HomeMy WebLinkAbout06-03-14 (2) � 15�5610140
REV-1500 EX (02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po eox 2soso� 2 1 1 3 0 0 7 5
Harrisburp PA 17128-0601 RESIDENT DECEDENT _
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 1 0 4 2 0 1 3 0 8 3 0 1 9 3 6
DecedenYs Last Name Suffix DecedenYs First Name M�
M 0 Y E R B E R N I T A M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name M�
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
O 1.Original Return � 2.Supplemental Return � 3. Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a.Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
QX 6.Decedent Died Testate ❑ 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 � 10.Spousal Poverty Credit(Date of Death � 11.Election 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 CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
S E T H T • M 0 S E B E Y , E S Q • 7 1 7 2 4 3 ,-.� 3 4 1
ry ,__, :.L1
REGI�F�,QF WILLS USE ONL—�-�
'�. ;.�J
C c"�
C'� ...� _._. -
�..;,� � g� � <:lJ
.=__r "
First Line of Address �`� �° �'� :-t �'
� . :�
1 0 E A S T H I G H S T R E E T . .. ` '
Second Line of Address 5 �j ''�' `"'' � •�'�
�-, �:� •-:� �
;�`s �-
„ :� W I""
0�1TE FILED r"
City or Post Office State ZIP Code �-- � ---�----Et� �
N
C A R L I S L E P A 1 7 0 1 3
Correspondent's e-mail address: SMOSEBEY(a�MARTSONLAW.COM
Under pe s 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 tr ,co ect and complete.Declaration of preparer other than the personal representative is based on all i�formation of which preparer has any knowledge.
SI AT E OF P R N SPO LE FOR FILING RETURN ATE
��
RESS
7 HAMILTON R AD BOILING SPRINGS PA 17007
SI UR F P�AR THER T AN REPRESENTATIVE / `�EJ�
�Q �
ADDRESS
10 EAST HIGH STR T CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 150561014� �
� 1505610240
REV-1500 EX(FI) DecedenYs Social Security Number
oecedent's Name: B E R N I T A M • M 0 Y E R 1 8 1 4 2 7 5 6 6
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �•
5 2 5 0 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.
4 0 5 6 . 6 6
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. � • � �
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property � . � 0
(Schedule G) � Separate Billing Requested . . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. $ 6 5 5 6 . 6 6
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 1 9 5 � 6 . 4 7
10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I 10. 8 8 5 . 4 4
9 9 ( ) . . . . . . . . . . . . .
11. Totai Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 0 3 9 1 . 9 1
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12� 3 6 1 6 4 . 7 $
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. 3 6 1 6 4 . 7 $
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•045 � . � � 15. � . � 0
16. Amount of Line 14 taxable 1 6 2 7 . 4 1
at linea�rate x.045 3 6 1 6 4 . 7 5 �s.
17. Amount of Line 14 taxable Q � Q 0 17. � • � 0
at sibling rate X.12
18. Amount of Line 14 taxable � . 0 �
at collateral rate X.15 0 • 0 0 18.
19. TAX DUE 1 6 2 7 • 4 1
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
� 1505610240 1505610240 �
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 2i t3 oo�s
DECEDENT'S NAME
BERNITA M.MOYER ___ _ - —
STREET ADDRESS
720 GRAHAMS WOODS ROAD _ _
CITY STATE Z�P
NEWVILLE PA 17241
Tax Payments and Credits: ��� 1,627.41
1. Tax Due(Page 2,Line 19)
2. CreditslPayments
A.Prior Payments
B.Discount
Total Credits(A+B) (2) 0.00
3. I nterest
(3) 30.43
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,657.84
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 ............................... X
c. retain a reversionary interest ..................................................................................................... ❑ �
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? ....................................................................................... ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. ❑ 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
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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in�2 P.s.§s��s(a)(�)�.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
BERNITA M.MOYER 21 13 0075
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 decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OFDEATH
DESCRIPTION
1. Real Estate located @ 720 Grahams Woods Rd.,Newville,Cumberland Co.,PA,known as Tax 52,500.00
Parcel No.43-04-0385-014&being described in Deed dated 4/7/56&being recorded in
Cumberland Co.,Deed Bk. "B",Vol 17,Page 541 &being conveyed to Robert E. Moyer
&Bernita M.Moyer,his wife. Robert E.Moyer died 03/15/1982 leaving title solely vested in
Bernita M.Moyer,Decedent herein.
Value is actual sale value. See attached Settlement Statement
TOTAL(Also enter on Line 1,Recapitulation.) $ 52 500.00
If more space is needed,use additional sheets of paper of the same size.
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
BERNITA M.MOYER 21 13 0075
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointiy owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ACNB Account No. 142731 ���•��
See attached
2. Rowes Auction Service,proceeds from sale of personal property 1,720.60
3. Adams Electric Co-op,refund 154.36
4. Dale Eugene Moyer,balance of restitution due 1,053.04
5. Tax Proration 357.89
TOTAL(Also enter on Line 5,Recapitulation) $ 4 056.66
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMtNISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BERNITA M.MOYER 21 13 0075
DecedenYs debts must be repoRed on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Funeral Home,Carlisle,PA 17013,balance due 3,706.67
B, ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attomey Fees: Martson Law Offices(estimated)see attached explanation 8,000.00
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Cumberland County Register of Wills 228.50
5 Accountant Fees:
6. Tax Retum Preparer Fees:
7. Cumberland Law Journal,advertising Letters Testamentary 75.00
8. The Sentinel,advertising Letters Testamentary 200.16
9. Certified mailing,Dale Moyer 5.54
10. Deed copies 0.20
11. Advance of funds to pay 2011 real estate taxes to stay Sheriffs Sale 2,014.64
12. Tax Claim Bureau,2012/2013 real estate tax due 3,996.85
13. 2014 Real Estate Taxes due 28239
14. 1%Realty Transfer tax 525.00
15. Diversified Appraisal Services,appraisal fee 375.00
16. Recording fee 23'00
17. Home Depot,house keys 3.97
18. Cumberland County Landfill,trash removal pending sale of real estate 69.55
TOTAL(Also enter on Line 9,Recapitulation) S 19 506.47
If more space is needed,use additional sheets of paper of the same size.
_ _ _ _ _
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BERNITA M.MOYER 21 13 0075
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. ACNB Account No. 14373,outstanding check on date of death 505.00
2. Baric& Shearer,account payable 200.00
3. Adams Electric Company,account payable 180.44
TOTAL(Also enter on Line 10,Recapitulation) $ gg5.44
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
BERNITA M.MOYER 21 13 0075
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, Randy L.Moyer Lineal 18,082.37
7 Hamilton Road
Boiling Sprigns,PA 17007
2. Diane L.Eyer Lineal 18,082.38
88 Hollyberry Court
Dallas,GA 30157
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.
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
1.
TOTAL OF PART II-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 same size.
ATTACHMENT TO SCHEDULE H, LINE 2
EXPLANATION OF ATTORNEYS' FEES
The Inheritance Tax Return includes estimated attorneys'fees. The estimated attorneys fees
for this Estate include$854.50 for services rendered prior to Decedent's death. The actual attorney's
fees incurred are also more than in a typical estate of this nature. This is due to the fact that there
were various issues surrounding the sale of the real property identified in Schedule A. Such issues
included advising the Executor of the feasibility of his purchase of the property from the Estate and
payment of overdue real estate taxes in order to prevent a sale of the real property. Ultimately,the
real estate was sold to a third party. Attorneys' fees for the sale, including the preparation of an
Agreement of Sale, are included in the estimated attorneys fees.
_ _ _
, _F�FILES�CIien1�l57R B M�er�Ul.l.wi11.?0111
LAST WILL AND TESTAMENT
I, BERNITA M. MOYER, of Upper Frankford Township, Cumberland County,
Pennsylvania,being of sound and disposing mind and memory,do hereby make,publish and declaze
this to be my Last Will and Testament,hereby revoking any and all former Wills or Codicils by me
made.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and
all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property)shall be paid from my residuary estate as soon as practicable after my decease and as part
of the administration of my estate. My Executors shall have no duty or obligation to obtain
reimbursement for any such tax so paid,even though on proceeds of insurance or other property not
passing under this Will.
2.
I give,devise and bequeath such items of personal property as aze indicated in a list attached
hereto and signed at the end thereof by me or by other writing signed and dated by me.
3.
I give,devise and bequeath all of my estate,both real and personal property,in equal shares,
unto my children, RANDY L. MOYER and DIANE L. EYER, absolutely.
4.
Insofar as I have failed to provide in this Will for my son, DALE E. MOYER, such failure
is intentional and not occasioned by accident or mistake.
5.
I nominate, constitute and appoint my son, RANDY L. MOYER, my daughter-in-law,
CYNTHIA L. DARR, and my daughter, DIANE L. EYER, or any of them if one is unable or
unwilling to so serve, as co-Executors of my estate.
6.
I direct that my Executors shall not be required to file a bond to secure the faithful
� � �
B.M.M.
Page 1 of 3 Pages
_ _ _ _
performance of their duties in any jurisdiction.
7.
I authorize and empower my Executors,in their sole and absolute discretion,to purchase or
otherwise acquire and retain any investments of which I die seized or any real or personal property
of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in
regazd to any or all property of any kind forming a part of my estate for such terms and such prices
as they may deem advisable;to borrow money for any purposes connected with the protection and
preservation of my estate;to mortgage or pledge any real or personal property forming a part of my
estate or to join in or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
shaze to be composed of cash,property or undivided fractional shares in property different in kind
from any other share; to employ agents, attorneys and proxies and to delegate to them such power
as my Executors, consider desirable and to pay reasonable compensation for such services as may
be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as
may be necessary to carry out any of these powers. In addition,I direct that my Executors shall have
the power to conduct an inventory of any safe deposit box necessary to the administration of my
estate.
1N WITNESS WHEREOF I have hereunto set my hand and seal this z�? � day of
(� ,��� �1
C�,� L �
� p,P,,,,:�� ,-,-� n�.cy`�/�..
Bernita M. Moyer
SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testatrix,as and
for her Last Will and Testament,in the presence of us,who at her request,have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other.
� (�l��`t1�r+�`�1,-�.:,.�-��
�LY1
B.M.M.
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA )
. SS.
COUNTY OF CUMBERLAND )
r �
We,BernitaM.Moyer, ��r� �'� �/c - i�''�'�f�,� ,and �, t!. ��_e C_ �✓�'��y.t,�J ,
,
the Testatrix and the witnesses, respectively,whose names are signed to the foregoing instrument,
being first duly sworn,do hereby declaze to the undersigned authority that the Testatrix signed and
executed the instrument as her last Will and that the Testatrix has signed willingly, and that the
Testatrix 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 a 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.
��� ��
Bernita M. Moyer, Testatnx
Witness
�
1
Witness .�
Subscribed,sworn to and acknowledged before me b}�Bernita M. Moyer,the Testatrix,and
, �
sub�cribed and sworn to before me by �r�i r�/ :���, �<�-' �%�,���-.; and
� ��/ / ^ �
,
C i�,n/'.� ,� . � ��- , the witnesses,this .'�'��` of i'-f�2-�� �- fu.t' �I .
- / �(°l'E
�l( ��� �_ , r
Notary Public
,���tLVaNtn
�,r�'T;r�1AL S�lic
Vitt+�ne' '�"`°'NO�j�t County
Gt1i�1�F��n' ' ��Zp,2014
M oaanmiai�
Page 3 of 3 Pages
' OMB NO. 25 2-026 �
q, B. TYPE OF LOAN:
U.S.DEPARTMENT OF HOUSING&URBAN DEVELOPMENT 1.QFHA 2.QFmHA 3.QCONV. UNINS. 4.QVA 5.QCONV. INS.
� 6. FILE NUMBER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT g. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actua!sett/ement costs. Amounts paid to and by the settlement agent are shown.
ltems marked"(POCJ"were pa�d outside the closing;they are shown here for informational purposes and are not included�n the fota/s.
1.0 3/98 (15579.1 BEAR PFDI15579.1 BEAR/35)
D. NAMEAND ADDRESS OF BORROWER: E. NAMEAND ADDRESS OF SELLER: F. NAMEAND ADDRESS OF LENDER:
Keith E. Bear and Estate of Bernita M.Moyer
Carri L. Bear 720 Grahams Woods Road � O p`�
91 Russell Road Newvilie, PA 17241 �
Carlisle, PA 17015
G. PROPERTY LOCATION: H. SETTLEMENTAGENT: I. SETTLEMENT DATE:
720 Grahams Woods Road Martson Deardorff Williams Otto Gilroy&Faller
Newville, PA 17241
May 15,2014
Cumberfand County,Pennsylvania PLACE OF SETTLEMENT
10 East High Street
Carlisle,PA 17013
J. SUMMARY OF BORROWER'S TRANSACTION K.SUMMARY OF SELLER'S TRANSACT�ON
101. Contract Sales Price � 52,500.00 401. Contract Sales Price 52,500.00
102. Persanal Pro er � 402. Personal Pro er
103. Settlement Char es to Borrower Line 1400 ; 1,233.50 403:
104. ; 404.
105. 405.
106. Coun /Tw .Taxes 05/16/14 to 01/01/15 177.94 406. Coun Rw .Taxes OS/16l14 to 01/01/15 � 177.94
107. School Taxes 05/16/14 to 07/01/14 179.95 407. School Taxes 05/16/14 to 07/01/14 179.95
108. Assessments to ; 408. Assessments to
109. ; 409. �
110. ! 410.
111. 411.
112. 412.
120. GROSS AMOUNT DfJE FROM BORROWER 54,091.39 420. GROSS AMOUNT DUE TO SELLER 52,857.89
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500.REDUCTIONS IN AMOUNT DUE TO SELLER:
201. De osit or earnest mone 5,000.00 501. Excess De osit See Instructions
202. Princi al Amount of New Loan s 502. Settlement Char es to Seller Line 1400 8,510.91
203. Existin loan s taken sub'ect to 503. Existin loan s taken sub'ect to
204. 504. Payoff of first Mortgage
205. i 505. Pa off of second Mort a e
206. 506.
207. ! 507. De osit disb.as roceeds
208. 508.
209. ' S09.
ustments or tems n ai e er ustments or tems n a� e er
210. Count /Tw .Taxes to 510. Count !Tw .Taxes to '
211. School Taxes to 511. School Taxes to
212. Assessments to 512. Assessments to
213. 513. i
214. ' 514.
215. ' 515.
216. � 516. i
217. 517.
218. 518.
219. 519. i
220. TOTAL PAID BY/FOR BORROWER 5,000.00 520. TOTAL REDUCTION AMOUNT DUESELLER 8,510.91
300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SEIIER:
301. Gross Amount Due From Borrower Line 120 54,091.39 601. Gross Amount Due To Seller Line 420 � 52,857.89
302. Less Amount Paid By/For Borrower(Line 220) '( 5,000.00) 602. Less Reductions Due Seller(Line 520) ( 8,510.91
303. CASH( X FROM)( TO)BORROWER 49,091.39 603. CASH( X TO)( FROM)SELLER I 44,346.98
The undersigned hereby ackno I ge receipt of a completed copy of pages 182 of this statement&any attachm�t�referred to herein.
Borrower �1��� � � Seller �'
Esta�4f�rnita M.Moyer �
Keith E.B��e�a�r � ,
�C.t',r.� '�� ,t�1+�1.. �v/� � .,°';:/ � t�� � �',' """" ,
� �jwi,V� � /��� /'.
Carri L. Bear
HUD-1(3-86)RESPA,H84305 2
Pa e 2
L.SETTLEMENT CHARGES
700. TOTA�COMMISSION Based on Price a r^AIDFROM PAIDFROM
' Division ofCommission line 700 8S FOIIOWS: BORROWER'S SELLER'S
70�. �J t0 FUNDSAT FUNDSAT
�OZ. $ �0 SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704. to
TE PAYABL IN C NNECTI N WITH L A
801. Loan Ori ination Fee % to
802. Loan Discount °/a to
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mort a e Ins.A .Fee to
807. Assumption Fee to
808.
809.
810.
811.
901. Interest From to @ $ /day ( days %)
902. Mort a e Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 ears to
904.
905.
1 R D D
1001. Hazard Insurance $ er
1002. Mort a e Insurance $ er
1003. Caun /T�v .Taxes g ef
1004. SchoolTaxes $ er
1005. Assessments @ $ per
1406. $ er
1007. @ $ per
1008. $ er
1 IT
1101. Settlement or Closin Fee to
1102. Abstract or Title Search to
1103. Title Examination to
1104. Title Insurance Binder to
1105. Document Pre aration to
1106. Nota Fees to
1107. Attorney's Fees to
includes above item numbers:
1108. Title Insurance to Old Re ublic National Title Insurance Co an 641.50
includes above item numbers:
1109. Lender's Coverage $
1110.Owner's Coverage $ 52,500.00 641.50
1111.
1112.
1113.
RD N T N F AR
1201. Recording Fees: Deed $ 67.00;Mortgage $ � Releases $ 67.00
1202. Cit /Count Tax/Stam s: Deed 525.00�Mort a e 525.00
1203. State Ta�JStam s: Deed 525.00;Mort a e 525.00
1204.
1205.
1 AD I A LEMEN CHA E
1301. Surve to
1302. Pestlns ection to
1303. Funeral Bill to Ewin Brothers Funeral Home 3,706.67
1304. 2012 8 2013 Taxes to Tax Claim Bureau 3,996.85
1305. 2014 Township/County Taxes to Shirley J.Armold,Tax Collector 43-04-0385-014 282.39
1400.TOTAL SETTLEMENT CHARGES Enter on Lines 103,Section J and 502,Section K) 1,233.50 8,510.91
By signing page 1 of this statement,the signatories acknowledge receipt of a completed opy of page 2 of this two page statement.
;�. vJ j, � �.,
�
Certified to be a true copy. Martson Deardorff Williams Ott Gi oy&Faller
Settlement Agent
(15579 1 BEAR I 15579.1 BEAR/35)
�
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ACNB
BANK
,
February 7, 2013
�
Marston Law Offices
Attn: Victoria L Otto
lOEHighSt
Carlisle PA 17013
RE: Estate of Bernita M Moyer
Dear Ms. Otto:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
� D.O.D.
Esteem 143731 $770.77 $0.00 Individual 12/23/85
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company
at 1-800-368-5948. If you need any additional information, please contact me at(717)339-5122.
Sincerely,
1
_�-
Barbara J Warne
ACNB Bank
Deposit Services Representative II
acnb.com•acnbbusiness.com• P.O.Box 3129,Gettysburg,PA 17325 •Phone 717.334.3161 •Toll Free 1.888.334.ACN6(2262)