HomeMy WebLinkAbout04-07-05
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REV-1500 EX<(&oo)
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'*' COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128.0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
FILE NUMBER
2 1 - 0 5 0 0 0 6 7
COUNlY CODE -YEAR - - NUMBER - - -
SOCIAL SECURITY NUMBER
188 1
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
DATE OF DEATH (~M.DD.YEAR)
DATE OF BIRTH (MM-DD-YEAR)
01-12-2005 05-17-1
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
EJ 1. Original Retum
o 4. Limited Estate
!!J 6. Decedent Died Testate (AIIach copy of WiQ
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest Compromise (dale 01 dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTlUsl)
o 10. Spousal Poverty Credn (dale ofdealh between 12-31-91 and 1-1-95)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposns & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property
(Schedule G or l)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
NAME
Keith O. Brenneman
FIRM NAME (If AppIcable)
Snelbaker & Brenneman P.
TELEPHONE NUMBER
717-697-8528
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14. Net Value Subject to Tax (Line 12 minus Line 13)
o 3. Remainder Retum (dale ofdealh prior 10 12-13-82)
o 5. Federal Estate Tax Return Required
J!. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Allach SchO)
COMPLETE MAILING ADDRESS
44 W. Main Street
Mechanicsburg, PA 17055
(1)
(2)
(3)
(4)
(5)
146,000.00
11,531. 86
....J
(6)
ii
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(7)
(9)
33,856.47
(8)
157,531.86
(10)
942 14
(11)
(12)
(13)
34,798.61
(14)
122.733.25
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
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16. Amount of Une 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
122,733.25
x.O _ (15)
x .0 45- (16)
x .12 (17)
x .15 (18)
5,523.00
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19)
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20.0
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Decedent's Complete Address:
STREET ADDRESS
11 Glauser Road S ur
CITY
Mechanicsbur
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5,523.00
276.15
Total Credits (A + B + C ) (2)
276.15
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund (4)
A. Enter the interest on the tax due.
(5)
(5A)
5,246.85
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
5,246.85
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;.......................................................................................... 0 !]
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 !]
c. retain a reversionary interest; or.......................................................................................................................... 0 !J
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 U
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 .[]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ Q 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of peljury, I declare that I have examined this return, induding 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 al intonnation of which preparer has any knowledge.
S NATURE OF PERSON RESPONSIBLE FOR FILING RETURN J I
, Go Executor D ~ Go Executor
RESS 16 Glauser Road Spur 1438 Boiling Springs Road
Mechanicsburg, PA 17055 Boiling Springs, PA 17007
SIGNATUR~~ REPRESENTATIVE
ADDRESS --
DATE '1/(, I() SO
DATE ""4;,,.r
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
(72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. 99116 (a) (1.1) (iill.
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary. .
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one 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% [72 P.S. 99116(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%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (6-9*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Miriam M. Luther 21-05-00067
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is jolntly-owned with right of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
All that certain tract of land improved with a
residential dwelling commonly knkown as 11 Glauser
Road Spur, Monroe Township, Gumberland Gounty,
Pennsylvania as described in Gumber1and Gounty Deed
Book "W", Volume 28, Page 342, sales price
February 3, 2005 (see HUD-1 attached):
146,000.00
TOTAL (Also enter on line 1, Recapitulation) $ 146.000.00
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX+ (6-98) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
sCHEDULEE
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Miriam M. Luther
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-05-00067
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
2.
3.
4.
5.
6.
PNC Bank, N.A. checking account No. 5070025302
PNC Bank, N.A. savings account No. 5080280569
2004 Pennsylvania Property tax rebate
Blue Cross refund
4,699.20
2,457.66
500.00
249.74
37.26
Refund of insurance prem1um overpayment
Miscellaneous personal property, furniture, furnishings
and 1986 Pontiac Sunbird sedan
3,588.00
TOTAL (Also enter on line 5, Recapitulation) $ 11,531.86
(If more space is needed, insert additional sheets of the same size)
REV.1510 EX+ (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Miriam M..Luther 21-05-00067
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUOE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO OECEOENT ANO DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Monumental Life Insurance Co. policy 500.00 100% 100% -0-
No. 15611991. Beneficiary at date of death:
Myers Funeral Home
2. Monumental Life Insurance Co. policy 1,500.00 100% 100% -0-
No. 14596875. Beneficiary at date of death:
Myers Funeral Home
3. Monumental Life Insurance Co. 1,000.00 100% 100% -0-
policy No. 14933419. Beneficiary at date
of death: Myers Funeral Home
TOTAL (Also enter on line 7 Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEH
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Miriam M. Luther
FILE NUMBER
21-05-00067
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
1.
Myers Funeral Home - funeral expenses (net of 1nsurance
payment)
2. Gingrich Memorials - headstone and engraving
3. Funeral luncheon to Trindle Spring Lutheran Church
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions $3,650.00; $3,650.00
Name of Personal Representative(s) Judith A. Meck/Ronald D. Luther
Social Security Number(s)/EIN Number 01 PersonaTRepresentative(sf
Street Address 16 Clouser Road SpUT. Meehan; eSbllTg, PA 170')')
City 1438 Boiling Springs Road, Boilin8tat~pring~ PA 17007
Year(s) Commission Paid:
2005
2.
AttomeyFees to Snelbaker & Brenneman, P. C.
3.
Family Exemption: (II decedent's address is not the same as claimant's, attach explanation)
N/A
Claimant
Street Address
City
State _Zip
Relationship 01 Claimant to Decedent
4.
Probate Fees to Register of wills (initial ($110.00) and
additional probate fee ($200.00)
Accountant's Fees and reserve for filing fees and miscellaneous
expenses
~~~ repair expense to septic system for sale
Advertise grant of Letters Testamentary:
a. The Patriot News
b. Cumberland Law Journal
Realty transfer tax:
Real estate broker's comm1SS1on and transaction fee:
Personal property appraisal fee and auctioneer's commission
to Haar's and C. Bricker
5.
6.
7.
8.
9.
10.
AMOUNT
7,380.00
1,943.00
190.00
7,300.00
3,500.00
310.00
1,000.00
931. 67
294.42
75.00
1,460.00
8,885.00
587.38
(If more space is needed, insert additional sheets of the same size)
33,856.47
TOTAL (Also enter on line 9, Recapitulation) $
REV.1512 EX+ (12-03)
'*
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABIUTIES, & UENS
ESTATE OF FILE NUMBER
Miriam M. Luther 21-05-00067
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
County, Township, Library real estate taxes due (net)
47.96
2.
Manor Care Carlisle - balance due on account
684.00
3.
PP&L Electric Utilities Corporation - payment on account
173.49
4.
Lancaster HMA Physicians Management of Central
Pennsylvania - payment on account of medical expense
36.69
TOTAl (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
942.14
LAST WILL AND TESTA!1ENT
OF
MIRIAM 11. LUTHER
I, MIRIAM M. LUTHER, or the Township of Monroe, County
of Cumberland and State of Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
declare this my Last Will and Testament, hereby revoking and
making void any and all prior Wills by me at any time heretofore
made.
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can be conveniently
done.
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever and
wheresoever the same may be situate, to my five (5) children,
to wit, my son, LA.."'tRY R. LUTHER, my da.ughter, SHARON L. GIBLIN,
my daughter, JUDITH A. MECK, my son, RONALD D. LUTHER and my
son, ALAN W. LUTHER, share and share alike, per stirpes.
LASTLY, I nominate, constitute and appoint my son,
-1-
RONALD D. LUTHER and
or thO
~s my Last Will
rrom Post 0 b
~ng ond or th
r -f - 0 ; er secllri ty 1'or
o heir duties 1 '
.' n any JU1-~~diction.
my dau,ghter, JUDITH A.
and Testament and
MEeK
, CO-Executors
direct that th
ey be e.:tcUsed
the r .t.1...... '
at L4.I. ul per-P ..
.I.0I'11lance
. IN WITNESS WHEREOF,
thi.a _ ij..d- de.'
, ,,- ,y or J:.une,
I have hereunto
A. D set my hand arid seal
-.' 2003.
,
CO~lliONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND
)
I, MIRIAM M. LUTHER , the testatriX
whose name is signed to the attached or foregoing instrument, having
been duly qualified according to -law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that I signed it as my free and volun-
tary act and deed, for the purposes therein contained.
MmIAM
day of
. Sworn and affirmed to and <l;cknowledged before me b~L1
M. Ltr~ ' "the testat rix ,this y y"\.
June' . A. D., 'A. D.. J 2,0,03
, :', \(,:'. ", : .- .... ~
'-/7J~7h,' o(~~.
Miriam M. Luth
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
MAURA A. JENKINS, Notary Public
Mechanlcsburg 80ro. Cumberland County
My Commission Explrell Novamber 10, 2003
)
55.
COUNTY OF CUMBERLAND
)
We, the undersigned, J. ROBERT STAUFFER
and HEIDI M. NELSON , 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 the
testat rix MIRIAM M. LUTHER , sign and exe-
cute the instrument as~miher Last Will and Testament; that the
said testatrix , MIRIAr4 M. LUTHER , executed it as
~/her free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testat rix , signed
the Will as witnesses; and that to the best of our knowledge, the
testatrix was, at the time, eighteen (18) or more years of age,
of'sound mind, and under no constraint, duress or undue influence.
Sworn and
me this
June
su~cribed to before
~ t
day of
,. 20 3
NOTARIAL SEAL
MAURA A. JENKINS, Notary Public
Mechanicsburg Bo~. Cumberland County
My Comml$-,/on Explros November 10.2003
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U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.QFHA 2-DFmHA 3,OCONV, UNINS, 4,OVA 5,~CONV, INS,
Iii, : I '0079284960 :
SETTLEMENT STATEMENT 05062
6, MORTGAGE INS CASE NUMBER:
C, NOTE: This form is furnished to give you a statement of ectual saWement costs. Amounts paid to end by the settlement agent ere shown,
Items marked "(POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals,
1.0 3IlIll (05002IOS062I27)
D, RESS OF : E, v, ,,: F, NAME AND ADDRESS 0 :
Wendy Jo D, Korte Miriam M, Luther Estate Irwin Mortgage Corporation
10500 Kincaid Drive
Fishers, IN 46036
G, PROPERTY LOCATION: H, SETTLEMENT AGENT: 25-1676915 L SETTLEMENT DATE:
11 Clouser Road Spur Keystone Land Transfer, Lid,
Mechanlcsburg, PA 17055 February 26, 2005
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
3421 Market Street
Camp Hill, PA 17011
J. ,,",
00. : 400. :
f01. contract sa es ....nce 140,000,00 401, Contract sales t"nce 141i,OOO,00
102, t"ersona t"roperty 4llT.l'ersonal ....roperty
f03: sewement lJnarges to tiorrower (Une 14UU I 5,409,44 403,
104, 1404,
105, [405:.
AajUSlments For Items Paid By Seller In adVance AUjUstments ror Items paid By Seller In advance
106, lJllV/1 own I axes 0 I 406, l;lly/1 own Taxes to
1lJ7, l;ounly I axes . 02126105 to U1lU1/oo 253,63 1 407. l;ounIY I axes U:.!{:llllU:> 10 -ul101f06 . 253,1l3
'lOll. scnoo ax U:.!{:llllU:> ro UflU1{U:> 423,10 1 406,:;cnoot ax U:.!{21l1U:> to UflUl/U:> 423.10
109, 1409,
10, 1 41U,
11, 411,
112, 4f2:
120, GROSS AMOUNT DUE FROM BORROWER 152,066,37 420. GROSS AMOUNT DUE TO SELLER 146,676,93
200, I -sERAI:r : 500. IN "Muun I UUI: :
201, ueposl or earneSt money , Excess Deposit (See Instructions)
2U2, PrlnClpa AmOUn 01 New Lcan(Sf 131, ' SeWement lJnarges to :;ener (LIne 1400) 11,:>9:>.40
1203, EXisting lcan(s I taken subject 0 503, ExisDng lcanls) taken sUDJectto
1204, o04,--PayoII Olllrst Mongage
"205, 505, ayolI 0 secona Mongage
"200. 506,
207, 507, (Deposit aISD, as proceeas
206, 5Ull,
209, 509,
AUjUstments or Items unpalifBy ;:)8/{er AUjUStmen s ror Items unpalu l:ly--se11ilr
210, CityfTown Taxes to -51lJ, lJllV{ 1 own axes to
211, County Taxes 10 01' ,-COUnty I axes 0
~12, :;cnoot I ax to 512, SCllOOl Tax to
2lJ,- 513,
214, 514:
215, 010.
216, 516,
217: 517.
!111, 518,
1219, -sm.
220, TOTAL PAID BY/FOR BORROWER _.0 132,400.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 11,595,46
,3UU, : 600. ..",," " I "I: I I LI:MI:N I :
I3U1. ulOSS A/11Ount uue rom lSOROW8I' (Line l:lU/ ' Gross AIIllIUntuue 0 ...,ner lune 4201
,302, Less AIIllIUnt t"alQ tiy/t"Ol' ne ;au) 1.....4W.OOJ 602. LeSS K80UCUonS uue :;ener lune :>:lU) 11,090,4tl.
303, CASH ( X .FROM) ( TO) BORROWER ' 19,686,37 603. CASH ( X TO) ( FROM) SELLER 135,061,47
OMB NO 25U2oU2li5 . -.
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n.-=-:hT~:;_m_,u.."~&~:::~'G
'~ . nam ,utherEstate ;
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.,....;->:"'".~~~-:";T.-:-~':"'_~,~.. . "K~'"''
. . . ._~
.' " .." L. SElTLEMENT CHARGES
00. I Based on Price $ 146,000.00 @ 6.0000 % 8,760.00 PAID FROM PAID FROM
LJIVISlon or vommlSSlon "09 (WJ as rollOWS: BORROWER'S SElLERS
IUI. 0 r<8IMax r<BaIlY _SOCIa....., nc. FUNDS AT FUNDS AT
IU... .. 4,4UO.W 10 nowaro rnonna "...weller SETTlEMENT SETTlEMENT
IU... l,;Ommlsslon ...ala a, ",etUemenl <r.76lT.OO
'04. I ransacDon ee 10 r<8IMaxruoany ASSOC. nc. ,,"".uu
800.
,801. Loan DrlglnaDon t"ee u.uuuu .,.. lU
802. Loan DIs.count or. to
ou... APpraiSal 1 ee 10 <:nK .on Kelsser "vv.uu
004. ..reon r<epoll lU "Dv vompaOles 14.90
llUo. Lenoers nspeCDon ee '0
llUo. Mortgage Ins. App. Fee to
llU'. l\SSumpuon ree lU
DUO.
OU9.
llU.
Ill'.
1112. I ax seMce t"ee ,0 Lere... Il.UU
,,... rlOOO U9leffillnauon lU rsll\lHencan rlooa uata servo '.OU
114. r'OOO Lone \LIJe Or Loan 10 rsl """,ncan rlooa ualll s-erv. ".OU
1 o. uocumem t reparauon ee 10 IWIn Munllage \,;OTpOfauon "uu.uu
1 D. unoerwnung ree 10 IWIn Mangag~raDon "UU.UU
1f. Insurance llaCKlng to Ll,; :;1901ng '.uu
DID. M<:r<" r<~ISlTauon ee lU M<:r<<> "."0
01".
O"U.
1900. IIRED D' LJ:;nllJ:;"
901. Interest From 02126105 to 03101/05 @ $ 21.150000 /day ( 1 days %) 21.15
,902. Mongage Insurance ....remlum 01 monDlS 10
, 903. Hazard nsurance Premium lor I.U years lO:;tate t"affil nsurance
,904.
!905.
1000.
1001. Hazard Insurance 3.000 monms 36.50 per monm 109.50
1002. MOrIIIage nsurance monms 42.71 per monm
1003. Gity/Town Taxes monms per monDl
1004.- CountY Taxes 2.000 monms 2ti.17 per monm 52.34
lUU5. scr 001 ax ...uuu monmS 104.62 per monm >l41.:X:
1WO. monUlS .. per monDl
1007. monDlS $ per month
1 UUll. Aggrega19 AOJuSlmen monDlS $ permonm -..4...
1100. TITLE
1101. SettlementarCloslng Fee to
11 U2. AOstract or 1109 :;earm 10
11U3. Title Examination 0
1104. -iUe nsurance tilnaer
1105. Document preparation 0
1106. Notary Fees 10 (;ASH 12.00 l;t.oo
11U/. Anorneys Fees (Deed Prep) 10 Snelbaker & tirenneman PUl;
(lnClU09S aDOve I 8m numoers. I
11 Ull. IIDe nsurance 10 I\evs ransIer, Lid. I,UOO.
(inc UdeS aDOve item numDers: j
llU9. Lenoers I.Alverage .. 1"',400.\1\1
, 111 u. uwne S l;Overage ~
,1111. t:noarsemems . VV,oNU,U. lU l\eyslUJItI Ld'1U ransl9r. LIO. ,"u.uu
11". lJlDSlng I"lOtecuon Leiter lU ""yslUlle Lano ransl9r, LIO. ..".uu
11113. lax KecelplS o l\eyslUlle Lano ransler;-l.lll; 2.UU
11114. uvemlgnt 10 l\eyslOllel:llilllTransTer. LIO. 14.UU
1:1.
110. ax l.AllUi lU ....pI..., "ellfOll Lano I rans er 3.UU
111. :;epDC InSp '" Keplars lU ...e..... ""pac seMce I.U.UU 931.tiT
1111.
1200.
1201. Recording Fees: Deed $ " -; 38.50; Mortgage $ 64.50; Releases $ 103.00
1.<U... vIIY/VOUn,V I a 1,4tlU.W; Monoage ,"CV.uu
1203. State TaXlStamps: Kevenue stamps 1,460.oo:-MOOQage r,;mr.oo
1204.
l"Uo. -
1300. ADDITIONAL 5ET I LI:Mt:N'
1301. Survey to
1302. Pest Inspection to
13U3. ome warranty to I\III9lIcan HOme Shield 4UO.UU
1304. ;too5 UlUnty ax . 10 Mary A. Murray, ax COllector 301.79
1305. I ransacuorv....lOC9SSIng t"ea ...~ '... 10 ,~ nna Delweiler . 125.00
1400. \I:nter on Lines 103, 5ect1on J and 502, Se qtIon 1\ O,4U".4'l 11,595.46
"1'__,......._ '_COPY"'_2"'~"'.~ m (/-fuLl r#v-
IJJ
no ransrer, LIO.
Certified to be a true copy.
Settlement Agent
(05062105062127 )
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