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HomeMy WebLinkAbout09-08-14 ••J REV-1500 EX (02-11)(FI) 1505610140 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 1 3 0 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 1 2 1 1 2 0 1 3 1 0 2 4 1 9 2 4 Decedent's Last Name Suffix Decedent's First Name MI W E S T F A L L , J R C H E S T E R C (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI G 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 r 2.Supplemental Return r 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) ® 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received F] 10. Spousal Poverty Credit(Date of Death F� 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 REO6TER OF IMILL,!LUPE ONLY ` CZ :X Q FIT rn First Line of Address ;:0 Ci 0 CD 4 1 4 B R I D G E S T R E E T rte- n r— v --r o 1-11 I,1 m co Second Line of Address City or Post Office State ZIP Code u.;> c DATE FIa_.,_�_� ..Ff -1 ru j:6 N E W C U M B E R L A N D P A 1 7 0 7 0 li -a cn cs m �-t Correspondent'se-mailaddress: 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 ail information of which preparer has any knowledge. SIGNATURE OF PERSON RE PONSIB FOR FILING RETURN DAT fin. . 9-� . . ADDRESS 7979 AN ERN VE ALNONT MI 48003 SIGNATUR F PFiEPA OT E HAN REPRESENTATIVE DATE ADDRESS 414 BRIDGE STREET NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 1505610240 REV-1500 EX(FI) RECAPITULATION 1. Real Estate(Schedule A) .. . ... . .. . .. . ... ... ... . . . .. . .. ... ... . .. . .. . 1 1 7 0 0 0 0 . 0 0 2. Stocks and Bonds(Schedule B) . .. . . . . . ... .. .. ... .. . 2. 1 9 7 3 8 7 . 7 5 1 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. 8 6 9 9 9 8 . 3 1 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested & 3 2 7 9 3 . 4 1 7. Inter-Vivos Transfers&Miscellaneous N Probate Property (Schedule G) t Separate Billing Requested . ... .. T 1 ? 0 1 ? 4 , 9 4 8. Total Gross Assets(total Lines I through 7) . . . . . ... . 8. 1 4 4 0 3 5 4 , 4 1 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 4 8 6 4 4 . 5 0 10. Debts of Decedent,Mortgage Liabilities, and Liens(Schedule 1) . . . 10, 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . 11. 4 8 6 4 4 . 5 0 12. Net Value of Estate(Line 8 minus Line 11) 12. 1 3 9 1 7 0 9 . 9 1 ,13, Charitable and Governmental Bequests/See 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 3 9 1 7 0 9 9 1 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. 11 . 0 0 16. Amount of Line 14 taxable at lineal rate x •0 4 5 1 3 7 9 4 9 4 5 6 16. 6 2 0 7 7 . 2 6 17. Amount of Line 14 taxable at sibling rate X.12 0 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.16 1 2 2 1 5 . 3 5 18. 1 8 2 2 . 3 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 6 3 9 0 9 - 5 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 13 1309 DECEDENT'S NAME CHESTER C• WESTFALL, JR STREET ADDRESS 817 THIRD STREET CITY STATE ZIP NEW CUMBERLAND PA 17070— Tax Payments and Credits: I. Tax Due(Page 2,Line 19) {i} 631909.56 2, Credits/Payments A.Prior Payments 52,000-00 B.Discount 2,736 -84 Total Credits(A+B) (2) 541736 .84 3. interest (3) 0. 00 4. it Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0. 00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 9,172 - 72 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 ...................................................................... ❑ MR b. retain the right to designate who shall use the property transferred or its income .............................I. ❑ c, retain a reversionary interest ..................................................................................................... ❑ d. receive the promise for life of either payments,benefits or rare? ....................................................... ❑ 2. If death occurred after December 12,1982.did decedent transfer property within one year of death without receiving adequate consideration? ................................................................._.................... 171 M 3. Did decedent own an'in trust for"or payable-upon-death bank account or security at his or her death? ......... © ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?........................................................................................._....... ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE 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 [72 P.S.§9116(a)(1.1)(fill.The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in p2 P.S.§9i%(a)(1))• • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. i REV-1502 EX+(12-12) pennsyluania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHESTER C . WESTFALL, JR 21 13 1309 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1 Property located at 817 Third St New Cumberland 170,000 .00 Cumberland County, PA sold to Robert E Kelly on April 11, 2014 TOTAL{Also enter on Line 1,Recapitulation.} $ 170,000-00 It more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER CHESTER C . WESTFALL, JR 21 13 1339 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 111 shares Hershey Creamery Company stock sold 194 ,805 .00 at $1,755.000 each (company is private and not on stock market 2 50 shares Met-Life Inc . stock a9 $51 . 655 each 2 ,582.75 I TOTAL(Also enter on Line 2,Recapitulation) $ 197,387-75 If more space is needed,insert additional sheets of the same size REV-1508 EX-(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: CHESTER C . WESTFALL, JR 21 13 1309 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2001 Buick Park Avenue at Kelley Blue book value 21725 . 00 2 Comonwealth of PA-refund on decedents 2013 PA40 350 .00 3 Cumberland County-refund 100 .00 4 Fulton Bank-Cert of Deposit #000-0386816 10,159.20 Princ $10,159 . 20 , Int $7 . 27 5 Fulton Bank-Cert of Deposit #000-0386816 - Accrued 7.27 6 Fulton Bank-Cert of Deposit #052-0361667 15,333. 45 Princ $15,333 . 45, Int $23 . 21 7 Fulton Bank-Cert of Deposit #052-0361667 - Accrued 23. 21 8 Fulton Bank-Checking Acct #3622-71612 11,601 .34 joint w/Virigina H Westfall (Spouse predeceased decede t) 9 Members 1st FCU-Cert of Deposit #29261-42 69,069 . 72 Princ $69,069.. 72, Int $11.35 10 Members 1st FCU-Cert of Deposit #29261-42 - Accrue 11 . 35 11 Members 1st FCU-Cert of Deposit #29261-43 331486.98 Princ $33, 486 . 98 , Int $5 . 05 12 Members 1st FCU-Cert of Deposit #29261-43 - Accrue 5.05 13 Members 1st FCU-Cert of Deposit #29261-46 20,067.09 Princ $20,067.09, Int $3 . 02 14 Members 1st FCU-Cert of Deposit #29261-46 - Accrue 3.02 15 Members 1st FCU-Cert of Deposit #29261-48 28,341 . 10 Princ $28,341.10, Int $4 .27 16 Members 1st FCU-Cert of Deposit #29261-48 - Accrue 4 . 27 TOTAL(Also enter on Line 5, Recapitulation) $ 869,998 - 31 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent CHESTER C,VVESTFALL,3R 21 13 1309 Decedent's Name Page t File Number Schedule E -Cash, Bank Deposits,& Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 Members 1st FCU-Cert of Deposit #29261-49 300,661 . 18 Princ $300 ,661 . 18, Int $110 . 38 18 Members 1st FCU-Cert of Deposit #29261-49 - Accrue 110.38 19 Members 1st FCU-Cert of Deposit #29261-50 100,106 .87 Princ 5100,106 . 87, Int 517 . 83 20 Members 1st FCU-Cert of Deposit #29261-50 - Accrue 17.83 21 Members 1st FCU-Cert of Deposit #29261-59 63,603.80 Princ $63,603 . 80, Int $17. 43 22 Members 1st FCU-Cert of Deposit #29261-59 - Accrue 17. 43 23 Members 1st FCU-Cert of Deposit #29261-60 100,150 .74 Print $100,150.74, Int $27. 44 24 Members 1st FCU-Cert of Deposit #29261-60 - Accrue 27 . 44 25 Members 1st FCU-Cert of Deposit #29261-61 6,895. 14 Princ $6,895.14, Int $1.89 26 Members 1st FCU-Cert of Deposit #29261-61 - Accrue 1 . 89 27 Members 1st FCU-Cert of Deposit #29261-62 64,173.55 Princ $64 ,173 . 55, Int $17 . 58 28 Members 1st FCU-Cert of Deposit #29261-62 - Accrue 17.58 29 Members 1st FCU-Savings Acct #29261-00 391753.76 Princ $39,753 - 76 , Int 51 . 63 30 Members 1st FCU-Savings Acct #29261-00 - Accrued I 1.63 31 PA Media-newspaper refund 74 .00 SUBTOTAL SCHEDULE E 6751613 - 22 Continuation of REV-1500 Inheritance Tax Return Resident Decedent CHESTER C.VVESTFALL,_JR 21 13 1309 Decedent's Name Page 2 File Number Schedule E -Gash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 32 PAWC-refund on water bill 19 . 51 33 Personal property sold by Cordier Auctions 477-04 at various times 34 Principal Financial Group-pension received 1,943.71 on Virginia ' s pension 35 USSR-homeowners insurance refund 187-43 36 USSA-refund on Mastercard 189-09 37 USSA-refunds 174 -03 38 Verizon-refund due 106. 23 SUBTOTAL SCHEDULE E 3,097-04 GRAND TOTAL SCHEDULE E $ 889,998.31 REV-1509 EX+(01-:0) pennsylvania SCHEDULE F DEPARTMENT OE REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHESTER C. WESTFALL, JR 21 13 1309 If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule 0. SURVIVING JOINT TENANT($)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. JEAN M - GROSS ?9?9 LANTERN DRIVE Daughter ALMONT, MI 48003- B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 - A- 8114/12 PNC Bank-Checking Acct #5140068018 65,586 . 82 50 - 32,793. 41 joint w/dean M . Gross dtd 8-14-12 Princ $65,586 ?1, Int $ - 11 $65,586.82 divided by 2 0 . 00 TOTAL(Also enter on Line 6, Recapitulation) $ 3 2,?9 3-41 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 FILE NUMBER CHESTER C . WESTFALL, JR 21 13 1309 This schedule must be completed and filed if the answerto any of questions 1 through 4 on page three of the REV-1500 is yes, DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % 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 PNC Bank-Cert of Dep #31100369175 84,981 . 58 100 . 00 84 ,981. 58 w/Jean M . Gross as POD dtd 11-15-12 Princ $84,957 . 15, Int $24 . 43 2 PNC Bank-Cert of Dep #31400329933 731129 . 96 100 . 00 731129 . 96 w/Jean M . Gross as POD dtd 11-15-12 Princ $73,127 . 55, Int $2 . 41 3 PNC Bank-Cert of Dep #31700295160 12 ,063 . 40 100 . 00 121063 . 40 w/Jean M . Gross as POD dtd 11-15-12 Princ $12,063 . 16, Int $ • 24 TOTAL (Also enter on Line 7,Recapitulation) $ 170,174 . 94 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX*(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER CHESTER C. WESTFALL , JR 21 13 1309 Decedents debts mast be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1 Parthemore Funeral Home-funeral expenses 3,085.28 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representativets) Street Address City State ZIP Yearts)Commission Paid: 2 . AftorneyFees: David H Stone, Esquire 15,000 . 00 3. Family Exemption:(if decedents address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4 . Probate Fees: See #7 below 5. Accountant Fees: 6 - Tax Return Preparer Fees: 1 PNC Bank-check order fee 5.00 2 PNC Bank-check printing fee 5.00 3 PNC Bank-check images in statement fee 3 . 00 4 PNC Bank-check printing fee 13 . 73 5 US Treasury-taxes due on dec 2013 1040A 724 .00 6 Register of Wills-additional short certificates 30. 00 7 Register of Wills-probate costs 933 . 50 8 Tania Duncan-Reimb for airplane tickets 11000 .00 9 Rita-Reimb for supplies (shredder etc) 50 .00 10 Jean Gross-Reimb for gas and house sitting 300 . 00 11 Jean Gross-Reimb for gas, tolls and cat sitting 250.00 12 WC Eshenaur & Son-fuel oil for property 194 .89 TOTAL(Also enter on Line 9,Recapitulation) $ 48,644 -50 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent CHESTER C.WESTFALL,JR 21 13 1309 Decedents Name Page 3 Fite Number Schedule H -Funeral Expenses&Administrative Costs-137. ITEM NUMBER DESCRIPTION AMOUNT 13 Jean Gross-Reimb for moving expenses 2,374 . 02 14 Jean Gross-Reimb for travel expenses 396.05 15 Jean Gross-Reimb for pet/house sitting 100.00 16 Jean Gross-Reimb for travil expenses 508 .15 17 Stone LaFaver & Shekletski-adv in Cumb Law 75.00 18 Stone LaFaver & Shekletski-Reimb on Sentinel adv 190.54 19 Stone LaFaver & Shekletski-Reimb on fedex 20 . 00 20 New Cumberland Boro-sewer and trash at property 115.24 21 Check written by decedent prior to death 21.50 22 USAA Savings Bank-reimb of check issued 432. 37 23 WC Eshenaur & Son-oil for property 250 . 04 24 Jean Gross-Reimb for postage and traveling exp 582 . 05 25 WC Eshenaur & Son-oil for property 316 . 03 26 Jean Gross-Reimb for overnight postage 19 . 99 27 Jean Gross-toll fees from 12-15-13 33.10 28 Jean Gross-Reimb for supplies 47 .69 29 Jean Gross-Reimb for postage for prop settlmt 5 .75 30 B&B Crassy Cars-battery and service on auto 162.84 31 Don Russell-snow removal at property 60.00 32 Don Russell-snow removal at property 100 . 00 33 Don Russell-snow removal at property 80 .00 34 Don Russell-snow removal and help at property 180 .00 35 Alpine Tree-tree removal from storm 150 . 00 36 Don Russell-snow removal and help at property 200 . 00 37 Don Russell-snow removal at property 160 .00 38 Don Russell-snow removal at property 160 . 00 39 Selling costs ($19148 . 39) less reimb ($1156 .15) 17,992 . 15 40 Verizon-service at property 133.81 41 PPL-electric service at property 146. 63 42 PAWC-Water service at property 36 . 17 43 PPL-electric service at property 149 .28 44 PAWC-Water service at property 36 .13 45 PAWC-Water service at property 30 . 00 46 Verizon-service at property 132. 75 47 PPL-electric at property 143 .29 48 PAWC-water service at property 41 .11 49 Verizon-service at property 133. 97 50 PPL-electric service at property 156.69 51 PPL-electric at property 81 .03 52 PPL-final electric at property 13 .78 53 PAWC-final water service at property 42.95 54 Stone LaFaver & Shekletski-Reimb for fedex charges 40. 00 55 Reserve for closing expenses 11000 . 00 SUBTOTAL SCHEDULEH-B7 27,050 . 10 REV-1513 EX+(01-10) pennsyivania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHESTER C . WESTFALL, JR 21 13 1309 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions and transfers under Sea 9116(a)(1,2).1 1• JEAN M GROSS Sch G and 33% of res Lineal 573,281. 48 7979 LANTERN DRIVE ALMONT MI 48003- 2 LINDA RENEE SILKOWSKI 33% of res Lineal 403,106 . 54 511 RUTLEDGE DRIVE HOLLY MI 48442- 3 TANIA M DUNCAN 33% of res Lineal 403,106 . 54 1603 HOWELL MTN ROAD ANGWIN CA 94508- 4 VIRGINIA CARL-SMITH 1/7 of 1% of res Collateral 1,745.05 1809 ALYSSA LANE POTTSTOWN PA 19465- 5 FRED CARL 1/7 of 1% of res Collateral 1,745.05 48 GALLANT FOX DRIVE MEDIA PA 19063- 6 MARGARET CURTIS 1/7 of 1% of res Collateral 1,745.05 610 WYNDAM CIRCLE KELLER TX 76248- 7 CATHERINE JACKSON 1/7 of 1% of res Collateral 1,745.05 19251 SPANISH NEEDLE DRIVE HOUSTON TX 77084- 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional streets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent CHESTER C.WESTFALL,JR 21 13 1309 Decedent's Name Page 4 Fite Number Schedule J -Beneficiaries-1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributors and transfers under Sec.9116(a)(1.2).) 8 DAVID LASEK 1/7 of 1% of res Collateral 11745.05 822 CHAPEL ROAD ROYERSFORD PA 19468- 9 EDWARD LASEK 1/? of 1% of res Collateral 11745.05 140 ERDENHEIM ROAD ERDENHEIM PA 19038- 10 VIRGINIA KRAFT 1/7 of 12 of res Collateral 1,745 . 05 4114 ISLAND TERRACE COURT FLORISSANT MO 63034- Z:\EP\WILLS,Westfall.Jr.Chester.wpd LAST WILL AND TESTAMENT OF CHESTER C. WESTFALL, JR. I, CHESTER C. WESTFALL, JR. , of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last w 11 and revoke any will previously made by me . 11EM I : I direct that my Executrix hereinafter named shall Ipay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. I ITEM II : I devise and bequeath the residue of my estate, of every nature and wherever situate, as follows : A. Thirty-three (33%) percent to my daughter, JEAN M. GROSS, if living, or in default thereof, to her issue, per stirpes . i B . Thirty-three (33°s) percent to my daughter, LINDA i RENEE SILKOWSKI, if living, or in default thereof, to her issue, per stlrpes . I C . Thirty-three (33%) percent to my daughter, TANIA I M. DUNC:AN, if living, or in default thereof, to her issue, per stirpe,: . D. One ( 1% ) percent to the following named nieces and � I nephew-, , who survive me, VIRGINIA CARL, FRED CARL, MARGARET i CURTIS, CATHERINE JACKSON, DAVID LASEK, EDWARD LASEK and VIRGINIA KRAFT. I Page 1 of 3 ITEM III : I appoint my Executrix and her 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 appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possib-le to the minor or 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 ti.. to his or her parent ' s ability to provide for such support and education, or to make payment for these purposes, without further respon:.ibility, to the minor or to the minor ' s parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, JEAN M. GROSS, Executrix of this my last will. I^;EM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his or her duties in any jurisdiction. IN WITNESS WHEREOF, I, CHESTER C . WESTFALL, JR. , have hereunto set my hand and seal this day of 2012 . l I CHESTER C. WESTFAL JR.-',,/ Page 2 of 3 SIGNED, SEALED, PUBLISHED and DECLARED by CHESTER C . WESTFA .L, JR. , the Testator above named, as and for his Last Will and Testament, and in the presence of us, who at his request, in his presence and in the presence of each other, have subscribed our names a wi nesses . 414 Bridge St . , New Cumberland PA Wig Address 414 Bridge St . , New Cumberland PA Witness Address I Page 3 of 3 ZARE\DEMW estfall.Chester to Kelly. Robert-817 Third St. Tax Parcel#:25-25 4)008-097 Address:817 Third St. New Cumberland,Pa 17070 DEED nI/ THIS INDENTURE made the v? day of in the year 2014, between JEAN M. GROSS, Executrix of the Last Will and Testament of CHESTER C. WESTFALL, JR., late of the Borough of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, - AND- ROBERT E. KELLY, of the second part, hereinafter called the Grantee; WHEREAS, the said CHESTER C. WESTFALL, JR. became in his lifetime seised, as of fee, of and in a certain tract of land, together with the improvements thereon erected, situate in the Borough of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on December 11, 2013, having first made his Last Will and Testament in writing dated August 16, 2012, duly probated and registered in the Office of the Register of Wills of Cumberland County on December 19, 2013, wherein and whereby he appointed as Executrix, the said JEAN M. GROSS, to whom Letters Testamentary were duly issued by said Register of Wills on December 11, 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: NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED SEVENTY AND 00/100------($170,000.00) --------Dollars, which has been paid to they by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and continued, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN piece or parcel of land situate in the Borough of New Cumberland, County of Cumberland and State of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point at the northeast intersection of Third Street and Poplar Avenue; thence in a Northerly direction along the eastern line of Poplar Avenue One Hundred Fifty-Nine (159) feet, more or less, to River Avenue; thence in an Easterly direction along the southern line of River Avenue, Forty-one (41) feet, more or less, to line of Lot No. 12 on the hereinafter mentioned Plan of Lots; thence in a Southerly direction along line of Lot No. 12, One Hundred Forty (140) feet to Third Street; thence in a Westerly direction along the northern line of Third Street; One Hundred Eighteen (118) feet, more or less, to the Place of BEGINNING. ylV BEING Lot No. 13, Block "FF" on Buttorffs Second Addition to New Cumberland, which Plan is recorded in the Cumberland County Recorder's Office in Plan Book "N", Volume 5, Page 498. HAVING THEREON ERECTED a dwelling house known and numbered as 817 Third Street. BEING the same premises which Helen B. Mc Aneny and Robert J. Mc Aneny, her husband, by Deed dated September 3, 1968 and recorded September 4, 1968, in the Office of the Recorder of Deeds of Cumberland County in Deed Book X22, Page 625, granted and conveyed unto Chester C. Westfall, Jr. and Virginia H. Westfall, his wife. The said Virginia H. Westfall died on August 3, 2012, thus by operation of law vesting title in Chester C. Westfall, Jr., 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 him, the said CHESTER C. WESTFALL, JR., at and immediately before the time of his decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot 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 Grantee, to and for the only proper use and behoof of the said Grantee, forever. AND the said Grantor, for herself and her respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, that she, 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. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above written. Signed, Sealed, and Delivered in theePresen e of c ��( ih 'Laa� rn . CXGa-a� (SEAL) Witness : JEAN M. GROSS, Execu 'x of the Last Will :a estament of CHE R C. WESTFALL,JR. V2v STATE OF SS: COUNTY OF Lc�Y Q� On this, the a day of AQ,f ` 2014, before me a Notary Public, the undersigned officer, personally appeared JEAN M. GROSS, Executrix of the Last Will and Testament of CHESTER C. WESTFALL, JR., known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. ERIN E. Notary Public,Lapeer peer County,MI Acting in Lapeer County My Commission Expires March 13,2015 Notary Public �- I hereby certify that the precise address of the Grantee is DATE: Attorney for V3- HERSHEY CREAMERY COMPANY June 19, 2013 Mr. Chester C. Westfall, Jr. 817 Third Street New Cumberland, PA 17070 Dear Chet: Thank you for sending me the last certificate. Enclosed is your new certificate number .5570 for 1 1 1 shares registered in your name: It was really great to see you last week, you look wonderful. Take care of yourself and enjoy your summer. If you have any questions please don't hesitate to call me. Sincerely, Hershey Creamery Company • r Linda L. Rittel Assistant Secretary Enclosure 301 S. CAMERON STREET HARRISBURG, PA 17101 PHONE: 717-238-8134. FAX: 717-233-7195 h '® ,f _`� N IIIIIII!I I I IIII 11 4 II�IPIIII Illllll I' II!' I (IIII N X� I I 5 t •1 � IIII I Illllll I III IjII(I IIj 1111 p II I'I ''l IjIII IIII)I L � O '� ' Y III IIII IIII IIIIII I IIj III I I O � W {�. 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Page 1 of 1 r" Pa l Enter Syntbcls or Kaywortls SEARCH _ Charts' JildmNa Met Basic Chart Advanced Chart Interactive Chart ..r Home Circles Naws , Induswes Markets Higarkal Oslotns BlgReports Taia Hismnral Ouotes lool avows you to look up a sepualys oken damp price. Starry type in the symbol and a hill data to Al a al le aria minl titan for(hat security. Enter SymboP. Met Enter Oate' 12/11/13 � MetLifo Inc. Wort Dec n,2013 cmatw n c. 51.43 n. 51.80 corn 52.02 51.29 5,881,]]3 No Splits Warren Buffett Confesses Warren Buffeds Shocking Confession WII Change your Investing Strategy ww,v.Ms,WT,nMSIOnal,- New Rule in PENNSYLVANIA: (DEC 2013):If You Pay For Car Insurance You Must Read This immediately cocoa Conv�mm PlnenoeOSey tom (1200%)Stock? If This$0.50 Stock Hits$6.00,$10,000 Will Become$120,000.See How. 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"99S , . ,1 ` 'Ob203DD390D2Q93=.pD1. . `; - t ... .... ... . _ ..r t1G4C454K.8142696.9 '{F 1 VEHICLE IDEN Mlml NUMBER I VAR � B�U!'GK = 5641b239301: NE I 11RE NUMBER . ._• Yp' BDDY1TYPET''{' glPa, I(� 9EATRCA}P PRgF NTlE8I�TE •l ODDAf FROCD DAT6: ODDM.MMES I^. .ODOM BiNTU9 "1 OATS DF ISSUE ( UNLADEN WEIGHT• �. ••:' GVWR I" __ _: '. ,_ . •. . TIRE BRANDS -;.. I ,� L! , F 0•ACTIMI Vt�A�02B RAT19 i:�; As i I.UMEEAGB EKCEEW THE MEDINKa.1L �. - ��_, . 'f� F ♦. +�,f'\- � j .. 2•NOT THE ACTWUMKEADB 7' V 1.NJT THp ACfUK MEFMELpCMETEP'I � l"'�p'• c ..EMe.Pr FRONre"B'000 EIeB Olxiosu`aB fiEOtsTVtEDOWNERfSf-..rA A.ANr1GIIIVENI�G6�. r CHESTER' C"WESTFAL. °�-;%E rdr`nft jnB qfT�,� _ _F \ L 'D:OBT.WAILT MT®:fON APPYCT{.. VIRGINI:ASH'" NESTFALIt�i �w +"' A D WBUgNl I s d t i N.AOmaaltmALvENmE'; 817 •THIRO• ST DDDeavENGE. �. . P.eNMAPDMCaVEBGE NNN�N>CUMBERl:ANDrPA'•17070" ' . � � T.REDDVEaED THEFT VE1110.E - �.._ � '.A �. - _ a �.rENK1E DDNTAwS REL441RL VIN- ' : W.FLDDp VEMklE 'FIRST_UEM FAVOR OR= _i..y,,t • SECOND LIEN FAVOR OF. x,"MAIM i 1' it I .lows son M INNO Boom stall a ee•ISM dM1 de NEI T f dBhIIdM mMq IorE•eN ell SEE W de '. W MMO(VIhkWil ae I FIFISI UEN REIEASFd' F w rowmlaM roAn NI. A E: .: BV SECOND UEN RELEASED . ".AUTHDR47=O REPAESEMARVE DATE - _MAILINGADORESSP, �- BY v' AGTHORIgD REPRE9ENTAT CHESTER"C': WESTFALL JR , & ' VIRGINIA'• H-WESTFALL ' 817:'iTW9R0-ST'*,r NEWiCUM9ERCANO PA 17070 I wOel EE oI ve de a I.Re, nw WoaM�xae.W BIB PemPoN OBBEroBMa �- BRADi?EIY.f'l: XAL'4DRT' IIISSS a TrEnmommolrtMEa dm:ml wMnu M oOnomry wma BIIIEI.Ie ev B.h. . ditwd vWaa.. sm"atTT d TEEngFrfEuNE APPROMATIT SECTIONS ON i` _. Z. APPLICATION FOR TITLE ANO LIEN,INFORMATION' 10 BE COMPLETE. 01 EVBSCRmEO ANO SV/Oid.' r If a co-purthaem Whm than yaR spouse I9 listed aM yoo want the title to l a; fO BEFORE ME;- - r „ be listed o•'Jdm Tenema WIN RISM of SUndvorehip'(On OBeth of one F owt .this goes W au mg o .)CHECK HERE O.OlhonElne.the tale' p t WIl be Issued BE'Bnmda IN Common•fen ddalh of one-o«ner.IMON at of F r• I deceased owner goeE to hisbe,halt or Offers).: . �i wrbtUw OT KpeGx.Awor[vwenw UEN DAIS -�•IF NO USN,CHEG("- ❑ , f ' - 19T 11ENHOLpEN .�+ :;K,ka,1N'.PRFSEt:"" srREEr'. . Gtt STATE LP t, f I FINANCIAL INSTIM NUMBER - 2tAI UEN DATE: IF NO UEN.CHECK NNIN IN umes a rE. a M1 ..b. wwM /�� 4w..blitlbM1Ae�s�lw�bpA b.�.m bm�.n 2ND llENHDIDER VA _ 1 STREET co 11 $Ip OIFGaEArnrwvronwrNmasDWENE. - GN STATE LP �[ E s . . Sb1I.rVBE OrooArnv+Prmu:as EVrNwnxevMME IFINANGAL IN9TINt10N NUMBER Rdtm Bank LISTENING IS JUST THE BEGINNING! January 6, 2014 Stone LaFaver& Shekletski 414 Bridge St PO Box E New Cumberland PA 17070 Dear Mr. Stone, RE: Chester C Westfall Jr, deceased 12/11/2013 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking#3622-71612, opened 12/13/04, date of death balance $11601.34, (accrued interest of.89 would not have been payable had the account been closed on the date of death) titled jointly always with Virginia H Westfall. DATE OF DEATH ACC CD# BALANCE INT RATE OPEN ROLL OVER MATURITY 000-0386816 10159.20 7.27 30 9/16/13 N/A 9/16/14 (titled in his name alone) 052-0361667 15333.45 23.21 .30 5110110 6/11/13 6/13/14 (titled in his name alone) If you should have any further questions, please do not hesitate to contact me at 717-327-2497. I Very truly yours, This information is furnished as a matter of business in answer to your inquiry, and Is frr your umfidential use. Ip The bank iurNShlog This imormr.-tion dos net reprascn: .'r guarantee tho accuilcy, comp!'stencas c'. .J;:n[.i'i1. " April Billett Information r „ Credit Confirmation Processor bank or any m iis )*'il s .. :IS: ,.:'y herein expressed is sur3uct :u cn ;;.c e.'ithOut 1.800.FULTON.4 • fultonbank.com Fulton Bank,N.A.Member FDIC. Member of the Fulton Financial Family 2014/01 /23 12:08:47 2 /3 St MEMBERS 1`1 aIDeMLMMMUMON REGULAR SAVINGS ACCOUNT: Account Number/Suffix 29261-00 Date Account Established 01/22/1982 Principal Balance at Date of Death $39,753.76 Accrued Interest to Date of Death $1.63 Total Principal and Accrued Interest $39,755.39 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 29261.42* 29261-43** Date Account Established 04/26/2013 06/1712013 Principal Balance at Date of Death $69,069.72 $33,486.98 Accrued Interest to Date of Death $11.35 $5.05 Total Principal and Accrued Interest $69,081.07 $33,492.03 Name of Joint Owner None None *Rollover from CD 29261-45 opened 01/24/2012. **Rollover from CD 29261-70 opened 11/15/2011. CERTIFICATE OF DEPOSIT: Account Number/Suffix 2926146* 29261-48** Date Account Established 07108/2013 07108/2013 Principal Balance at Date of Death $20,067.09 $28,341.10 Accrued interest to Date of Death $3.02 $4.27 Total Principal and Accrued Interest $20,070.11 $28,34537 Name of Joint Owner None None *Rollover from CD 29261-90 opened 12108/2011. **Rollover from CD 29261-71 opened 12/0512011. MEMBERS 1'FIEDEJRAL Cj2EDIT UNION j �_ Tessa L Klugh Lending Insurance Support Specialist January 15, 2014 i Estate of: CHESTER C.WESTFALL JR. Date of Death: 12/11/2013 Social Security Number: 219-12.2619 'II 5000 Louise Drive P.O.Box 40 Mechanicsburg,Pennsylvania 17055 (800) 283-2328 www.memberslst.org 2014/01 /23 12:08:47 3 /3 St i MEMBERS 19 PODBMLCABDIT UNION I CERTIFICATE OF DEPOSIT: Account Number/Suffix 29261.49 29261-50 Date Account Established 10/02/2013 10/02/2013 Principal Balance at Date of Death $300,661.16 $100,106.87 Accrued Interest to Date of Death $110.38 $17.83 Total Principal and Accrued Interest $300,771.56 $100,124.70 Name of Joint Owner None None CERTIFICATE OF DEPOSIT: Account Number/Suffix 29281-59• 29261-60 Date Account Established 01/06/2013 10/07/2013 Principal Balance at Date of Death $63,603.80 $100,150.74 Accrued Interest to Date of Death $17.43 $27.44 Total Principal and Accrued Interest $63,621.23 $100,178.18 Name of Joint Owner None None *Rollover from CD 29261-57 opened 10/14/2011. CERTIFICATE OF DEPOSIT: Account Number/Suffix 29261-61• 29261-62•• Date Account Established 11/01/2013 01/16/2013 Principal Balance at Date of Death $6,895.14 $64,173.55 Accrued Interest to Date of Death $1.89 $17.58 Total Principal and Accrued Interest $6,897.03 $64,191.13 Name of Joint Owner None None `Rollover from CD 29261-58 opened 04/02/2012. "Rollover from CD 29261-56 opened 10/1412011. MEMBERS 1 S FEDERAL CREDIT UNION Tessa L Klugh Lending Insurance Support Specialist January 15, 2014 Estate of: CHESTER C.WESTFALL JR. Date of Death: 12/1112013 Social Security Number: 219-12-2619 I i - I i i 5000 Louise Drive P.O. Box 40 Mechanicsburg,Pennsylvania 17055 (800) 283-2328 www.memberslst.org Aug. u' 2014 9: 0 5AM PNC Bank No, 9622 P. 1 I i P C August 5, 2014 Stone, Lafaver& Shekletski Attorneys at Law David H Stone Esq 414 Bridge St PO Box E New Cumberland, PA 17070 RE: Name: Chester C Westfall Jr SSN: 219-12-2619 DOD: 12-11-2013 Dear Mr. Stone: 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#31700295160 CHESTER C WESTFALLJR POD Established: 11-15-2012 JEAN DOD balance: $12,063.16+ 0.24 accrued interest n GROSS Interest paid 01-01-2013 thru 12-11-2013 $54.25 YTD Account#31400329933 CHESTER C WESTFALL JR POD Established: 11-15-2012 JEAN M DOD balance: $73,127.55 +2.41 accrued interest GROSS Interest paid 01-01-2013 thru 12-11-2013 $314.21 YTD Account#31100369175 CHESTER C WESTFALLJR POD Established: 11-15-2012 DOD balance: $84,957.15 +24.43 accrued in erlest GRO55 Interest paid 01-01-2013 thru 12-11-2013$0.00 yTD i i f t Page 1 of 2 �� t Aug. ,6� 2014 9 : 05AM PNC Bank No. 9622 P. 2 Checking Account Account#5140068018 Established: 08-14-2012 CHESTER C WESTFALLJR JEAN M GROSS DOD balance: $65,586.71 +0.11 accrued interest Interest paid 01-01-2013 thru 12-11-2013 $7.53 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 This 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 exempt from 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 notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this foxed document. Page 2 of 2 ' A. Settlement Statement {HUD FINAL B.Type of Loan 1.❑FHA 2.❑RHS 3.Q Cone.Untee, 6.File Number: 7.Loan Number: S.Mortgage Insurance Case Number: 144403GC 1351411351 4.❑VA 5,©Conw.Ins. C.Note:This form is furnished to give you a statement of actual Settlement caste.Amounts paid to and by the settlement agents are Shown Items marked '(P.o.c)'were paid outside the dosing;they are shown here for informational purposes and am net included In the totals. D.Name&Address of Borrower: E.Name&Address of Seiler: F.Name&Address of lender. Robed E.Kelly Jean W Gross,Exeoutnx d the Estate of Chester United Wholesale Mortgage 7114th St.,New Cumberland,PA 17070 Weslall,Jr. 1414 East Maple Rd,Troy,MI 48083 G.Property Location: H.Settlement Agent: I.Settlement Date:0411 V2014 817 3rd St. Guardian Transfer Corporation Disbursement Date:04/1 V2014 New Cumberland,PA 17070 4075 Market SL.Camp Hill,PA 17011 New Cumberland Borough 717-9094700 Place of Settlement: TileExpress 4075 Market Sired.Camp Hill,PA 17011 Printed 0 411 012 01 4 at 2:21 pm by SLG 100.. Gross Amount Due from Borrower 400. Gross Amount Duo to Seller 101. Contrad sales prlce 17 ,000.00 401. Cientrad 170,000.00 102. Personal oropedy 4024 Personal property _ 103. Settlement charges to boroxar(line 1400) 6,646.20 403, 104. 404. 105, 405, Adjustments for Rom pW by eellorm sdvenoe AdIntmones for items paid by selerin advance 106. CltyBean taxes to 406, CityAown taxes to 107. County taxes 0411112014 to 12512014 803.89 407. County tomes WI 112014 to 12131/2014 803.89 108. Schad taxes 04111,7014 to 081'=14 35235 408. School fates 041112014 to ON302014 352.35 109. 409. 110. 410, 111. 411, 112. 412 120. Greta Amount Duo from Borrower 177.804.44 42A Gross Amount Due to Seller 171,156.24 200. Amounts Paid by or In Behalf of Borrower 500: Reductions In Amount Duo to Seller 201. Deposit or earnest money 2,00000 501. Excess deposit less instructions) 202 Priwod amount of new Inertia) 161,SWO 502. Settlement oe%"to set*ON 1400) 14,035.73 203. Existing m s taken suded to 503. Esisli a taken subktMo 204. 504. Payoff of first atortgage ban 205. 505. Payoff of second mortgage roan 206. Sellers Assistance 5,100.00 506. Sellers Assistance 5,100.00 207. W. 2D8. 508. 209. 509, Ad ustments fm ttema unpaid seen Ad usbnento for items unpaid b stow 210. C8yA0an razes 10 5 D C.4.lazes to 211. County taxes to 511. County taxes to 212. School taxes to 512. School taxes to 213. 513. 214_ Sewer 0410112014 to 0411111014 842 514. Seger 0410101419 041112014 842 215. Refuse 041012014 to 041112014 424 515, Refuse 04/01/2014 to 0411172014 4.24 216. 516. 217. 517, 216 518. 219. 519. 220. Total Paid byftr Borrower 168,612.68 520. Total Reduction Amount Due Seller 19,148.39 300. Cash at Settlement fromho Borrower 600. Cash at Settlement telrom Seller 301. Gross amount due Dan bony (Orre 120) 177,804.44 601. Gross amxxalt due to selle Dhe420) 171,15624 i 302 Less amounts paid byttor bommarr litre 220) 168bt2.66 602. Less reductions in amount due seller pure 520{ 19,148.39 303. Cash ❑X From ❑ To Borrower 9,191.78 603. Cash ® To ❑ From Seller 152,007.85 uam. na R J,9GPrice t70�ao0.{@ (COS-6 k 14148,31 CT5 I 1 5614 Page 1 of 4 HUD•1 .:1-4ayr1 edc r t�t,49�2 .15 700.. Total Real Estate Broker Fees $10,750.00 - Paid From,. Paid From Division of commission tlne700 as follows. Borrower's. Seller's 701. $5450.00 toColdwau Barlow Homestead Group Funds at Fundsat 702. $5300,00 to Coldwell8anker Homestead Group Settlement Settlement 703. Commission paid at settlement 200.00 10.550,00 800. items Payable In Connection with Loan 801. Our origination charge (Includes Origination Point 0.W0%or$0.00) $3,561.00 (from GFE 111) 802. Your credit or charge(points)for the specific interest rate chosen $-2,666.30 (tram GFE#2) 803. Your adjusted origination charges (from GFE A) 894,64 804. Appraisal fee to Class Appraisal $475.00 P.O.C.B (tram GFE#3) 805. Credit report to from GFE 93 806. Tax service to tram GFE 113 807. Flood certification to Corer is Flood Services (tram GFE#3) 12.00 808. 3rd parry processing fee to Turnkey Processing,LLC (from GFE#3) 395.00 900. Items Resolved hir Lenderto be Paid in Advance 901 Daily interest charges from from 0411112014 to 05m/2014(@$20.46401day (from GFE#10) 40918 902. Mortgage insurance premium fa monthsro (ram GFE#3) 903. Homeowner's insurance fat years to Mutual Benefits $682.00 P.O.C.B (tram GFE#11) 904. months to from GFE#11 1000, Reserve Reseries Deposited 1001. Initial deposit for your escrow aoxunt (from GFE 99) 1,306.28 1002.Homeowners insurance 4 months 0$ 56.83/month $227.32 to United Wholesale Mortgage 1003.Mortgage insurance months Q$ 0.00/month $ to United Wholesale Mortgage 1004.Property taxes months A$ 0.001monm S to United Wholesale Mortgage 1005.County taxes 3 months P$ 92.271month $276.81 to United Wholesale Mortgage 1006,School Was 11 months A$ 132.311monm $1.455.41 to United Wholesale Mortgage 1007.Aggregate Adrystmenl S-M.26 to United Wholesale Mat e 1100.Title Charges 1101. Title services and lenders title Insurance 8 from GFE 94 1,535.00 10.00 1102. Settlement or closing fee to $ 1103.Owners title insurance-First American Title Insurance Company $ from GFE 95 40.00 1104. Lenders title insurance-First American Title lnsurenca Company $1,210.00 1105. Lenders title policy limit$161,500.00 Lenders Policy 1106. Owners title polity limit$170,000.00 Owners Polley 1107. Agent's potion of the total fire insurance premium $1,062.50 to Guardian Transfer Corporation 1108. Underwriters patron of the total title insurance premium $187.50 to First American Title Insurance Company 1109. 100 No Vioftl00 to First American Title $5000 Insurance Company 1110. 300 Survey= to First American Title $50.00 Insurance Company 1111.900 EPL-Res18.1 to First American Title $50.00 Insurance Company 1112. ClosingSvcLIdCL to First American Title $75.00 Insurance Company 1200.Government Recording and Transfer Charges 1201.Government recording charges $ (from GFE#7) 156.00 1202. Deed$67.00 Mortgage$89.00 Release S to Simialfifile 1203. Transfer taxes $ (from GFE#8) 171)(100 1204. City/County taostamps Deed$1,700.00 Mortgage$ to Simplifies 1205, Slate Taxistampe Deed$1700.00 Mortgage S to Sim lifile 1.70070 1206. Deed S Mod $ to 1207. $ to 1300.Additional settlement Charges 1301.Required services that you can shop fa (from GFE#6) 1302. 2014 Countyrlwp Taxes Due to Robin Gasperetti 7085.0 1303, Home Warranty to First American Home Buyers Pnowlon 365.00 1304. Sewer for Jan/FeblMarch,2014 to New Cumberland Borough Office 7664 1305. Electrical Repair to W.S.Carey Electric 1280 1306. Painting Services to Jahn Clemmer Professional Home Painting Se 120.00 6,648.20 T 14,035.73 'Paid outside of closing by(B)onwier,(S)eller,(L)ender,(i)nvesla,Bro(K)er.-Credit by lender shown on page 1.-Credit by seller shown on page 1. Previous eddions are obsolete Page 2 of 4 HUD-1 Comparison of Good Faith E%Umm GF and IlUD61 Charges."-- -- Good Faith Estfma% HUD•1 Charges That Cannot increase- -w- HUD•1 Una Number , Our Origination charge, . 0.out-. 3,561.00 3.561.00 Yom credit a charge(points)for the specific interest rate chosen #,802,; -. Ini s -2.666.36 -2.666.36 Yomadpsledogglaticndrages - d 803. 894.64 894.64 Transferlues 1203 - 1700.00 1700.00 Charges That M Total Cannot Incressa Mon Than l0%"-": - . v I Good Faith Eagnam HUD•1 Govemunrntrecordkg dlalges'-... •�+ - 'd 1201 :' - 175.00 156.00 Appraisal fee. , a. • - ;r• d 1104 475.00 475.00 Flood ceNfxatlon y4. .., 1'807• .+, 0.1717 12.00 3rd parry,processing fair If 800,. 395.00 395.00 Title services and laMers88e NSUraw - — — 41101, - 1,695.00 1,535.00 D*Wstitleinsurxce-FkMAmorl=TiOelnsmana Compmy r . , 0.1103 A 100.00 4000 p . p 2,840.00 2,613.017 Increase between GFE and r S -227.00 -7.9930% Charges That Can Chan s - - - Good Falh Estimate HUD-1 Incfiai depceltla yaw escrow arworrM d 1001 1,398.00 1,306.28 Daily intense Charges from 901. 20.46401d 409.28 409,28 Homeowner's mumerice - s d 103. 5800 682.00 d Loan Terms Ya1rINBallowarrantU - r. _. .K $161,500.00 Yoxlomtemis, - - .• - •' . 'r', 30.years Your Initial Interest rater .-V '" 4.6250% your lnl0al monthly MOM awed for pmhcipai;Interest and any rno tgapa 5830.34 includes InsurerweH •, . " 'h: _ {f ®PriaJpal . - i r • ©Interest 5 s'.A.,.s ❑ Mortgage Insurance Can your Interest has dse?'e 4 N " ± .r -fi ©No. ❑Yes,it can rise to a maximum Of %. The first charge �' x{ wiz a m I I and can change again every Years after I I . Every •1; — r'. -• change date,your Interest rate can Increase a decrease by %. Over the rite d w..1- the ban,your interest rate is guaranteed to nave be lower than %ahighs than %. Even 0 you make payments on time•anyea ban balance rise?, ©No. ❑Yes,itcanthetoomadmrmdS Even gym make payments on Ume,an your monUty amodm aced for; ®N0. ❑Yes,the fiat in crease carp be m I I and the monthly principal.Interest and mortgage irisumrice rise? i amount owed can rise to i The maxlnxxi k can ever dse to h5 Does your kwn have a prepepnenl Pmale/7 _ ©No, ❑Yes,your wdm .prepayment penalty is$ Does your ism have a balloon p3ymffd? - , ❑74 No. ❑Yes,you have a balloon paymem of$ due In years on I I Taal monthly amount owed Including escrow a000uM payments ❑You do not have a min"esoo«payment fa hems,such es pOPMY tarn and homeowners insurmce You must par'these Items direly yourself. ©You have an additional monthly esww payment of$281.41 that result;in a total Initial mm"amount owed of 51,111.75. This includes r ' prinipal,interest my mmgage insurance and my Items checked below. ' r ®property lazes 1laneownees Insurance I ❑ Flood insurance ❑ ❑)( sdwd IM Note: If your have my questions about the Settlement Charges and Loan Terms listed on this form,please contact your tender. Previous editions are obsolete Page 3 of 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER II have carefully reviewed the HUDt Settlement Statement and to the best of my knowledge and belief,it Is a two and accurate statement of an receipts and disbursements made on my account or by me In this transaction I further certify that I here receNed a Copy of the HU61 Settlement Statement Robed E.Kelly Jean M. Ea E e al CApter Weidatl,Jr. The HUOt Settlement Statement which I have prepared Is a true and accurate account of this transaction I have caused or win Cause the funds to be disbursed In accordance wKh this statement 5E/VMENT DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 1e:U.S.CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD-1 tt-emization of Your Loan Origination Charges Name of Rondonia: Name of Seller File Number. Robert E.Kelly Jean M.Gross,Executrix of the Estate of Chester 140409GC Wes0all,Jr, Prepared 0411012014 at 2:21 pm Note:This page displays an Itemization of the adjusted origination charges shown in section 800 of the HUD-1 Settlement Statemen This page accompanies but is not a part of the HUD-1 Settlement Statement If a discrepancy exists,the information on the HUD-1 Settlement Statement applies, Your Loan Origination Charges Borrow Sell" 801. Our origination charge includes Origination Point 0DA or$0.00) Origination Fee to Pamela S.Bentz CBA Bentz Mor$ 2,666.00 Underwritingfee to United Wholesale Mon $ 895.00 802. Your credit or charge(points)for the specific interest rate chosen credit to United Wholesale Mortgage $ -2,666.36 803. Your adjusted origination charges 89464 0.00 Itemization of Line 1101 Name of Bonawer: Name of Seller: File Number Robert E.Kelly Jean M.Gross,Executrix of the Estate of Chester 14 0409G Wesdall,Jr. Prepared 041102014 at 2:21 pm Note:This page displays an Itemization of the charges shown an line 1101 of the HUD-1 Settlement Statement This page accompanies but Is not a part of the HUD-1 Settlement Statement If a discrepancy exists,the information on the HUD-i Settlement Statement applies. 1100.Title Charges: Total Charge Borrow Seller 1101.Title semCes and lender's title insurance to Wine In to Guardian Trsnsfer Corporaton $ 15.00 15.00 Notary Fee-Purchasers to Guardian Transfer Corporation $ 35.00 35.00 Courier Fee-Purchase to Guardian Transfer C radon $ 15.00 15.00 Electronic Document Fee to Guardian Transfer Corporation $ 35.00 35.00 Tax Can Reimbursement Fee to Guardian Transfer Corporation S 10.00 10.00 1102.Settlementorcceingfee to $ 0,00 1104.Lenders title insurance-First American Titto First American Title Insurance rA$ 1,210.00 1,210.00 1109.100 No�roN00 to First American Title Insurance Cr$ 50.00 50.00 1110.300 SuneyU00 to First American Title insurance GS 50.00 50.00 1111,900 EPL.Res%.1 to First American Title Insurance G$ 50.00 50.00 1112.CIoaingSvcUdCL to First American Title Insurance G$ 75.00 7500 Totals: S 1,545.00 0.00 1,535.001 10.0 Seller/Lender credos shoran an page 1 . POC a Paid Outside Closing CR-Lender Credit Previous editions are obsolete Page 1 of 1 MUD-1