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Home My WebLink About03-05-14 J 1505610140 REV-1500 � �Q2-11)(FI} OFFICUIL USE ONLY PA Department of Revenue Couniy Code Year Fle Number Bureau of Individual Taxes �NHERITANCE TAX RETURN Z � 1 3 0 0 3 8 Po BOx z8oso� RESIDENT DECEDENT Harcisbu PA 17t28-0601 ENTER DECEDENT INFORMATION BELOW Soclai Security Number Date of Death MMDDYWY Date of Birth MMDDYYYY 1 2 2 0 2 0 1 2 0 7 1 5 1 9 2 .8 Suffix DecedenYs First Name M� Decedent's i..ast Name F G A R D N E R K A T H R Y N (If Applicabte}Errter Surviving Spouse's Informatlon Below M� Spouse's Last Name Suffa Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH TNE REGISTER OF WILLS FILL iN APPROPRIATE OVALS BELOW � 1.Original Retum � 2.Supp{emental Retum � 3.Remainder Retum(Date of Death Pnor to 12-13-82) � 4.Limfted Estate � 4a.Future Interest Compromise(date of � 5.Federal Estate Tax Retum Required death after 12-12-82} � 8.Decedent Dfed Testate ❑ 7.Decedent Maintained a Living Trust � 8.Totaf Number of Safe Deposit Boxes (Attach Copy of Wiil) (Attach Copy of Trust.) � 8.LRigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 11.Eledion to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHaULD BE DIRECTED T0: Name Daytime Telephone Number S U S A N H . C O N F A I R 7 1 7 7 6 3 1 3 8 3 REGISTER OF WILLS USE�N�LY <r., .-'- �� First Line of Address Q =��^� "� %--' "�l� ym _ 3 l.. ./� r'q7 � (.. � �� 2331 MARKET STREET �'�; � � f �-, Second Line of Address ��,� ; � v��_' —,� c• .z �..? "�'1—;; _. —s-; t,..., t.�4 `-�{=:} C or Post Office State ZIP Code ��E� � '-4 r�' �Y CAMP HI L L PA 1 7 0 1 1 � � �n� CorrespondenYs e-mail address: SCONFAfR _REAGERADLERPC.COM _ Ur�der penalties of perjury,I declare that I have examined this retum,induding ac�comparryinp schedules and statements,and to the best of my knowledge and belief, it is true,cortec:t and comp�ete.Dedaration of preparer o�er than ihe personal representaWe is based on all intormation of which preparer has arry knowledge. SIGNATU PERSON R SlBLE FOR FIUNG RETURN DAT � AODRESS 1828 OWN P T WOODS CI CLE OCOEE FL 34761 SiGNATURE OF PREPARE THER THAN REPRESENTATNE DATE �,�� 3 ADDRESS 2331 MARKET STREET CAMP HILL PA 17011 PLEASE USE ORIGtNAL FORM ONLY Side 1 L 150561014Q 1505610140 � � 1505610240 REV-1500 EX(FI) Deceden�s Social Security Number �,�ae�rBNe,,,,: KATHRYN F. GARDNER 1 1 2 RECAPITULATIOH 1 1 8 5 0 0 , 0 0 1, RealEstate(Schedule A) .............. ............................. 1. 2. Stocks and Bonds(Schedule B) ...... ... ............. .. .............. 2• 3. Closely Heid Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. � 4. Mortgages and Notes Receivable(Schedule D) .......................... 4• � 96915 , 75 5. Cash,Bank Deposits and Misceilaneous Personai Property(Schedule E)....... 5. 6. Jolntly Owned Property(Schedule� ❑ Separate Billing Requested .. ..... 6. � 7. Inter-VNos Transfers&Miscellaneous N -Probate Property � (Schedula G) � Separate Biiling Requested ....... 7• 8. Total(iross Aasets(total Lines 1 through 7} ..... ......... 2 � 5 4 1 5 . 7 5 ........ ..... 8. 9, Funeral Expenses and Administrative Costs(Schedule H) ..... ............ . 9. 8 4 9 5 . 6 7 10. Debts of Decedent,Mor#gage Liabilities,and Liens(Schedule i) 1 3 7 1 9 �J 9 • ............. 10. ' ��. Total Deductions(total Lines 9 and 10) .. ......... ... ............... .. 11. 2 2 2 � 5 . 2 6 12. Net Yalue of Estate(Line B minus Line 11) ........ ...... ......... ..... �2• � 9 3 2 0 0 . 4 9 13. Charitabte and Govemmental BequestslSec 9113 Trusts for which an election to tax has not been made(Schedule J) .................. .... �3• ' 14. Net Value Subject to Tax(Line 12 minus Line 13) .............. ........ 14. � 9 3 2 0 0 . 4 9 TAX CALCULATION-SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec_9116 (a){1.2)X.0_ � . � 0 15. � . � � 16. Amount of Line 14 taxable 1 9 3 2 0 0 . 4 9 �6. 8 6 9 4 . 0 2 ' at lineal rate X•045 17. Amount of Line 14 taxable � . � � at sibling rate X.12 0 . � � 17. 18. Amount of Line 14 taxable O . O O 18, Q . 0 � at coltateral rate X_15 19. TAX DUE ....... .. .............. 19. 8 6 9 4 . 0 2 ...... .... ...... ........ ....... 20. FILL IN THE OYAL IF YOU ARE REQUESTtNG A REFUND Of AN OVERPAYMENT Q Side 2 � 1505610240 150561024� � � �:. , .. �� a:�. �� .� a _ �.� - � � �,� _ _ __ File Number REV-1500 EX(FI) Page 3 2� 13 ��38 Decedent's Complete Address: DECEDENT'S NAME KATHRYN F.GARDNER 9TREET ADDRESB 79 HUMMEL AVENUE � STATE �P cmr pq 17043 LEM�YNE Tax Payments and Credits: �1� 8 g�.p2 1. Ta�c Due(Page 2,Une 19) 2� ��'�m� 9,200.00 A.Prlor Payments 4�.�.0 , B.Discount Totai Credits(A+B) (2) 9.634.70 3. Interest t3) 4, If Une 2 fa greater than Une 1+line 3,enter the differ�ce.This is the OVERPAYMENT. {4} 940.68 FIII in oval on Page 2,Llne 20 to request a refund. 5. If Une 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 ., , n 4 :-` � ��`' _ � �,� , - , s �.� �,. z ., . . .�. , �� „_ ....�....._.. _. ._ . ... —.. 4. ;r . x ' . - '.,a' � , .: � .:. . :,.,ta .xr.� .:.,� .,,,,_J�. .,.w_ _.. .n._,...:;-.._ _:. .�.�_...: �....._.._ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS 1. Did decedeni make a transfer and: Yes No a. retain the use or income of the property transferred ...................................................................... ❑ 0 b. retain the right to designate who shan use the property transferred or its income ............................... ❑ � c. r�ain a reversionary interest ..................................................................................................... ❑ � d. receive the promise for Irfe ofi either payments,benefits or care? ....................................................... ❑ ❑ 2. If death occumed after December 12,1982,did deoedent transfer properiy within one year of death without reoeiving adequate oa�sideration? ....................................................................................... ❑ � 3. Did decedent own an'in trust for"or payabte-upon-death bank acoount a security at his or her death? ......._. ❑ 0 4. Did decedent own an individual reGrement acoount,annuity or other non-probate property,which contains a henefiaary designation?.................................................................................................. ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS YES,YOU MUST COMPIETE SCHEDULE G AND FILE IT AS PART OF THE REfURN. ... . ,.,. _ _ _ - _ ,. �; . . _ �. �Y, , _ ;x. - �x,_ , _. _� :. 1 , ._. ._ .. . . . . _ . ._ ,; „ _ . .. .. � .. , ; - ,, __, _ . . ,.. a: _ _._. . _ .. 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)J. For dates otdeath on or after Jan. 1,1995,the tax rate imposed on ihe net value of tr�ansfers to or for the use of the surviving spouse is 0 percent (12 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 disdosure of assets and firng a fa�c reium are stitl applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2004: • 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 a a steppa�ent 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 percen�except as noted in p2 P.S.§9t16(an1)�. • 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,wheifier by blood or adopfion. REV-7502 EX;(12-121 pennsyivania SCHEDULE A pEpqRTMEWT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN �� FILE NUMBER: ESTATE OF: 21 13 Q038 KATHRYN F.GARDNER atwhichproper�l AII roai property owned sclely or as a tenaM in common must be reported at fair mark��or sell,both having reasonable nowl�ge of the�eleva�t facts. wouid be exchanged beMreen a willing buyer and a willing seller,neither bein9 canPei Rea�property tha�is jolntfyowned with right of survivonhip must be disclosed oe Schedule F. Attach a copy of the sett�ement sheet'rf the property has been sdd. VALUE AT OATE ITEM Include a oopy of the deed�owin9�e°t's interest if owned as tenant in common. OF DEATH NUMBER DESCRIPTION 79 HUMMEL AVENUE, LEMOYNE, PA 17043 118,500.00 SOLD ON 11/22/13, SETTLEMENT SHEET ATTACHED TOTAL{Also enter on Line 1,Recapitulation.) ; 118 500.00 REV-1508 EX;(06-12) pennsytvania SCHEDULE E pEP��R�N� CASH, BANK DEPOSITS &MISC. INHERITANCETAXRETURN PERSONAL PROPERTY RE8IDENT DECEOEW'f FILE NUMBER: ESTATE OF: 21 13 0038 KATHRYN F. GARDNER indude the proceeds of litigation and the date the proceeds were received by the estate. All property jcinth►owned W�th rig�t of sunrivorship must be disclosed on Schedule F. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 4,250.00 �, 2000 CADILLAC SEDAN DEV{LLE z, M&T BANK-CHECKING ACCOUNT 17,034.00 499 MITCHELL ROAD MILLSBORO, DE 19966 52,521.03 3. M&T BANK-SAVINGS ACCOUNT 499 MITCHELL ROAD MILLSBORO, DE 19968 1,016.95 4. FULTON BANK-CERTIFICATE OF DEPOSIT 1 PENN SQUARE LANCASTER, PA 17602 5. FUL70N BANK-CERTIFICATE OF DEPOSIT 1,011.63 1 PENN SQUARE LANCASTER, PA 17602 6. FULTON BANK-CERTIFICATE OF DEPOSIT 1,010.07 1 PENN SQUARE LANCASTER, PA 17602 7. FULTON BANK-CERTIFICATE OF DEPOSIT 1,028.23 1 PENN SQUARE LANCASTER, PA 17602 8. FULTON BANK-CERTIFICATE OF DEPOSIT 1,023.91 1 PENN SQUARE LANCASTER, PA 17602 9. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 1,001.67 26 NORTH CEDAR STREET LITITZ, PA 97543 10. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 5,015.00 26 NORTH CEDAR STREET LITITZ, PA 17543 11. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 5,015.00 26 NORTH CEDAR STREET LITITZ, PA 17543 12. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 1,009.32 26 NORTH CEDAR STREET LITITZ, PA 17543 13. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 2,537.81 26 NORTH CEDAR STREET LITITZ, PA 17543 14. SUSQUEHANNA BANK-CERTIFICATE OF DEPOSIT 2,505.86 26 NORTH CEDAR STREET LITITZ, PA 17543 15. PERSONAL PROPERT`f 300.00 16. REAL ESTATE TAK AND TRASH PRO RATIONS FROM SALE OF PROPERTY 635.27 AT 79 HUMMEL AVE., LEMOYNE(SEE SETTLEMENT SHEET ATTACHED) TOTAL(Also enter on Line 5,Recapitulation) S 96 915.75 If...........��.�'�_�_J ..__ _JJU:___i_�__._ _e____. .•.i - REV-151 t EX+(08.13) pennsylvania SCHEDULE H DEPARTMEN'i OF REVENUE FUNERAL EXPENSES AND ,r�wrfwcETn�c�rur� ADMINISTRATIVE COSTS RESIOENT DECEDENT fILE NUMBER ESTATE OF 21 13 0038 KATHRYN F.GARDNER pecedeoYs debts must be reported on SaNedufe 1. ITEM DESCRIPTION AMC)UNT NUM9ER p, FUNERAL EXPENSES: 82Q.62 �, MUSSELMAN'S FUNERAL HOME 150.00 2. MINISTER FOR CHURCH SERVICE 72 O6 3. ROYER'S FLOWERS-MEMORIAL FLOWERS 100.00 4. FiRST CHRISTIAN CHURCH-RENTAI FEE FOR MEMORIAL 125.00 5. LEMOYNE BOROUGH-RENTAL FEE FOR RECEPTION �g 98 6, CATERING AND ADDITIONAL FOOD FOR RECEPTION 245.93 7. POSTAGE/GAS FOR VEHICIFJTHANK YOU GIFTS 4g,30 8. NEWSPAPER ANNOUNCEMENT 19.47 9. PROGRAMS FOR CHURCH SERVICE 10. PHOTO ENLARGEMENT FOR CHURCH SERVICE 7.45 B. ADMINISTRATIVE COSTS; 1. Personal Representative Commissions, Name(s)of Personai Representative(s) Street Address ��y, S�te ZIP Year(s)Commission Paid: 2, AuorneyPees: REAGER&ADLER, PC 2�8d0•� 3, Family Exemptiorc(If decedenCs address is not the same as daimanCs,atlach e�lanation.) Claimarn Street Address �i�r Srabe ZIP Relatia��ship of Ciaimarrt to Decedent � 4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 418.50 5 AcaountantFee.s: GIFT 8�ASSOCIATES 225.00 6. Taz Refum Preparer Fees: 7. . EXECUTORS EXPENSES FOR AIR TRAVEL, MOVING TRUCK, GAS, 3,013.36 COST OF REPAIRS FOR REAL ESTATE AND VEHICLE, MOUSETRAPS FOR HOUSE, KEYS, AND LIGHT TIMER. TOTAL(Aiso enter on Line 9,Recapitulation) 5 g 495.67 if more spaoe's needed,use�ditional sheets of paper of�e same size. REV•1612EX+(72-12) SCHEDUI.E 1 pennsylvania DEPARTMENT OP REVENUE DEBTS OF DECEDENT, INHERI7ANCETAXRETURN MORTGAGE LIABILITIES 8�LtENS RESIDEt�!'f�ECEDEtdT FILE NUMBER ESTATE OF 21 13 0038 KATHRYN F.GARDNER Rapod debb Ucurred by the dscedent prfor to death that rema�ned unpafd st the date of deafh,including unreimbursed medica�expenges• VALUE AT OATE ITEM DESCRIPTION OF DEATH NUMBER �Q� �, LAWN MAtNTENANCE FOR REAL ESTATE 2, NEWSPAPER ADS FOR SALE OF HOME AND CAR 85.75 3, PENN WASTE-GARBAGE COLLECTION 174.00 4. COMCAST-CABLE,TELEPHONE, INTERNET 905.06 5. PA AMERICAN WATER-WATER 241.79 g, PPL-ELECTRIC 346.49 7. UGI-GAS 413.46 8. VERIZON WIRELESS-CELL PHONE FINAL BILL 31.85 9. LEMOYNE BOROUGH-SEWER 81LL 80•� 10. FREEDOM SYSTEMS-SEWER BILL 360.00 11. PENN NATIONAL-CAR INSURANCE 312_Od 12. REAL ESTATE COMMISSION FROM SALE OF REAL ESTATE 6,945.00 (SETTLEMENT SHEET ATTACHED) 13. TAX CERTIFICATE FEE FROM SALE OF REAL ESTATE 10.00 (SETTLEMENT SHEET ATTACHED) 14. TRANSFER TAX FROM SALE OF REAL ESTATE 1,185.00 {SETTLEMENT SHEET ATTACHED) 15. HOME WARRANTY FROM SALE OF REAL ESTATE 365.00 (SETTLEMENT SHEET ATTACHED) TOTAL(Also enter an Line 10,R�apitu(ation) S 13 79 9.59 If more space is needed,insert additi�al sheets of the same size. , , ..., ,�h�,..� :�-:�- : �,�.��..� Continuation of REV-1500 Inheritance Tax Return Resident Decedent 21 '13 0038 File Number KATHRYN F.GARDNER Pag�Z pecedenYs Name Schedule 1-Debts of Decedent,Mortgage Liabilities,8�Liens AMOUNT ITEM DESCRIPTION 57.OQ NUMBER 16� SETT EMENT SHEET ATT CHEp) R��ESTATE { 100.OU 17, BILL FREUNDEL-REIMBURSEMENT F�R SETTLEMENT EXPENSES �g, FAITH NICOLA,TAX COLLECTOR-PROPERTY TAXES 1,372.19 375.00 �g, HOMEOWNER'S INSURANCE SUBTOTAL SCHEDULE I ��•�9 GRAND TOTAL SCHEDULE i S 13,719.59 REV-1513 EX+(01-00) pennsytvania SCHEDULE J OEPAR'iMENT OF R�� BENEFICIARIES INHEWTANCE TAX RETURN �si�►�oECEO�r FILE NUNIBER: ESTATE OF: 21 13 0038 KATHRYN F. GARDNER RELA710NSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIYING PROPERN Do Not Ust Trustee(s) OF ESTATE I. T/U(ABLE DlS7RIBUTiONS [�91�T6(a(1.2)jdi��u�� 1. JAN JENNINGS Lineal 193,200.49 1828 CROWN POINT WOODS CIRCLE OCOEE, FL 34761 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABQVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. ]I, NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTR18UT10NS ON LINE 13 OF REV-1500 COVER SHEET. ; If more spaoe is needed�use additional sheets d p�er a�U�e same size. y ' . ..�.�� R�ca�� o��c� o� REG153'ER OF �_';�.�S ?Oi3 vF�iV 10 Ffl 2 S6 , CLEFtK 4�= L4STW/LLANOTESTAMEN7�RpyANS CdURT 6;�MBERLAND CO., PA OF KATHRYN F. GARONER I, KATHRYN F. GARDNSR, of 79 Hummel Avenue, Borough of Lemoyne, Cumberland County, Pennsylvania, do make, publish and declare this as and for my Last Will and Testament, hereby expressly revoking all wills and codicils made by me heretofore, and dispose of my estate as follows: IT� 1: I direct the payment of my just debts and funeral expenses to be paid as soon as can be conveniently done following my demise. I direct that my mortal remains be cremated and my ashes scattered in the Atlantic Ocean. ITEM 2: I direct all State and Federal Transfer In::eritancE Tax, Estate Tax, Succession Tax or any other tax, including any interest, assessments or penalties thereon, that may become due and payable by virtue of my death, or by virtue of the passing of any property either under my Last Will and Testament, or in any other manner, shall be paid by my estate, just as if such taxes were my debts, and no beneficiary shall be required to pay or refund any part thereof. This shall not, however, include � . ._... ...... ..... .._.. . ..... . ........ ... . ... ... .. . .... . . .. . . . . .. .... . . . .. . 1 .. . . .. ..... ' y I . . taxes for assets to be administered in any foreign country. Taxes on future interest may be prepaid. ITEM 3: All of my belongings, which include all the rest and residue of my tangible personal and real property of whatever nature and wherever situate, I give, devise and bequeath unto my daughter, JAN J'ENNINGS, of 1828 Crown Point Wood Ci, Ocoee, Florida 34761. � IT$bi 4: Should my daughter, JAN JENNINGS, fail to survive me by thirty (30) days, then I give and bequeath all my estate unto my son, Jere G. Gardner, of 27 Hornsilver Place, The Woodlands, Texas 77381. I specifically leave nothing to my other children. ITSM 5: I nominate, constitute and appoint my daughter, JAN JSNNINGS, to be the sole Executrix of this my Last Will and Testament. Should JAN JENNINGS be unable or unwilling to act or continue to serve, then I nominate, constitute and appoint JSRE G. GARDNER, my son, to be sole Executor of this my Last Will and Testament. ITSM 6: I direct that no fiduciary appointed in my Last Will and Testament shall be required to give or enter into any bond or security in any jurisdiction, regardless of the state of their residency. � 2 IN WITNSSS WS$REOF, I have hereunto set my hand and seal to this my Last Will and Testament consisting of three (3) typewritten pages, this _r' day of �q �s� , 2003 . q`H'nr • o✓.� (SEAL) KATHR F. G NER We, the undersigned, hereby certify that the foregoing Last Will and Testament was signed, sealed, published and declared by the above-named Testatrix, KATHRYN F. GARDNER, as and for her Last Will and Testament, in the presence of us, who at her request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. ��j-,�"�,QP�-- residing at ?� 7 �a K l��01� �Q il�e w Guw�be�l o►�d PI� � 70 7 0 r residing at ��5� �W� L��L �.(,� C.c�ritQ��a2t.M�l� � l�� tZ�?0 � 3 � . . , COb�IONWLALTH OF P$NNSYLVANIA . . 53. : COIINTY OF CUMBSRLAND , We, the Testatrix, KATHRYN F. GARDNER, and -�0��-}-�,� •� t�r� a� and �Av�, l• �CC�c-�2 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 Testament and that she had signed willingly, and that she 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 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. `rl°`�r �• c��.�.-- KATHR F. G NER � o itn s Wi n ss Subscribed, sworn to and acknowledged before me by the Testatrix, THR F. GARDNER, and s sc i ed and sworn to before � by da of and , witnesses, this �_ Y . , 03 . �/` - Notary Public -- (SEP;T�1 ' My Commission Expires: ' �..�r,� ' NOTARW.SEAL � ' �� • ELfUBETH M.IYWOU,Notary PubNc 4 New Cumberl�a�d Boro,t�mberland Co. MY Car�saion E�kss Dec.31,2006 «,��.�..�.� A SEfttF)AENTSfATEMENf MU61) & TVPE OF LOAN �fi'"""`t� Seled PlaBnum Seltlement Services,LLP �' � Z '�g x �•urm�s. s.❑vn s❑conv.i�+s. 3912 Market SUeet e.ESCRO�NFllEN1AA8ER �.i-ow+NUas�n: �" *� 00132535-001 MAW 7129815872 `�w,� Camp Hill,PA 17011 (71�737-0884 8.MORTG�GE WSURANCE CJ15E NUMBFIt 446-1942157-703 FINAL c.r�o� msrwmu�mranmrov�w�,��a.�wdmm«��a�w�mn�aar�eeyee�m�rrb�eaa+�rar»�,o�. lbms ma�lmd TP.O.GI'xere Peid oufslde Ne daa'lnD:AYeyare sMan hma farinbime6orml WrPoses end ere nolMGUdedM Me tdds. D.NMAE OF BORROWER: Lindsey A Biermnski woness oF eowcov+era 232 Glenn Road Camp Hill PA 17011 E NNAEOFSEIIER: Estate of Kathryn F.Gardner . . ADDRESS OF SHLER: ' F.NAMEOF LENDER: PHH Home Loans,LLC d/b/a ERA Home Loans noorsESS oF�+oers: 1�Mortgage Way Mount Laurel,NJ 08054 c.acoemnwcanoK 79 Hummel Avenue Lemoyne,PA 17043 Cumberland County 12-21-0265�35 Parcel#12-21-0265�35 M.sFrno.�+rnc�r+T: Select Platinum Settlement Seniices,LLP,3912 Market Street,Camp Hill,PA 17011(717) 737-0884 auce oF sErrt�rrr: 3912 Market Street,Camp Hill,PA 17011 i. sern�Ertronh:11222013 PRORA7qNDA7E 11l22f2013 �seuRS��ttro^TE 11222013 J. SUMA4RYOFBORROwFA'STRANSAC710N K � SUI.M9RYOFSELIER'STRANSnCT10N ��101. Conhact Saks Price . . : •. :. �118.500.00 401. CoMrad Saks PfiCe x ~ 118.5W.00 102 Personel RopeM1y 402 Personal Ptoperly 103. SeHlament charyes to 8ortdaer(6ne 7400) B.T18.07 403. 104. � 105. � AW US7MENTS FOR REMS PND BY SELLER IN ADVANCB AOJUS7MHlTS FOR ITBAS PAID BY SELLER kl ADVANCE 106. C ?ownTatros � �. R�T� 707. Coun Taxes 712?J73 to 12f31113 48.97 407. .Cou Taxas 71122l13 to 14lS1M3 48.97 108. Assesxnenb � �WB. AsaeasmeMa � 109. School Tax 11l22113 to OBI3N14 567.71 409. School Tax 11R7113 Eo OCJ30H4 587.71 170. Trash 1127J13 M 11/31I73 18.59 410. Trash 11f22M3 l0 1?li1l73 78.59 111. 411. 112. �12 113. �13. 114. 41A 715. 415. 120. c+aoss�wouNroue�eonnowEre: 125,863.34 �20. onoss�rouMOUerosEiten: 119.135.27 z3..` �xL3P. :.EQ.. _ . „ . _, _,. , �zo7. DaP�or eamest mmaY .750.00 507. Etrwss h xe imtrudbns 202 PrinrJpal amount o!new ben(a) 176.353.0� 502. SetlkrtiaM d�aigas to Selbr ina 1400 7,3T7.00 Z03. Exlsting loan(s)taken 8u0ject to 503. ben a feken sub� M zpq_ 504. Pa of Rrat mo aga loan 205. 505. otaemM eban 296. Selkrportionoftra�fertaz 1.185.00 508. SetlerpoNonoftransM,tarz 1,185.00 207. `�7. 208. 5D8. 209. `�• ADJUSTMENTS FOR REMS UNPAID 8Y SELLFR � ADJUSTAENTS FOR fTEMS UNPAID BY$ELLER: 210. Ca'q�lfown Taxes 510. C lfown Tams 211. County Tws 517. Cou Taxes 212. ASSeasmenb 512 AssmartK+�b 213. 573. �214. 514. � 215. 515. 218. 518. 277. 517. 21& 51& 219. 519. 220. 7o7AlPaDBrIFORBORROweR: 118�288.00 520. MTU_rtEDUenOUSwANO11NTWESE�LEic 0.b82.OD �301. Gmsf omouN dw Gom Bortowar(Ons 120) 7T3.883.74 607. G�aas�mount dus to SeOer(Ilns 420) 119.13527 302 Lsss rnouM Wid MRor Bortnvwr(Ww 720) 118,RB8.00 602 lns�adu�2fon h anw�u�t Mr S�Ner tWr 5201 8,58200 303.CA9X l�FROY 1( ❑ 10)BOBROYYEft: 7.6i6.Y1 80]. CMH(0 rrzoM 1 1�To)e[Ltert: �to.57J.37 rn�wd�r�wn`w e�.a.�oaw.�aw�di�.uo�u�m�e au mn�ua��aan.brca«mc,teuledo0.+��Y M6fa TNt agen9'mry mlmNdh4 tiamre5on aneYuu an na Rwtae b carn�eY�tmn urleu t E4Wfa■wmEY w1E OMB cmCtl nndr.W eaddenlal9'b sud:Ns Cletlo�u+4 mrq�WY.7N�h Ges�y�wtl b P��NePRb b�RE�/1 rnmW MwcOanM/�Irbmutlm EutIn01M w11MnMpo�a. o,.,,w».nMl,...am Nxtlele Paoe 1 W 4 HU0.1 l SETTLEMENTCIWRGES ESCPt1WFlLENULBER: 007]]3]5-0OiMNW.. . ... ... . ..y .. , .. �, . „ .. ; . '�' 'r�'"?�:� '�tl0: '�3'..,... . .A'�. • - .avE'L�ds'q��' ��.-M„79��..:.i .. PAID FROM PAID FR01A DMSIONOFCOnMiSS�ONN�"�E��1�FOLLO�NS BORROWER'SFUNUS SELLER'S 701. 39.990.00 to Cdtlwel BaN�ef Homeatsd GmuP Selal PmhSdaWS AT SETTLEAENT FUN0.SAT SE'i'fLBAFHI' 702. l7.555.0o ro ERA NRT LLC 6�945.00 703. Canm4sdanP�rtseWcne�tt 704. 705 . � ,.-. :. � 'T..;'.0,��' �" " " a�':. 0.�� ,�:.. �r.-.;v,. . _ :�P,....., CONNEGI�(ki: :.. . . . .. . ,. . :. ..r 801 'Ow«qWtlon W� .. . . ,.. 'A Sf27zs 1��+1 . 802 VaurcrodNVWroe(P�b)fwtlrsP��r�p�^ (57.627.21)I�r+'�W �99.% 803. Vouredl�w�Wnatlm7�s I�GCEN . 804. ADP�feebS7ARS M�c�o) 495.00 RamorERl 8.34 BOS. CmdR�eva�bcBCUVwvinlnc. �� 806.Taaavke �cFEal 807. FlooGwd��^ 808. 809. 810. ;��... .P�-.s �:. ` ., : >' x ^vEe�a�;t;�'7T�:,-:.. :.:._., . . �:��- . , � .S17EMS'�,�4: BY`� . ��.. .� �^ . �• . 121.95 •.' 901. OaN'IMere�tauiyn f�a�rtq fmmtt/tN2(114b17N/2017Qf19.5500fday %(9�K) � 902. �aYeYiwienceqaNiM^IOrortanN(s)bDepub�mtatHW ltunGFEt�I 2,001.16 903. HaneownMSWwarintor7Y�(slroShOOFam� leanGFEtttl 612.00 900. 905. .. .... . ..�:a:e�.< t� ' "F4.. .. .. ...... .:.. ,�,r.. .,.. .. �...... . . . ' _ . .__. . . . �. . . q�000,� ERYES!LEP.U. �. . .. .� . .��.��. ..503.08 " toot. u,m�a�x�ywr�ow,�m 1002 ��MS� Snrontlis@f 57.00 petmonN 5163.W 1003. �1or�aBe inswsrca montlis�S 1T7.86 manM 1004. Gbp�PrN� montlnQf P�monM 1005. �mbv�PsMvnu tomona�aOS x.1Y permmm s7al.so 1006. MnuN sueasmeNS naiNr Q S Per monN 1007. SUnd�s Smontl�a�i 7BA9 permonl� 3792A3 1008. matlRs�1 Dl�� 1009. A9Y��1' montlu�t D�monYi 3�N27 . . � r ., �. , a F-:� .x;_< ; �-3�:� ,.. ��,..,.. . : ..- . ..` ��M� 1�335.00�. 1101 71tle brulces+^E IaWei'°W°W Wr�e 1102. Settlrnerdado�^0� 10.00 1103. OxnefsUtlainr+ancabSakctPlafinumSettlemeMSaMas.LLP I��al 1104. Lercbh tltle InrYSn.e•b Sded Plntinum Se�tSenkes.LLP f90.'i.00 t 105. laieets tltla o�Y Wrvt site.�s9.00 � 1106.�O+me�s tltle W�i'�M S7t45a0.0o 1107. �rb D�^T��°�^C°�°m�" S�'.75 b StlM Pietl�m S�t Services.LLP 1108- UntlxwMefsDalbndtMmbltlwNwanaPre^�^ it�925 mOlaReWElelLtlmd7ltlaW.Ca 1109. Enea 100.]oo.e.t•W SeKCt Patlnun SeWemmlSarviaes.LLP St60.0o 1770. WwadCbsinBL�ler•ro0ldRepuDPCNetlaWTitlehaCO. f7Sao 1111. NdaryFam•bSankmeino�rc 3u'.00 70.00 t�t2. -s.s.a.�.erorawkeow� seaoo . . - . '•��'"�"�Y:, _. ..._... .... _ ... ._. ..... ._._.. . ,��`,n��, ., .. , ' ��Y7201. Go�nmmemrt�m�q�w9�� l�"�^��I� 152.00 1202. OneOi87.00 FbRpsyeS05.00 NdeYe50.00 1203.T�� h"�^��°> 2.370.00 1204. GH�°��bhwsmmpz DeaeSl,tas.o0 �an7�io.ao 1205. �elx�lslamDS OeeES1.785.0o Mor10s9�S0.00 120& 120R .. . .. . . . . .. , . . .... .� �„h, , . . . ._ ......... .�.... .. .. .,�: ., ... .. . ,. . . S1 ' Q.�. ' .. . . . � . , �. ,. . - 1301. ReV��+muYa+onamPlor R�c,�ESSI 1950 1302 Mwne N�artanb p FYrtAmerNan Home Buy�rs Pm0[cilm 365.00 1903. HomelPaaURaeon MnP�+b MW&�eety��^iP�^^� l4ts.ao) 1304. FimO Cu�•b STARS 519.60 1305. 7et Sarvke Fea b STARS(PUC U �'� 57.00 130& Sw•siC�Ylt].ttltlHaloWmp�bao 8.728.07 7.377.00 14ao. �rorn�s�'r�onerrt cHnaoES l�nrrm nns�oa.saata,�-.ne-��s ws,sacron q ��,,.m,.+w,.w.weam.xuai seuM�e sn�+.ne bwe.:army wa+n.em.ne ea�r.nr.we.m,�c�,.t:e+�n�a r�xew.m emua.nw+m.a��r .emueo.Mm•�nu,rawa�um�wm.raru�iwe�n.w.o�wu.mviwnsxuo-�sen.maKSmams�� l �^ �" �, �, �. . A 8 Eshte M KathM�f: ner�� - eono+rs seYUs lM FW61 BUIWIwM1 9dsmal WJe�I M�P�OYM I��tu�rd�mnb VtdntM WsM�Nqt I lr�a ouuA a W CYne�1e MC,b M W W wW II YJmfbnw Wtll Wa st.rna�t , ,1 ''t 2 r211� �'�` n.�.. n � -0. s.w«�.nt�a.�� T ' Se�jeU platlnum Senlert�eM S�kas�LLP WFRNIN(t Rb�uYnebbqWfdYmNeObesWanrllbbMtMbESWnmhYOr+MlWnbrbml W��WnCalNCbnwnlWtl��fMnCYnpYamri FafWbYwc Tia�e us.coes s.cbn+am.m s.abn�o�o. � HU61 �f��w� Paoo 2 af 4 Eaaow Numher. 00132535-001 NU1W � — ,. -:. h ...� , , .. �anr-?� ��tiie� , .. �rt'�'��.. �alfhfESM� HUD-�,'. `?7�. �.�S' ��' Charges That Gmot increase � HU0.1 Ltne Number Our originatbn cha�ge t801 M725 72725 7our aWtt orcha�ge(points)Por the specific iMaest nte ehosen 1802 -1,62721 -1,827.21 Your�usted oriyinatlan tliargas M803 -899.96 -099.96 Transfertama AH2O3 2,380.00 2,370.00 ;CIiY!5ss>.,... ��ofal.CaiS.�_�. .,,-^ - ... . .` .>' .;.: ��'�,i'=- � ...a...� . ,. � ,.. GovemmeM rewNing fe¢s M1201�� 299.00 15200 Appnisal fee 1'809 495.00 495.00 CredR report . A805 8.34 8.94 Mo�eqe linuronce A802 2.001.16 2,001.16 Flaod Certificallo� i1304 19.50 19.50 • B 0 s s s � Total 2,82;.00 2,676.00 Increasa DeAVaen GFE and NU61 Cluiges S -147.00 or 5.2072% .:- r8es�frY�a�.- .�p��.. . ,�:'•�.:�-� :.�-. �� ;..� . ,. .. �.. . �. ....�' ; ,�.i �r: � ��'esNm F�� 'NUn..TS;g�,:. InRialdeposkforyouresaowaaouM i1001 5p3,p8 5p3,p9 Dsily iMerest charges IF901 S 13.5500/day ' 121.95 121.95 Haneownefs Msurance #903 61200 6120D lttle services anC kndefs titk inwrance i1101 515.00 1,335.00 Ovme(stltkinsurente f1103 7,000.00 70.00 x f 6 N � ? � # Loan Tertns Your ini�al ban amouM Is s 116,353.00 Your ben teon b 9p ysys Your MMiel interost rote fa p,y6ppy. Your INtial monL�y amouM w+ed far pindppl.k�Mrest and ary 5 7�O.OS InrJuda fnoR92ge�nsulancels Q% Principal Q Interest ' X�Mal9ape Wu�ance Can your interest rate rise9 ❑X No.Q Yrs,It nn rlse to e m�pnum d Q0000%.The first clq'ge wiN be m arM can dunge ag�in erery eRer.Every C�enge tlate,yar kRaeat rnRe can inc�se adec�easa byQODOD%.O�ertlw IHe ofihe baR yourinle�es[ra[e k guaraNeetl to re�er De bxer Wn 40000%or higMr Tan 0.W00%. Even H you make your paymenta on tYne,nn your ban bal�nce risa9 %�Na.�Ves,R un rise to e mocimun d S 0.00. Even Nyou makeyourpeymerds on tk�w.un yourmoMhyamauM �X No.�Yas,Ma firsl hrae�a can bson and the mmNy amouM owed�an wved for prindpel.inteiast.end morlgopa inauro�ee rise7. tse to f O.OD. The rtwdmum R ran evc�e M Is S 0.00. Does your loan�ave a plepaymeM penaMy? Q No.Q Yes,yoirmadmum pepsymeM penaly y S Qpp, Does your ban hava a balbon payment7 x�No.Q Yes.you M�e r 6apoon payment of S 0.00 aue In 0 yeen m. To�l monVtly amowd oxeG 1nduAin9 m�w aocwnt peymaNS ❑Yw tlo nat twe a mm1hN exraw paynbncfar 4anu,auoh as propdty Lma � and Mmeonnds Ns�wan�s.You rtwst PeY Mess items directly ywneM. � x❑Yau Iws an tldtiond monWy mww pyrmeA d S 187.88 Ciat�swMs in a tdd InHd monlNy�meud wrod of S 887.73.Thh Indudas DMeiPW.YdreeC any mal9eVe tsvancs antl a�Y Nenm c�edced Eabw. Ox Propartylazaa ❑X HmnownersWuranoe . ❑Flood Munnes ❑ ❑ � ❑ Note:ttya�eve any questbna about Ilie Sdtlenent CMigea aM Losn Tmns Wbd al EW foim,pbns Wntact ywr lendef. . P�pWpy pAtlms ye o0wkle Pwe]Ot� . HUD-t EcaavNUmeer. 0073253SW1MAW " . . — . HUD 1112 DETAILED BREAKDOWh OF ADDITIONAL TITLE CHARGES pey� Seller Deseription Amou�t � Amou� 1113.Doc Tran�re Fees•to Select Platinum Settlement Services,LLRSO.00 1114.Ovemight Fees•to Select Platinum Settlement Services,LLP S3o.00 11�5.Tax Cert Fee Reimbursement to Selec[Platinum Settlement Senices,l 10•00 Totai as shown on HUD page 2 Line#1112 70.00 HUD 1200 DETAILED BREAK�OWN OF GOVERNMENT RECORDING AND TRANSFER FEES Buyer Seiler � Amount Amourd City 8 County TaxlStamps CityTax/Stamps: Deed $1,185.00 Total as shown on HUD page 2 Line#1204 7,185.00 Buyer Seller Amourt Amour�t State Tax/Stamps StateTax/Stamps: Deed$1,185.00 Total as shown on HUD page 2 Line#7205 1,185.00 P2��s�op�m � Paaelaf4 HU41