Loading...
HomeMy WebLinkAbout07-10-14 (2) i ,.- � 1505610105 REV-1500��az_���«��_ PA Department of Revenue pennsylvania Bureau of Individual Taxes °"""'"`"°w OFFICIAL USE ONLY PO BOX 2go6oi INHERITANCE TAX RETURN �ounry Code Year EN7ER DECEDENT INFORMATION BELOW File Number RESIDENT DECEDENT p�� � Social Security Number �� 166-32-27g7 Date of Death MMDDYYYy Date of Birth 10/17/2013 MM��m�y DecedenYs Last Name 04/30/1942 Suffix DecedenYs First Name Barbara M� (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 DUPLICqTE WITH THE FILI,IN APPROPRIATE OVALS BELOW REGISTER OF WI�LS � 1.Originai Return O 2.Suppiemental Return O 4.Limited Estate O 3. Remainder Return(Date of Death O 4a.Future Interest Com romise(date of Prior to 12-13-82) O 6.Decedent Died Testate death after 12-12-g2) O 5. Federal Estate Tax Return Required (Attach Copy of Will) � �� �ecedent Maintained a Living Trust Q � 9.Litigation Proceeds Received �Attach Copy of Trust.) 8� Total Number of Safe Deposit Boxes O 10.Spousai Poverty Credit(Date of Death Q 11. Eiection to Tax under Sec.9113(A) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX 1 Name (Attach Schedule O) NFORMATION SHOULD BE DIRECTED T0: Sue R. Leach �aytime Telephone Number REGISTER�yy��LS USE f��y First Line ofAddress 217 Shauffnertown Rd. � � � �,�y ��_ � .�`�i Second Line of Address r`- '�? �'s�'; ` :7 � ��.; � � �T� City or Post Office �C� :*.�, � r- �, C2�:.. _:� `,; New Cumberland state ZIP Code �' '�j47'L�FIIED �3 C'^� PA 17070 " ` �' � ~�� Correspondent's e-mail address: Under penalties of perjury,I declare that I have examined this retum,including accom it is true,correct and cpmp�ete.Declaration of v NATURE O PERSON p���'�other than the personal represen ati9e Is based on all informaHon ofwhich p pare h sn�y k��y�9���ef, /� SPONSIBL FOR FILING RETURN ADDRESS . DATE 217 Shauffnertown Rd., New Cumberland, PA 17070 �( SIGNATURE OF PREpqRER OTHER THAN REPRESENTATIVE ADDRESS DATE PLEASE USE ORIGINAL FORM ONLY L Side 1 1505610],p5 15�56101p5 � _ _ �1.�� _ _ J 15�5610205 REV-1500 EX(Flj Decedent's Name: Decedent's Social Security Number RECAPITULATION 166-32-27$7 �. Real Estate(Schedule A). . . . . . .. . . . . . . . . . . 1. 2. Stocks and Bonds(Schedute B 169,90�.00 ) ... . . . . . . .. . . . . . 3 Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ... . 3 0.00 4 Mortgages and Notes Receivable(Schedule D 0.00 ). .... . . ... . 5� Cash, Bank Deposits and Miscellaneous Personal Pro ert 4 0.00 P y(Schedule E)., . . 5 6. Jointly Owned Property(Schedule F) p Separate8illing Requested . .... . 12>415.19 7. inter-Vivos Transfers&Misce�laneous Non-Probate Property (Schedufe G} 6 O Separate Billing Requested.... .. . . 7 262•07 $. Total Gross Assets{total Lines 1 through 7)... . . . 0.00 . .... . .. . . ...... 8. 9. Funeral Expenses and Administrative Costs(Schedule H). , . ., �82'S77'26 1�. Debts of Decedent, Mortgage Liabilities and Liens(Schedule i). . ... . . . . 9 3,523.60 11. Total Deductions(total Lines 9 and 10). , ... ,O 123,291.66 . ... . .. ... . ..... . ... . . .. . . . ii. 12. Net Vatue of Estate(Line 8 minus Line 11) ,. �26,815.26 �3 Charitable and Governmental Bequests/Sec 9113 Trusts for which .. .. . . .. . . 12. an election to tax has not been made(Schedute J) .. , . . 55,762.00 . . .. . ... . . . 14. Net Value Subject to Tax(Line 12 minus line 13) 13 0.00 T�CALCULATION. . .... . . .. . ... SEE INSTRUCTIONS FOR APPLICABLE RATES 14 55,762,00 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.g1�g (a)(1.2)X.0_ 16. Amount of Line 14 taxabie at�ineal rate X.0 45 15. �� AmountofLinel4taxable 55,762.00 16 at sibling rate X.12 2,509.29 18• Amount of Line 14 taxabie at collateral rate �� X.15 19. TAX DUE . .. . . 8. . . . . . .. . . . .. . .. . . . . . . . . .... . 19 2,509.29 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O L Side 2 150561p205 1505610205 J REV-7500 EX(FI) Pa9e 3 Decedent's Complete Address: DECEDENTS NAME F��e Number Barbara Jane Beward --- - - STREETADDRESS - - - 501 Ricky Rd. - _ _ . _ - . _ _ . _ _ __ _ _ _ _ ___ arr -- - _ _ _ . _ _ Mechanicsburg _ _ __ _ _ STATE . - __ _ PA ziP __ _ Tax Payments and Credits: 17055 1. Tax Due(Page 2,Line 19) 2 CreditslPayments A.Prior Payments ��� 2,509.2g _-- .Discount - - - --- _ - _ Interest Total Credits(A+g� �2� 4. If Line 2 is greater than Line 1 +�ine 3,enter the difference. This is the OVERPAYMENT. �.00 Fill in oval on Page 2,Line 20 to request a refund. �3� 0.00 5. If Line 1 +�ine 3 is greater than Line 2,enter the difference.This is the TAX DUE. (4) �5� 2,509.29 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" �. oid decedent make a transfer and: IN THE APPROPRIATE BLOCKS a. retain the use or income of the property transferred................ b. retain the right to designate who shali use the ro e Yes No .......................................... c. retain a reversiona .. . ....... ... � � P P rty transferred or its income ..... ry interest............................................................................................................................. � � d. receive the promise for life of either payments,benefits or care?........... 2. If death occurred after Dec. 12, 1982,did decedent transfer ro e ■ ....... ...... � without receiving adequate consideration?.................... .... .. .. .. ......... . ............ P P �y within one year of death 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?....... .......................................................................... ❑ 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 ❑ ■ For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rat � SCHEDULE G AND FILE IT AS PART OF THE RETURN. is 3 percent[72 P.S.§9116(a)(1.1)(i)]. e imposed on the net value of transfers to or for the use of t For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of tran he surviving spouse (72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax an filing a tax return are still applicable even if the surviving spouse is the only beneficiary_ sfers to or for the use of the surviving spouse is 0 percent d the statutory requirements for disclosure of assets and 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 ou adoptive parent or a stepparent of the child is 0 percent(72 P.S.§g11g(a���2�� The tax rate imposed on the net value of transfers to or for the use of the decedenYs lin y n9er at death to or for the use of a naturai parent, an . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblin s is 1 eai beneficiaries is 4.5 percent,except as noted in[72 P.S.§g116(a)(1)). under Section 9102,as an individual who has at least one parent in common with the decedent,wheth 9 2 percent[72 P.S. §9116(a)(1.3)].A sibiing is defined, er by blood or adoption. i . .:..... ... . . _ . REV-1502 EX+(12-12) �pennsytvania S DEPARTMENT OF REVENUE CH E D U L E q INHERITqNCE TN(RETURN RESIDENT DECEDENT REAL ESTATE esrare oF: 8arbara Jane Beward All real prope FILE NUMBER: rty owned so�e�y or as a tenant in common must be reported at fair market value.Fair market value is def' would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both hav� 2��13-1122 Real property that is jointly-oWned with right of survivorship must be disclosed on Scheduleep as the price at which property ing reasonable knowledge of the relevant facts. ITEM Attach a copy of the settlement sheet if the property has been sold. NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. DESCRIPTION VALUE AT DATE 1' S01 Rick Road,M OF DEqTH 1' echanicsburg,pA-t�parcel no.42-27-1886-070 Value per sale price-settlement sheet attached 169,900.00 TOTAL(qlso enter on Line 1, Recapitulation.) $ 169,900.00 If more space is needed,use additionai sheets of paper of the same size. REV-i5o8 EX+(o8-iz) �pennsylvania SCNEDULE E DEPARTMENT OF REVENUE INHERIfqNCE 7AX RETURN ��H/ BANK DEPOSITS & MISC. RESIDEN7 DECEDENT PERSONAL PROPERTY esrare oF: Barbara Jane Beward FILE NUMBER: Include the proceeds of litigation and the date the proceeds were received by the estate. 21_12_�122 ITEM A��p�O��'tY]ointly owned with right of survivorshi NUMBER P m�st be disclosed on Schedule F. 1. Pennsylvania State Employees Credit Union,PO B xR6 13,Hb ,pq VALUE AT DATE 9 Savings Acct No.01663227g7 OF DEATH 2. Pennsylvania State Empioyees Credit Union,PO Box 67013,Hb PA,Checkin A 370.84 3. Intemal Revenue Serofce.2p�3 Federal Income Tau Refund 9 9 �No.0166322787 208.79 4. PA Central Federal Credit Union,959 E.Park Dr.,Hbg,pq,�Rq No.29285-pA4 1,057.56 5. Erie Insurance Group-refund of insurance premium 10,551.00 227.00 TOTAL(Also enter on Line 5, Recapitulation) $ If more space is needed, use additionai sheets of paper of the same size. 12�415•19 REV-i5�9 EX+(01-10) �j�F�µ :' pennsylvania � DEPqRTMENT OF REVENUE SCNEDt1LE F INHERIfqNCE 7AX RFI'URN )OINTLY OWNED PROPERTY RESIOENT DECEDENT ESTATE OF: Barbara Jane Beward If an asset �ILE NUMBER: became jointly owned withi�one year of the dec�enYs date of death,it must be re�rt�_13-1122 SURVNING JOINT TENANT(S)NAME(S) on Schedule G. A•Sue R. Leach ADDRESS RELATIONSHIP TO DECEDENT 217 Shauffnertown Rd. New Cumberland, PA 17070 Daughter B. C. ]OINTLY OWNED PROPERTY: 1TEM fOR p NT MADE NUMBER 7FNqM INCLUDE ryqME OF f7NqN DESCRIp7jON OF p{ZQpERTY )OINT IDEN17Fy1NG NUMBER,A17q��j pEED FpRp�Y HEID ftEqL ESTATE. 1. /,�. ��UNT NUMBER OR SIMILqR pA.���TM �°� DATE OF DEAT}� ��`i�5 PA Centrai Federal Credit Union,Savings Acct No.2g2g5-014 VALUE OF a5� ����� VA�UE OF INTEREST DECEDENPSINTEREST 2. q 173.95 5a � �N�S PA Central Federal Credit Union,Checking Acct No.29285-074 86•98 350.18 50 175.09 TOTAL(Aiso enter on Line 6, Recapitulation) � If more space is needed,use additional sheets of paper of the same size. 262•07 REV-1511 EX+ (08-13) , � pennsylvania SCHEDU�EN DEPARTMENT OF REVENUE ■ ■ INHERITANCE TAX RETURN FUNE�L EXPENSES A�yD RESIDENT DECEDENT ADMINISTRqTIVE COSTS ESTATE OF Barbara Jane Beward FILE NUMBER ITEM DecedenYs debts must be reported on Schedule I. 21-13-1122 NUMBER A• FUNERAL EXPENSES: DESCRIPTION 1. Auer Cremation Services of Pennsylvania,4100 Jonestown Rd.,Hbg, pq aMOU►ur 1,708.00 B• ADMINISTRATIVE COSTS: 1• Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City Year(s)Commission Paid: State Zip ------- 2• Attorney Fees: 3• Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation. ��400.00 Claimant ) Street Address ------ City Relationship of Claimant to Decedent State Zrp --__ 4' Probate Fees: 5' Accountant Fees: 358.50 6• Tax Return Preparer Fees: �• Extra Short Certificates $� Extra Death Certificates 25.00 9� U•S•Postal Service-mail 18.00 14.10 If more space is needed, use additional shOTA�L papse of the s�a e�S Ze' RecapitUlation) $ 3,523.60 _ __ REV-islz Ex+ �iz-iz� . �pennsylvania SCHEDU�ET DEPqRTMENT OF REVENUE + E ID NTNDEC ENTrURN MORTGAGE L ABILIT ES &LIEN ESTATE OF S Barbara Jane Beward Report debts incurred by the decedent prior to death that remained unpaid at the date of death i FILE NUMBER ITEM 21-13-1122 NUMBER , ncluding unreimbursed medical expenses. 1, DESCRIPTION VALUE AT DATE PSECU,PO Box 67013,Hbg,pq 17�pg_Pe�nal se►vice Ioan no.01663227g7 OF DEATH 2• PSECU,PO Box 67013,Hbg,Pq 17106-Visa no.01663227g7 972.23 3� Chase,PO Box 7g420,Phoenix,AZ. Home Mortgage loan No. 195864gg4p 3�2���63 4� PA Central FCU,959 E.Park Dr.,H 89,907.38 bg,PA-Home Mortgage loan No.2g2g5_p3q 5- SRC Electric,445 Herman Ave.,Lemoyne,PA-electrica�box repair to home nece 3,914.28 6� Kreamer Brothers Glass,inc., 1714 Hummel Ave,,Camp Hill,PA-repair to real S�ry for sale) 950.00 �� York Waste- estate(nec.for sale) 9arbage disposai bill 155.72 8� Tiger Trash-dumpster rental(nec�ssary for sale of real estate) 65.05 9� Rick Road Repairs-repairs to real estate(necessary for sale) 720.00 10. Fataba Swaray,3021 S.72nd St.,F11,Philadelphia,PA-home health care 1,545.68 ��� Griswold Home Care,6 W. Main St.,Shiremanstown,PA-home health care �.740.00 12� UGI-gas bill 595.00 13. Orthopedic Insitute of Pennsylvania,Cam Hill,PA- p medical bills 329.66 14. Volkswagen Credit-acct no.871806140-balance due on leased vehicle(vehicle 193.46 15. United Water Penns Ivania,81gg Adams Dr.,Hummelstown,pq_ �tumed to lessor) Y 3,639.83 16. water bill Computer Credit,Inc.,PO Box 5238,Winston Salem,NC-for Holy Spirit Hospita!-medi 44.00 17. Verizon-acct no.799000 8983007019Q4- �I bill phone bill 129.13 �8� DCM Services_for Target Credit Card Balance,acct no.'"*5490 203.82 19. Ascension Point-for Citibank NA >Sears Gold Mastercard Balance,acct no, �95.21 20� Barclays bank Delaware,LL bean credit account balance,acct no.*"'651q �3�9 229.67 21. West Shore Anesthesia Assoc.Ltd.,PO Box 947,Chambersbur ,pq_ 435.10 �� Holy Spirit Hospital,503 N.21st St.,Cam Hi��,pA_ g medical bill p medical bills 16.38 23. PPL-electric bills 935.01 24. DCM Serivices for American Express Centurion Bank credit card balance,acct no."� 619.71 (Balance from attached addendum) 3007 219.63 12,318.08 If more space is needed,insert adr on Is�h etsnof the same 5 O Recapitulation) $ 123,291.66 SCHEDULEI (Addendum) Estate of Barbara Jane Beward File No. 21-13-1122 25. Realtors Commission to CB Select Professionais and ReMax 1S' Advantage(necessary to sale of real estate) 26. Guardian Transfer- Deed preparation (necessary to sale of real �10,494.08 27• Transfer taxes for sale of real estate estate) 125.00 1----�•Q� Addendum Totai: $12,318.08 REV-1513 EX+(01-10) ,� .�.�, pennsy(vania SCHED DEPqRTMENT OF REVENUE ULE � INHERITqNCE TA7(RETURN BENEFICIqF�ES RESIDENT DECEDEN7 ESTATE OF: Barbara Jane Beward FILE NUMBER: NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPER7Y 21-13-1122 I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under RE��ONSHIP TO DECEDENT �o Not List Trustee(s) AMOUNT OR SHARE Sec.9116(a)(1.2),] OF ESTATE 1• Sue Leach,217 Shauffnertown Rd.,New Cumberland,PA 17070 Daughter 2• Michaei L.Huber, 144 S.Lockwillow pv.e,Harrisburg,PA 17112 28,��2.04 Son 27,749.96 ENTER DOLLAR AMOUNTS FOR DISTRIgUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHE II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: �AS APPROPRIATE. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTlONS ON LINE 13 OF REV-�500 COVER SNE If more s'ace is needed,use additional sheets of paper of the same size. � � LAST WI�L AND TESTAIV�ENT OF BARBARq J BEWARD �, Barbara J. Beward, currently of 501 Ric . Cumberland Coun y kY Road, Mechanicsburg, ty, Penns Ivania being of sound mind, memory and u hereby make, publish and deciare this to be m nderstanding, y Last Will and Testament, hereby revoking a�l previous Wiils and Codicils made by me. ART-- �_E� It is my intention by this Will to dispose of all of the pro e However I hereb elect not to exercise an p �wh�ch I may own. , y Y power of appointment exercisable by a Will which i now have or which may hereafter by conferred o shall be construed as an exercise in whole or i n me; no provisions of this Wi�� n part of any such power. ARTICLE 11 All estate taxes, inheritance taxes, transfer taxes and oth nature a able b reason of m death to an er taxes of a similar p Y Y Y y government or subdivision thereof upon or with respect to any property subject to any such tax, and a paid by the executor out of the residue, without ny penalties thereon, shall be among the beneficiaries, reci ients �e1mbursement from or apportionment P or owners of such property for any such taxes, penalties or interest. PAGE 1 OF 5 ARTICLE III I hereby give, devise and bequeath my entire estate w or mixed, as follows: . hether real, personal a. Fifty(50��0�percent to my daughter, SUE R. LEACH,of2 Road, New Cumberland, PA 1707p �7 Shauffnertown , provided she survives me by thirty (30) days. In the event that my said daughter should predecease me or fail to s then and in that event, her share shall be distribut uNive me by thirty(30)days, ed to her issue, per stirpes. b' F�� �50°�a) percent to my son, MICHAEL S. HUB Lockwiliow Avenue, Harrisburg, PA 17112, provided �ER, of 144 South the event that my said son should re he sunnves me by thirty(30) days. In p decease me or fail to survive me by thirty(30) days then and in that event, his share shall be distributed to ' his issue c• In the event that either one of m ° per stirpes. y children should predecease me or fail to survive me by thirty(30) days, leaving no issue, then a deceased child shall be distributed to rri nd in that event, the share of my y survivmg child. ARTICLE IV I nominate,constitute and appoint my daughter, SUE R. LE of my estate. ACH, as Executor No Bond Re uired No bond or other security shali be required of any Executo Will. ►'appomted in this ARTICLE V If any beneficiary or remainderman under this WiII in an mdirectly, contests or attacks this Will or any of its rovisi y manner, directly or P ons, any share or interest in my PAGE 2 OF 5 estate established by this Wi11 given to that contesting benefic' this Wi1I is revoked and shall be disposed of in the S �ary or remainderman under contesting beneficiary or remainderman h ame manner provided herein as if that ad predeceased me without issue. ARTICLE VI If any of the provisions of this WiII or of any Codicils th inoperative, invalid or illega►, it is my intention that all of t ereto are heid to be shall continue to be fully operative and e he remaining provisions thereof ffective so far as is possible and reasonable. IN WITNESS WHEREOF, I, gqRgq� � BEWARD T my hand to this m , estatrix, hereby set , y Last Wilt, consisting of FIVE 5 of ( ) typewritten pages, on this� day , 2012. arbara J. Be rd (S�AL) Attestation Clause named Testats x asdand fordher b��shed and declared by Barbara J. B her request, in � � ast Will and Testament, in the presence of usewho, at same � p ce, and in the presence of each other all bein � � ed our names as witnesses. 9 p►'esent at the , residing at ,1i� � � ��C� ~'-� � � /� ��'o�o residing at ���U � ��� �� �� ,��-��� PAGE 3 OF 5 ACKNOWL.EDGMENT Commonwealth of Pennsylvania ) County of Cumberland ) ss: ) �, Barbara J. Beward, the Testatrix whose name is si n instrument, having been dul y qualified according to law, do hereby a knowledge ghat g signed and executed the instrument as my Last Wi11; and . my free and voluntary act for the purposes therein ex resseat I signed it will►ngly and as P d. Barbara J. Bewa Sworn to or a�rme to and acknowledged before me b 6 the Testatrix, this��` day of �_ y arbara J. Beward, , 2012. COMMONWEAL�H 0F H6�l�ib�1,VANlA NOTARIAL SEAI- Mariann L.Stiely,Notary Public Eest Pennaboro Township,Cumbedand County M commission ox ires Janua 02,2013 Nota ry Public PAGE 4 OF 5 AFFIDAVIT Commonwealth of Pennsylvania ) County of Cumberland ) ss: ) We, �-- d �'�(��,�,( � signed to the foregoing instrumen �� witnesses say that we were present and saw he1 Testatrix si n whose names are 9 y qualified according to law, do depose and Last Wi11 and Testament; that Barbara J. Beward si ne it as her free and voluntary act for the u 9 and execute the instrument as her hearing and sight of the Testatrix, S� �ed�poses therein expriessed; t at eacshe executed knowledge, the Testatrix was at that timeh 1 o�r�m e'tnesses; and that, to the best of oue under no constraint or undue influence. years of age, of sound mind and . � ness l�'`t/� itness Sworn or affirmed to and subscribed to before me b and J .'�.sa�; Y � � �- , witnesses, thi �"`� �`day of , 2012. COMMONWEALTH OF PENNSYLVANIA NOTARIAI-SF.AI- Niariann L.Stiely,Notary Public East Peansbom To'rmship,Cumbedand County M commission ex ires Janua 02,2013 Notary Public PAGE50F5 .ue : II�,II� , �*i���(��` � A.Settlement Statement (HUD-1) �MBAPP�ovalNo.2502-0265 B• TYpe of l:oan 1. [�FHA ,'2. Q RNS 3. �Conv.Unins. s.Fiie Number. 4' Q�A 5• ❑ 2�24-007-Fidelit �Loan Number: Conv.Ins. y N�A 8.Mortgage Insurance Case Number: C.Note: Thjs forrn ls furnished to give you a statement of actual settlement costs. Amounts paid to and by the settl m/nt a ���Pf��)"Were paid outside the closing;they are shown here for informational purposes and are not included in the totals. o.Name&qddress of eorrowec gent are ShOWn. Mary Kaiharine G�een E.Name&qddress of Seller: Items marked 204 FainvaX Orive Estate of Barba�a Bewa�d,Sue R.Leach, F�Name&qddress of Lender: Mechanicsburg,pq�7055 Michae/p, �ecutrix N�A 204 Fainve NGreen 50f Ricky Road pA Mechanicsb�r�p Mechanicsburg,pq�7055 9 A 17055 G.Property Location: 501 Ricky Road Mechanicsbur,p N Settlement Agent: 9 A 17055 DETHLEFS•PyKOSH I.Settlement Date: Cumberland County Michae/J.Pykash,Esqu eGROUP,LLC, py27�2014 , Phone Number.(717)g75-9q46 2132 Ma�ketStreet Camp Hill,PA 17011 Place of Settlement: .1• Summary'of Borrower's Transactfon R�Max 1st Advanta e, 100.Gross qmaunt Due From Borrower 9 6375 Mercury Disbursement Date:02/p7/yp14 101,Contrac�sales price K•Summary af Seller's Transaction 400. Gross Amount Due To Seller 1�2.Personal property �� SZ69,gpp,00 401.Contract sales price 103.Settlement charges to borrower(line 1400) 104. 40z•Personal property SI69,900.00 54.277.50 403. 105. Adjustments for items paid b 404 106.City/town taxes y se11efi1n advance 405. Co Adjustments for items paid by seller in advance 107.County taxes 406.City/town taxes 108.Assessments 02 27 to � /zo11 to 407.County taxes �� 109.Munici a1: 06/30/2029 to r' 02/27/20Z4 - p3�31�2029 S8o1.69 408.Assessments 110. ' 02/27/2019 to 06/30/2014 11L S4Z.07 409.Municipal: 02/27/20Z4 - 03/3i/ZOZ9 S80Z.69 112 410. Sa1.o7 , 411. 412. 120.Gross Amount Due From Borrower 200.Amounts paid gy p���gehalf Of Borrower $Z 75�ozo. Gross Amount Due To Seller 36 420. 201.Deposit or earnest money - 500.Reductions In Amount Due To Seller 2�2•Principal amount of new loan(s) ' SZ���792 76 S5,000.o0 501.Excess deposit(see instructions) 203.Existing!loan(s)taken subject to '' S02.Settlement charges to seller(line 1400) 204. 503.Existing loan(s)taken subject to $ZO'911'88 205. 504.Payoff of first mortgage loan Chase . .. 589,907.3B 206. _ 505.Payoff of second mortgage loan 2ACentrIFCU � � $3,590.92 z�� 506. 208. 507. 209. � 508. 509. Adjustments for items unpatd by seller 210.City/town taxes Adjustments tor items unpaid by seller 211.Count taxes to y 01/O1/2019 -to 02�27�2024 510.City/town taxes 21z.Assessments $Z3z•99 511.County taxes �Z to 213. to /OZ/2014 to 512•Assessments 02�2��2014 274. �o 5132.99 215. 513. '16. 514. '17. 515. '18. 516. 19. 517. 518. ?0.Total paid By/For gorrower 519 �0.Cash At Settlement From/To Borrower s5'132•99 520.Total Reduction Amount Due Seller �1.Gross amount due from borrower(line 120) 600.Cash At Settlement To/From Seller �2.Less amounts paid by/for borrowe�(line 220) $ZZ9�5q3.17 � SZ 75,02D.36 601.Gross amount due to seller(line 420) - � S5�I32•99 602.Less reductions in amt.due seller(line 520) $1���742.�6 3.Cash �From � Szza,543.I7 ❑To Borrower $169,887,37 e public Reportin 603.Cash �To 9 Burden for this collection of information is estimated at 35 minutes �From Seller $q6�I99 59 �orting the data.This agency rpay�ot collect this information,and you are not required to complete this form,unless ' �ently valid OMB contro�numbe�. per response for collecting,reviewing,and ESPA covered transaction with info�mat ofn�durinlg the settle ent processsure is mandato Y ,it displays a ry.This is designed to provide the parties to �ious editions are obsolete - - Page 1 of 3 _ _ _ HUD-1 L. Settlement Charges 700.Total Real Estate Broker Fees �fvision of Commission(line 700)as follows; 701.$ 5,397.00 , $10,490.00 702.$ 5,097,pp f0 CB Se2ect Prof Paitl FrOm Paid From � (+53008roXerFee) Borrowers Seller's 703.CORifI11SSlOf1 pyld 8f S@ffl@!1'1@p� � f0 Re/Max Zst Advantage Fund58t Settlement Funtls at 704. eroker Fee to Re/Max Zst�Advantage Settlement 800.Items Payable In Connectlon With Loan � 801.Our origination charge N/a P.O.C.by SZ�.'199.00 � $900.00 802.Your credit or charge(points)for the specific interest rate chosen $ 803.Your adjusted origination charges (from GFE#1) 804.Appraisal fee to 1v/,q $ (from GFE#2) 805.Credit report to N/A ( P.O.C.by (from GFE A) So,oa 806.Tax service to � P.o c.by ) (from GFE#3) 807.Flood certification � ) (from GFE#3) P.O.C.by 808. � � (from GFE#3) 809. P,o.c.by � (ftom GFE#3) 810. 811. 812. 900.Items Required By�ender To 901.Daily interest charges from o2s2 P 2 piQ Advance 9�2.Mortgage Insurance Premium for- to 03/pl�yp1q to @$ /day(from GFE#10) months. 903.Fiomeowner's insurance for � (from GFE#3) to years. � 904. (from GFE#11) �O years. 905. 7000.Reserves Deposited With Leniier 1001.Initial deposit for you�escrow account 1002.Homeowner's insurarjce 1003.Mortgage insuran&e' months @g (from GFE#g) 1004.Property taxes months @$ Per month $ 1005. months @$ Per month $ 1006. months @g Per month $ 1007,Aggregate Adjustment months @$ Per month $ 1100.Title Charges per month $ 1701.Title services and lender's title insurance "$ �•o0 7102.Settlement or closing fee ; 1103.Owner's title insurance (from GFE#4) 1104.Lender's title insurance � $ 1105.Lender's title policy limit$ �, (from GFE#5) S1,250,op 1106.Owner's title policy limit$16g,yoo.oo $ 1107.Agents portion of the total title insurance premium DethZefs-pykosh Law croup ���8•Undenvriter's portion of the total title insurance premium Fiaelit 7109. (Sa1e Rate - � $1,062,50 Or+ner Poiicy p� Y National T3t2e $IB7.50 1110. Michael J, 3' ' No End.J Pykosh (NOta"ry FeeJ 1111. Dethlefs-Pykosh Law GrouP (Tax Cert Fee RembursementJ 1112. Dett�Iefs-Pykosh Law GrouP (ppe� 510.00 1113. Guardian Traasfer 9ht Fee - 2 pa�,offs� SZ0.00 1114. (Deed-preP� S15.00 1115. S5 1200.Government Recording and Trensfer Charges SZ25•o0 1201. Cumberland County Recori3er 1202.Deed$67.0o Government recording charges: (from GFE#7) 7203.Transfer taxes am,berlaaa�,� �Mortgage$ :F°U++ty Recorder ;ReIBBSBS$ $6�.00 1204.City/County tax/stamps: 1205.State tax/stamps: Deed$Z,699.00 (from GFE#8) $Z,699,00 1206. ; Mortgage $ Sz,699.00 Deed$1,6yg,pp i207. : Mortgage $ 208. $ 209. $ 300.Addittonal Settlement Charges $ ±01.Required services that you can shop for � �02. �03. (from GFE#6) 04. $ 05. $ ?6. American Houie SkieSd (Home WarrantYJ �7. Do^„•s Zerbe. Treasurar`. � (2014 Co J ESTIayA� �8. Upper�1� TownshiP (3rd/4th /�✓P Tax I '9. Escrox Por Pa 9trs 2013 and Zst 5520.00 yment of Iniyaritance T� Rtr 2024J $851.60 0.Total Settlement Charges(ent�r on Ifnes 103,Section J and 502,Section K) '5398,38 57,645.50 �: . $4,277.60 $20,911.88 ious editions are obsolete . Pa9e 2 of 3 HUD-1 PAGE 3 �F HUD NOT qppLlC ABLE ON CASH TRANSACT 14NS r' i Certification (continued from HUD-1) I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and be� it is a true and accurate statement of all receipts and disbursements made on my account or b transaction. I further certify that I have received a co �ief, py of the HUD-1 Settlement Statement, y me in this Borrower: � \ Seller or /� � � ��� Mary K arine Green e� —Zp�"'"/'�`/ Agent: /�1,c � Sue R. Leach, Executrix ate: �-7 ) 204 Fairway Drive Estate of Barbara Beward Mechanicsburg; PA 17055 501 Ricky Road ` Mechanicsburg, PA 17055 ri Borro er. • ° '� q/ Dated`/Z 7 Z�j Seller or Michael P.Green Agent: = Date: —_ 204 Fainnray Drive Mechanicsburg,'pq�7055 The HUD-1 Settlement which i have prepared is a true and accurate account of this transa ' caused or will cause the funds to be disbursed in accordance with this statement. ction. I have �;Date: �_ Settlement Agent: � ichae J �ate: ,� ;27 � sh, Esquire WARNING: It is a�rime to knowin I similar form. Penalties uponk onvictionacan Includeta fine and Smpreis nmenk�For deta Is see:Title 18 U.S. Code Section 1001 and Section 1010. �.._.