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HomeMy WebLinkAbout09-23-14 (2) 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 2 1 3 3 9 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 1 3 0 2 0 13- 0 9 0 4 1 9 4 0 Decedent's Last Name Suffix Decedent's First Name MI M Y E R S S A N D R A L (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 ❑X 2. Supplemental Return 3. Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate 4a.Future Interest Compromise(date of F� 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 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: N Name Daytime T8ephone NumM 70 m I V 0 V - 0 T T 0 I I I 7 1 t Q 4 3,3 01 RE 1 TER OPNILLS USE ONi.YC7 ••� D rV rrj tT1 First Line of Address `? ' ° rz:, J n © 5 1 n 1 0 E A S T H I G H S T R E E T ° .1 k . C. Second Line of Address T -={ r p CJl rn 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: IOTTOPMARTSONLAW.COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. �SIGNATURE OF PERSON R.E.�SPO—NSIBLE FOR FILING RETURN DATE mnNrny, I �Mp � �z�1q ADDRESS 139 OAK FLAT ROAD NEWVILLE PA 17241 SIGNATURE VF fP_EA' R OTHER THAN REPRESENTATIVE ATE �,�,.s- lzLiiv ADDRESS 10 EAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J �� Continuation of REV-1500 Inheritance Tax Return Resident Decedent SANDRA L. MYERS 21 12 1339 Decedent's Name Page 11 File Number Correspondents Name Daytime Telephone Number I V O V O T T O 1 1 1 E S Q 7 1 7 2 4 3 3 3 4 1 First line of address 1 0 E A S T H I G H S T R E E T Second line of address City or Post Office State ZIP Code C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address:IOTTOPMARTSONLAW.COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT E OF PERSON RESPONSIBLE FOR FILING RETURN PATE Cec.�PL/lrryc.�. /z Y-ZZ- / C/ AD RES�-e r 154 KERRS ROAD NEWVILLE PA 17041 Name Daytime Telephone Number First line of address Second line of address City or Post Office State ZIP Code Correspondent's e-mail address: 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 atl information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 154 KERR'S ROAD CARLISLE PA 17015 J 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: SANDRA L . MYERS RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 1 1 4 9 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. 0 . 0 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 0 . 0 0 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) MX Separate Billing Requested . . . . . . . 7. 0 . 0 0 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 1 4 9 0 0 . 0 0 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 2 7 2 6 1 . 0 1 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . . . . . . 10. 5 7 . 8 2 11, Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 7 3 1 8 . 8 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 8 7 5 8 1 . 1 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 8 7 5 8 1 . 1 7 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 8 7 5 8 1 . 1 7 16. 3 9 4 1 . 1 5 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. 3 9 4 1 . 1 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 L 1505610240 1505610240 REV-150D EX(Fl) Page 3 Fite Number Decedent's Complete Address: 21 12 1339 DECEDENT'S NAME SANDRA L.MYERS _ STREET ADDRESS 158 Virginia Avenue CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 3,941.15 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 124.42 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) 4,065.57 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 ..................................................................................................... ❑ ❑ 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? ....................................................................................... ❑ ❑ 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 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(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. REV-1502 EX-(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SANDRA L. MYERS 21 12 1339 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. Real estate located at 158 Virginia Avenue, Carlisle,PA, known as Tax Parcel No: 114,900.00 29-16-1096-115,beign described in Deed dated 6/30/94&recorded in Cumberland Co.,Deed Bk 107, Pg.,920&being conveyed to Sandra L. Myers,Decedent herein. See attached Settlement Statement TOTAL(Also enter on Line 1,Recapitulation.) $ 114,900.00 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 SANDRA L.MYERS 21 12 1339 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2, Attorney Fees: MARTSON LAW OFFICES(estimated) 6,340.00 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. PNC Bank,check fees 53.14 8. Seller paid closing costs 2,000.00 9. Detwiler Realty Help U Sell,commission 2,450.00 10. ERA-NRT LLC, commission 3,387.00 I1. Home Warranty 320.00 12. 2014/2015 School Taxes 1,522.25 13. Duplicate Tax Bill,fee 1.00 14. PPL Electric,service pending sale of real estate 735.65 15. North Middleton Authority,sewer/water pending sale of real estate 747.63 16. IPSF Corporation,homeowner's insurance pending sale of real estate 1,659.51 17. 2013 County/Twp. Real Estate taxes 360.16 18. 2014 County/Twp.Real Estate taxes 367.54 TOTAL(Also enter on Line 9,Recapitulation) $ 27 261.01 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent SANDRA L. MYERS 21 12 1339 Decedent's Name Page 8 File Number Schedule H -Funeral Expenses &Administrative Costs -B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Paul Myers,reimbursement for home repair labor,pending sale 1,517.30 20. Home repair supplies pending sale of real estate 3,573.33 21. Filing fee, Supplemental Inheritance Return 15.00 SUBTOTAL SCHEDULE H-B7 5,105.63 REV-1513 EX-(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SANDRA L.MYERS 21 12 1339 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 Sec.9116(a)(1.2).l 1. Paul L.Myers, Jr. Lineal 43,790.59 154 Kerrs Road Carlisle,PA 17015 2. Bonnie K.Bitner Lineal 43,790.58 139 Oak Flat Road Newville,PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. Il. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. I. TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: Discount: 0.00 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 1988 through 1991 1992 1993 through 1994 1995 through 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 through 2014 385 3,941.15 124.42 TOTALS 385 124.42 Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: "'Si' nr OMB Approval No.2502-0265 ^�* �'���II HUD-1 A.lll��fl� A. Settlement Statement (HUD-1) I Page 1 of 3 B.Type of Loan 1.E FHA 2.❑PHIS 3.E:]Carry.Unins. 6.File Number: 7.Loan Number: S.Mortgage Insurance Case Number: 4.❑VA 5.❑Cory.Ins. 401402632-JLP 3329084120 446-2188526 C.NOTE: This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown. Items marked '(p.o.c.)"were paid outside the closing;they are shown here for informational purposes and are not Included In the totals. D.Name and Address of Borrower E.Name and Address of Seller F.Name and Address of Lender DORIS N.RAMOS PAUL L.MYERS,JR.,CO-EXECUTOR AND QUICKEN LOANS,INC. 1901 DOUGLAS DRIVE BONNIE K.BITNER,CO-EXECUTOR Of 1050 WOODWARD AVE, CARLISLE,PA 17013 SANDRA L.MYERS ESTATE DETROIT,MI 48226 158 VIRGINIA AVENUE CARLISLE,PA 17013 G.Property Location H.Settlement Agent SECURED LAND TRANSFERS,LLC 158 VIRGINIA AVENUE, 485 ST.JOHNS CHURCH ROAD, CARLISLE,PA 17013 SHIREMANSTOWN,PA 17011 Phone:(717)901-8342 PARCEL COUNTY: CUMBERLAND :29-16-109 Place of Settlement I.Settlement Date 09/15/2014 PARCEL ID: MBER 1096-115 TOWNSHIP: NORTH MIDDLETON TOWNSHIP 1068 HARRISBURG PIKE Disbursement Date 09/15/2014 CARLISLE,PA 17013 3. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100.Gross Amount Due from Borrower 400.Gross Amount Due to Seller 101. Contract Sales Price $114,900.00 401. Contract Sales Price $114,900.04) 102. Personal Property 402. Personal Property 103. Settlement charges to borrower tine 1400 $8,297.97 403, 104, 404. 105. 405. Atl ustment for items paid by seller in advance Atl ustment for Items Paid by seller In advance Taxes 106. Taxes 406. City/Town --- ----___ 107. County Taxes 367.55 r 9/15/2014 to 1/1/2015 $108.75 407. County Taxes 367.55/ r 9/15/2014 to 1/1/2015 $108.75 108. Assessments 408. Assessments 109. School Taxes 1,522,25/y,9 15 2014 to 7 1 2015 1 205.29 409. School Taxes 1 522.25 r 9115/2014 to 7/1/20.15 61,205.29 110. 410. 111. 411. 112. 120.Gross Amount Due from Borrower 124 532.01 420.Gross Amount Due to Seller __::::14116,214.04 200.Amounts Paid by or in Behalf of Borrower 500.Reductions In Amount Due to Seller 201. De osit or earnest money $1,000.001 501. Excess Deposits _ 202. Principal Loan Amount from Quicken Loans Inc. 112 815.00 S02. Settlement Charges to Seller _t-$16,585.00 203. Existing loans taken sub ect to 503. Existing loans taken sub'ect to 204. Seller Paid Closing Costs 2 000.00 504. _.. _... 205. Lender Credit from Quicken Loans Inc. 1700.00 505. _ 206. 506. Seller Paid Closing Costs $2,000.00 207. 1 507. 208, 508. 209. 509. Adjustments for Items unpaid by seller Atl ustments for items unpaid by seller 210. Ci Town Taxes 1510. Ci Town Taxes 211. County Taxes 1511. County Taxes 212. Assessments 512. Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. 517- r 218. 518. -_ 219. 519. 220.Total Paid by/for Borrower Li 520.Total Reduction Amount Due Seller _ 18,585.00 300.Cash at Settlement from/to Borrower 600.Cash at Settlement to/from Seller 301. Gross amount due from borrower line 120 124 512.01 601. Gross amount due to seller(line 420) _ _ $116,214.04 302. Less amounts aid b /for borrower line 220 117 515.00 602 Less retluctlons In amount due seller line 520 $18 585.00 303.Cash X From To Borrower 56,997.01 603.Cash X To Lj From Seller $97,629.04 The Public Reporting Burden for this wreclien of information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may not collect this information,and you are not required to complete this farm,unless it displays a currently valid OMB control number.No confidentiality Is assured;this disclosure is mandatary.This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. Initials �y 401402632-ILP HUD-1 Page 2 of 3 L. Settlement Charges 700.Total Real Estate Broker Fees$6062.00 Division of Commission line 700 as follows: Paid From Paid From 701. $2450.00 to Hel -U-Sell Detwiler Realty Borrower's Funds Seller's Funds At Settlement At Settlement 702. $3612.00 to ERA-NRT LLC$3,387+ 225 703. Commission paid at settlement $225.00 $5,837.00 704. 800.Items Payable in Connection with Loan 801. Our origination charge $1,108.75 from GFE#I 802. Your credit or charge(points)for the specific Interest rate chosen from GFE#2 803.Your ad usted origination charges from GFE A $1.108.75 804. Appraisal Fee to TSI APPRAISAL SERVICES from GFE#3 505.00 805. Credit report to Quicken Loans Inc. from GFE#3 6.63 806.Tax Service to TITLE SOURCE INC. from GFE#3 18.00 807. Flood Cent.Fee to CORELOGIC FLOOD SERVICES from GFE#3 $5.00 808, Flood Determination Fee to CORELOGIC FLOOD SERVICES $10.50 809. Compliance Inspection W TSI APPRAISAL SERVICES 100.00 900.Items Required by Lender to Be Paid in Advance 901. Daily interest charges from 9/15/2014 to 10/1/2014 @ 13.14/day Quicken (from GFE#30) $210.24 Loans Inc. 902 Mortgage Insurance Premium for 12 years to FEDERAL HOUSING (from GFE#3) $1,940.32 ADMINISTRATION FINANCED 903. Homeowner's Insurance Erie Insurance Company from GFE#11 627.00 904. 1000.Itese wes Deposited with Lender 1001.Initial deposit for your escrow account from GFE#9 621.53 1002.Hazard Ins.Reserve 3 Months It 52.25 per Month(s)Quicken Loans Inc. $156.75 1003.County Property Taxes 8 Month(s)@ 30.63 per Month(s)Quicken Loans, $245.04 Inc. 1004.School Taxes 4 Months @ 124.32 per Months Quicken Loans Inc. $497.28 1005.Aqqmqate Accounting Ad ustment to Quicken Loans Inc. -$277.54 1006. 1007. 110O.TItte Charges 1101.Tnle services and lenders title Insurance to Secured Land Transfers LLC from GFE#4 $1.495.001 1102.Settlement or closinq fee to Secured Land Transfers LLC $22b.uo 11103.Owner's title Insurance to Secured Land Transfers LLC from GFE#5 10.00 1104.Lender's title Insurance to Secured Land Transfers LLC $1,115.00 1105.Lenders title Policy limit $112,815.00 11106.Owner's title Policy limit $114,900.00 1107.Agent's portion of the total title insurance premium to Secured Land $1,012.50 Transfers LLC 1108.Underwriter's portion of the total title insurance premium to TRGC $112.50 1109.Insured Closing Protection Letter to TRGC $125.nn 12OO.GOVernment Recording and Transfer Charges 1201.Government recording charges from GFE#7 266.00 1202.Deed$79.00 Mortgage$187.00 Releases s - _.. 1203.Transfer taxes from GFE#8 $1 149.00 1204.Cit Cou nty tax stam es Deed$1149.00 Mortgage _ 1205.State tax/stamps Deed$1149.UO Mortgage $1,149.00_ 1206. 130O.Additlunal Settlement Charges - 1301.Required services that you can shop for from GFE#6 1302.Home Warranty to First American Home Buyers Protection $320.00 1303.Escrow for Inheritance Taxes to Secured Land Transfers-Mechanicsburg $7,755.75- 1304.2014 2015 School Taxes to Melanie Strickland Tax Collector $1,522.25 1305.Duplicate Tax Bill Fee to Melanie Strickland Tax Collector $1.00 1306.Home antl Pest Ins action to Central PA Home Inspections POC B 460.00 14OO.TOtal Settlement Charges(enter on lines 103,Section 1 and 502,Section K) r $8,297.971 $16,585.00 It you have any questions about the settlement charges and loan terms listed on this form,please contact your lender.Settlement agent is not responsible for content of lenders assessments on HUD. The seller's and borrowers signatures hereon acknowledge their approval and signify their understanding that lax and insurance proration and reserves are based on figures for the preceding year or supplied by others or estimated for the current year,and In Ina event of any change for the current year,all necessary adjustments will be made between borrower and seller directly.Any deficit delinquent taxes or mortgage payoffs will be pmmpdy reambarsed to the settlement agent by the seller. I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is two and accurate statement of all recelpts and disbursements made on my acceun or y main this transaction.I further certify that I have received a copy of the HUD-1 Setllement Statement. B ERS \rV SELLERS Sang a L.Myers 1 Dons N amos - By: ul L.My .,Jr.,Co-Exec tar Q � By Bonnie .eitneq Co-Exemtor The HUD-1 Settlement Statement w' h I nave prepared Is a true and accurate account 11his lransaction.I have caused or will ow the funds to be disbursed in aieordanee with this st semen f Battleme�Ag n Date ' U1.L;�/ \ 09/152014 -Any items marked"POC"were paid outside Borrower by:Boower POC(B),Lender FOG(L),Mortgage Broker FOG(M),Seller POC(S),Real Estate Agent POC(R),or Other POC(0).