Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
07-17-14 (2)
r 1505610140 REV-1500 , EXI02-11)(Fl) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 1 3 1 1 6 0 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 0 2 7 2 0 1. 3 0 2 2 2 1 9 3 0 Decedent's Last Name Suffix Decedent's First Name MI C A R M A N A N N A 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 DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 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) ❑X 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 TO: Name Daytime Telephone Number D A V I D H S T O N E , E S Q U I R E 7 1 7 7 7 4 7 4 3 5 REGISTER OF WILLS USE 04Y 4C G. l� First Line of Address Du C—, rj �; 4 1 4 B R I D G E S T R E E T r,Ir Second Line of Address City or Post Office State ZIP Code r E-FILED O (ZD N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's e-mail address: DSTONEa9STONELAW • NET 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.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN T RE OF PE ON VZ SP ISLE FOR FILING RETUR —7 - 1 DATE— I ADDRESS 2227 EAGLE R JEFFERSON CITY TN 37760 SIGNAT� R OTH TH N REPRESENTATIVE DATE J i{ ADDRE S 414 R NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J 1505610240 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name: A N N A M • G A R M A N RECAPITULATION I. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 1 4 4 9 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. 1 6 8 1 4 , 3 8 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous N -Probate Property (Schedule G) t Separate Billing Requested . . . . . . . 7. 2 6 4 4 8 , 2 2 8. Total Gross Assets(total Lines 1 through 7) . . . -.. . . . . . . . . . . . . . . . . . . . . . . . 8. 1 8 8 1 6 2 , 6 0 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 3 9 8 8 8 . 3 3 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . . . . . . 10. 1 8 9 2 . 8 4 11, Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 4 1 7 8 1 . 1 7 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 4 6 3 8 1 . 4 3 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. 1 4 6 3 8 1 . 4 3 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.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x .045 1 4 6 3 8 1 . 4 3 16. 6 5 8 7 . 1 6 17. Amount of Line 14 taxable at sibling rate x.12 0 . 0 0 1z 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 6 5 8 7 . 1 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 L 1505610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 ' 13 1160 DECEDENT'S NAME ANNA M • GARMAN STREET ADDRESS 415 CASCADE ROAD CITY STATE ZIP MECHANICSBURG PA 17055- Tax Payments and Credits: 1, Tax Due(Page 2,Line 19) (1) 6 ,58?-16 2. Credits/Payments 6,000.00 A.Prior Payments B.Discount 315.79 3, Interest Total Credits(A+B) (2) 61315-79 4. It line 2 is greater than Line 1+Une 3,enter the difference.This is the OVERPAYMENT. (3) 0 .00 Fill in oval on Page 2,Line 20 to request a refund. (4) 0. 00 5. if Line f +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 271 .3? 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 light to designate who shall use the property transferred or its income ❑ nX c. retain a reversionary interest ..................................................................................................... ❑ d, receive the promise for life of either payments,benefits or care? ................................................_..... ❑ 2. It 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'intrust 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 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 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 172 P.S.§9116(a)(1.1)(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 dales 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. • 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(x)(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-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE INHERITANCE TAX RETURN CASH, BANK DEPOSITS & MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: ANNA M . GARMAN FILE NUMBER: 21 13 1160 Include the proceeds of litigation and the date the proceeds were received by the estate. All propertyjointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. 2000 Toyota Camry-Title No . 54691028401GA sold OF DEATH to Bryan Jacobs 3,500 . 00 2 Capitol Blue Cross-refund on premium 63. 70 3 GGNSC-insurance repayment on hospice bill 19 . 90 4 Gun-Mowery Insurance-refund on car insurance 130 . 00 5 Miscellaneous deposits 243 . 64 6 PNC Bank-Cert of Deposit #31100322148 2,153 . 07 Princ $2,153 . 07, Int 5 . 07 7 PNC Bank-Cert of Deposit #31100322148 - Accrued Int 0 . 07 8 PNC Bank-Checking Acct #5140273652 9,180 . 88 Princ $9,180 . 88, Int $ • 03 9 PNC Bank-Checking Acct #5140273652 - Accrued Int D - 03 10 Time Warner-pension check 113 . 95 11 US Treasury-retirement check received 1,409 . 14 TOTAL(Also enter on Line 5,Recapitulation) $ 16,814 - 38 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX.(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF ANNA M . GARMAN FILE NUMBER 21 13 1160 This schedule must be Completed and fled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH TINTEREST (IF�PLI�BLE) TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET 1 American General Life-IRA Contract 5,396 . 32 VALUE #XP233842 with Cindy Bisset, Lloyd 5,396 . 32 Garman and Kathy Himes as benef 2 OneAmerica-NonQualified Annuity 21,051 . 90 21,051 . 90 #2051114862 with Cindy Bisset, Lloyd Garman, and Kathy Himes as benef TOTAL (Also enter on Line 7,Recapitulation) g 26, 18 . 22 If more space is needed,use additional sheets of paper of the same size. REV-11 511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND EIDNTDEc o N RETURN T ADMINISTRATIVE COSTS ESTATE OF FILE NUtdBER ANNA M. ISARNAN 21 13 1160 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1, Baughman Memorial-memorial stone 11833. 00 2 Cocklin Funeral Home-funeral expenses 6,690 . 00 3 Cocklin Funeral Home-additional funeral expenses 540 .62 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City state ZIP Year(s)Commission Paid: 2, Attorney Fees: David H Stone, Esquire 91408 . 00 3, Family Exemption:(It decedents address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Cumberland County Reg of Wills (Reimb to 338. 50 Cindy Bisset) 5 Accountant Fees: 8, Tax Return Preparer Fees: 7. PNC Bank-check printing fee 5.00 2 PNC Bank-check images in statement fee for 3 months 9.00 3 Cumberland Law Journal-advertising grant of letters 75 . 00 4 The Sentinel-advertising grant of letters 189.54 5 Federal Express-postage fee 40 . 00 6 Notary fee on car title 5 . 00 7 PNC Bank-check images in statement fee for 2 months 6.00 8 PNC Bank-calculated service charge 15.00 9 PNC Bank-calculated service charge 15.00 10 PNC Bank-check images in statement fee 3 . 00 11 PNC Bank-check images in statement fee 3.00 12 Cindy Bisset-Reimb for filing Inh Tax Ret & Inv 30.00 TOTAL(Also enter on Line 9, Recapitulation) $ 39,888 - 33 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ANNA M. GARMAN 21 13 1160 Decedents Name Page 1 File Number Schedule H -Funeral Expenses&Administrative Costs-B7. ITEM NUMBER DESCRIPTION AMOUNT 13 Direct TV-services at property 12.21 14 Time Warner Pension Plan-overpayment 113. 95 15 Verizon-services at property 14 . 85 16 United Water-service at property 29.24 1? Allied Waste Service-services at property 39.03 18 Lloyd Garman-Reimb for oil at property 369 . 50 19 Bryan Jacobs-carpet work done 325 . 00 20 Kathy Himes-Reimbursements made 158. 50 21 United Water-services at property 17.74 22 United Water-service at property 11 . 54 23 Lower Allen Township-sewer services at property 112 .00 24 US Treasury-return of railroad retirement check 1,409.14 25 Checks written prior to death but not cleared 898 . 43 26 Terminex-service at property 80.56 27 Direct TV-service at property 58. 44 28 Direct TV-service at property 12 . 21 29 Upper Allen Township-sewer sery at property 112.00 30 Bryan Jacobs-services done at property 161. 00 31 Terminex-services at property 80 . 56 32 Selling costs ($18,514 .17) less escrow & reimb 161022 . 40 33 United Water-service at property 23.70 34 PPL Electric-services at property 71 . 80 35 PPL Electric--service at property 60 .59 36 PPL Electric-service at property 56 .02 37 PPL Electric-service at property 72. 50 38 PPL Electric-service at property 39 . 17 39 PPL Electric-service at property 49.71 40 PPL Electric-service at property 56 .98 41 Lloyd Garman, Jr - -Reimb for final United Water bill 13 . 90 42 Reserve for closing expenses 200 .00 SUBTOTAL SCHEDULE H-87 20,682 .67 REV-1512 EX+(12-12) pen nsylva SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF ANNA M • GARMAN FILE NUMBER 21 13 1160 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH i Health South-therapy/living expenses 275. 00 2 Alixa RX Billing Dept-perscriptions 43 . 17 3 Alixa RX Billing Dept-perscriptions 20 . 34 4 Golden Living Center-expenses at nursing home 1,222 . 58 5 Community Lifeteam Inc-ambulance service 96 . 00 6 West Shore EMS-ambulance service 135 . 75 7 East Pennsboro Ambulance Serv-services rendered 100 . 00 TOTAL(Also enter on Line 10,Recapitulation) $ 11892 - 84 If more space is needed, insert additional sheets of the same size. REV-1513 EXt(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE NHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF ANNA M . GARMAN FILE NUMBER: 21 13 1160 NUMBER NAME AND ADDRESS OF PERSON S RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE ( � Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] LLOYD D GARMAN JR Lineal 48,793 . 81 2227 EAGLE RIDGE LANE JEFFERSON CITY TN 37760- 2 CECELIA ^CINDY^ A BISSET Lineal 481793 . 81 5242 WYNNEWOOD ROAD, APT C HARRISBURG PA 17109- 3 KATHY E HIMES Lineal 481793 . 81 151 SOUTH BALTIMORE STREET, APT 1 DILLSBURG PA 17019- 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. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 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. ep\wills\GARMANa.na y¢ A p LAST WILL AND TESTAMENT of ANNA M. GARMAN I, ANNA M. GARMAN, of ,the Borough of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executor hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II : I bequeath such of my tangible personal property which is set forth in a separate memorandum which I shall place with this will to_ the persons therein designated. ITEM III : I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, in equal shares to my children, LLOYD D. GARMAN, JR. , CINDY A. BISSET, and KATHY E. HIMES, of to their issue, per stirpes . ITEM IV: I appoint my Executor and his successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or Page 1 of 5 t to another for the minor' s benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor ' s support and education (including college education, both graduate and undergraduate) without regard to his or her parent ' s ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM V_ T appoint my son, LLOYD D. GARMAN, JR. , Executor of this my last will. Should my son, LLOYD D. GARMAN, JR. , fail to qualify or cease to act as Executor, I appoint my daughter, KATHY E . HIMES, Executrix of this my last will. ITEM VI: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, ANNA M. GARMAN, have hereunto set my hand and seal this _t� day of 7 2 2004 . J ANNA M. GARMAN Page 2 of 5 SIGNED, SEALED, PUBLISHED and DECLARED by ANNA M. GARMAN, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of e ch • other, have subscribed our names as witnesses . W " t n e s s Address Witness Address t Page 3 of 5 i COMMONWEALTH OF PENNSYLVANIA: : SS : COUNTY OF CUMBERLAND I, ANNA M. GARMAN, the Testatrix whose name is signed to the at- tached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ANN M. GARMAN Sworn to or affirmed to and acknowledged before me by ANNA M. GARMAN, the Testatrix, this VA//_ day of �i��J 2004 . S:�s Q_"' "� Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL CAROL L TROXELL, Notary Public New Cumberland Boro.Cumberland Co. My Commftlon Explres Dee.27.2005 Page 4 of 5 COMMONWEALTH OF PENNSYLVANIA SS : COUNTY OF CUMBERLAND, ( We, ., �Q and I�Cra�Jdl����m the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. OWX4 tness Witness Sworn to or affirmed to and acknowledged before me by h . �� f lftne and witnesses, this day of ����©�a 2004 . �\ . "i�-.. oopuL sqw Sgjldx]uepawwoO 9 Notary Public •00 puepegwnO•wog puepegwn0 Mery 3IIQnd tieloN '113XOLU 'l 10uV0 1431 IVIHVION 3M VINFUSNN3d JO HLTiNOW W00 Page 5 of 5 Z.\RE\DFD\Garman.Anna to'raschek&Thompson—415 Cascade Rd. Tax Parcel#:42-28-2423-125 Address:415 Cascade Road, Mechanicsburg,PA 17055 DEED THIS INDENTURE made the day of ;�Nl? L- in the year 2014, between LLOYD D. GARMAN, JR., Executor of the Last Will and Testament of ANNA M. GARMAN, late of the Township of Upper Allen, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND - PATRICIA L. TASCHEK, single individual and KATLIN E. TIIOMPSON, single individual, as joint tenants with rights of survivorship, of the second part, hereinafter called the Grantees; WHEREAS, the said ANNA M. GARMAN became in her lifetime seised, as of fee, of and in a certain tract of land, together with the improvements thereon erected, situate in the Township of Upper All, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on October 27, 2013, having first made her Last Will and Testament in writing dated November 4, 2004, duly probated and registered in the Office of the Register of Wills of Cumberland County on November 1, 2013, wherein and whereby she appointed as Executor, the said i LLOYD D. GARMAN, JR, to whom Letters Testamentary were duly issued by said Register of Wills on November 1, 2013, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills, recourse thereunto being had, appears: i NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED FORTY FOUR THOUSAND NINE HUNDRED lAND 00/100----------($144,900.00)-------------Dollars, which has been paid to they by the said Grantees at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, ! has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, i bargain, sell, alien, release and confirm unto the said Grantees, ALL THAT CERTAIN piece or parcel of land situate in the Township of upper Allen, County of Cumberland and State of Pennsylvania, bounded and described in accordance with a survey and plan thereof made by Ernest J. Walker, Professional Engineer, dated February 10, 1965, as follow to wit: BEGINNING at a point on the eastern line of Cascade Road, said point being two hundred seventy-three and eighteen one-hundredths (273.18) feet measured in a Northerly i direction along the eastern line of Cascade Road from the interscction of the easterly line of Cascade Road with the northern line of Kim Acres Drive, said point also being the division line between Lots Nos. 3 & 4 as shown on the hereinafter mentioned Plan of Lots; thence along the east side of Cascade Road, North seven (7) degrees twenty-three (23) minutes West eighty (80) feet to a point at the division line between Lots Nos. 4 and 5 on said Plan; thence along said l i 4 division line North eighty-two (82) degrees thirty-seven (37) minutes East one hundred thirty-eight (138) feet to a point; thence along the eastern line of Lot No. 4 on said Plan, South seven (7) degrees twenty-three (23) minutes East eighty (80) feet to a point at the division line between Lots Nos. 3 and 4 on said Plan; thence along the said division line South eighty-two (82) degrees thirty-seven (37) minutes West one hundred thirty-eight (138) feet to a point on the eastern line of Cascade Road to the place of BEGINNING. BEING Lot No. 4 on Plan of Section B, Mt. Allen Heights, said Plan being recorded in the Recorder of Deeds Office of Cumberland County in Plan Book 10, Page 57. BEING the same premises which Raymond S. Dluzeski and Pamela R. Dluzeski, his wife, by Deed dated September 29, 1988, and recorded October 4, 1988, in the Office of the Recorder of Deeds of Cumberland County in Deed Book P33, Page 338, granted and conveyed unto Anna M. Garman, decedent herein. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said ANNA M. GARMAN , at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said Iot or piece of ground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantees, to and for the only proper use and behoof of the said Grantees, forever. AND the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantees, their heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. i IN WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above written. Signed, Sealed, and Delivered in the Presence of .(SEAL) Witness: LLOYD D. 6ARMAN, JR., Execut of the Last Will and Testament of ANNA M. GARMAN I 1 I 2 � STATE OF-5r- ~ s5-e COUNTY OF SS: On this, the 9Tr day of Nf t� 2014, before me a Notary Public, the undersigned officer, personally appeared LLOYD D. GARMAN, JR., Executor of the Last Will and Testament of ANNA M. GARMAN, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. �k\NE A 4f'.,, Notary Public STATE `�'�� YQ: OF r , ' y TENNESSEE F - NOTARY I - 5 PUBLIC •.�� o /�It C0 — '\\O I I hereby certify that the precise address of the Grantees is DATE: IAttorney for I I V3- t CERTIFICATE OF TITLE FOR A VEHICLE '" 06 Dal 02Y99900fl1l"", 4TIRG221(711`047044 {I{ 200tI TOYOTA 54691028401"GA • Ys4w VOE VtWXATLYF NumRER t YEAR AUI�O€4E111CtE RILE NUMBER S/r17/OD 000008 (J .:7, E BODY TYPE 4 D� ( ..SEAT Gl PRIDR TfilE STATE GDGY.RfKKZ,DATE v DOW HIES DOOM.StATW r 5fL7l00 - sli�tflo . I .. _ DATE PA TR)ED DACE OF ISSUE UNLNEN WLIGHf GVN'R pG.M TIRE BRANDS i NDNETEA WAta I � tl.AE11LLL LMLGDE f.W1.EADE EXDEEDB YNE NEWHILiC t f UNRI -t A1��, S•NOT M AO[La41lG.()E n w AC MLSADE•DDDIIhTq • I �ir ¢ d `•I�e A.EA'F]/(FIYNICCONEIER DgC6MlM11 { REOUtMAEO OWHEWB). ! 'yry l" �na i'r{ l.Yty- A.ANRMN VDeGS r , .ANNA' M GARMAN • � T' '^gnrr-0frvi�:i^j'✓ c: e1 .4„KtE '� °A)e•�'�`' i�''�h�,t1:,'� o:EwDMofA1LTiwD FOR NONUB. t -415 CASCADE ROAD MECHANICSBURG PA 1705T`A=^%' E°N P."AR A Ip.CE VDIKLL T.PECWEREU T£FT VEM0.E V.Vp•pJCOWtF iE#aA9Vft w.RUOD VEMIRE i1RBT LIEN FAVOR OF SECOND UEN FAVOR O€' A."A$*TW i E •]•bolt YMYCYW N Y]NE IPCU FFII•ItlYAI a w FrN Mn, w MK raYFAIw EwN bn.•d t•] iM n w&+•FU d)M)or V•fwMF.au+w w FIRST UEN RELEAS® ]OOIMMY loon M . R DAM S BY SECOND UfDtAGXABED AWHORIZED REPRESEMATIVE DAM MAXP4 AOORESB BY t • AUTNDRIZPD REPREBENTATVE ANNA M' GARMAN 415 CASCADE ROAD 4 MECHANICSBURG PA 17055 I unN..a w aFU a NYN,w axow dcnEF a w vdwRA'•d.D+P•M1EwnI %1)1 It A' L INAtWORY d TmgxNYa .aNa tN w PaNVU aTM1•nYNW MMf r w 4M wNf✓ ice .t }1 d Y1•YM wnkM. GvrtlarZ d'2rlapsreltNn t APPLICATION e• TITLE AND LIEN INFORMATION- I sLexwBED MO SwdM D 1 C ed al'Id oVw Ibn Ya ]DtlMr1 U fats ERE'( n as dt t' ro eEFaRE ME: a NFtea E]•.Joint WrAVV YVnn RIRM E SU HERE ip'(fM Earn a ORE owar, aft M pal w wMr .uwTEt.)CHECK HERE o t]B) ,,.m tRE Ba AM a IS]Ma a'Tfnlnrl n Cmurwn'(On E,). d dIl owner,m)eral d . •� UKaaE E'ATK Qal p hlAE)lt MXi IX•ft1N). tYIIItTAIM.[IIM.M RwR WfY ❑ i 18T LIEN DAiE� � IF fq UEN Ol1ECK i} ! )ST UEMR%DER �.•�-• 9TREET q _ 'i/J OfIV STATE ZW FlNANLlA{.HtBTITRkIft WMEER 2NV UEN DATE END{JEx.CNEOE 13 iIy wwyr.warr .w a]a>•F w 4..Anr a n. N .. ..w a..aw w.+,.u.v Nw wMOMe�.ra wr W+aw.wamwn 2ND LKttIOLDER STREET yrafiwbr 4n,a'aNt a.UnaV eo soon 1 Om STATE ;w NNaTIRMF�AFF1GN�iTi)l VnViWw3p ypN6l1 t FWANGAL k15T111TON NUMBER (TYPE OR POINT)Certificate of Title must be submitted within 20 days,unless the purchaser Is a registered dealer holding the vehicle for resale. WARNIN — O OMLEAHTEaoq AATRpVIpw.$.P, ,m,TATA.T MARESULT HE MILEAGE IN IMPRIb'1IIEM THE TRMIaFER OF a ERSHIP, FMURE A. ASSIGNMENT OF TITLE- 'R4^ ^ 4 tm 'xA°s a,YI. _ "'ar FIRST M.I. y,amamv»mvcnw.l Mrc.,a.Yp euxclae mRU �ht.A fY N WW a!uy,mm•b4dmymrs aw h•abmaN 4 { aU31NE88 xAYE w?. m r �—t .f^.,f',S`.�]"""'• A tuPIIRCHAEER �___..� rrv- _..,Ip:"1...7.�.�r._: X mw w Nnran IM•cma.+b•o+a m...Iw<w m .dlN a4d fib WM Vq MWa Y tliw:kN. f n OEE&1 f t )C (bn Rabcb ub•nw,rt a mr.a! T El I•NOT n4.aNrI In•ror•a WRw:wne14M• WA O ft rMM wnauwulartlla E4NI#tl•4 Mea Aa}NC4dnror Ar- a.tWlIA,4Ambp.. SS«wce 3 2 bCl.`NI.eiRe»vMRlt.)M m.awalbtu. IBATe ml �Oj SUBSCRIBED AND SWORN r) .7 �I e�Ol3j' '4 r •� ,r. - A TO BEFORE ME: Q ♦ b AY A RXICHAVE ' m t N f v�q G6Pis BASER L' L MMLTH PENNSYLVANfA # y M, BllRK6Y,Nberand Bom, Cumberland Co.mlBabn ae 115, 2017 'El M HERE• . • z VN•[nay,mm•MYq mWa4� hM N•abM•rlNaryY J•. LAST FlPBT Ma. tb a.:i•„,.._. •i.�.i s:.i'ut X MN W i d4 KIwai, .W or TI Mklkj WPCNl01 M FUlC C ti'l .A4AM M•aM mbNptm••NMw4aQ r" " , I� RrF�sab.mw+a�w.p• bROr aw.rnw - "l�l.� b 'hndNaWmN14nWAa4 O WAPMNe:Nnnryltr� " Y,'MAu[NraNytlWwrr1+M MMnNJ m M prWll(.)p IM WImM N•'O ETU ANW MiM r clrr SUBSCRIBED AND SWORN, TO BEFORE ME:' { "Am >.r: Iry a rm�a z Mo. DAY �AAI ry 4 MYAJUSE z x m Qy ASC•elweTi -p mF Y NFC6 � ` 5�j. r,�UgT m A MANWFfiAMl HEAE Q z Ew.A•RM•m[4 MY a,my/av llwwP LAW•r oEOR44r,Nap b � lAST RRST MR � ::v.:^=�°�:w:a'�c.-i XeNN r,d+w.c4 e4.w4t mMp•a»Nfii. aNOUtm oRau YWN m•a tlY m•UA1re Emu•Y d4cMr,t l r'7' RMwbIM M4M11an4NY 4NpT Yb.a„MMINp. i WNICIWM I�..1 N.R•N a k11TlEAMYLW YR1b WARNING:0JYM4f a.rnpm4Y hMI hRlMrcvNNMMv.bd.YhNanY a[v�WYCr rM NnMM+M�mb bMIMY I�'gaFRe"sp ?y, tt.MfYMmIMpMP{i)u YV dMN MM6 .� SUBSCRIBED AND SWORN ! CnY TO BEFORE ME: DAY YEAR,f MAT[ ap. onvu ga pmC[ T O b 4 T A rrMJR� YP RlghMTME O Q ' ! ' ' IN EA11 V. 'z U1 kSaaG_ y (n Sy fi { qq A F RINT HERE 4 • . A {a AY& V.btl46M dmyYwflpw 'it,l#n MYMHt(•NYIgY - UST FIW wit *ExrN} -.-- .�" X miN Rm.rl4cv M aa,W m!••[•a m•vN:l01r, 51FU A6EP qi W W LAW''N`'T7pq a tlN mbMllV LO+u Y aM(%.Q rN11�p�! C4PIALMAIFII NAMII IJ 4iol WA IAWAn•[.•aaei I� WARRNININ4!OA�Atlde4W E4e.M1YY STP£Ei tM1W A}IMrc.rtlytMt m•.Wtln•Y kNdw7am✓rtA'Yp AroMpw am.N,b4MnCy Mdf£8s MNt•ft•Qm Ma.'ldkA}MM aWV Wbe. aN'r SUBSCRIBED AND SWORN ! TO BEFORE ME: T "Are , wM1�M.Face YEAMP' A J � NASER ANWR Q N Mt19T Nov. 15. 2013 11 :480 PNC Bank No. 9810 P. 1/2 l f ACt YOU WAY November 15,2013 David II Stoner Esq. Stone Lafaver&Shekletski 414 Bridge St POBoxE New Cumberland, PA 17070 RE- Anna Garman SSN: DOD: 10-27-2013 Dear Mr. Stoner: In response to your request for Date of Death(DOD)balances for the customer noted above, our records show the following: Certificate of Deposit Account#31100322148 Established: 11-19-2007 ANNA GARMAN DOD balance: S 2,153.07+0.07 accrued interest Interest paid 01-01-2013 thm IO-27-2013 $5.36 YTD Checking Account Account# 5140273652 Established: 09-21-1988 ANNA GARMAN DOD balance: $9,180.88+0.03 accrued interest Interest paid 01-01-2013 thru 10-27-2013 $0.71 YTD Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank,N.A. Member FDIC Page 1 of 2 Nov. 15. 2813 11 :48AM PNC Bank No. 9810 P, 2/2 Ais message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exemptfrom disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited If you have received this communication in error,please not6 me immediately by reply or by telephone at 800-762-1775,and immediately destroy this faxed document. Page 2 of 2 American General Life Companies November 15, 2013 DAVID STONE ATTORNEY AT LAW PO BOX E NEW CUMBERLAND PA 17070 Re: Annuity Contract XP233842 Dear Mr_Stone: The Internal Revenue Service (IRS)requires reporting of all death benefits for federal estate tax purposes. As this contract is an annuity, IRS Form 712 is not applicable and will not be issued by Western National Life Insurance Company. Listed below is the death benefit information for this contract. Contract Number . Type of Annuity Contract: (Flexible Premium) Individual Retirement Annuity - Tax Deferred Date of Issue: 03/10/2011 Contract Owner's Name: Anna Garman Accumulated Value as of Date of Death on $5,396.32 10/27/2013: tel Total Death Benefit as of 11/15/2013 $5,311.62 Proceeds made payable to Beneficiaries: Cindy Barrett, Lloyd Garman and Kathy Hines Mr. Stone, we appreciate the opportunity to assist vou. Should you have any questions, please contact our Client Care Center at 1-800-424-4990. Sincerely, l.iL'�9l(1 -y ��/nr �'������.. �fY tA, 1viao n Aic 33r of ` M g\-j Annuity Claims Department p Blsset Annuity Service Center• P.O. Box 3018• Houston, TX 77253-3018 LH-AGF d13 11:52 17179394344 NOLL FINANCIAL SERVICES #2794 P, 002/002 _— rMga 1 or 1 ONLINE SERVICES jor Mra aawpawfs of tlaaymerke• Policy Detail Cwrnar ANNA N GAfOMAM PoW Numbef: 2MI145a Poflq: AWAnrA=tft cwivwvl AUL ���naaaNaPeario.rr '�•«�a:l �rtt PaOny iSab &mail PNdweg Ppsr»,ma<:atd8f lean 0ala: od 0,1999 Tool Poky carobutwo: $20,000.00 WOndrawwM: W370AG aims 04 a0rode sk%*Paadum Oast Pro nk"RM vatl: Cd 9,1999 COM iw Stoma: Amva Yea WwlUlauow NanquaWsd Wwohted Rata for 1010912012 323% though 10M9 MS: MIMMU rt Gusmnbwd IntIMM 3.00% RaM cowra9a Itdemwllen Plan of IMUMOM: Ac=Amuily Nam Relwc mhl ANNA M(CARMAN AMUW t ANNA M CARMAN .. .. � ... .. � gWn9f Pays ...... Tx .. ...... . . . Cwr"3W*tgA0wd Poky Valunn of Oct 25 2013 AseenM Value: $21,091.90 Nwfagh Vela: - 521A91.00 Nob:71w a000unt ralw Is 0w Mt 1MA of pmrdaw Paid,*A' asrw an ON OtMMums,mina any dwmaa deducwc0.mwa any Parad w4x twf9iolon. M&nwcaM vaneofft Poft ia0w eo=Mv"fW"MW sppWMwwi0alwwwidww KMCIM 0w poky laddab'. PM U Merb yma'OW&M trMID dulaft i*4y 7howaWantaso 1ONSAMMCAFWANCfer.PA ?aRS,INC. ussotwH Oi4tltk�Ces arw tame Uulcr«.�.&tthmsr.{C^OYr4M41aQw9waOWarkaR+e�FgYtrwaMMk •« htVsJlwww.o ls.oneemecicacomrmforcermfomesc rcL&m 10/2912013 vo OMB Approval No,25024280 le A. Settlement Statement(HUD-1) S. T pe of Loan 4.TK FHA 2.0 RHS 3,OCO1n Unina 6. File Number, 7. Loan Number, S. Mortgage insurance Case Number: 4.OVA 10 Conv,Ina TCS$2014-021 206401632 446-2047514-703 C. Note; 7hrsform is fumr#red to grw youesmtemento/actual settlement w#: Amountsp®M to and by the settlement agent"shown. Items marked-fgaa)-were pad oufxde the dosing;theyera shown hero for iMamatonel purposesarH are not incket d n it,faiah 0. Name and Address of Borrower: E. NamiandAddrossof Sellao F. NameandAddress ALender: Patricia L Tasdtek and Primary Residential Mortgage, Kaflin E.Thompson Estate of Anna M.Garman Inc.ISAGAIATIMA 415 Cascade Road do STONE LaFAVER 8 SHEKLETSKI 1460 North 2200 West Mechanicsburg,PA 17055 414 Bridge Street Say Lake City,UT 64118 Post Office Box E New Cumberland,PA 17070 G. Property Location: H. Settlement Agent: 1. Settlement Date: 415 CSsrade Road TC Settlement Services,LLC Meciamostrurg,RA 17055 5006 East Trindle Rd. April 30,2014 Cumberland County.Pennsymma, Mechanicsburg,PA 17050 Ph. (717)715.0562 Place of Settlement: 250 East Park Orve Harrisburg,PA 17111 J. Summary of Borrowees transaction K. Summary of Sellers transaction 100. GrossAmount Due from Borrower: 400. GromAmount Due to Seller; 101, contract sales prim 1",900.00 401. Contras sales price 144 900,00 102, Personal property 402. Personal property 101 SetASment Charges to Borrower Le1e 1400 9,303.30 403. 104. 404. 105. 405. Ad ustments for Items paid by Seller In advance Ad ustments for items paid by Salter In advance 106. Cftyfrmn Taxes to 406. Ctl frown Taxes to 107. County Taxes 0M30/14 to OV01115 424.56 407,County Taxes 04130114 to 01/01115 424.56 -108. School Tax 04/30,14 to 07/01/14 286.90 408. School Tax 04/30/14 to 07/01/14 268.90 109. Sewsr rk-June04rM14ta07I0t714 76.31 409. Sewer April-June 04/30/14 to 07/01/14 76.31 110. 416 tit. 411. 112, 412. 120. Grose Amount Due from Borrower 154,941.07 420,Gross Amount Due to Seiler 145,68737 200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due Seller, 201. Depose or earn"money 1000.00 501, Excees deposit see instructions YO-2Principal amount of new bans 140,063.00 502. Settlement charges to Sauer Line 1400 18,614.17 203. Exeft kis(s) taken subanct to 501 Emoting loans taken subject to 204. WC Payoff First Mortga 205. 505, Payoff Second Mortgage 208. We. 207. 507. (Caputo diet.as proceeds) 208. 508. 209. Seller'sASSist 5,79890 509. Seller'sAssig 5,79640 Adjustments for Items unpaid bv Seller Adjustments for Items unpaid by Salter 210. C Town Taxes to St0,CRY/Town Taxes to 211. County Taxes to 511. County Taxes to . 212. School Tax to 512. School Tax Io 113. 513, 2',4, 514, 215. 515. 216. 516, 217. 517. 210. 516 219. 519, 220, Total Paid b )for Borrower 146.859.00 $20. Total Reduction Amount Due Seiler 24,310.17 300. Cash at Settlement from/to Borrower 60(, Cash at settlement to/form Sailor 301. Gross amoum duct tram✓3arrower line 120 154,991.07 601. Gross amount due to Seller line 420 145.687.77 302. Less amount paid b lfor Bormwar(Ace 220) ( 148,659.001 602. Less reductions,due Seter(line 520) ( 24,310.1 303. Caen �% From To Borrower 8,132.07 603. Cash XQ To From Setter 124,377.60 The unUSaamled hereby acknowledge vmrf a cu 1 The untlersiynatl M1ereoy acknowledge recei�ptys-fa Wmplet py of this statement&any attachments reterted to hsresY Borrower �� /�2 Seller n n Patrisa L 7aschek r Kallin E.Thompson PW'Aosc Price_ 119 9O0.o0 �e 6u'�'?sot3uo Ira}=•- 1b,41GA7 TMfttll4ftgrrtl�9YC fa Sir MYUM11Hp'mgMnKK �yp 5srry mgMCelW aYf tdemaMpl NYwreNtgJrgbWM1peM1 vislwm ufW lle.nga.drr-4Y Vela OMampol lunor. 1 (57.77 ipueebreEealf.VmMYweawmenleMm WelMytle rativneY c e t pcwr. r EI s,4�`FCS HUD-i (4'0�a 90 (TASCHEKTHOMPSON.PFOrrCSS2014.02it26) L.Settlement Charges 700.Total Real Estate Broker Fees $8,346.24 Pao From Paid From Mobn Of wmmlSSon(fine 700)as avows' earcaers Selena 701.5417112 to REINIA)(FinthAssadweamc, Funds Fords at 702,S 4,173.12 io REMA7(Really Salad Settlement Sealemerl 703.C Ommissuon paid at settlement 8,346.24 704. Buyer Broker Fee to REIMAX Really Select 245.00 705. 800.items Payable in Connection with Loan 801.Our origination charge S 237135 om GFE#1 802.You etle or dl ants for h cfe'mallet ate chosen S.IAOOS3 (from GFE#2 803.Your ad sted origination charges (from GFE#A 970,92 804,,0 rahai fee to AMC LINKS (fro"InGFEIKII 4 805.Credit Report to CREDCO from GFE#3 18.00 806,Tx swings to Iran GFE 113 807.Flood cartifxnnion to FAFD$ (from GFE 03 808,INSPECTION F to MC LINKS (from GFE#31 155,00 M. Wom GFE#3 i 810. firm GFE 113 811. (from GFE#3) 900.Items Required by Lander to Be Paid In Advance 901.Daily interest char es from 04130114 to 001114 1 $183047001d iron GFE#10 16,31 902.Mortgage keuranne proration for months to HUD (from GFE#3) 2,408.96 903.Homeowner's insurance for 1.0yearsto State Farm (from GFE#11) 459,00 904 from GFE#11 905. (from GFE#11 1000, lers D tr etl wol Lender 1001. ew account (from GFE#9) 1,489.11 1002.Homeowner's insurance 2.000 months ® a 38.25 per month $ 76.50 1003.Mod a e Insurance 0.00 months 0 $ 147.98 per month $ 1004.Prop"taxes $ 1,541.18 Coun Tam 2,000 months 0 $ 52.48 por month School Tax 10.000 months $ 143.62 per month 1005, 1006. months S per month $ 1007. months it par month $ 1008. S 1009.Aggregate Adjustment $ -128.57 1100,Title Charges 1101. Tula servima and lender's We insurance from GFE 94) 1,465.00 1102.Settlememe closky(ee 1103. Owner's title insurance to First American Tale insurance Company (from GFE#5) 20.00 1104. Lenders tale insurance to Find American Tale Insurance Company S 1,255.00 1105. Lender's Idle policy ante $ 140,063.00 1106. Owner's tab policy pons $ 144,90000 1107. AqwCs Won 01 the Inch the insurance prennum to TC Settlement Services,LLC $ 1,08175 1106. Underwriters portion of the total His insurance Premium to First American Title insurance Company S 191.25 1109. Rasnb for Tax Cod to Search One Abstracting,inc $ 15.00 1110, S 1111. $ 1112. $ 1113. $ 1200.Government Recording and Transfer Charges 1201.Government recording Merges to Search OneAba(rad inc from GFE#7 148,00 1202 Dead S 67,00 Mortgage S 81.00 Releases a Other a 1203.Transfer taxes to SoorMOne Abstraclng,ma (from GFE N) 1,449,00 1204.City/County tax/stamps Deed a 1,449.00 Mortgage S 1205.State tax/slam a Deed $ 1,449.00 Mortgage$ 1,449,001 1206. 1207. 1300.Additional Settlement Charges 1301. equiretl servkaa That you can shop for from GF #8) 1302. 2014 County Taxes to Dennis Zerbe $ 629.93 13D1 Hone inspection to Inspection Center by Mee Skinner inc 295.GDPO.C.529500(S' 1304.Past Inspection to Inspection Center by Mike Bladder Inc 45.00 P.O.C.S45.00(8)' 1305. $ 1306. Sewer Jan-March to Upper Allen Township $ 112.00 1307. Sewer Apra-June to Upper Allen Township S 112.00 1308.ESeowed innersance Taxes to Slone LaFraver d ShaFx id S 7,500,00 1309. Replace,Samoa Came to C&C Plumbing 8 Electrical Service.Inc $ 285.00 1310. Electrical Inspection to John A.Esser $ 65,00 1400.Total Settlement Charges(enter an lines 103,Section J and 502,Section K) 9,303.30 18,514.17 -sea ants d as+ry pr scrawl e..ax(a}.rarrwiti.a x+mrwMT! aftlTNwPtahsrYtvx,a.ea.a.�c'u®MayriaRUataa#Ma9YaPPx4ienree� ruwnrnt /� TC Settleme I i s,LLO,StItlemilintAgent CedlSed to be a true copy. Page 2 of 3 HUD-i (TASCHEK THOMPSON.PFOfTCSS2014-Q21M) Comparison of Good Faith Estimste jGFE)and H1.10-1 Charges Good Faith Estimate HUD-1 Charges That Cannot Increase HUD4 Line Number Our Origination charge #801 2,371.55 2,371.55 Your credo or charge(points)for the speclic rate chosen #802 -1,400-63 -1,400.63 Your adjusted orginatbn charges #803 970.92 970.92 Transfer lazes #1203 1,449.00 7'4gg00 Charges That in Total Cannot Increase Moro than 10% Good Faith Estimate HUD-1 Government recording charges #1201 150.00 140,00 APprarmi ree #804 550.00 450,00 Credit report #805 78.00 tBAO Flood POMMIstbn #807 9.00 9.00 INSPEGTtOFi FEE #Wit 135,00 155.00 Mortgage Insurance Premium #902 2,408.98 2,408.96 Home Inspection 2,408.96 295.00 295.00 'Peat Inspection #1304 45.00 45,00 Tots! 3,610.98 3,528.98 Increase bermean GFE and HILDA Charges S -82.00 or Charges That Can Change Good Faith Estimate HUD-1 Initial deposit for your sash w account 91001 - 2,536.W 5,489.41 Daily interest charges At 901 S 16.308700/day 16.31 Title Homeowner's insurance # 903 0.00 459,p0 Tills services and lender's IBb Insurance #1101 1,475.00 1,465A0 Owner's; #1103 1050 2000 Loan Terms Your Initial loan amount Is S 140,003.00 Your town teen to 3600 years Your initial Interest rate Is 42500% Your Initial monthly amount owed for principal,interest and 5037.01 Includes any mortgage Insurance is n principal n x Interest IOJ Mortgage lnauranm Can your interest rate rise? [ No ❑ Yea,d mn 1158 to 8 mD61311 of %. The feet change will be on„_and can change Open every_months after - Every change date,your interest rate mn increase or decrease by %, Over the Ufa of the loan,your interest rate is guaranteed to now be lower than of higher than %. Evan if you make payments on time,can your loan balance nee? No ❑ Yes.a mn rise to a maximum of tl Even It you make payments on time,can your monthly $❑( No ❑ Yea,the first ncrease mn boon__and the monthly amount owed for principal,Interest,and mortgage lnauranca Has? amount owed mnrbe toff Tne maxsnum it bark sour rise to is S Don your loan have a prepayment penalty? ❑ No ❑ Yea,your maximum prepayment penalty b S -Does your loan have a balloon payment? ❑R No ❑ Yes.you haw a batbon payment of fi due in_years on Total monthly amount owed Including escrow account paymanta ❑ You do not haw a monthly escrow payment for items,such as property taxes and homeoweh insurance. You must pay these items directly YmUse0 X❑ YOU have an addalmal monthy escow payment of 5234.36 fiat rmuaa in a total Wial monthly amount owed Of 51,071,37. The includes prmdpal,interest,any mortgage insurance and any items checked below: ❑ Property lazes ❑ Homeowner's nwranm ❑ Flood insurance Q 5bhodtaxes ❑ ❑ Note: If you have any Questions about the Settlement Charges and Loan Terms listed an the form,please contad Your finder. Page 3 of 3 HUD-t (TASCHEK T1H0MPS0N.PFD/TCSS2014-021/26) HUD-1.Attachmant� Bortowe4s):Patricia L Taschek and Katlin E. Seile(s): Estate or Anna M.Garman Thompson , 415 CascadeRbad Mechanicsburg, PA 17055 Lender-Primary Residential"Mortgage,'Ir di ISAOAIATIMA Settlement Agent:TC Settlement Services,LLC (717)715-0562 Place of Settlement:250 East Park Drive Harrislaurg,,PA 171'11. . Settlement Date :April 30,2014 Property Location:415 Cascade Road " Mechanicsburg, PA 17055 Cumberland County, Pennsylvania Additional Adjustments For Items Paid By Seller In Advance(Borrower Debit) Descd lon Amount From/Through Prorated Amount Sewer April June 112.00 04/01/14 through06/30/14 76,31 Total Line 109/409 76,31 Adjusted Origination Charge Details Origination Charge Origination Points 1,376.55 to Primary Residential Mortgage, Inc. ISAOA/ATIMA Application Fee - 24500 to Primary Residential Mortgage,Inc. ISAOA/ATIMA Underwriting Fee 400.00 to Primary Residential Mortgage, Inc. ISAOA/ATIMA Processing Fee 350.00 to Primary Residential Mortgage, Inc.ISACAIATIMA Total $ 2,371.55 Origination Credit/Charge(points)for the specific interest rate chosen Credit/Charge -1,400.63 to Primary Residential Mortgage, Inc. ISAOA/ATIMA Total $ -1.400.83 Adjusted Origination Charges $ 970.92 Reserves Deposited with Lender Homeowner's Insurance 75.50 County Taxes 2.000 at 38.25 per month 104.98 2.000 at 52.49 per month School Tax 1,436.20 10.000 at 143.62 per month Aggregate Adjustment -128.57 Total $ 1,489.11 Title Services and Lender's Title Insurance Details BORROWER SELLER Notary Fee 25.00 to TO Settlement Services, LLC wARNiNG: it Is A Mme to knowingly make fat"atatamirts to the United States on this or any similarfo nt. P6nattiea upon conviction can include a fine and imprlaonmmt. Fordetailasea: Title l9 US.Codaswoonlaotandsectionlato- (TASCHEK THOMPSON.PFDrrCSS2014-021/26} HUD-1 attachment• Continued Wire Fee - .. to TC Settlement Services, LLC Overnight Fee 30.00 - to TC Settlement Services, LLC E-Mail Doc Fee 30.00 to TC Settlement Services, LLC CPL _ 50.00 to FirstAmerican Title Insurance Company Lender's title insurance 75.00 to FirstAmerican Title Insurance Company 1,255.00 Total - - L,1 465.00 $��— — 00 Owner's Title .Insurance Owner's Policy Premium BORROWER to FirstAmerican Title Insurance Company SELLER 20.00 Total — $ 20.00 $ Lender's Title Insurance 'tees also ahawn above In Tltla Servlr:ae and I.endete Title Inaurdnoe Details Lender's Policy Premium BORROWER SELLER to FirstAmerican Title Insurance Company t Lender's Endorsement Charges 1,105.00 .Endorsement ALTA Endorsement Form 8.1 Endorsement Charge 150.00 Lien) (Environmental Protection Endorsement 100 50.00 Endorsement 300 50.00 50.00 Total I have carefully reviewed the HUD- accurate statement of all receipts and disbursements madeaon m the best or my me Wedge certify that I have received a copy Of the HUD- antl belief, it I is rt true and 1 Settlement StatemenLOUnt or by me in this transaction. I further Patricia L Talchek Estate o V. ar an Ka Kadin E Thompson 8� ^ . =T.'e: It Is a crime to knowingly make false statements to the United States on Mle or an Inclutle a fine antl lmpneonment. Fordetalle see: Title n U.S.the U iced States ieel and Section similar form, Penalnea upon convlcnon can 7010. (TASCHEK THDMPSt7ry.pFD/..CSS201q 021/26)