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HomeMy WebLinkAbout03-10-14 (2) 1505610140 REV-1500 EX `a2-"'(FI' OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 1 1 5 6 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 0 2 1 9 2 0 1 3 0 8 1 0 1 9 1 8 Decedents Last Name Suffix Decedent's First Name Ml S H E A R E R M A R Y V (It Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mf Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW © 1.Original Return 2.Supplemental Return f-I 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) © 6.Decedent Died Testate 7. Decedent Maintained a Living Trust Q 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9.Litigation Proceeds Received E] 10.Spousal Poverty Credit(Date of Death El 11.Election to Tax under Sea.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 Daytime Telephone Number.. I V 0 V 0 T T 0 III 717Q043 3: 3 �1F :X .fir; REGIST WILLS VfVDNLYZ7 r First Line of AddressG' � 1 0 E A S T H I G H S T R E E T j { � r1l Second Line of Address City or Post Office State ZIP Cade `__ DATE FILED C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address: IOTTO(rt},MAR'TSONLAW.COM 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. SIG,,#�TURE OF PERSON RESP NSkBIE FOR FILING RETURN DATE Yil3�n/ 1�cP. .4rvrdt 3�ct—!'� ADDRESS 32 RIDGE AVENUE CARLISLE PA 17013 SIGNA E O PR RER ER THAN REPRESENTATIVE DATE ADDRESS 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 , l 1505610140 15Q561014Q t'V 1505610240 REV-1500 EX(FI) RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . ... . .. . . . . . 1 1 3 5 0 0 0 0 0 2. Stocks and Bonds(Schedule 8) .. .... .. .......... . .. 2. 3, Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) 1 4. Mortgages and Notes Receivable(Schedule D) -, .,. ....... . . . . ... .... ... 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)... .. .. 5. 2 1 7 7 0 2 3 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .. 6. 0 . 11 13 7. Inter-Vivos Transfers&Miscellaneous N Probate Property (Schedule G) t Separate Billing Requested ... . . . . 7. a . 0 0 8. Total Gross Assets(total Lines I through 7) 1 5 6 ? 7 0 . 2 3 9. Funeral Expenses and Administrative Costs(Schedule H) 4 2 8 4 3 . 8 1 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) . . . . . .. . . . . . . 10. 6 4 4 9 0 . 4 6 11, Total Deductions(total Lines 9 and 10) ..-.... ,.. ....... ...... .. 11. 1 0 7 3 3 4 . 2 7 12. Net Value of Estate(Line 8 minus Line 11) . . . . . .. . . . . . . . . . . . . . . . . . . . . . 12. 4 9 4 3 5 . 9 6 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. 4 9 4 3 5 9 6 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 . a 0 16. Amount of Line 14 taxable at lineal rate X.045 4 9 4 3 5 . 9 6 16. 2 2 2 4 6 2 17. Amount of Line 14 taxable at sibling rate X.12 0 . 11 a 17. 0 . a G 18. Amount of Line 14 taxable at collateral rate X.15 0 0 0 18. a 0 a 19. TAX DUE ... .. ... . ... . . .... .. ... ....... ..... .... 19. 2 2 2 4 6 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 REV-15110 EX(FI) Page 3 File Number Decedent's Complete Address: 21 13 1156 DECEDENT'S NAME MARY V. SHEARER _ STREETADDRESS 930 N.COLLEGE STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 2,224.62 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 26.37 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) 2,250.99 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 0 b. retain the right to designate who shall use the property transferred or its income ............I.................. c. retain a reversionary interest ..................................................................................................... ❑ I] d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ n 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an"in trust for or payable-upon-death bank account or security at his or her death? ......... ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑ 7 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(x)(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 V. SHEARER 21 13 1156 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 Joinfly-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. Real estate located in the Borough of Carlisle,Cumberland County,PA,known as Tax Parcel No. 135,000.00 06-19-1643-150,being described in Deed dated 10/27/48,being recorded in Cumberland County Deed Bk"Y",Vol 13,Page 339. Value is actual sale value. See attached Settlement Statement TOTAL(Also enter on Line 1,Recapitulation.) $ 135 000.00 If more space is needed,use additional sheets of paper of the same size. REVA508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. RESIDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: MARY V.SHEARER 21 13 1156 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. Orntown Bank checking 1060002002 20,014.75 ($20,01425+$.52 interest) 2. Highmark,refund of premium 856.00 3. Tax Proration 761.48 4. Millville Mutual Insurance Company,refund of premium 138.00 TOTAL(Also enter on Line 5,Recapitulation) $ 21,77023 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND RESIDENT ED RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY V. SHEARER 21 13 1156 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Hoffman-Roth Funeral Home,Carlisle,PA 17013 3,180.26 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Patricia E.Rockwell 5,825.00 Street Address 32 Ridge Avenue City Carlisle State PA ZIP 17013 Year(s)Commission Paid: 2014 2. Attorney Fees: Martson Law Offices(estimated) 8,000.00 3, Famity 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: Cumberland County Register of Wills 353.50 6 Accountant Fees: 6. Tax Return Preparer Fees: T The Sentinel,advertising Letters Testamentary 200.16 8. Cumberland Law Journal,advertising Letters Testamentary 75.00 9. Death Certificates, Raymond Shearer 46.00 10. Landex-title search and Deed copy 1.32 IL. Millville Mutual, homeowner's insurance pending disposition of real estate 175.00 12. SAC Oil Company, service pending disposition of real estate 831.25 13. Calaman Lawn Service, lawn care and snow removal pending disposition of real estate 214.55 14. Herman's Plumbing, home repair pending disposition of real estate 74.60 15. Borough of Carlisle, school tax pending disposition of real estate 2,066.05 16. Borough of Carlisle,sewer/water pending disposition of real estate 8.01 17. PPL,electric service pending disposition of real estate 106.55 18. Seller assist to sell real estate 5,925.00 TOTAL(Also enter on Line 9,Recapitulation) $ 42 843.81 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARY V. SHEARER 21 13 1156 Decedent's Name Page 4 File Number Schedule H - Funeral Expenses &Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. County taxes 66.60 20. Wolfe&Company,real estate commission 3,225.00 21. S. W. Barrett Real Estate&Appraisal Services,real estate commission 3,225.00 22 S. W. Barrett Real Estate&Appraisal Services,repairs&improvements funds to buyer, 7,000.00 23. l%Realty Transfer Tax 1,350.00 24. Orrstown Bank,Tax services 75.00 25. Borough of Carlisle,final sewer/water 55.89 26. Overnight package fees 14.07 27. Orrstown Bank, escrow for repairs 750.00 SUBTOTAL SCHEDULE H-87 15,761.56 REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY V. SHEARER 21 13 1156 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. Thomas&Myma Shearer, loan payoff 64,490.46 See attached TOTAL(Also enter on Line 10,Recapitulation) $ 64 490.46 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 V. SHEARER 21 13 1156 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [Includeoutri ht spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Patricia E. Rockwell Lineal 16,478.66 32 Ridge Avenue Carlisle,PA 17013 2. John M.Shearer Lineal 16,478.65 13271 Sherburne Circle Bonita Springs, FL 33923 3. Thomas P. Shearer Lineal 16,478.65 32600 North Route 44 Lock Haven, PA 17745 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 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed,use additional sheets of paper of the same size. F VU E"ATAFILEIWILLStt66SW.WIL " ORIGINAL RCLAINE'n RV: LAW OFFICES G/�lat<!'soix, catdo:ff fvirriam! & t!�tto A PROFESSIONAL CORPORATION 'FEN EAST HIGH STREET CARLISLE.PA I7113 (717)2434341 LAST WILL AND TESTAMENT I, MARY V. SHEARER, of the Borough of Carlisle, 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 by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance 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,Executor 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. In the event my husband shall predecease or fail to survive me by thirty (30)days;then I give such items of personalty as are itemized in a certain list attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof, 3. If my husband shall survive me by thirty(30)days,then I give,devise and bequeath all of my estate, both real and personal property, unto my husband, RAYMOND P. SHEARER, absolutely. 4. In the event my said husband,RAYMOND P. SHEARER,shall predecease or fail to survive me by more than thirty(30)days,then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, in equal shares, unto my children, PATRICIA E. ROCKWELL, JOHN M. SHEARER and THOMAS P. SHEARER, absolutely. 5. In the event that any of my said children shall fail to survive my husband and me, but shall leave issue surviving,then such deceased child's share shall be held by the surviving parent of such deceased child's issue and the net income therefrom shall be used, in equal shares, for the support, MVS M.V.S. Page I of 4 Pages demands of my estate against others of 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 personal representative(s) consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition,I direct that my personal representative shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this k day of M 1997. ( l� c �J� U !!CQ/G rJ �n�i (SEAL) Mary V. Aearer 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. Page 3 of 4 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) 1,Mary V. Shearer, Testatrix,whose name is signed to the attached or foregoing 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 willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Mary V. Shearer 5t Sworn or Affirmed to and acknowledged before me by Mary V. Shearer,the Testatrix,this �I day of 1997. Notary Public DJetariP.l Seal COMMONWEALTH OF PENNSYLVANIA i Corzine L. .bur,Notary Public } Carlisla Boro. Cumberland County SS. - �7ry Comrr..^':isR cx,r;ces iY"ray 27, 7999 COUNTY OF CUMBERLAND ) p t We, Z VO U. ©`f+O = 0-4'tOt {V r CJ l 0 /C- k 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 Mary V. Shearer, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it 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 18 or more years of age, of sound mind and under no constraint or undue influence. Address !© C�r(i3le f} / wi3 iCr�G n t�lcrn0( Address ;— 2 Sf" Sworn or affirmed to and subscribed before me this J day of r/ , 1997. Notary Public Notarial Soal Gorr!ne L.Myers,Noiary Public I C;:nislu Boro,Ci.nbc?!and County ti-1y t;o;;ammon Ec(>arrs fSay 27. !PA t Page 4 of 4 Pages ° A. Settlement Statement (HUD-1) OMB Approval Na.25020265 t.©FHA 2.❑RHS 3.❑Conv.Union. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number; MT2014� 0000008156 446-17209-703 4.❑VA 5.❑Conv.tns. C.Note;This to is furnisbetl to glue you a statement of actual settlement vests.Amounts paid to one by the settlement agents are shown items marked "(p.o.cy'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: Daniel M.Gibbs Estate of Mary V.Shearer,Estate of Raymond P, Onstown Bank 104 E.Louther Street,Cadisle,PA 17013 Shearer 2695 Philadelphia Ave.,Chambersburg,PA 32 Ridge Ave.,Carlisle,PA 17013 17201 G.Property Location H.Settlement Agent: 1.Settlement Date:013/2014 930 N.College Street ACCP,Inc. Disbursement Date:011312014 Carlisle,PA 17013 26 West High Street,Carlisle,PA 17013 Parcef 06-19-1643-150,Carlisle Borough Place of Settlement TitleExpress 26 West High Street,Cadisle,PA 17013 Printed 04312014 at 10:31 am 1by FILM 100. Grass Amount Due from Borrower 400. Gross Amount Due to Seiko , 101. Contract sales Vice v 135,00O,00 401. Contract sales price _ 135,0 .00 102. Personal property 402. Personal property _ 103. Settlement charges to borrower(line 1400) 7,629.89 401 104 404. 105, 405. Adjustments for items paid b seNer in advance Adjustment%for Items paid 6 seller in advance 106. Cools n taxes to 406. Citylfown taxes to 107. County taxes to 407. County taxes to 108. School Taxes 011312014 to 06730/2014 761.48 408. School Taxes 01131014 to 06!3012014 76148 109, 409. 170. 410, 111, 411. 112. 412. 120. Gross Amount Due from BOrower 143,391.31 420, Gross Amount Due to Seller 135,761.48 200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due to Seller 201. posit or mirmit money 1,000.00 501. Excess deposit(see instructions) 202. Principal amount of new loans) 132554.00 $02. Settlement charges to seller(line 1400) 8,694.96 203. Exist- loans)lamil subtect to 503. Fxistln loos taken subject to 204. Appraisal Fee Refund 2500 504. Payoff of first mortgage loan to Thomas and Myna 64,490.46 Shearer 205, 505. Payoff of second mortgage loan 206. Seller Assist 5,925.00 506, Seller Assist 5,925,00 207. 507. 208, 508. 209, 509. Adjustments for Items unpaid by seller Ad ustmenta tar items unpaid h seler 210. CityOown taxes to 51 . ey4own taxes to 211. County taxes 0110112014 to 0113112014 66.60 511. County taxes 0170112014 to 01/31044 66.60 212. School Taxes to 512. School Texas to 213. 513. 214. 514, 215. 515. 216, 516. 217. 517. 218, 518. 219. 519. 220. Total Paid by-for Borrower 139,570.60 520. Total Reduction Amount Due Seller 79,177.02 300. Cash at Settlementfromtta Borrower 600. Cash at Settlement William Setter 301. Gross amount due from borrower(line 120) 143,391.37 601, Gross annum due to seller(im+420) 135,761.48 302. Less amounts paid byllor borrower(line 220) 139,570.60 602. Less reductions in arneunt due seller(Ime 520) 79,177,02 301 Cash ❑X From ❑ To Borrower 3,620.77 603. Cash 0 To ❑ From Seiler 56,58446 .n,ay. wx+n Previous editions are obsolete Pa e 2 of 4 HUD-1 L.Settlement Char as 700. Total Real Estate Broker Fees $6,450.00 Paid From Paid From Division of commission line 700 as follows. Borrowers Seller's 701. $3.22500 to Barrett Real Estate Funds at Fundsat 702. $3,225.00 to Wolfe&Company Settlement Settlement 703. Commission paid at sehlemant 6,450.00 806 items Payable in Connection with Loan R Our onsnation charge {Includes Origination Point 0.000%or$0,00) $700.00 (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2) 803. Your adjusted origination charges (flan GFE A) 700. 804. Appraisal fee to Appraisals a EJ Ko nhav $375.00 P.D.C.B'(from GFE#3) 805. Credit report to CBCINNOVIS,INC. (from GFE#3j 27.70 806. Tax service to Onstown Bank 75. 807. Flood certification to CBC INNOVIS (from GFE#3) 10.00 808. Inspeclions to EJ KOPENHAVER (from GFE#3) 900. Items Re ubed b Lender to be Pa"In Advance 901. Daily interest charges from ham 013112014 to 02701120149$16.3400tday from GFE#10) 15.34 902. Mortgage insurance premium to months to DEPT OF HUD (from GFE#3) 2,279.81 903. Homeowner's insurance Pori yearstoStateFarm $850.00 P.O.C.B'(from GFE#11) 904. months to frown GFE#i i M6.Reserves Deposited with Lender 1001.Buhr deposit for our escrow account (from GFE#9) 1,463.97 1002.Homeowner's insurance 3 months @$ 70.831month $212.49 1003.Mortgage insurance morns @$ 145.48fmonth $ 1004. Property faxes months 0$ !month 1005.Counly taxes 12 months @$ 67.521month $810.24 1006.School Taxes 8 months M.$ 153.39fmonth $1,227.12 1007.Aggregate Adjustment $-765.88 1100.Title Cha ea 1101.Titte services and lenders true Insurance from GFE fM 1,391, 7 1102.Settlement or dosing fee to $ 1103.Owners title insurance-Old Republic National Tate Insurance Ca from GFE#5 10.00 1104. Lenders titre insurance-Old Republic National Title lceurance Co. $1,215A0 1105.Lenders title policy limit$132,554.00 Lenders Policy 1106.Owners title policy limit$135,000.00 Owners Policy 1107.Agent's pardon of the total title insurance pmmium $1,063.75 to Abstract Company of Central PA{c, 1108.Underwriters portion of the total title insurance premium $161,25 to Old Republic National Title Insurance Co. 1109.Clotmag ProtecOon Letler to Abstract Company of Cents$75.00 1110.Attorney Fees to Martsm Law Office POC Si 1200,Govemarent Recording and Transfer Charges 1201.Government recording charges $ (from GFE#7) 161.00 1202,Deed$67.00 Mort e$85.00 Release$ 1203.Transfer taxes $ (from GFE#8) 1,350.00 1204. CIIylCounly laxlstamps Deed$1,350.00 Mortgage$ 1205. State Taxlslamps Deed$1,350.00 Mortgage$ 1 .00 1206, Deed$ Mat $ 1207.Electronic Filing fee $9.00 1300.Additional Settlement Cha es 130 ,Required services that yoacanshop for (it=GFE ) 1302. to 1303. to 1304.Final Water/Sewer 005673 to Borough of Cartisle 551 M. Overnight Payment of Claim to Sadis Sullivan 8 Rogers 14.07 1306.Escrow for Repairs to Orrstown Bank 750.0 -41 i t 7,629.89 8,894.96 'Paid outside of closing by(B)ommer,(5)eller,(L)ender,(pnvestor,Bro(K)er.**Credit by tender shown on page 1,°'Cruet by setter shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Felth Estimate HUD-1 Charges That Cannot Increase HUD-1 Line Number Our origination charge # 801 775.00 700.007 Your credit m charge(points)no me specific merest rate cSmsen is 802 0.00 0.00 Your adjusted origination charges # 803 775.00 700.00 Transfer taxes # 1203 1,350.00 1,350.03 Charges That In Total Cannot Increase More Than 191/4 Good Faith Estimate HUD-1 Government recording charges # 1201 250. 161.00 Appraisal fee #814 400.00 375.00 Credit repel to 805 40.66 27.70 Flood cenifical on # 807 10.00 10.00 Inspections #808 100. 200.00 "age insurance premium to 902 - 2,279.81 2,279.81 it # 3,080.47 3,053.51 Increase botmen GFE and HUD-1 $ -26.96 or -0.8752% Char es That Can Change Good Faith Estimate HUD-0 Initial deposit for your escrow account _ —q iJ1 1,107.64 1,483.97 Daily interest charges from # 901 — 16,WU/da 277.78 16. tuners mewl' #903 750.00 850.00 Title services and lender's into insurance # 1101 1,565.00 1,391.07 Owners title insurance-Old Republic National Title insurance Go, # 1103 100.00 10.00 if # Loan Talons Your initial loan amount is $132,554.00 Your loan term is 30.years Year leftist interest rate is 4.5000% Your hotel mormly mount cored for pdncpal,interest,and any mortgage $817.11 includes insurance is M Principal ❑X Interest Q Mortgage Insurance Can your interest rate rise? ❑X No. ❑Yes,it can rise to a maximum of %. The first change w0l be on t t and can change son Avery years after I I . Every change date,your interest rate can increase or decrease by % Over the life of the loan,your interest rate is guaranteed to never be tower than %or higher than %. Even if you make payments on time,can your loan balance rise? QNo. ❑Yes,it can rise to a maximum of$ Even If you make payments on lime,can your monthly amount owed for Q No. ❑Yes,the first increase car.be on t t and the monthly principal,interest,and mortgage insurance rise? amount owed can rise lo$ The maximum It can ever rise to is$ Does your loan have a prepayment penalty? END, ❑Yes,your maximum prepayment penalty h;$ Does your loan have a behead payment? 0 No. ❑Yes,you have a balloon payment of$ due in years on 1 Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for Items,such as property taxes and hpmaowrets a surarco. Years[pay these items directly yourself. M You bean addifforal monthly escrow payment of$291.74 that results in a total initial monthly amount owed of$1,108.85. This includes pdncipat,interest,of mortgage insurance and any items checked belay: Q Property taxes 0 Ho eeovrnets insurance Flood insurance ❑ Note: N you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your tender. Previous editions are obsolete Page 3 of 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD1 Sattlement Statement and to the best of my knowledge and belief,A 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. Daniel M1 ESTATE OF MARY V.SHEARER ESTATE OF RAYMOND P.SHEARER The HUD-1 Settlement Statement which I have prepared Is a true and accurate account of this WInsactan I have caused or will cause the funds to be disbursed M accordance with this statement. SETTLEMENT AGE DATE WARNING:IT 1S 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 I&U.S.CODE SECTION 1001 AND SECTION 1014. Previous editions are obsolete Page 4 of 4 HUD-1 ORRSTO N BANK A Tradition of ExceUewe January 2,2014 Martson Law Offices 10 E High St Carlisle,Pa 17013 Fax: 243-1850 Re: Estate of Mary V. Shearer Social Security Number 177-14-3981 Date of death 2/19/13 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE FOLLOWING ACCOUNT WITH ORRSTOWN BANK: CHECKING ACCOUNT Account No: 106002002 Account Type- Relationship Interest Checking Account Title, Mary V. Shearer Date Opened- 3/5/01 Joint Account(name/date)- No Balance- $20,014.25 Account Interest- $0.52 Best Regards, Kim Deposit Pr erk 2695 Philadelphia Avenue •Chambersburg, PA 17201 The Estate of Mary Shearer hereby acknowledges that a check in the amount of$7,000 shall be provided Steven W. Barrett as general contractor for repairs and improvements to be made to the subject property at 930 North College Street on behalf of Daniel M. Gibbs. This payment represents full satisfaction of repair obligations for which Gibbs assumes all further responsibility. Said check shall be provided Barrett upon satisfaction of mortgage commitment and may not be cashed until settlement is completed. For the Estate of Mary Shearer Commonwealth of Pennsylvania County of Cumberland Sworn to and subscribed before me this I V day of can x _2014. COMM WMXIHOfPENNMVAN sm"sw �L� �pptm N� 0■7kp Spa,QmtGp4and Oprnq Natary blic opnndcaon°peas i zs 7Dis !t Mr OK ft aasnvAW AS90oArrox OF A TAM My commission expires: *r c aid/(� NOTICE OF CLAIM (Filed Pursuant to 20 Pa.C.S. § 3532) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF MARY V. SHEARER DECEASED No, 21-2013-1156 To the Clerk of the Orphans' Court Division: Enter the claim of THOMAS SHEARER AND MYRNA SHEARER in the (Claimant) amount of$ 64,490.46 against the above entitled Estate. The Decedent, who resided at 930 N. College Street, Carlisle,Pennsylvania (Street Address) ,died on February 17. 2013 Written notice of (Date ojDeath) said claim was given to No V. Otto, 111, Esquire (Personal Representative or his/her counsel) at 10 E High Street Carlisle Pennsylvania 17013 _. (Address) on October 31, 2013 and November 25, 2013 (Dale) Thomas Shearer and Myrna Shearer (Claimant) c/o Kenneth L. Eckard, Esquire (Street Address) 180 Darlene St., York, PA 17402-5053 Kenneth Lee Eckard 32692 (City.state.zip) (Cloonam's Counsel) (Supreme Court LD,No.) 180 Darlene Street (Address) York, PA 17402-5053 717-846-8831 (Telephone) Form OC-07 rev. 10,13.06