ®Homeowner's Insurance p Flood Insurance [Xp Wool Taxes ©USDA Annual Fee Note: K you have any questions about the Settlement Charges and Loan Terms dated on this form,please contact your lender. I )mrtous editions are obsolete Page 3 of HUD-1 Itemization of Seller Credits: Lien 801 Origination Fee 1211.00 Line 804 Appraisal Fee 505.00 Line 805 Credit Report 30.52 Line 807 Flood Certification 8.00 Line 809 Final Inspection 175.00 Line 901 Daily Interest 392.50 Line 903 Homeowner Insurance 537.00 Line 1001 Initial Escrow Deposit 884.21 Line 1101 Title Services 1345.73 Line 1202 Recording Fees 162.00 Line 1204 City/County Tax/Stamps 1200.00 Line 1303 Home Inspection 295.00 Line 1309 Septic Inspection 454.04 Total Seller Credits $7200.00