HomeMy WebLinkAbout05-08-14 REV-1500 EX(°r_r°' 1505610101
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
County Code Year File Number
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg PA 17128-0601 RESIDENT DECEDENT d-
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
06/20/2013 09/17/1922
Decedent's Last Name Suffix Decedent's First Name MI
Willhlde Banks F
(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
1. Original Return O 2. Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
CID 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9, Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sen.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name 9 Daytime Telephone Number
James W. Kollas, Es q. � (717) 731-1600
-rn
REGIST6MO ILLS USE NLY o>
n
_ O
First line of address z" r r'f FIT
OD cj
Kollas and Kennedy N I
Second line of address C') —n
1104 Fernwood Avenue fV�� r— Fri....-.-.... ....... .....-. .......... -BATE FILED r O
City or ffi
Post Oce State ZIP Code T
Camp Hill PA 17011
Correspondent's e-mail address:fames @kollasandkennedy.com
Under penalties of perjury.I declare that I have examined this return,including accompanying schedules and statements,and lathe beater 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.
SIGNATUVI PERSbN RESPOWL_E OR ILIyy ETURN 111=E g_,`
ADDRESS
850 Kiehl Drive, Lemoyne PA 17043
SIGNATU}E'G P ER OTHER THAN REPRESENTATIVE DATE
DRESS
1104 Fernwood Avenue, Camp Hill, PA 17011
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 J
1505610105
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Banks F. Willhide
RECAPITULATION
E
1. Real Estate(Schedule A). . .. . . . . ... .... . . . .. . . . . . . .. . . . 1. 150,155 60
2. Stocks and Bonds(Schedule B) . . . . . . . . .. . . . . 2. 251,127.43
I
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . .. 3. 0 00
4. Mortgages and Notes Receivable(Schedule D). . .. . . . . .. . . . . .__ . . . . . . 4 0.00
5, Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . .. .. . 5. 84,171.27 i
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . . 6 0.00
Z Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. . . .. . . 7. 0.00J
------------------___1____________1---!
8. Total Gross Assets(total Lines 1 through 7).. . . . . .... .. .. .. .. . . . . . .. . . . 8. 485,454.30 I
9. Funeral Expenses and Administrative Costs(Schedule H).. . . .. .. . . . . . .. . . . 9. 20,556.65 ,
10. Debts of Decedent, Mortgage Liabilities, and Liens(Schedule 1) .... . . . ... . . . . 10. 9,563.271
11. Total Deductions(total Lines 9 and 10). .. ... . . . .. . . . . .. . . . . ___. . . . . 11. I 30,119.921
12, Net Value of Estate(Line 8 minus Line 11) ... . .. . . . . .. . . . . ..... .... . . 12 455,334.38 '
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which w�._.�
an election to tax has not been made(Schedule J) . . . .. . . . . .. . . :. ...... .. . 13. = 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . .. . . . . ... .... .. .. . 14 455,334.38
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 1
(a)(1.2)x.0 0 0.00 ` 15. 0.00
16. Amount of Line 14 taxable { I
at lineal rate x.0 45 304,385.49 16. 13,697.35
17. Amount of Line 14 taxable
at sibling rate X.12 0.00E 17.1 0.00'
18. Amount of Line 14 taxable -�'E `
150,948.89 A A22,642.33
at collateral rate X.15 18.
.-.......... ................
.....
19. TAX DUE .. . . .. . . . .. .. . . . .. . . . .. . . . .
19.1 36,339.681
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610105 1505610105 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Banks F. Willhide
STREET ADDRESS
734 W. Louther Street
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) - (1) 36,339.68
2. Credits/Payments
A.Prior Payments 24,375.00
3.Discount 0.00
Total Credits(A+g) (2) 24,375.00
3. Interest
(3) 0.00
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)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 11,964.68
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;......................................................................................... ❑ ❑
b. retain the right to designate who shall use the property transferred or its income;............................................ ❑ 0
c. retain a reversionary interest;or.......................................................................................................................... ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ ❑K
2. If death occurred after Dec. 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ 9
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ ❑X
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation? ........................................................................................................................ ❑ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116 (a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
fling 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)1.
• 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,under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-152 Ex+ (11-08)
pennsylvania SCHEDULE A
DFPARIMFNI'OF REVFNUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDE19
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
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 willino 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
1 734 W.Louther Street,Carlisle PA 17013 150,155.60
TOTAL(Also enter on Line 1, Recapitulation.) $ 150,155.60
If more space is needed,insert additional sheets of the same size.
REV-1503 EX,(6-98
SCHEDULE 6
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Morgan Stanley Acct#410-059823-012 251,127.43 -
TOTAL(Also enter on line 2,Recapitulation) $ 251,127.43
(If more space is needed,insert additional sheets of the same size)
REV-1506 EX,(6-96)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
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 Checking Acct#444979 23,664.85
2 M&T Bank Savings Acc't#15004200904339 11,712.32
3 Fraternal Order of Eagles Benefit 500.00
4 Real Estate Tax reimbursement 250.00
5 Bowmansdale Lodge IOOF Benefit 1,000.00
6 AAA reimbursement 18.59
7 Humana reimbursement 253.80
8 Thomwald Home reimbursement 3,301.13
9 Bowmansdale Lodge IOOF reimbursement 30.00
10 Century Link refund 44.85
11 M&T Bank CD#31003911151452 37,540.82
12 Total Sales from Auction of Household/Personal Items 5,116.00
13 Check from PA Treasury 738.91
TOTAL(Also enter on line 5,Recapitulation) $ 84,171.27
(If more space is needed,insert additional sheets of the same size)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
• --
DEPARIMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
I' Ewing Brothers Funeral Home 7,654.00
2 Back Door Cafe, Repast provider 699.60
3 Cemetary Lot 8 Grave Opening 1,906.00
B. ADMINISTRATIVE COSTS:
I. Personal Representative Commissions: 0.00
Name(s)of Personal Representative(s)
Street Address
City State_ZIP
Year(s)Commission Paid:
2. Attorney Fees:
0.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 0.00
Claimant
Street Address
City State_ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 804.95
S. Accountant Fees: 0.00
6. Tax Return Preparer Fees: 0.00
7. Allied Maintenance Systems 849.42
B Jim's Custom Lawn Maintence 1,399.20
9 Carlisle Borough Tax Collector 1,800.42
10 Borough of Carlisle 394.61
11 UGI 83.24
12 Century Link 102.21
TOTAL(Also enter on Line 9, Recapitulation) $ 15,693.65
If more space is needed,use additional sheets of paper of the same size.
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
ITEM
NUMBER DESCRIPTION AMOUNT
13 Leffler Energy 1,970.90
14 PP&L 313.92
15 PA State Employees' Retirement Sys. 246.30
16 Dehumidifier and other Misc. Maintenance Items 496.88
17 Auction Costs 1,835.00
Sub Total 41863.00
Total for all of Schedule H
Schedule H, Page 1 15,693.65
Schedule H, Page 2 4.863.00
Total 20,556.65
2
REV-1512 Ex+ (12-08)
(j0 pennsylvania SCHEDULE I
DEPARInEN1 Of REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Banks F. Willhide 2013-00729
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Millennium Pharmacy Systems,Inc. 139.25
2 Quest Diagnostics 62.48
3 Trugreen#5840 138.61
4 Thomwald Home 9,222,93
TOTAL(Also enter on Line 10, Recapitulation) $ 9,563.27
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE ]
DEPARIMFNI OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Banks F. Willhide 2013-00729
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. Dianne Kollas,850 Kiehl Dr,Lemoyne PA 17043 Stepdaughter —35%
2 Chad Kollas, 10021 Honey Tree Ct,Orlando FL 32836 Grandson —11.5%
3 Mary Kollas Kennedy,124 Pin Oak Dr,New Cumberland PA 17070 Granddaughter —11.5%
4 James Kollas,860 Hilltop Rd, Lemoyne,PA 17043 Grandson —11.5%
5 Charles McKain, 1101 Sherwood Dr,Carlisle PA 17013 Nephew —7.7%
6 Kelly McKain,10627 Tyne Ct,Charlotte NC 28210 Niece —7.7%
7 Todd McKain,Entenc A991-D,08015, Barcelona, Spain Nephew —7.7%
8 Stephen Willhide, 1526 Terrace Ave,Carlisle PA 17013 Nephew —7.7%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
11 NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1 0
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
0
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0
If more space is needed,use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
BANKS F. WILLHIDE
I, BANKS F. WILLHIDE, of the Borough of Carlisle, Cumberland County,
Pennsylvania, do make and declare this to be my last Will and Testament, hereby revoking all
prior Wills and Codicils.
FIRST: I direct that all my just debts and funeral expenses be paid as soon
after my decease as may be practicable, except that the payment of any debt secured by a
mortgage or pledge of real or personal property may be postponed by the Executrix in her
discretion.
SECOND: All my personal effects, clothing, furniture, furnishings,jewelry,
automobiles, other tangible personal property of every kind, and insurance thereon, I give to my
stepdaughter, DIANNE L. KOLLAS, to be distributed among herself, her heirs, and my surviving
brothers and sisters, nephews and nieces as my stepdaughter and Executrix, DIANNE L.
KOLLAS, in her sole discretion determines.
THIRD: I give all the coins listed below which are in my Farmer's lockbox
No. 109') on my date of death equally to my two sisters, ROBIE MAE WILLHIDE and DONNA
L. MCKAIN, if both are living or to the survivor if one has died, or to the issue of my sister,
DONNA L. McKAIN, if both predecease me.
Page 1 of 5
1. Miscellaneous cash
2. Wooden box of old silver money and old 1848 large penny
3. Carson City Uncirculated 1884 silver dollar
4. Two George Washington Silver Commemorative Half 1732-1932
5. Two George Washington Halfs Uncirculated 90° silver 1732-1932
6. Proof set Commemorative Halfs 1732-1932
7. U.S. 1986 Statue of Liberty Prestige set
8. Silver dollars 1889, 1890, 1921
9. Masonic Penny 1964
10. One $1.00 Silver Certificate Series 1934
11. One $10.00 Silver Certificate Series 1934
12. One $5.00 Silver Certificate Series 1953
13. Silver Certificates
One 1935 G
One 1935 D
Six 1957
Six 1957 A
Nine others
14. Two Dollar Bills $22.00
15. Two Dollar Bills - Four U.S. Notes
16. Two Dollar Bills - Three Federal Reserve Notes
17. One Three Cent Piece 1 870
18. Ten Dollars Susan B. Anthony Halves
19. Two Kennedy Half Dollars 1964
20. Kennedy Half Dollar 1776-1976
21. Kennedy Half Dollar Plain $53.50
22. Denver Half Dollar $27.00
23. Eisenhower Half Dollars $2.00
24. Eisenhower Half Dollars $9.00 1776-1976
25. $29.00 Silver Dimes
26. $7.00 Quarters 1776-1976
27. Three old Quarters
28. $20.00 Silver Quarters
29. $6.00 old Nickels 1964 or before
30. Two Buffalo Nickels
31. $4.00 Nickels
32. Two packs Wheat Pennies
33. 36 Wheat Pennies
34. Masonic Commemorative Three Coins in box new
Page 2 of 5
FOURTH: I give and devise the real estate at 734 W. Louther Street, Carlisle,
Pennsylvania 17013 to my stepdaughter, DIANNE L. KOLLAS or her issue.
FIFTH: The rest and residue of my estate shall be divided equally into two
parts: The first half I devise and bequeath to my step grandchildren CHAD KOLLAS, MARY
KOLLAS KENNEDY and JAMES KOLLAS or their issue as my stepdaughter and Executrix,
DIANNE L. KOLLAS, determines in her sole discretion. The other half of my residuary estate
shall be divided equally among my certain nephews and nieces listed hereinafter. My nephews
and nieces are as follows: My sister DONNA'S three children, CHARLES, KELLY and TODD;
and my brother, LANE'S son STEVEN. These nieces and nephews shall share equally on a per
capita basis.
SIXTH: I nominate, constitute and appoint my stepdaughter, DIANNE L.
KOLLAS, as Executrix of my estate. If my stepdaughter is unable or unwilling to serve as such
Executrix, either at the time of the creation of my estate, then I nominate and appoint my sister,
DONNA L. McKAIN, as Executrix. No Executrix acting hereunder shall be required to post
bond or enter surety in any jurisdiction.
VX
IN WITNESS WHEREOF, I hereunto set my hand this °�7 day of
, 2009.
v
BY:
BANKS F. WILLHIDE
Page 3 of 5
SIGNED, PUBLISHED and DECLARED by the above, BANKS F. WILLHIDE, as
and for his Last Will and Testament, in the presence of us, who, at his request, in his presence,
and in the presence of each other, have hereunto subscribed our names as witnesses:
✓e UL of �' C
/701/
T
w// /ua of C// Y O,3 /P"-i /61'11a
l
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
I, BANKS F. WILLHIDE, Testator, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I have
signed and executed the instrument of my Last Will and Testament; that I signed it willingly;
and that I signed it as my free and voluntary act for the purposes therein expressed.
Sworn to and acknowledged before me by BANKS F. WILLHIDE, the Testator,
this Z1 day of,Ib-r 2_. 2009.
BANKS F. WILLHIDE
NOTARIAL SEAL
CAROLS A ROSE
Notary Public
Notary Public LOWER ALLEN TWP,CUMBERLAND COUNTY
My Commission Expires Dec 6, 2011
Page 4 of 5
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
We, 1 ^S{l' i2( — and A�S�lY1-1 d';
the witnesses whose names are signed to the attached instrument, being duly qualified according
to law, do depose and say that we were present and saw the Testator, BANKS F. WILLHIDE,
sign and execute the instrument of his Last Will and Testament; that he signed it willingly and
that he executed it as his free and voluntary act for the purposes therein expressed; that each of us
in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our
knowledge the Testator was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence. // �
Sw-Qrn to and sub cribed to before me by Ll SG,. &a(— and
GS�VI ICtdl, U f�klnAa , witnesses, this 31 day of „j L-A� 2009.
Witness Witness
' Cu.&LL t`''�(��7 NOTARIAL SEAL
/
Il �UK`� CAROLE A ROSE
Notary Public Notary Public
� LOWER ALLEN TWP,CUMBERLAND COUNTY
My Commission Expires Dec 6, 2011
Page 5 of 5
OMB Approval No.2502-0265
A. Settlement Statement (HUD-1)
NBxN OEJ ES
B. Type of Loan
1.Nx FHA 2. RHS 3.Q Conv Unins. 6, File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.❑VA 5.❑Conv.Ins, 201402363.PFD 0421972126 1446-2-21683-703
C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked"(p.o.c.)"were paid outside the closing,they are shown here for informational purposes and are not included in the totals.
D. Name and Address of Borrower: E. Name and Address of Seller: F. Name and Address of Lender:
Michael Horton Estate of Banks F.Willhide Wells Fargo Bank,NA
Tracey Sibble 734 W.Louther Street 2701 Wells Fargo Way
672 W.Louther Street Carlisle,PA 17013 Minneapolis,MN 55467-8000
Carlisle,PA 17013
G. Property Location: H. Settlement Agent: I. Settlement Dale:
672 W.Louther Street Central Penn Land Transfer,LLC
Carlisle,PA 17013 3800 Market Street March 12,2014
Cumberland County,Pennsylvania Camp Hill,PA 17011 Ph. (717)695-3166
Place of Settlement:
1104 Fernwood Ave,
Camp Hill,PA 17011
J. Summary of Borrowers transaction K. Summary of Sellers transaction
100. GrossAmount Due from Borrower: 400. Gross Amount Due to Seller:
101. Contract sales price 159,900.00 401. Contract sales prim 159,900.00
102. Personal property 402. Personal property
103. Settlement Charges to Borrower Line 1400 9,418.77 403.
104. 404.
105. 405.
Adjustments for items paid by Seller in advance Adjustments for items paid by Seller in advance
106. Cd/Town Taxes to 406. City/Town Taxes to
107. County Taxes 03/13114 to 01101115 691.621 407. County Taxes 03/13114 to 01101/15 691.62
108. School Taxes 03/13114 to 07/01/14 542.591 408. School Taxes 03/13/14 to 07/01/14 542.59
109. 1 409.
110, 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 170,552.98 420. Gross Amount Due to Seller 161,134.21
200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due Seller.
201. Deposit or earnest money 501. Excess deposit see instructions
202. Principal amount of new loan(s) 156,120.00 502. Settlement charges to Seller Line 1400 2,539.74
203. Existing loans taken subject to 503. Existing loans taken subject to
204 504. Payoff First Mortgage
205. 505. Payoff Second Mortgage
206. 506,
207. 507.
208. 508.
209, Seller Assist 8,338.87 509. Seller Assist 8,338.87
Adjustments for items unpaid b Seller Adjustments for items unpaid b Seller
210. City/Town Taxes to 510. City/Town Taxes to
211. Count Taxes to 511. County Taxes to
212. School Taxes to 512. School Taxes to
211 Seller Paid Tax Service Fee 100.00 513. Seller Paid Tax Service Fee 100.00
214. 514.
215. 515.
216. 516,
217. 517.
218 518,
219. 519. -
220. Total Paid by/for Borrower 164,558.87 520. Total Reduction Amount Due Seller 10,978.61
300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller
301. Gross amount due from Borrower line IZU2 601. Gross amount due to Seller line 420 161,134.21
302. Less amount paid by/for Borrower line 220) ( 164,558.87) 602. Less reductions due Seller(line 520) ( 10,978.61
303. Cash E From 1:1 To Borrower 51 994.11 603. Cash EX To From Seller 150,155.60
Paida ie d dw[Nr wrrw qB),SMIW(s).I (L),a brbWa (T)
The undersigned hereby acknowledge receipt a Tmpleted copy of this statement&any attachments referred to herein
Borrower Seller Este[ 0 Banks F.Willhide
_Mic a Orton /�3 nn
/ BY: W7��
�� y[ Diane L Kollas,Exam rix
ceySibDie -
L.Settlement Cha es
---
700LTOta1-Real Estate BrcAar FeW "- -- - - -
P aid Fran Pak From
DiNsiar of Commission((nit 700)as lo(bws: Bareners Sellers
701.$ 10 Funds nt Funds at
702.$ t0 Settlement Settlement
703.Commission paid at settlement
704.
800.Jiems.Payable in Connection with Loan
801.Our origination charge
$ 895.00 from GFE#1
802.Your credit or charge(mints)for the specific Interest rate chosen from GFE#2
803.Your ad'usted origination charges from GFE#A 895.00
804.Appraisal fee to RELS Valuation from GFE#3 60.66 POC-B -0.66
805.Credit Report to Corelpgic Credce LLC from GFE#3 P.0.C.$11.00 B'
806.Tax servke to from GFE#3
807.Flood certitication to from GFE#3
808. from GFE#3
609. from GFE#3
610. from GFE#3
811. (from GFE#3)
900.;Itema�Requimtl.by:LendeYto Be Paid In Atldance
901.DaRy Interest charges from 03/12114 to 04/01/14 20 $17.640000/da from GFE#10 352.80
902.Mortgage insurance premium for months to Dept.of HUD (from GFE#3) 2,685.11
903.Homeowners insurance for 1.0 years to OBE Insurance (from GFE#11) 839.00
904. (from GFE#11)
905. (from GFE#11)
1000E ReseNasD�oeI etlWith3ender ,-_ ' _ _ ?f - _ . �
1001.Initial deposit for your escrow account (from GFE 119) 1,219.02
1002. Homeowner's Insurance 3.000 months @ $ 69.92 per month $ 209.76
1003.Mortgage Insurance months $ per month $
1004. Property taxes $ 141.48
County Texas 2.000 months @ $ 70.74 per month
School Taxes months @ $ per month
1005.
1006. School Tax 10.000 months @ $ 150.04 per month $ 1,500.40
1007. months @ $ per month $
1008. $
1009. Aggregate Adjustment $ -632.62
l'11007TItle Charges . _
1101. Title services and lenders title insurance (from GFE#4) 1,514.50 10.00
1102. Settlement or dosing fee $
1103. Owners title insurance to Westcer Land Title Insurance Company (from GFE#5) 30.00
1104. Lender's title insurance to Westoor Land Title Insurance Company $ 1,320.00
1105. tenders title policy Emit S 156,120.00
1106. Owners title policy Rmff $ 159,900.00
1107. Agent's portion of the total title Insurance premium to Central Penn Land Transfer,LLC $ 1,147.50
1108. Underwriter's portion of the total tale insurance prernlum to Westcor Land Title Insurance Company $ 202.50
1109. $
1110. $
1111. $
1112. $
1113. $
1200GO'4mmenLRecording an_cI Trartisfer.Chirges �-" 7
1201.Government recording charges to Cumberland County Recorder of Deeds (from GFE#7) 166.00
1202.Deed $ 62.00 Mortgage $ 104.00 Releases $ Other $
1203.Transfer tsxes to Cumberand County Recorder of Deeds (from GFE#8) 1,599.00
1204.City/County tax/stamps Deed $ 1,599.00 Mortgage $ 1,599.00
1205.State tax(stam s Deed $ 1,599.00 Mortgage $
1206.
1207.
-._.. . _ .-,__ . ._.__.
1300.6QHdition_alfSettlement-Charges . _ _ _ -1
1301.Required services that you can shop for (from GFE#6) 119.00
1302. 2014 County Tax Due to Charles Hollry $ 858.65
1303. Tax Service Fee to Wells Fargo Real Estate Tax Service $ 100.00
1304. Flood(Life of Loan) to Wells Fargo Flood Services $ 19.00
1305. Final Water/Sewer Due to Borough of Carlisle $ Aod#008253 72.09
,1400I.Total Settlement Charges(enter on lieas 103;Section'J and-502;Sectio-mK) : . 9,418.77 2,539.74
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Centra enn Land Transfer,LLC,Settlem t ant
Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD-1
Charges That Cannot Increase HUD-1 Line Number
Our origination charge # 801 895.00 895.00
Your adjusted origination charges # 803 895.00 895.00
Transfer taxes #1203 3,180.00 1,599.00
Charges That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1
Government recording charges #1201 174.00 166.00
Appraisal fee # 804 460.00 460.00
Credit report # 805 11.66 11.00
Mortgage Insurance Premium # 902 2,685.11 21685.11
Total 3,330.77 3 322 11
Increase between GFE and HUD-1 Charges $ -8.66 or -0.260
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account #1001 2,470.00 1,219.02
Daily interest charges # 901 $ 17.640000/day 529.20 352.80
Homeowner's insurance # 903 960.00 839.00
Title services and lender's title insurance #1101 1,978.36 1,514.50
Owner's title insurance to Westcor Land Title Insurance Company #1103 10.00 30.00
Tax Service Fee #1303 100.00 100.00
Flood(Life of Loan) #1304 19.00 19.00
Loan Terms
Your initial loan amount is $156,120.00
Your loan term is 30.00 years
Your Initial interest rate is 4.1250
Your initial monthly amount owed for principal,interest and $927.90 indudes
any mortgage insurance is
❑
X Principal
❑
X Interest
❑
X Mortgage Insurance
Can your interest rate rise? ❑X No ❑ Yes,it can rise to a maximum of %. The first
change will be on and can change again every_months after
. Every change date,your interest rate can increase or decrease
by %. Over the life of the loan,your interest rate is guaranteed
to never be lower than %or higher than %.
Even If you make payments on time,can your loan balance rise? ❑X No ❑ Yes,it can rise to a maximum of$
Even if you make payments on time,can your monthly ❑X No ❑ Yes,the first increase can be on and the monthly
amount owed for principal,interest,and mortgage insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
Does your loan have a prepayment penalty? ❑x No ❑ Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? ❑X No ❑ Yes,you have a balloon payment of$
due in_years on
Total monthly amount owed including escrow account payments ❑ You do not have a monthly escrow payment for items,such as property
taxes and homeowner's insurance. You must pay these tems directly
yourself.
XJ Yop have an additional monthly escrow payment of$290.70 that results
in a total initial monthly amount owed of$1,218.60. This includes
principal,interest,any mortgage insurance and any items checked below:
❑X Property taxes X❑ Homeowner's insurance
❑ Flood insurance X❑ School Tax
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.