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09-11-14 (2)
1505610140 REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 1 3 0 9 0 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 8 0 1 2 0 1 3 0 9 1 0 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI R Y E S K Y R E G I N A E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return Q 2. Supplemental Return 7 3. Remainder Return(date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise(date of 7 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 [J 10.Spousal Poverty Credit(date of death 7 11. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) •;� CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX IN F RMATION SHOULD BE DDIIRWED TO: Name Daytime one Number rTt rn n I V 0 V 0 T T 0 I I I 7 1 5 F,,2 4 3 1 +, m x C') t v REDS R OR WIL 4i1SE 6 L�j O O First line of address C) O T 1 0 E A S T H I G H S T R E E T Z1 I- r C'> ' Second line of address City or Post Office State ZIP Code DATE FILED C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address: ]OTTOPMARTSONLAW.COM Under penalties of perjury,I declare that I have examined this return,including acrwmpanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIC�IG3�TURE OF PERSON ES_j2 PONSt$LE FOR FILING RETURN DATE ADYID`RRES�•S TIf7 Y�l M.'w-'Y_IY. rte^ 417 DARLA ROAD MECHANICSBURG PA 17055 SIGNATU O k RER OTHER THAN REPRESENTATIVE DATE ADDRESS 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J �,bti J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: REGINA E - R Y E S K Y RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . .. . .. . .. . . . . . .. .. . .. . .. . . . . . . .. . ... . 1. 2 0 1 0 0 0 . 0 0 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . .. . .. . . . . .. . . . . . . .. . .. ... . . 2. 0 • 0 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .. . .. 3. 4. Mortgages and Notes Receivable(Schedule D) . .. . . . . . . . .. . .. . .. .. . .. . .. 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . .. . . . 5. 9 6 2 5 . 5 8 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . .. . .. . 6. 0 • 0 0 7. Inter-Vivos Transfers&Miscellaneous N911-Probate Property (Schedule G) Separate Billing Requested . .. . . . . 7. 0 . 0 0 8. Total Gross Assets(total Lines 1 through 7) . .. . .. . .. . .. .. . .. . .. . .. . .. . 8. 2 1 0 6 2 5 . 5 8 9. Funeral Expenses and Administrative Costs(Schedule H) . .. . .. .. . .. . .. . .. . 9. 6 2 0 7 0 . 0 0 10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 0 • 0 0 11. Total Deductions(total Lines 9 and 10) . . . . .. . .. . .. .. . .. . .. . .. ... . .. . . 11. 6 2 0 7 0 . 0 0 12. Net Value of Estate(Line 8 minus Line 11) .. . . . . .. . .. . .. . .. ... . .. . . . . . 12. 1 4 8 5 5 5 . 5 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. . .. . .. .. . . . . .. . .. . .. 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) .. . .. . . . . . . .. . .. . .. ... 14. 1 4 8 5 5 5 . 5 8 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)x.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x .045 1 4 8 5 5 5 . 5 8 16. 6 6 8 5 . 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 at collateral rate X .15 0 . 0 0 18. 0 . 0 0 19. TAX DUE .. . . . . .. . . . . . . . . . . . . . . . . .. . .. . .. . . . . .. . .. . .. . .. . .. . .. . 19. 6 6 8 5 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Fite Number Decedent's Complete Address: 21 13 0904 DECEDENT'S NAME REGINA E. RYESKY STREET ADDRESS 301 GLENDALE STREET CITY STATE ZIP CARLISLE I PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,685.00 2. Credits/Payments A.Prior Payments 1,707.07 B.Discount 0.00 Total Credits(A+B) (2) 1,707.07 3. Interest (3) 53.88 4. If 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) 5,031.81 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...................................................................... ❑ ❑ b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑ c. retain a reversionary interest;or ................................................................................................ ❑ ❑ d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑ 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 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)(ii)].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 72 P.S.§9116(1.2)[72 P.S.§9116(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,uncle Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1502 EX-(01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: REGINA E. RYESKY 21 13 0904 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 I. Real Estate located at 301 Glendale St., Carlisle Borough, Cumberland Co.,Pa.,known as Tax 201,000.00 Parcel No. 04-21-0322-268&being described in Deed dated 6/23/81 &being recorded in Cumb. Co. Deed Book "L", Vol. 20,Page 650,&being conveyed to Samuel Ryesky and Regina Ryesky, his wife. Samuel Ryesky died 7/7/2011, leaving title solely vested in Regina Ryesky,Decedent herein. Value is actual sale value. See attached Settlement Statement. TOTAL(Also enter on Line 1,Recapitulation.) $ 201 000.00 If more space is needed,use additional sheets of paper of the same sae. REV-1508 EX+(11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: REGINA E.RYESKY 21 13 0904 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. 2014-2015County/Township Tax Proration 438.78 2. 2014-2015 School Tax Proration 2,486.80 3. Proceeds from sale of Honda Vehicle 6,700.00 TOTAL(Also enter on Line 5,Recapitulation) $ 9,625.58 If more space is needed,insert additional sheets of paper of the same size REV-1511 EX-(10-09) pennsylvania SCHEDULE H DEPARTMENT DE REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER REGINA E. RYESKY 21 13 0904 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: t. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Names)of Personal Representatives) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: Martson Law Offices(estimated) 10,070.00 3, Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 6 Accountant Fees: 6. Tax Return Preparer Fees: 7. Additional Probate Fee 100.00 8. Carlisle Borough Tax Collection,2013 School tax pending sale of real estate 2,772.65 9. Charles Holtry,2014 County/Twp.Real Estate tax,pending sale of real estate 1,291.58 10. PPL, electric service pending sale of real estate 254.24 11. American Modern Select Insurance Co.,homeowner's insurance pending sale of real estate 4,116.00 12. Carlisle Borough, sewer/water pending sale of real estate 291.60 13. Carlisle Petroleum, fuel oil costs,pending sale of real estate 1,991.61 14. ADT, security alarm service pending sale of real estate 620.81 15. Bryan Eshenour,home repairs pending sale of real estate 2,000.00 16. Mark Devos, lawn care and landscaping pending sale of real estate 7,075.00 17. Diana Ryesky,reimbursement for real estate clean up expenses 958.00 18. Melissa Wilson,reimbursement for real estate clean up expenses 968.00 TOTAL(Also enter on Line 9,Recapitulation) $ 62 070.00 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent REGINA E. RYESKY 21 13 0904 Decedent's Name Page 6 File Number Schedule H -Funeral Expenses&Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Andrew Kerr,home repairs pending sale of real estate 2,106.00 20. Realty Preparation Service,trash removal pending sale of real estate 80.00 21. Landex Title Search,Deed copies 0.60 22. 1%Realty Transfer Tax 2,010.00 23. 2014-2015 School Taxes 2,976.01 24. Closing costs paid by Seller 10,881.90 25. Wolfe&Company,real estate commission 5,703.54 26. Howard Hanna Real Estate,real estate commission 5,703.54 27. Carlisle Borough, final sewer/water 98.92 SUBTOTAL SCHEDULE H-B7 29,560.51 REV-1513 EX-(0140) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: REGINA E. RYESKY 21 13 0904 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Robert A.Ryesky Lineal 49,518.52 417 Darla Road Carlisle,PA 17055 2. Diana Ryesky Lineal 49,518.53 3905 Burke Avenue North Seattle,WA 98103 3. Melissa Wilson Lineal 49,518.53 1927 Rhododendron Way Bellingham,WA 98229 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. 1. TOTAL OF PART 1I-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. E If more space is needed,use additional sheets of paper of the same size. OM8 Approval No.2502-0265 A. Settlement Statement (HUD-1) e. Type of Loan 1, FHA 2.Q RHS 3,[]Con, Uru s, 6, File Number: 7. Loan Number 8. Mortgage Insurance Case Number 4 VA 5.©Conv,Ins. 134$4.3 BOEGEL 201474528 6274911960 C. Note: TMS torm rsfurrustaM to g7va yauastatamaM Of actual sarttement cosh. Amounts paid re and by Ore setitemantruma are mowrl hams marked yp a c.l'"to paidoutside the closing;they are shown here for informational purposes and are not included in the forals, D. Name and Address of Borrower: E. Name and Address of Seller: F. Name and Address of Lender: Michael H Seeger and Estate of Regina Ryesky Howard Hanna Mortgage Services Molly M.Boegei 301 Glendale Street 119 Gamma Drive 250 West Will ow Strong Carlisle PA 17013 PIrsburgh,PA 15238 Carlisle,PA 17013 G, Property Location- H. Stm ementAgent: {_ Settlement Date: 301 Glendale Street Manson Deardorff W.Marms Otto Gilroy 8 Faller Carlisle,PA 10 East High Street Au9usl29,2014 Cumberland Count,Pennsylvania Carlisle,PA 17013 Ph. (717)243.3341 Place of Settlement: 10 East High Street Carlisle,PA 17013 J. Summary of BomOwefs transaction N. Summary of Settees transaction 100, Gross Amount Due from Borrower: 400, Gross Amount Due to Seller: 101. Contract sales price 201,000,00 401, Crnnractsates price 21,000.00 102. Personal Eoptirly 402, Personal property 103. Settlement Charges to Borrower Une 1400 7,95832 403. 104 4w. 05, 405. Adjustments for items paid by Seller In advance Ad ustments for items paid by Seller in advance 106. County(Twid,Taxes 0&30114 to 0M1115 438,78 406.Courty/Twis.Texas 08+30/14 to 01101115 438.78 107 School Taxes 08730/14 to 07101115 2486.80 407. School Takes 08130114 to 07/01/15 2,486.80 108. Assessments l0 408.Assessments to 109, 409. T15- 1W 411. 112, 412. 120. Grose Am ou at Ou a from Borrower 211,881,90 420,Gross Amount Due to Seller 203,925,58 200. Amounts Paid by or in Behalf of Borrower 500. Reductions M Amount Due Seller. 201, Deposit or earnest money 1500.00 501. Excess deposit see imirucsans 202, Pnnci at amount of new tea s 180 900.00 502, Settlement Char es to Seller jUms 1400 16.492.02 203. Existing loans taken suti act to 503, Sal sit ad loans taken subject to 204. 504. Payoff First Mortgage 205, 505. Pa off Secnnd Mort a a 206. 506, 207, 507. [Chipinsit dish,as roceeds 208, 508, 209. Seller Assistance 10,881,90 509, Seller ASSlslance 10,881,90 Ad ustmenls for items u paid by Seller Atl ustments for items unpaid by Seller 210. Coun Rw .Taxes 10 $10, Catudyll,pi Taxes to 211, School Takes to 511. School Taxes to 212. Assessments to 512.Assessments to 213. 513. 214. 514, 215, 515. 218 Good Fauh Ca sit 4W.W 516, 217. 517, 218. 518. 219. 519. 220. Total Paid la ffor Borrower 193.681,90 $20. Total Reduction Amount Due Seiler 27,373,92 300- Cash at Settlement Iromfto Sofrewsr 600. Cash at settiemmrt toNmm Satter 301, Gross amount due from Borrower line 120 211,881.90 601, Gross amount due to Seller line 420 203.925.58 302. Less amount paid b ffor Borrower(line 220) ( 193,681,90) 602, Less reductions due Seller(line 520 ( 27,373.92 303. Cash X❑From ❑ To Borrower 18,200.00 603, Cash E To From Setter 176,551.66 Te th uar4e bgrusel brebyarvae(a]aabORO b^0e.{lt,x tlia0 el The undersigned hereby ackewsY(o�gar pt/ofJr apieted copy of this statement&arty attachments referred to herein Borrow er %��" Seller Estate of Regina E.Ryesky ,-Mi heel P.Boost ("j �"'}+' MBI y M,Been RobertA.Ryeaky,Ex tot U- Th.Pob{iCPapoNnq 3ulben bf NIk<oxaNen aNabrmaaen 6a0m8bd.135 minuYpeptlrreapanseipYGllvRng,renewing,Intl I.I.qv.r.l.TF13.1.1 yleant^.i WOeq PUmbrmaE0n,antl you m, YBeuvetlW Wmpleb tMatl m,-I.v,xClSplerek cull.n.r Ilia 0MamnP01lariblNb.0ftn.elxy Ir.fW.eC,Nis v lchilulele m-ah.u.'J Th-edlahr.a b pleriea Ne purs.aW.PESM.a,I.d Van.ac40n w1N mklmitlen d"Ple Ne seNemOnl pli.I. Page 1 of 3 HUO-1 (13454.3 SOEGEL PFOil34543 SOEGEU43) t.Settlement Char es 700.Total Real Estate Broker Fees $11,407.09 Division ofcommlaaion(line 700)as bllows' Paid From Paid From 6onowele Sellers 701.55,703.54 10 Wolfe BCom an Realtors Funds at Funds at 792.$ 5,703.55 to Howard Hanna Real Estate Settlement S.Viemegi 703.Commtasion -10 t iturement 704. 11 40799 705. 800.Items payable in Connection with loan 801_ on oration inhered S 940 00 from GFE#1 802.Your tread or cha oink br the s ecific int rest rate chosen n from GFE#2 801 Yo r adjusted origination chancel. (from GFE#A 940.00 804.A moral fee to A raisal b E. .Ko en from FE#3 395.0 805.Cratlrt Report to CDC lan.is,Inc. ham GFE#3 36.21 805 Tax !rule! to HHMS trom GFE#3 100 807.F1 99d certification to F SI from GFE#3 13 808.Employment Verification to from FE#3 0.00 809. (ram GFE#3 810.Finallns Von ham GFE#3 Btt. (from GFE#3) 900.Items Requlretl by tender to Be Paid In Advance 901.Doll interest char as from 00/20/19 to 091gV14 3 522.3000g01tla from GFE 6690 902.Mart a e insurance premium far month,to {tram GFE#3y 903.Homoowner's insurance far i 0 rs to Howard Nanna tnsutance Services (tram GFE#it) 1,G42.00 904. (/mm GFE#11) 905. (tram GFE N11) 1000.Reawas,Ge os(ted with tender 1001.Initial deposit for ur escrow account (from GFE#9F t30671 1002.Homeowner's insurance 4900 months $S 86,83 per month $ 347.32 1003. Mort a !insurance month! 2 $ 10703 per month § 1004 Property taxes S 336.72 Colin !fw .Taxes 8.000 months a S 4209 per month School Taxes months @ S per month 1005.Ci Ij Taxes $ 469.72 94y Taxes 8,0pa m n h! 58.64 par month 1006. School Taxee 4.000 months ® $ 248.00 per month S 992.00 1007. momma @ S par month S 1008. 5 1009. ag r ale Atllustmant f -838.45 1100.Tillq Charges 1101. Title services and hander's tithe insurance (hom GFE#4} 1,760 50 1102. Settlement or closing fee S 1103. Camara titlemsurance to Did Republic National Title insuranc.Company (tram GFE IS) 100.00 1104. Lender's till.insurance to Old Ne ublic National Tile Insurance Company $ 1,595.50 1105. Lender's title p01ic limit E 180900.00 1106. Dwner's title Policy limit S 291,00000 1107. mss portion of the total idle insurance premium to Manson Deartlorff Williams One Gilroy 8 Fa, S 1,441.17 1108- Underwriters panion of the total title insurance premium to Old Republic National Title Insurance Conpt S 254.33 1109. Closing Service Letter via Republic National Title Insurance Comp 75.00 1110. emparalion of Deed.POC7 $ tilt. S tt12. S 1113. S 1200.Govennn ReoaNln and Transfer Cha ee 1207.Government wcoroin char es !o Recorder or Oeeda from GFE#7 186.00 1202.Tend a 79.00 Mon a S 107.00 Raisesee S Other S 1203.Transfer to Recorderaf Deeds (ham GFE#8) 2,010.00 1204.G /County taxlstam s S 2010.00 S 1205 State lax/stam a E 2,p10.00 S 2,010.00 1206. 1200.Add(t(onai"Moment Charges 1301.Raguntio services that you can shop for (from GFE>W) 1302. S 730]. 2614-2015 SCnopi Taxes to Charier Hatt ,Tax S 297801 1304, Final Sewer H Water to Boro hot Carlisle $ #013021 98,92 305. 1400.Total Settlement Charge,(enter an Ilnas 103,Section J and 502,Section R $ I 7,956.32 16,492.02 Pm4 o„mae pman�a ey eorcowegel..en«Ifippnwn4,or n,.e.ptMlTl ""�� 8yu9�ma pdef toln,teAYmint n<ay!emnealCinavNEge reuipinte Wrzryl¢g4 wpyolpsyt281 atpyi TTe Ct9��St��0py /}f Morison Dearddoonft`lNW11il/i�ta,ms OOtto TI-r &Faller Settlement Agent Page 2 of 3 HUD-1 (13454.3 DOEGEL.PFDI13454.3 DOEGEU43) Comparison of Good Faith Estim ate(GFE)and HUD4 Charges Good Faith Estimate HUD-1 Charges That Cannot Increase HUD-1 Line Number Our origination charge At 601 94000 940,00 Your credit or charge(paints)for the specific rate chosen At 802 0 00 0,00 Your adjusted origination charges k 803 940.00 940.00 Transfer taxes #1203 2,010.00 2,010.00 Charges That In Total Cannot Increase More than 10% Good Faith Estimate HUD-1 Government recording charges #1201 21000 186.00 Appraisal fee # 804 40000 395.00 Credit report # 805 50,00 36.21 Tax service At 806 100.00 100.00 Flood certification At 807 13.00 13.00 Total 773.00 73021 Increase between GFE and HUD-1 Charges $ -42,79 or -5.54° Charges That Can Change Good Faith Estimate HUO-1 Initial deposit for your escrow account #1001 4,466,68 1,306.71 Daily interest charges - #901 $ 22,300000/day 56,90 66,90 Homeowner's insurance At 903 800.00 1,042.00 Title services and lender's title insurance #1101 1,81750 1,760.50 Owner's title insurance to Old Republic National Title Insurance #1103 110.00 10000 Loan Terms Your initial loan amount is f 180,900.00 Your loan term is 30.00 years Your initial Interest rate is 45000% Your initial monthly amount owed for principal,interest and $1,023.62 includes any mortgage Insurance Is ❑K Principal Interest ❑% Mortgage Insurance Can your interest rate rise? Q No ❑ Yes,it can rise to a maximum of %. The first change will be on_and can change again every_months after . Every change date,your interest rate can increase or decrease by %. Over the life of the loan,your interest rate is guaranteed to never be lower than .%or higher than %, Even if you make payments an time,can your loan balance rise? [E] No ❑ Yes,it can rise to a maximum of$ Even if you make payments an time,can your monthly ❑X No ❑ Yes,the first increase can beonand the monthly amount owed for principal,interest,and mortgage Insurance dsei amount owed can rise to f The maximum it can ever rise to is f Does your loan have a prepayment penalty? ❑X No ❑ Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? ❑X No ❑ Yes,you have a balloon payment of 3i due in_years on Total monthly amount owed including escrow account payments ❑ You do not have a monthly escrow payment for items,such as property taxes and homeowner's insurance. You must pay these items directly yourself. ❑K You have an additional monthly escrow payment of 5435.56 that results in a total initial monthly amount owed of$1.459.18. This includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes ❑X Homeowners insurance ❑ Flood insurance ❑X School Taxes ❑ ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender, Page 3 of 3 HUD-1 (13454.3 BOEGELPFO/13454.3 B0EGEL143) HUD-1 Attachment Borrower(s):Michael P. Boegel and Molly M. Boegel Sellel(s): Estate of Regina Ryesky 250 West Willow Street 301 Glendale Street Carlisle, PA 17013 Carlisle, PA 17013 Lender:Howard Hanna Mortgage Services Settlement Agent:Martson Deardorff Williams Otto Gilroy&Faller (717)243-3341 Place of Settlement: 10 East High Street Carlisle, PA 17013 Settlement Date:August 29, 2014 Property Location:301 Glendale Street Carlisle, PA Cumberland County, Pennsylvania Adjusted Origination Charge Details Origination Charge Originiation charge 940.00 to Howard Hanna Mortgage Services Total $ 940.00 Origination CrediUCharge(points)for the specific interest rate chosen Total $ Adjusted Origination Charges $ 940.00 Reserves Deposited with Lender Homeowner's Insurance 347.32 4.000 at 86.83 per month County/Twp.Taxes 336.72 8.000 at 42.09 per month City Taxes 469A2 8.000 at 58.64 per month School Taxes 992.00 4.000 at 248.00 per month Aggregate Adjustment -838.45 Total $ 1,306.71 Title Services and Lender's Title Insurance Details BORROWER SELLER Closing Service Letter 75.00 to Old Republic National Title Insurance Company Electronic Document Production 50.00 to Martson Deardorff Williams Otto Gilroy&Faller Overnight Mail Fee 20.00 to Mattson Deardorff Williams Otto Gilroy&Faller Incoming Wire Fee 20.00 to Martson Deardorff Williams Otto Gilroy&Faller Lender's title insurance 1,595.50 to Old Republic National Title Insurance Company Total $ 1.760.50 $ 0.00 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. Fordetate see: Title to U.S.Code Section 1001 and Section 1010. (13454.3 BOEGEL.PFO/13454 3 BOEGEU43) HUD-1 Attachment- Continued Owner's Title Insurance - BORROWER SELLER Owner's Policy Premium 100.00 to Old Republic National Title Insurance Company Total $ 100.00 $ 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above In Title Services and Lendees Title Insurance Details Lender's Policy Premium 1,305.00 to Old Republic National Title Insurance Company Lender's Endorsement Charges 290.50 Endorsement Endorsement Charge Endorsement PA 100(No Apparent Violation of 50.00 Restrictions) Endorsement PA 300(Survey Exception) 50.00 Endorsement PA 900(Environmental Protection Lien) 50.00 Endorsement PA 1030(Special Risks) 140.50 Total $ 1,595.50 $ 0.00 WARNING: It Is a crime to knowingly make false statements to the United States on this or any similar tam,. penalties upon conviction can include a fine and imprisonment. Far details see: Title 18 U.S.Code Section 1001 and Section 1010. (13454.3 SOEGEL.PFD/13454.3 BOEGEV43)