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HomeMy WebLinkAbout04-10-14 (2) J 1505610140 REV-1 500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 250601 2 1 1 3 0 8 0 8 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 6 2 8 2 0 1 3 0 3 1 4 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI S N Y D E R J E A N L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name full Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 1.Original Return E] 2.Supplemental Return E] 3.Remainder Return(date of death prior to 12-13-82) 4.Limited Estate 49.Future interest Compromise(date of 0 5.Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate E] 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 Q 10. Spousal Poverty Credit(date of death D 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 J A C Q U E L I N E A K E L L Y 7 1 7a 4. 1 5 5 0 cs REGIL#E"F WILLS4^E Ot First line of address r M rr1 z ::0 t� yin 8 4 5 S I R T H O M A S C O U R T " Second line of address S U I T E 1 2 ° .._t ri � r City r Post Office DATE FILED Y State ZIP Cods __,�,.._ �_�...� i H A R R I S B U R G P A 1 7 1 0 9 Correspondent's e-mail address: JACKIEJLBOVERIZON.NET Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowedge and belief, if is true,correct and complete.Decimation of preparer other than the personal representative is based on all information of which preparer has any knowledge. $]GNATUR OF PERSON R SPO SIBLE FOR FILING RETURN DE1TE / 9' �r � C% f, ADDRESS 229 16TH STREET NEW CUMBERLAND PA 17070 SI NATURE OF PREPA R�H HAN REPRESENTATIVE DATE _ it DRE 45 SIR THOMAS C URT SUITE 12 HARRISBURG PA 17109 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 l J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: JEAN L . SNYDER RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 5 1 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(Schedule E). . . . . . . 5. 1 3 3 6 9 , 4 4 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .. . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous N Probate Property n- (Schedule G) � Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) 8. 6 4 3 6 9 , 4 4 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . .. 9. 1 0 2 0 9 . 2 4 10. Debts of Decedent, Mortgage Liabilities, and Liens(Schedule I) . . . . . . . . . . . . . 10. 6 0 7 9 9 . 4 4 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 7 1 0 0 8 . 6 8 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. - 6 6 3 9 . 2 4 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. - 6 6 3 9 . 2 4 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 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 0 . 0 0 18, 0 . 0 0 19. TAX DUE . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . 19. a . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X Side 2 L 1505610240 1505610240 REV-1500 Ex Page 3 Fite Number Decedent's Complete Address: 21 13 0808 DECEDENT'S NAME JEAN L. SNYDER STREET ADDRESS 215 Herman Avenue Gn STATE ZIP Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount 3. Interest Total Credits(A+B) (2) 0.00 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) 0.00 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 nX b. retain the right to designate who shall use the property transferred or Its income; ................11.........11.. 0 12 c. retain a reversionary interest;or ................................................................................................ 0 0 d. receive the promise for life of either payments,benefits or care? ............................. ............. 0 QX 2. if death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................1..........111..... 0 XO 3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death? ......... 0 191 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)(11)(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 decedents 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: JEAN L. SNYDER 21 13 0808 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 Real property located at 215 Herman Avenue, Lemoyne, PA 17043 51,000.00 see attached settlement sheet TOTAL(Also enter on Line 1,Recapitulation.) $ 51 000.00 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX+(6-68) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC, INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JEAN L. SNYDER 21 13 0808 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank 6,787.09 Checking Account 80418961 2. M&T Bank 6.95 Checking Account 9847208023 3. M&T; IRA Account 35004201749651 5,377.91 Paid to Estate 4. Capital Blue Cross; refund 169.30 5. Lechner& Stauffer, Inc.; refund insurance premium 261.62 6. Reimbursement county taxes; real property at 215 Herman Ave 89.62 7. Reimbursement school tax; real property at 215 Herman Ave 641.49 8. Reimbursement final trash; real property at 215 Herman Ave 35.46 TOTAL(Also enter on line 5,Recapitulation) $ 13,369A4 (if more space is needed,insert additional sheets of the same size) RFV•1511 EX+(10-09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JEAN L SNYDER 21 13 0808 Decedents debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Funeral lunch and flowers 450.00 B. ADMINISTRATIVE COSTS: I. Personal Representative Commissions: Namets)of Personal Representative(s) Street Address City State Zip Yeaqs)Commission Paid: 2, Attorney Fees: Jan L. Brown &Associates 3,000.00 S, Family Exemption:(If decedents address is not the same as Claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent L Probate Fees: Cumberland County Register of Wills 113.50 5 Accountant Fees: 61 Tax ReturnPreparerFees: Parks&Company 480.00 7. Cumberland Law Journal; legal advertising 75.00 8. The Sentinel, legal advertising 178.92 9. Roland Johnson Appraisals; real estate appraisal 300.00 10. Register of Wills; additional probate fees 105.00 11. Settlement charges; real property at 215 Herman Ave, Lemoyne, PA 5,481.82 12. Register of Wills; FSA filing fee 20.00 11 Register of Wills; additl short cert 5.00 TOTAL(Also enter on Line 9,Recapitulation) $ 10 209.24 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-08) pennsylvania SCHEDULE I DEPARTMENT Or REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RE TURN MORTGAGE LIABILITIES, &LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER JEAN L. SNYDER 21 13 0808 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. Frey Village; outstanding medical bill 14,206.71 2. M&T Bank; home equity loan#12044445524954998 46,592.73 3. Department of Public Welfare; Estate Recovery Program 0.00 Restitution of medical assistance; CIS#400829602 Claim of$16,704.96 Amount available for payment to DPW= $0.00 TOTAL(Also enter on Line 10,Recapitulation) $ 60 799.44 If more space is needed,insert additional sheets of the same size. REV-1513 EX-(e1-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JEAN L. SNYDER 21 13 0808 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)(1.7).) 1. Nancy J. Snook Lineal 0.00 229 16th Street New Cumberland, PA 17070 2. Larry E. Snyder Lineal 0.00 1948 Ursinus Avenue Lancaster, PA 17603 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. $ If more space is needed,use additional sheets of paper of the Sam size. FILE LAST WILL AND TESTAMENT OF JEAN L. SNYDER I,JEAN L.SNYDER,now domiciled in Cumberland County,Pennsylvania,declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness,funeral,and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance,estate,and succession taxes(including interest and penalties thereon,but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which 1 have the power of appointment. Article III 1 give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govem. Article W All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate,I give,devise and bequeath IN EQUAL SHARES to my children,LARRY F. SNYDER,of Lancaster County, Pennsylvania, and NANCY J. SNOOK,of Cumberland County,Pennsylvania. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me,per stirpes, or if he or she has no issue, the share(s) are to be added equally to the other shares. Article V I nominate, constitute, and appoint my children, LARRY E. SNYDER, and NANCY J. SNOOK as Co-Executors of my Last Will and Testament. I direct that my Co-Executors be permitted to serve without bond and in addition to those powers granted by law,I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Co-Executors shall receive reasonable compensation for services rendered to my estate. Article VI In addition to the powers conferred by law,I authorize my Co-Executors,in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale,any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership ofinvestments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for al their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and 0)to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. - 3 - IN WITNESS WHEREOF,I,JEAN L. SNYDER, hereby set my hand to this my Last Will and Testament, on 2005. AN L. SNYDER In our presence,the above-named JEAN L. SNYDER signed this and declared this to be her Last Will and Testament and now at her request, in her presence,and in the presence of each other, we sign as witnesses. Name Address 5 fir 141amu5 ( .S�t 1��} rl� [ -M e? - 4 - I, JEAN L. SNYDER, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by JEAN L. SNYDER, the Testatrix on 2005. �G -6 �z Notate Public JEkN L. SNYDER COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JACQUELINE A KELLK NOTARY PUBLIC LOWER PAXTON TWP.,DAUPHIN COUNTY ATY COMMISSION EXPIRES DEC.17,2007 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses,and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by and ,i t!/ er sn/P> Witness witnesses, on 'J 12005. /Witness CL ota1� jPublic j COMMONWEALTH OF PENNSYLVANIA LIN0IARIE SEAL ' S ACOUELINE A.KELLY,NOTARY PUBLIC LOWER PAXTON TWP.,DAUPHIN COUNTY MY COMMISSION EXPIRES DEC.17,2007 OMB NO.2502'0265 if A B TYPE OF LOAN: _ U.S.DEPARTMENT OF HOUSING&URBAN DEVELOPMENT 1[]FHA 2'QFP;Kk 3❑CONV.U41NS aQVA 5 OCONV INS 6,FILE NUMBER' 7 LOANNUMBER SETTLEMENT STATEMENT TCSS2011151 _ ^_ 8 MQRTCC�+GE INS CASE NUMBER C_ NOTE: ihrY/rynr 4S lurnttllM td yhc pva4talemGnt eleCUelsGtkmGM wsfs AmounN POErooro OY Ure stllkmenr a0eru are s re i(pmY maNked"(P4X.'f uxre peiff dvf5#t the LhYTNj:theyere itK:sn t+dro fer ntetmafMMpYrapSGa dMJ MO rKK iWXICQm tM two,, 'P 49p Iri::4Si�'[r�y+CSY'Ira+:v'pr D NAME AND ADDRESS OF BORROWER. E NAVEANDADORESSOF SELLER F NAM.EANDACORESSOFLENDER DraOo Ssvk EAateol,N.+,nL Sayacr Danvel Orb 215 Herman AVenuo 1640many Orw Lemoymc,PA 17043 Camp lot PA 17011 G PROPERTY LOCATION H SETTLEMENTAGENI I SETTLEMENT OATS 215 He'a,"Aworu IC Settlement Se,,CGS LLC Lemore.PA 17x3 Ctlotur I$ 2013 Cmrt,"tp o C"mr,aennsrt:ama PLAC£OP SET TLEMA NT 80'East Para Ohm.Sure 106 HatSSaur9.PA 17111 J.SUMMARY OF BORROWER'S TRANSACTION K.SUMMARY OF SELLER'S TRANSACTION 100.GROSS AMOUNT DUE FROM BORROWER: 400, GROSS AMOUNT DUE TO SELLER: 101. Coptfad$ales Prke 51.000.00 4DI CorkraQSaks Prim 5100300 102, pelsonalproplYly 442 PersOnat Pro e 103 S60Gmen;Cmr est0 B0rrowor Lille 14001 1.46750 403 ID:. 404 ��.. .. 105. 445 ' uTm.Mtt Frye-0,Ps Paid By Seter m pCvHMYY ACvYmtn:Y FGr Moms PaiOB SciCr Mr aJVaM"e I% Ceyffreem Tares 10 406 C.:TIN t,TAMP ro 107 Coonly Tams !W;8eI3 to 0101,14 8962 407 Corm Taaes Nple,13 to WrOU1< 8962 108, SngrA Tax 10.'18'13 10 07101;14 64149 408 School Tar 10118,13 t0 07/01/14 64119 109, FnalTWt0t18'131o4u01A4 3546 409 Fera,TNashl0+t&131001+31714 3546 119 410 NI 4n, 112, 412 127 GROSS AMOUN 7 CUE FROM BORROWER 5323407 420 GROSS AAICUVT DUE TO SELLER 5176157 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SELLER: 201 Depost a ea'ne V,money 5.40000 541 Esoess0 1+:(Ste lnsaudonP 202 PrarGps'.+unGUnl of Ne.,Loantst 902 SeaemtM Cnaacs to Spier l Lcee 1440+ $48182 203 Emma ban st taken suCkcl to SW Easm ban Sµaker,stibrol to 204 504. PaycO Ol fev%lan0a oto M&T Bantu, Luveceri 46,34615 265 505 Pa f o!second monpaoe 206 506 20' S0: Ileaas:dst as roams} 208 500 209 50 A4uv"ms Fer Comt U road&Stttr Ativime+riS For neM Unaptl By SMk• 2:4 C4 rcwn Taaes :0 510 C4.4Ce'n Tales to 2:: Cover"Taxers :0 511 Count Tarts _to 212. SCem:AZ to 512. Senoct Tas to 213 513 214 514 2'.5 515 216 516 2" 218 516 219 $19 220 TOTAL FarD By.-FOR BORROWER 5,000 OD 524 TOTAL REDUC FIO.V AKO',AVT DUE SELLER 5'e2a% 300,CASH AT SETTLEMENT FROMJTO BORROWER: 600, CASH AT SETTLEMENT TOIFROM SELLER: 30- Gross AmdoM Due From Bpnpmer(Lre 120. 53 23407 841 Gro,Ameunl Due To Selbnlme 420- 51'S5 57 1212 Le PYEB,ro.Barrrcr(LIne 2201 1 5=031 602 Less Redo 411%Due Sort,(Lmt 5201 1 51 a26'T 30). CASeli FROai37 TO/BOPROWER 48.23407 6,3 CASHf TO), x FROJt SELLER 6:6"u T`G a 41,$ oC ndreoyy rlro v,kCSere,31V eta mmckl tt mp7 eea9es+&2 of tao r,"mmem&any asavments rclGne01,lere:' Bo,:Nrm" L'r GQl! sis2y IL $eM' Es=t of kanL Snttltr . D!am$O k BVNaptyJ Sn0ak.6dauP 1pr — Oatp:O✓1 The Estate of Jean I. Sny-a! L.SETTLEMENT CHARGES 100,TOTAL COMMISSION Based on Pried S •Q 3 OW GO = ! Orwzon of C"misvnlwe TOG)as FO:o:.s =' .,..: . i ?Ot S F,iGO O3 to RE+M;J(Real,Sena . .- 702 S 1.5000) to REMAXReaay Sena 703 Commasen Paid at SeOPmenl 7,00000 70,1. Broker Fee - to RFJMAK Rea4y Se'ea 195 col 19500 000,ITEMS PAYABLE IN CONNECTION WITH LOAN 00i loan OcT,,adde Fee % to 002 Loan Osmunt to 803 Acleaxl eee to 204 Credit.Rei to 005 tender's lnspeCron Fee to 005.ttul mx AAp Fee to 807 Assun:Ptean Fee to BO0 009 810 all 500.ITEMS REOUiRED BY LENDER TO BE PAID IN ADVANCE 901 Imeles!Fron to & S !day I days S021JIP Toons for L&kO!LOao for mom's to E03 HanU Insurance Premam for 10 yea's to 904 905 1000.RESERVES DEPOSITED WITH LENDER 1001 Haldrd Insurance on S ce1 month 1092 V.,togae,lnsurance menthx 5 cer month 1001 C.^.1Tdxn Tams nlw8as v 5 es, mdalb 1004 Comm Taxes months JZ 5 e: moot, 1005 Scrool Tav mom's _ 5 per mono' lox months S Ee, m me I= months Q S Per month 1008 months 4D 5 per molnh 1100.TITLE CHARGES HOl Setliement or Closing Fee to 1102 Abstract or TIP Searm to 1103 Domeriew or Fee to 1404 To,loserance Bever :a a0' 0.eolctovOe Ices :o aGf ramm Fees :o TC See dmem Seances.LLC 2000 2000 1107 Tax Cer1 Reimbursement Fee :o TC Sellemenl Sdnsces.LX 10 c (nJ es#bow dee,numbers 1 700 TM lnsvrd :o FeslAoIv",t Tlb tnswaa Company 630 50 (•asudes*bow k ntHnD S 1105 tcodcTs Cowage S 1110 O.+per's Coverage S 51.00 00 6}050 1111 IV2 111} 1300.GOVERNMENT RECORDING AND TRANSFER CHARGES ZOl Recording Fees. Deed S 6700 Mor'!gage 5 Renxses S 6700 !202 CV_.Counlylax tamps Do" 51000 Mon! a e 511100 1203 Slate T.WSWmps Deed 51000 Mort a e 51000 1204 Sahstaaen Pete Rm,Of2 to Combe+tan0 Coumv Recorder of Deeds 65501 120; 1300,ADDITIONAL SETTLEMENT CHARGES 1301 Surve to _ 1302 pest lneeeaOR to AeAmerean Td•m.te 1 102 2013+`.4 Smoot Taxes to FathA 4 no!a 01.62 1304 Termle Trealttnt to AnAm, v a,termle d POV Co^1o1 6837 1305 See add"dtJ) wince. to 0300 1400,TOTAL SETTLEMENT CHARGES (Enteron Lines 103•Section J and 502•Section K) 1 467,!Oil SAB,82 +.+x+1:m� or.l rvma-n.y,.a:.1s..o.•..n.«auaars.a,lwav ar•.n>:•1..1.emtev:n-.-r /� t..✓� TC _C Senbme s, C 5e!tnmenl'gent CetMad m De a bud cell' ADDITIONAL DISBURSEMENTS EXHIBIT Borrower. Danijel Okilj and Drago Savic,joint tenants with survivorship rights Danijel Oki§ Seller: Estate of Jean L.Snyder Settlement Agent: TC Settlement Services,LLC Place Of Settlement: 87 801 East_Park Drive,Suite 108 Harrisbu PA _ Settlement Date: October 8,2013111 Property Location: 215 Herman Avenue Lemoyne,PA 17043 Cumberland County,Pennsylvania PAYEE/DESCRIPTION NOTEIREF NO BORROWER SELLER Borough of Lemoyne Final Sewer Penn Waste 8/8-10/18 93.00 Final Trash POC:S43.50 Total A ddltionai Disbursements shown on Line 1305 $ 0.00 $ 93.00 (0101.!6 6AVIC.PF0/fCSS201}151/18)