HomeMy WebLinkAbout05-28-14 REV-1500 Ex(01-10) ; 1505610143
PA Department of Revenue OFFICIAL USE ONLY
P Pennsylvania County Code Year File Number
Bureau of Individual Taxes °E°"a,ME"'°'arw"°E
PO 6ox.280601 INHERITANCE TAX RETURN 21 14 0145
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
01 30 2014 11 12 1920
Decedent's Last Name Suffix Decedent's First Name MI
CRUM ELIZABETH I
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return 2, Supplemental Return 0 3. Remainder Return(date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise F 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
8 Decedent Died Testate y Decedeppt Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Gopy of Trust)
9. Litigation Proceeds Received to Spousal Poverty Credit(date of death 11.Eleclionto tax under Sec.9113(A)
between 12-3151 and T-1-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
N
Name Daytime TeleRl�one Number 711 rn
BRADLEY L GRIFFIE 717 243- 5-551 s m C->
13 c70
REGISTER OF WILLS-USE�Q I_Y- O
co A O
_7
First line of address x _� O
200 NORTH HANOVER STREE c o
> o :3 ? �
C C
Second line of address '7 t'V r R1
can
E
City or Post Office State ZIP Code DAT FILED
CARLISLE PA 17013
Correspondent's e-mail address: bgriffie @griffielaw.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.Declarati of prepre
ar other than the personal representative is based on all information of which preparer has any knowledge.
SIG/NAT.UR 5 FILIN URN ^ �Q ✓ DATE
`� /Jtyd Abel T. Crum,Jr.
ADDRESS
181 Sunset.Drive, Carlisle PA 17013
OF R R THAN REPRESENTATIVE DATE
Bradley L Griffie
ADD SS
00 N Hanover Street, Carlisle, PA
Side 1
L 1505610143 1505610143
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decetlenrs Nama Crum, Elizabeth I.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 173 , 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............_ 5. 838 . 05
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 3 , 789 . 64
7. Inter-Vivos Transfers&Miscellaneous Ioq-Probate Property
(Schedule G) u Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1-7)..................................................................... 8. 177 , 627 . 69
9. Funeral Expenses&Administrative Costs(Schedule H)....................................... 9. 34 , 193 . 85
10. Debts of Decedent, Mortgage Liabilities,&Liens(Schedule 1).............................. 10. 255 ,275 . 17
11, Total Deductions(total Lines 9&10)................................................................... 11. 289, 4 69 . 02
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -111 , 841 . 33
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. -111 , 841 . 33
TAX COMPUTATION-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.00 15. 0 . 00
16. Amount of Line 14 taxable 0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. Tax Due...... ......... ............................... ...... ....._...__ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El
Side 2
L 1505610243 1505610243
REV-1500 EX Page 3 File Number 21-14-0145
Decedent's Complete Address:
DECEDENT'S NAME
Crum, Elizabeth 1.
STREETADDRESS
Sarah A. Todd Memorial Home
1000 West South Street
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
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;.......................... .................................. ........... ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income;......... ........................ ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑ ❑
d. receive the promise for life of either payments, benefits or care?............................................................ ❑ ❑x
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?....... ❑ ❑x
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 is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 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 lax, and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116 1.2)[72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A
sibling is defined 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.(11+08)
It, SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
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 which 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
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1 West Countryside Drive, Boiling Springs, South Middleton Township,Cumberland County- 173,000.00
Single Family Residence
(See attached HUD-1 Settlement Statement)
TOTAL(Also enter on Line 1, Recapitulation) 173,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 11-08)
Rev-1508 EX.(6-98)
w SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Hartzell Eye Specialists Refund 43.55
2 United Healthcare Systems, Inc. Premium Refund 6.20
3 United Healthcare Systems, Inc. Premium Refund 234.00
4 Real Estate tax prorations at settlement 299.30
5 Social Security death benefit from pre-deceased husband's passing 255.00
TOTAL(Also enter on Line 5, Recapitulation) 838.05
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.6-98)
Rev-1509 EX.(6-98) 14
SCHEDULEF
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Deborah E. Stahl 609 West Pine Street Daughter
Mount Holly Springs, PA 17065
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH VALUE OF
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSET DECD'S DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE INTEREST
1 A 08/17/2013 F&M Trust Co. - 1,767.63 100.000% 1,767.63
Checking Account No.XXX3845
(See attached statement)
2 A 0 811 712 01 3 F&M Trust Co. - 2,022.01 100.000% 2,022.01
Savings Account No. XX7380
(See attached statement)
TOTAL(Also enter on Line 6, Recapitulation) 3,789.64
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev. 6-98)
REV-1151 Ex.(10-05) 0.
SCHEDULE H
commoI{E�VgqJ�pppIN1 OF $'Y`VANIA FUNERAL EXPENSES &
'"RES'IDEN DT D N1(RN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Hollinger Funeral Home & Crematory, Inc. -
(Stone etching and grave marker)
175.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Abel T. Crum,Jr.
Street Address 181 Sunset Drive
City Carlisle State PA zio 17013
Year(s)Commission paid 2014 8,880.00
2. Attorney's Fees Griffie &Associates, P.C. 4,000.00
3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State zio
Relationshio of Claimant to Decedent
4. Probate Fees 500.50
5. Accountant's Fees
6. Tax Return Preparers Fees
7. Other Administrative Costs 20,638.35
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 34,193.85
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 The Sentinel (Advertising) 135.44
2 Butterworth Electric Service- 700.00
(Real estate repairs prior to sale)
3 Met-Ed 248.76
4 Med-Ed 173.72
5 Met-Ed 114.89
6 Real Estate Expense-Law Maintenance to Tom Crum 300.00
7 Real Estate Expense-Snow Removal to Fred Stahl 175.00
8 South Middleton Municipal Authority(Water&Sewer) 135.22
9 Orrstown Bank Check Fees 16.25
10 Real Estate Settlement Fees - 17,639.07
(See attached HUD-1 Settlement Sheet)
Realtor's Commission 10,380.00
Title Insurance letter 40.00
Realty Transfer tax 1,730.00
2014 County/Twp.taxes 444.67
Pest Treatment 265.00
Water/Sewer final bill 44.40
"Seller Help" to Buyers 4,735.00
11 Reserves 1,000.00
H-B7 20,638.35
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX.(12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDEWDECEDENT
ESTATE OF FILE NUMBER
Crum, Elizabeth 1. 21-14-0145
Report debts incurred by the decedent prior to death that remained unpaid at the data of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Three Springs Family Practice(Medical) 134.58
2 Department of Public Welfare- 255,086.94
Division of Third Party Liability
Medicaid Claim
3 Sarah Todd Nursing Home(final billing) 53.65
TOTAL(Also enter on Line 10, Recapitulation) 255,275.17
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX.(11t081 +�
H SCHEDULE J
COMINOERITANCE�AX RETURN ANIA BENEFICIARIES
RE IDEN DECEDENT
ESTATE OF FILE NUMBER
Crum, Elizabeth I. 21-14-0145
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSONS)RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal Do List Trustee s
distributions,and transfers
under Sec.9116(a)(1.2)]
Abel T. Crum,Jr. Son One-third of net
181 Sunset Drive distributable
Carlisle, PA 17013 estate
Mary A. Fry Daughter One-third of net
11 South Walnut Street distributable
Mount Holly Springs, PA 17065 estate
Deborah Stahl Daughter One-third of net
609 West Pine Street distributable
Mount Holly Springs, PA 17065 estate
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II.. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 11-08)
pp3Mci�r ppy OMB Approval No.2502-0265
�4 If �I OG HUD-1
A. Settlement Statement (HUD-1)
i
H9 4N OEgt-'p Page 1 of 3
B.Type of Loan
1.❑FHA 2.E]RHS 3.❑Conv.Unins. 6.File Number: 7.loan Number: 8.Mortgage Insurance Case Number:
4.❑X VA 5.❑Conv.Ins. 401400473-SK 6800765329 10-10-6-0657332
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
BRIAN M.PALMER ABEL T.CRUM,JR,ADMINISTRATOR OF MEMBERS 1ST FCU
523 BEDFORD CT. ESTATE OF ELIZABETH G.CRUM 5000 LOUISE DRIVE,
MECHANICSBURG,PA 17050 1 WEST COUNTRYSIDE DRIVE MECHANICSBURG,PA 17055
BOILING SPRINGS,PA 17007
G.Property Location H.Settlement Agent
SECURED LAND TRANSFERS,LLC
I WEST COUNTRYSIDE DRIVE, 485 ST.JOHNS CHURCH ROAD,
BOILING SPRINGS,PA 17007 SHIREMANSTOWN,PA 17011
Phone:(717)901-8342
COUNTY:CUMBERLAND
PARCEL ID:40-28-2100-281 Place of Settlement I.Settlement Date 04/30/2D34
TOWNSHIP:SOUTH MIDDLEFON TOWNSHIP
1068 HARRISBURG PIKE Disbursement Date 04/30/2014
CARLISLE,PA 17013
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. Contract Sales Price $173.000.00 401. Contract Sales Price $173,000.00
102. Personal Property 402. Personal Property
103. Settlement charges to borrower line 1400 $9,619.79 403.
104. 404.
105. 405.
Adjustment for items paid by seller in advance Adjustment for items paid by seller in advance
106. City/Town Taxes 30.14/yr 4/30/2014 to $20.29 406. City/TOwn Taxes 30.14/yr 4/30/2014 to $20 29
12/31/2014 12 31 2014
107. County Taxes 414.53 r 4/30/2014 to 12/31/2014 $279.01 407. County Taxes 414.53/ r 4/30/2014 to 12/31/2014 279.01
108. Assessments 408. Assessments
109. School Taxes 1 478.05 r 4130/2014 to 6/30/2014 247.70 409, School Taxes 1 478.05 r 4130/2014 to 6/30/2014 247.70
110. 410.
111. 411.
112. 412.
120.Gross Amount Due from Borrower 1$153,166.79 420.Gross Amount Due to Seller 173 547.00
200.Amounts Paid by or in Behalf of Borrower 500.Reductions In Amount Due to Seller
201. Deposit or earnest mane $1,500.00 501. Excess Deposits
202. Principal Loan Amount from Members 1st FCU $176,719.00 502. Settlement Charges to Seller $24,581.57
203. Existing loans taken subject to 503. Existing loans taken subject to
204. Credit for Appraisal Fee from Members 1st $375.00 504.
205. 505.
206. 506.
207. 5D7.
208. 508.
209. 509.
Adjustments for items unpaid by seller Atl ustments for items unpaid by seller
210. CI Town Taxes 510. CI own Taxes
211. County Taxes 511. County Taxes
212. Assessments 512. Assessments
213. Seller's Assist $4,73 5.00 513. Seller's Assist $4,735.00
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220.Total Paid by/for Borrower 1$183,329.00 1520.Total Reduction Amount Due Seller 29 316.57
300.Cash at Settlement from/to Borrower 600.Cash at Settlement to/from Seller
301. Gross amount due from borrower line 120 183 166.79 601. Gross amount due to seller line 420 $173,547.00
302. Less amounts aid b /for borrower line 220 183 329.00 602. Less reductions in amount due seller line 520 29 316.5]
303.Cash Lj From LX j To Borrower 1 $162.21 603.Cash LX J To LJ From Seller 144,230.43
The Public Reporting Burden for Nis collection of Information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may not
collect this information,and you are not required to complete this form,unless it displays a currently valid OMB control number.No confidentiality is assured;Nis disclosure
Is mandatory,This Is designed to provide the parties to a RESPA covered transaction with Information during the settlement process. p p
Initials D 1
401400473-SK _
HUD-1
L. Settlement Charges Page 2 of 3
700.Total Real Estate Broker Fees$10380.00
sion of Commission line 700 as follows; From Paid From
701. 5190.00 to Geor a L.Ebener&ASSOCIates Borrower's Funds Seller's Funds
702. 5190.00 to ERA-NRT LLC At Settlement At Settlement
703. Commission paid at settlement
704. 10 380.00
800.Items Payable in Connection with Loan
801.Our on [nation char a 395,00 from GFE#1
802. Your credit or cha a ointr for the s ecifc Interest rate chosen from GFE#2
803.Your adjusted ad inatlon char es from GFE 395.00
804.A sisal Fee to Members A
1st FCU from GFE A 375.00
805. Credit re ort to Members 1st FCU from GFE 4 3 13.50
806.Tax Service from GFE#3
807. Flood Cart.Fee to Members 1st FCU from GFE#3
808.VA Funding Fee(Financed) 32.50
$to Members 1st FCU 3 19.00
809.VA Fee Cash W Members 1st FCU $0.50
900.Items Required by Lender to Be Paid in Advance
901. Daily Interest charges from 04/30/14 to 05/01/14 @ 18.g082/day Members
1st FCU (from GFE#10) $18.41
902. Mortgage Insurance Premium from GFE#3
903. Homeowner's Insurance Strickler Insurance A enc from GFE#11 $415.001 1
904.
1000.Resemes Deposited with Lendsr
1001.Ini8al deposit for Your escrow account (fmm GFE#9 $1,2 56.86
1002•FCU $103.74
Ins.Reserve 3.0000 menth(s)@ 34.58/month(s)to Members 1st $103.74
1003.County Property Taxes 3.0000 month(s)@ 36.32/month(s)to Members 108.96
Jet FCU $
3004.School Taxes 11.0000 months @ 120.71 months to Members 1st FCU 1 327.81
SOOS.A re ate Accountin Adjustment to Members tat FCU -$283.63
1006.
1007.
1100.Title Charges
1301.Title services and lender's title Insurance to Secured Land Transfers LLC from GFE#q $1,510.00 40.00
1102.Settlement or closing fee
1103.Ownees title Insurance from GFE#5
1104.Lender's title Insurance to Secured Land Transfers,LLC $1,435.00
1105.Lender's title policy limit $176,719.00
3106.Ownees title policy limit $176,719.00
1107.Agent's portion of the total title insurance premium to Secured Land $1,291.50
Transfers LLC
3108.Underwriter's Portion of the total title Insurance premium to TRGC $143.50
1309.Insured Closing Protection Letter to TRGC $75.00
1200.Government Recording and Transfer Charges
1201.Govemment recording charges from GFE#7 $174.00
1202.Deed 3 Pages) 67,00 Mortgage 24 Pages) 107.00 Releases
1203.Transfer taxes from GFE#e $1,730.00
1204.Ci /County tax/stamps Deed$1730.00 Mortgage
1205.State tax/stamps Deed$1730.00 Mortgage $1,730.00
1206.
1300.Additional Settlement Charges
1301.Required services that you can shop for from GFE#6
1302.2014 County/Twp Taxes to Jennifer L.Varner Tax Collector $444.67
1303.Pest Treatment to Archer Pest Control $265.00
1304.Water and Sewer Bill to South Middleton Township Municipal Authority 44.40
1305.Inheritance Tax Escrow to Secured Land Transfers-Mechanicsburg $11,677.50
1400.Total Settlement Charges(enter on lines 103,Section 1 and 502,Section K) $9,619.]9 $24,581.57
If you have any questions about the settlement charges and loan terms listed on this farm,please contact your lender.Settlement agent is not responsible for content of
lender's assessments on HUD.
The seller's and borrower's signatures hereon acknowledge their approval and slgntly their understanding that tax and insurance promgons and reserves am based on
figures for the preceding year or supplied by others or estimated for the current year,and In the event of any Mange for the current year,all necessary adjustments will be
made between bonnier and seller directly.Any deficit delinquent taxes or mortgage payoffs will be promptly reimbursed to the settlement agent by the seller.
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,It Is 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 resolved a copy of the HUD�l Settlement Statement.
BWERSV SELLERS
Estate Ii bel�rui0„
etlan M.Palmeri Cil�L
By:Abel T.Crum,Jr,Admlp tur
The HUD. 8edleme 18tstement w Ich I have prepared is a true and accurate account of this transaction. have caused or will rouse the funds to be disbursed In .
a r ce with Ihls slatemen.
atllem t n( oete
garJgrzota
'Any Hem marked-POC"were paid outside dosing by:Borrower POC(B),Lender POC(L),Mortgage Broker POC(M),Seller POD(S),Real Estate Agent POC(R),or
Other PO (0).
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