HomeMy WebLinkAbout07-22-14 (2) ! 1505607121 .
+1 REV-1500 EX (0645) OFRpAL USE ONLY
. PADapararRntoSRevarpra Code Year t�eNumSet
PPOWX2 I Tares INHERITANCETAXRETURN
HardsDNe PA17126-0601 RESIDENT'.DECEDENT 3 '.0 1 7 Ir.
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 1 2 1 2 0 1 3 1 1 2 5 1" 9 4 1
Decedent's Last Name Suffix Decedents First Name MI
Z E 1 'L E R S T H O M A S L
r' (it Applicable)Enter Surviving Spousfa intonation Pelow, . ;'
Spouse's Last Name Su(fht Spouse's Fimt"Name Mf
Z EL . L ERS a0N 'ITA 1
Spouse's Social Security Number
1 9 5 5 D 3 2 9 $ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILES "
FILL IN APPROPRIATE OVALS BELOW
®
1.Original Return 0 2.Supplemental Return 3.Remainder Return(date of death
prior to 12-13.62)
0 4.Limited Estate 4a.Future Interest Compromise(date of 0 5.'Fedeml Estate Tax Return Required
death after 12-12.82) 1 1 1 r .
® 6.Decedent Died Testate 7.Decoder[Maintained a Living Trust S.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9.Lftigation Proceeds R'waived 10.Spousal Poverty Credit(date of death 11.Flticticn to tax under Sec.9113(A)
between 1231.91 and 1-1-95) (Attach Sch,D)
CORRESPONDENT-THIS SECTION MUST SE COMPLETED.ALL CORRESPONDENCE AND CONODENTIAL TAX INFORNATiON SHOULD BE DIRECTED T0:
Name Daytime Telephone Number '
H A R 0 L D S I W I N I I I 7 ,1. 7 2 .43 6 0 4 0
= Finn•Name(it Applicable) _
REGISTER OF WILLS USE ONLY
I R W I N L A W O F F I C E
First line of address O •`'- i"'"' .
6 4 S O U T H ' , P Z T T S T R E E T
Second,line of address , r: N
xn: .
City or Past Office State ZIP Code DA CEO "n
C A R L I S L E P., A. 1 7 91 3 °v .:_cr,
Correspondent's 6-mail address:irWinlaW6f iCer gf7 ail.Com
U n tre� ' wdedam001havasonlredthisreLrtn,indudNamonprn mtoftbestoinryWwwNdgeandbelid,
h is d anp ;s. .
Dedaration of preparer other Ohan Me personal mpresaM We is based on d 6tldnnafm of which p gpa arhas a ry W owiadga,
S19VATURE RESPONSIBLE FOR RLINO RETURN DATE
ADDRESS ItL AV
342 ERMA AVENUE LEMOYNE PA 17043
SI RE OF PFIEPAR8R REPRESENTATIVE TE
�.
ADDRESS
64 SOUTH PI STR ET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
3505607121 " 1505607121 �`�
1 1505607221
-1 REV-1500 EX Decedent's Social Security Number
Decedent's Name: THOMAS L• • ZEL_ LERS -
RECAPITULATION
1. Heal estate(Schedule A)-
„1. 8 7 5 0 _0. 0 0
2 Stocks and Bonds(Schedule B) ' .................................. 2.
3..Closely Held Corporation,PaMemhip or Sale-Proprietorship(Schedule C) .,.:.. 3. - �-
'4. Mortgages&Notes Recelvable(Schedule D) ....... ,....:! '4. - 0 � 0 a
... ;
,6. Cash,'Bank Deposits&Miscellaneous Personal Property(Schedule E) ......: 5. - 3 6 1 2 . 9 4 .
S. Jointly Owned Property(Schedule F7 ❑ Separate.Billing Requested ....... 6. 0 • 0. 0
7. Inter-Vhms Transfers&Miscellaneous Nj2B,Probate Property -
• (Schedule G) _ ; ' t_.I Separate Billing Requested....... 7. : • 0 . 0 0,
8.Total Gross Assets(total Lines 1-7)' .........:...........:..... 8.. 9 1 1 1 2 . 9 4 -
9. Funeral Expenses&Administrative Costs(Schedule H) :............... 9. 1 6 0 1 2 . 7 0
10. .Debts of Decedent Mortgage Liabilities,&Liens(Schedule I) ............. 10. 8 0 3 2 4 . 8 1 _
11. Total Deductions(total Lines 9&10) .................... 11. 9 6 3 3 7 . 5 1
12 Net Value of Estate(Line 8 minus Una 11) ......7.................. 12. 5 2 2 4 . 5 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. 5 2 2 4 . 5 7
TAX.COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES ..
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 --
(a)(1.2)X.o_ . 0 . 0 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate x.o_ 0 . 0 0 16. 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0. 0 0
18. Amount of Line 14 taxable 0 . 0 .
at collateral rate X.15' 0`. 0 0 18.
19.Tax Sue 19. r0 . 0 . 0 -
20. .FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
L 1505607221 1505607221
REV-15.00 IX Page3 . , "Rte Number -
Decedent'sComplete Address: 21 13 0170
DECEDENT'S NAME
THOMAS L ZELLERS
STREET ADDRESS -
342 HERMAN AVENUE
Crry STATE LP '
LEMOYNE PA 17043
Tau Payments and Credits:
I. Tax Due(Page 2 Line 19) - (1) '0.00
2 Credits/Payments
A Spousal Poverty Credit
i B.Odor Paym6nls
C.Discount
ToialCredd;(A+B+C) (2) 0.00
3. Intersiffenalty if applicable
D.interest
E Penalty
Total lntemd? nalty(D+E) (3) 0.00
4. If Line 2 is greater than Line 11+Line 3;enter'the difference.This lathe 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) 0.00
A Enter the Interest on the tax.due.
B.Enter the total of Line 5+5A This is the BALANCE DUE (58) 0.00
Make Check Payable to REGISTER OFMLLS, 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 transfened: ........................::.....................:a................: ❑
b. retain the right to designate who shall use the property iransfemed or Its Income; ..............................1. ❑
a retain a reversionary interest;or ........:........................................................................................ ❑
d. roe"the promise for Ide of either paymerds,benefits or pre? .....................................................::❑ ' .
2. It death occurred after December 12,1982,#id decedent ttmnster property within are year d death
wfthoul rareiving adequate oorusideration7 ;...... .':......:....... .:........................I.......................... . ® —
3. 'Did decedent own an in turd for or payable'upon death bank account or security at M .`s or her death? .... ;,.
4. Did decedent own an Irafvidual Retirement AoommL annuity,or other non-probate property which
mrdairnsa beneficiary desigli don?........................................................ .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS.YES,YOU MUST COMPLETE SCHEDULE G AND RLEIT AS PART(fF THE RETUf4N.
For dates of dearhon or after July 1,1994 and before January.1,1995,the tax rate imposed on the net value dtransfers tb or for the use of Me surviving spouse
1s three(3)percent(72 P.S.§9116(a)(1.1)(7]
For dates of death on or after January 1,1995,.the tax rate imposed on the not value of transfers to or for the used the surviving.spouse is zero(0)percent.
(72 P.S.§9116(a)(1.1) n).The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure d assets ant
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 rateimposed on ft net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent,an .
adoptive pared,or a stepparent of the child is zero(0)percent(72 P.S.§9116(a)(12)1
The tax rate Imposed on the not value of transfers to or for the use of the decedents Kneal.bensficiaries Is four and one)ualf(4.6)percent;except as noted in, .:
72 P.S.§9116(1.2)(72 P.S.§9116(aXt)].
-The tax rateimposed on the not value of transfers to or for the use of the decedent's slbfings is twelve(12)perwM V2 P.S.§9116(aX1.3)).A sibling is defined,under
Section 9102,as an individual who has at feast are pared in common with the.deoedent,whether by blood or adoption. .
•. REV-j6o2EX+(6-sa) s. :u•�::--
60 EDULE A.: -
'00?&.40 MTHOFPENN$WVMM REAL ESTATE
RNIHO N CETAXRETURN
RESIDENT DECEDENT _ r
ESTATE OF
FILE NUMBER
THOMAS L.ZELLERS 21 13 0170
`
All properly ow O so]4 ix as a gnaMln common.mu6t he reportad at fair.maht Ww.Fait marketvakm Is deRW as fto prim at whkh.properry would 4e:. .
emn aMod baron a wArig buyer and a w&V seller,nmtW bebg oampetl6d to buy«sell,both havbg masom to kmwl*e of*mlavardfa&u '
Reef pmpwy wMchis lokftowmd wb rfLht of suftomrdp must bedisdasedonSehoduteF. . .
(TE wt VALUE AT DATE
NUMBER DESCRIPTION . OF DEATH
7 HOUSE AND LOT AT 342 HERMAN AVENUE,LEMOYNE, PA 17043 87,500.00
Value Based an Sale Prime_.....
See HUD-1 attached as Exhibit`B°
,
TOTAL Alsowrter'on Iine 1;Rwo lutahon g' 87 500.00
. - y' ofm m$pawis weft k=ftaditmisheeisofdresamft) . ,
,REV-t603 EX't-.{8-89) •. .: . . .
SCHEDULE B ...... . _. ... . .
ooM^AIDNWmTHOFFENNmVANtA ".STOCKS& BOND$ -
MNEWTA mTAX RETURN .
RESIDENT DECEDENT.
ESTATE OF FILE NUMBER
THOMAS L.ZELLERS 21 y 13 0170
An progeny 10*V mea wM AgM.crsla*OMhIO MUSS be mscmien on Saw"-F.
ITEM VALUE AT-DATE
NUMBER DESCRIPTION OF DEATH
i. NONE
(TOO
r I'
f
TOTAL(Also e ironlineZRecepWatmn) $ 0.00 i
. .' pin brespace�n�aedrmmneaaluw�sneetsm9�ee�redm� , . ,E
AEV-i%A EX+Isle) -
SCHEDULE C .
CLOSELY-HELD CORPORATION;
OOM MONWE&TH OF PENNSYLVANIA' PARTNERSHIP OR'.
E
SID ri DE MEW SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER.'
THOMAS-L.ZELLERS • 24 13 0170
• Sdr ";c-1 or C-2lh k&V a0 We"Ntorrnafion)must be attkhed for each doseVN?d cogntio*dne ft Interest of the decederd,other then a.- .. T
se"roprietorship. See k0uct rts for the&WeR ft ftmatonhebeabr fted for w"mpdatareh0&'
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE 0.00
Y _
.r`
TOTAL Also,enteron line 3,R 5 0.00
(ttmaeWace Israteded,troertA tonal sheets offtseinestm)
REV-1507 EX (6.99)
SCHEDULE D
COMMONWEALTH OF PENNSYLVANIA MORTGAGES && NOTES
INHERITANCE TAX RETURN -RECEIVABLE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THOMAS L.ZELLERS 21 13 0170',
All proleertY phldyowned with the right of surAvoeship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE 0.00 -
TOTAL Also enter on line 4,Recapitulation s 0.00
of more space is needed.inert additional sheets of the same size)
REV-1509EX+(6-99)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. .
INHERITANCE TAX RETURN PERSONAL PROPERTY -
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THOMAS L.ZELLERS 21 13 0170
Include Ore eds of fitigat onand the date the p oceeds were recePed fry
=All- - All progeny olMly4wr�d wllh AgM of survNorshlp must he dlselosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1977 PLYMOUTH VOLARE 50.00
Value Based on Sale Price
2. ' 1986 FORD F-150 TRUCK 50.00'
Value Based on Sale.Price r f
3. VARIOUS USED SPORTING GOODS 1,000.00
4. VARIOUS USED TOOLS AND EQUIPMENT 1,000.00,
5. MISCELLANEOUS HOUSEHOLD GOODS 250.00
6. BANK OF AMERICA, 514.94
Real Estate Tax and Homeowner's Insurance Escrow Balance
See statement attached as Exhibit"C"
7. REAL ESTATE TAX PRORATION 748.00
See HUD-1 at Exhibit"B"
TOTAL(Also enter on line 5,Recapitulation) $ 3,612.94
(it more space is needed,Insert additional sheets of the same sin) '
REV-1509 EX+(6-98) .
SCHEDULEF
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER.
THOMAS L ZELLERS 21.' 13 0170
If an asset was made joint within oneyear of the decedents data of death,it must be reported on SehedUle G.
SURVNING JOINT TENANT(S)NAME - -ADDRESS RELATIONSHIP TO DECEDENT
A. NONE 0.00
B
C
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
REM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK AOODL"r NUMBER OR SIMILAR DATE OF DEATH DECDS VAUIEOF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A NONE . 0.00 10.00
TOTAL(Also enter on line 6,RecaptUlation) S 0.00
(If more space Is needed,Insert additional streets of the same size) '
REV-1510EX+(698) _
SCHEDULE G
INTER-VIVOS TRANSFERS&
COMMONWEALTH NHERrrAHETAXRET"UURRriA"� 'MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THOMAS-L. ZELLERS 21 13 '0170
This schedule must be completed and filed 9 the ans4er to arty of questions 1 through 4 on the reJelse sldB of the REV-1500 COVER SHEET Is(m -
DESCRIPTION OF PROPERTY
ITEM DATE OF DEATH %OFDECO'S EXCLUSION TAXABLE
NUMBER VALUEOFASSET INTEREST VALUE
1. NONE 0.00 0.00
TOTAL(Also enter on line 7 Recapitulation) $ 0.00 ' '
(If more space's needed,Insert additional sheets of the same size)
REV-1511 EX+(10-06) -
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES& '
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THOMAS L. ZELLERS 21 13' 0170
' Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
t. MUSSLEMAN'S FUNERAL HOME 3,495.00
B. ADMINISTRATIVE COSTS:
1. Personal Representafr4s Commissions
Nacre of Personal Representative(s)
SbeetAddress
Cdy State Zip .
Year(s)Commission Paid:
2 AttonreyFees IRWIN LAW OFFICE 500.00
3, FemOy Emmpt on:(If decedents address Is Trot the same as claimants,attach explanation) 3,500.00
Cahmant BONITA J.ZELLERS
Streetaddress 342 HERMAN AVENUE
Gry LEMOYNE State-PA 4p17043
Relattonshipofctaimantto Decedent •SPOUSE
4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS : • 363.50
5 AeDmmtanrs Fees
6. Tax Retum Prepares Fees ,
7. IRWIN LAW OFFICE-Attomey Fee on Real Estate Settlement 300.00
8. LEMOYNE BOROUGH TAX COLLECTOR '-2013 County/Borough Taxes' "485.83
9. LEMOYNE BOROUGH TAX COLLECTOR-2014 County/Borough Taxes 543.61
10. PENN WASTE-Trash Bill 42.80
11. BOROUGH OF LEMOYNE-Sewer Bill 329.96
12. PURITY ABSTRACT- Notary Fees,.Wire'Fee, and Tax Cert Fee for R.E.Settlement 32.00
13. RECORDER OF DEEDS-Real Estate Transfer Tax 875.00
14. CENTURY 21 PISCIONERI - Real Estate Commission 5,545.00
TOTAL(Also enter online 9,Recapitulation) $ 16 012.70
(If more space is needed,insert additional streets of the Sartre size)
REV-1512 E)(+(12-03) • '
SCHEDULEI
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, -
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
THOMAS t.ZELLERS 21',13 0170
Report debts incurred.by the decedent prior to death which remained unpaid as of the date of death,.including unreimbursed medical Wenses.
ITEM VALUE AT DATE
NUMBER- DESCRIPTION OF DEATH
1. LEMOYNE BOROUGH SEWER ACCOUNT 53.30
Sewer Bill
2. SAC, INC., 187.00'
Fuel Oil Bill
3. PP&L 110.34
Electric Bill
4. PENNSYLVANIA AMERICAN WATER 47.12
Water Bill
5. PENN WASTE, INC. 43.50
Trash Bill
6. BANK OF AMERICA 79,88155
Mortgage Payoff
TOTAL(Also enter on line 10,Recapitulation) $ 80 324.81
(If more space is needed,Insert additional streets of the same s'¢.e)
REV-15136(+(9-00) - -
SCHEDULE J
` COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER-
THOMAS L.ZELLERS 21 13 0170`
RELATIONSHIP TO DECEDENT AMOUNTORTHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not UstTrustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (fndude spousal das0ullons;andtransfers urder
Sec.9116 a 12
1. THOMAS B.ZELLERS Lineal
P.O. Box 301709 25%Residue and
St.Thomas VI 00803 Sporting Equip/Tools ,
R: TRACEY L..WILLIAMS •,' j• Lineal / y
22 Coon Creek'Road 25% Residue,
Palmyra,.PA 17078
3. CHRISTINE M. BURGER Lineal'
16 Honeysuckle Drive 25%Residue
Mechanicsburg, PA 17050
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REVA500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. BONITA J.ZELLERS -
342 Herman Avenue
,Lemoyne, PA 17043
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NONE_.: 0.00
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET . $ 0.00
(If more space is needed,insert additional sheets of the same size)
EXHIBIT "A"
LAST WILL AND TESTAMENT
I, THOMAS L. ZELLERS, of 342 Herman Avenue, Lemoyne, Cumberland County,
Pennsylvania 17043, do hereby make, publish and declare this to be my last will and testament,
hereby revoking all wills heretofore made by me. _
1. 1 direct my personal.representative to pay all of my debts,.funeral and administrative
expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed
or payable by reason of my death and interest and,penalties thereon with respect to all
property, whether or not such property passes under this Wilt, shall be paid by my personal
representative out of my estate.
2. 1 authorize and empower my personal representative to sell any realty and/or personalty
owned by me at my death and not specifically devised or bequeathed herein, at public or private
sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple,
as I could do if living. My representative is authorized and empowered to engage in any
business in which I may be engaged at my death, for such period of time after my death as
seems expedient to said representative.
3.. 1 give, devise and bequeath all of my estate of whatever nature and wherever situate as .
follows:
o co m A. Tq(my son, Thomas B. Zellers, any of my sporting goods and tools that he
w _j "' adesires; and all the
—r o
air E u
li 4. p'. .`� a C.>G.1 p
w cu BZ ZoF*t residue and remainder to my spouse, Bonita J. Zellers, my son, Thomas B.
c� ►— ' ' 1-,=2flers,.,and my.daughters, Christine M. Burger and Tracey L. Williams, share
Cf- (n CO
wca* share.alike, or the survivors thereof.
4. 1 nominate and appoint my spouse to be the personal representative of my estate, to
serve without bond. If my spouse cannot or does not serve, then I appoint my son, Thomas B.
Zellers,:to be the,substitute.personalrepresentative, with the same powers and also without
bond.
b. I suggest that-my personal representative.retain the-services;of Harold S. Irwin, III,
Carlisle,Pennsylvania.irt the settlement-of my estate:
IN WITNESS WHEREOF, I have hereunto set my;"nd°seWANS:l9"'day of January, 2013.
MA R IG
(SEAL).
. :THOMAS.L. ZELLERS
Signed, sealed, published and declared by the above-named person as and for a,last will and
testament, in our presence, who at said person's request, in said person's presence and in the
X
presence of each other have hereunto set our names pa�sdbing witnesses.
•
EXHIBIT OWN
OMS NO.2502-0265 T
A B. TYPE OF LOAN:
U.S.DEPARTMENT OF HOUSING'&URBAN DEVELOPMENT I 011 2.❑FMHA 3.❑CONY UNINS. 4.C]VA S.QCONV INS.
6. FILE NUMBER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT P14-047
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is humished to gne you a statement o/actual cettlemenf costs. Amount$paid to and by the settlement agent are sho n.
Items marked 7POCJ-were paid outside the arcing,theyere shown hem for imonnafionelpurposes antl ere trot mdudedj m the f1t111L
10 38 r E8a Mw"'%MAm
D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Scott Webb and Bonita J.Zeliers.Executrix
Kathleen Webb 402 Herman Avenue
10 Criswell CT Lemoyne.PA17043 -
Sterling,VA 20165 -
G. PROPERTY LOCATION: H:SETTLEMENT AGENT:. 234402316 I. SETTLEMENT DATE'
342 Herman Avenue PURITYABSTRACT COMPANY
Lemoyne,PA 17043 March 14,2014
Cumberkntl County,PennayNank r3315 CE OF SETTLEMENT „ t
tury 21 Realty Services - -
Market St.Camp Hit,PA 77011
J.SUMMARY OF BUYER'S TRANSACTION K.SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Saks Prim 1 87,500.00 401, Contract Saks Prim 87,500000 - -
102. Personal Property 402. Personal Property
103. Settlement Charges to Buyer(Ure 1400 2,087.70 403,
104. -
105. 405-
Adjustments For items Pad B Seller in advance Adjustments For Items Paid By Seger le edvance
106. Coun /Boro Taxes 03114114 to 01/01/15 436.38 406. County/Born Taxes 03/14/14 to 01101115 1 436.38
107, City Tax to 407. City Tax to
108. School Tax 03114/14 to 07/01114 .311.62 408. School Tax 03114/14 to 07101/14 311.62
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BUYER 90,335.70 420, GROSS AMOUNT DUE TO SELLER 88,248.00
200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deposit or earnest money 1,000.00 501. Excess Deposit See Instructions) --
202. Prim' alAmount of New Loans 502. Settlement Charges to Seller Line 1400 7,66837 - -
203. Exist" bans taken sublect to 503. Existin bans taken subject to
204. 504. Payoff of first Mortgage to GREEN TREE 79,883.55
205. 505. Payoff of second Mortgage
206. 506.
207. 507. (Deposit disb.as proceeds)
208. 508.
209. 1 509.
Adjustments For Items Unpaid By Sekst - Adjustments For Items Unpaid By Seller
210. Coun IBoro Taxes to 510. Countyg3oro Taxes to
211. C' Tax to 511. C' Tax t0
212. School Tax to 512. School Tax to
213. 513.
214.. 514.
215. 515.
216. 516.
217, 517.
218. 518. - --
219. 519.
220. TOTAL PAID BY/FOR BUYER 1,000.00 520, TOTAL REDUCTION AMOUNT DUE SELLER 87,551.92
300. CASH AT SETTLEMENT FROMRO BUYER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Grass Amount Due From Buyer Line 120 90,335.70 601. GrossAmount Due To Seller Line 420 88,248.00
302. Less Amount Paid (For Buyer(Line 220) ( 1,000.00) 602. Less Reductions Due Sal 520 ( 87,$$1.9
303 CASHf X FROM)( TO)BUYER 89,335.70 603. CASH(X TO)( FROM)SELLER 696.08
The undersigned hereby ackn\owleddgg,/epe re'eptpt\of a compkled copy of pages 1112 of this statement d any attachments referred to herein.
• -
Buyer `l U-4 Seller ,r,�
Scott Webb Bonita J.Zell -Execul
Kathleen Webb - -
Rol
L.SETTLEMENT CHARGES
700.TOTAL COMWSSION Based on PACs S 87,500.00 A 6.0000% 5,250.00 RED FROM MO FROM
Dms widf Comm0SiOn fire 700 as FOlbws - eur s aEUER$
701.S 5. 5000 to Century 21 Realty Serom FUNDSAT FUNDSxT
7021$ to Cereury2l Really Serynae SMm NT sE*nEMEwr
703.Comm¢SOn Paid at S comers 5,250,00
04.ADD'L COMMISSION to CENTURY 21 REALTY SERVICES 295.00 295.60
800.ITEMS PAYABLE IN CONNECTION WITH LOAN
801.Loan Origination Fee % to
802.Loan Dsceunt % to
803.Appraisal Fee to
806. Credit Report to
805. Lender's Inspection Fee to _
8(l6. Flood Gen Fee to - - - -
807.Tax Service Fee to
808. Document Prep Fee
809.
810.
811.
900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901.(merest From 10 S /day ( days %)
902. Mort a e Insurance Premium for monlhsto
903.Hazard Insurance Premium for years to
1905.
1000.RESERVES DEPOSITED WITH LENDER
1001 Hazard Insurance $ per
1002.Mortgage Insurance 114 E per
1003. Coun IBoro Taxes a E per
1004. CityTax cp S Per _
1005. SMOol Tax @ $ per
1006. S per
1007. r
1008. AGGREGATE ADJUSTMENT E4r 1 0.00
1100.TITLE CHARGES
1101. Settlement or Closing Fee to
1102. Abstract or Title Search to
1103. Tale Examination to
1104. Title Inwrance Binder to
1105. Document Preparation to
1106. Notary Fees to NOTARY CLERK j834.00 10.00
1107. Attorneys Fees to IRWIN LAW OFFICE 300.00
_ MOWes&bow 0em numbers:
1108. Title lnwrance to PURITY ABSTRACT COMPANY
,nCUdes show item numbers.'1101,1103.SALE '
1 09.rerd s Coverage , S
1110.Owners Coverage S 87,50000 834.00 -
1111. Payoff Outgoing wire fee to PURITYABSTRACT COMPANY 12.00
1112. Tax Ced Fee to PURITY ABSTRACT COMPANY 10.00
1113.
1200.GOVERNMENT RECORDING AND TRANSFER CHARGES '
1201.Recording Fees: Deed $ 68.00;Mortgage S Releases $ 68.00
1202.C' (Coun Tax/Stam : Used - 875.00 Mortgage 875.00
1203.State Tax/Stamps: Revenue Stamps 875.00;Mortgage 875.00
1204.' - RECORDER OF DEEDS
1205. - RECORDER OF DEEDS
1300.ADDITIONAL SETTLEMENT CHARGES
1301. S to '
1302. Post l dfon to - WAIVED
1303.2014 COUNTY/SORO TAX to FAITH A NICOLA,TAX COLLECTOR 643.61
1304. 1ST OTR REFUSE to PENN WASTE 10.70 42.80
1305. FINAL/OUTSTANDING SEWER BILLS to BOROUGH OF LEMOYNE 1 329,96
1400.TOTAL SETTLEMENT CHARGES Enter on Lines 103 Section J and 602,Seetlon K 2.087.701 7,668.37
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IT7 ABSTRACT COMPANY
lament Agent
Certified to be a True copy. ,
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EXHIBIT v,C••
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Green Tree Servicing LLC
Vendor Number CUSTOMER
Check Number 2748624
If you-are unable to apply these,payments,-please call 1•-800-643-0202.
Invoice # Description •Document'# Date Invoice Amt
667027313649W 'CLOSED ACCOUNT 1900699116 06242014 - 54361
Sun total + 643.61
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