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02-05-15 (3)
1505611101 - REV-1500 Ex(02.11) OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes "PARTMENTOFNUE County Code Year File Number PO BOX 28o6o1 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT � � t � O g 9 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 05 1 1 R 0 1 03Q e? q3d Decedent's Last Name Suffix Decedent's First Name MI ` A & GONER KAR 10Al (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 Q 3. Remainder Return(Date of Death Prior to 12-13-82) C=) 4. Limited Estate Q 4a. Future Interest Compromise(date of (:;o 5. Federal Estate Tax Return Required death after 12-12-82) GO 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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 J cFE_ /f kAIV 7 1 7 67 ! ! 0 10 0 REGISTER OF MILLS USERNLY 70 � rn First Line of Address O - � A & LIF5 i6) k1 "73' w " rt Second Line of Address ,_ 7 cD T E 0 41 DATE, ED n City or Post Office State ZIP Code i O r 1-t ARA 15- 6uR6 PA ! 7I 1 - ' c`n 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.Declara' n of preparer other than the personal rep sentative is based on all information of which preparer has any knowledge. SIG NQTU OF ERSON RESPO BLE FOR FILING RETUR DATE ,// -S S ADDRESS 311A Old S fukws-e- Rd. Svufh fja//in,G Spr/nc.s PA- l7oo 7 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE A RESS a U57} n4(nsiulu/f Rd, SUl aUd,, ydyu a bvry 1-411- 17//0 PLEASE USE ORIGINAL FORM ONLY Side 1 1505611101 1505611101 1505611201 REV-1500 EX Decedent's Social Security Number RECAPITULATION 1. Real Estate(Schedule A). ... . . ... ... ... .. ..... ...... . ... .. ... . . ... .. . 1. 1 3 F, 07944) 2. Stocks and Bonds(Schedule B) ... .. . ... ... .. ... . .. . .. ..... . .. .. .... . . 2. • 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. �P d 9 S • 9 f 6. Jointly Owned Property(Schedule F) p Separate Billing Requested .. . .... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. .. ... . 7. 8. Total Gross Assets(total Lines 1 through 7).. .... .. ..... . . .. .. ... .. . .... 8. a G Q . [) 3 9. Funeral Expenses and Administrative Costs(Schedule H).. .. . ..... ..... ... . 9. a 7 o� a 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). .. . .. ... . . ... . 10. ' ' 7 `q" �f 11. Total Deductions(total Lines 9 and 10). ... .. ... .. . ... ... ... .. . .. .. ..... 11. 3q tD • 9 12. Net Value of Estate(Line 8 minus Line 11) . . . . ... . . ..... . ... .. . .. .. ... .. 12. 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. ' I 1 7 L� 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 15. 16. Amount of Line 14 taxable at lineal rate X.0_ 16. 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 6 Q S 3 18. 0 7 . 6 /6 19. TAX DUE .. . . ... . ..... ..... . ... .. ..... . ... .. . .. . .. . .. . .. .... . ... .. 19. 9 .0 7 • IoG 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 1505611201 1505611201 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME MA-gi,od F W1�GG�IUER STREET ADDRESS 15q SlmmojiS R d. CITY �1 ech an r cs htJr P� STATE PA ZIP J7 055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 7 d b'7, rC 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 3. Interest 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) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 90 k , r Make check payable to: REGISTER OF WILLS, AGENT. J ` j ' b„� y;,a' °"t i t t'. �;• ��� .+�=:1�y T�'a nBE.r.+ '�� J <'c..rs;.. .�� ��r'�'%� 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 ............................................ ❑ M c. retain a reversionary interest .............................................................................................................................. ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 .2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. El 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? ........................................................................................................................ ❑ 5d 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+(01-10) pennsylvania SCHEDULE A ' DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARio&/ E. WA 6 GONFld al -lq- jgg7 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 1 154 Simmons Road, Me.M aMC5611t-f , Can*rland Lv. W 13 q. ff 79- 14 rnk A [1U5'j TOTAL(Also enter on Line 1, Recapitulation.) $ 139 97 /, 44 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+(ii-io) pennsytvania SCHEDULE E {� DEPARTMENT OF REVENUE CASH, BANK DEPOSITS &'MISC. _ INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MSR I�u WA66 o4tER 1Q1- 1q- 0gg1 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 M� "A $ 3 35'7- PjVc 3 q 1q, /7 q, PlV e- sa vIn � . J r Jam}} ;iovq J kl" TOTAL(Also enter on Line 5, Recapitulation) $ 100/ If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND - INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER mmloN a, -/y -ogg7 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL ,EXPENSES: G,7/,00 td B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: /� I` Name(s)of Personal Representative(s) K ADS a Dorw . t ti B,a dQ+uta Street Address a 4Q Stan a h o u m Rd city ,801IM47 9,on as State #* ZIP /700 Year(s)Commission Paid: (,1K1 CRO15 Yn, via) ¢ c9QL5 2r Attorney Fees: 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: —7/g- 5b 5. Accountant Fees: �QQ r 0 6. Tax Return Preparer Fees:7. Ad v araC 0 77. 93 1,,wn pas mem iso, a� TOTAL(Also enter on Line 9, Recapitulation) $ 7 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+ (12-08) e pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF .DECEDENT, INHERITANCE TAX RETURN MORTGAGE-LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER 1-//tRION G ql47 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Final AedlMl dnd blur5mg ham i4 a Q00 Cvuh Real Eft s-y'es ' ► f) TOTAL(Also enter on Line 10, Recapitulation) $ /// 7/1. 4?/ If more space is needed, insert additional sheets of the same size. REGISTER OF WILLS Certificate of Grant of Letters CUMBERLAND COUNTY, PENNSYLVANIA !- ' 1 U No. 21-1.4-0497 PA No. 21-14-0497 ESTATE OF Marion E. Waggoner a/k/a Marion Sta!U Waggoner Late Of: North Middleton Township, Cumberland County, Deceased Social Security No. WHEREAS, on the 22nd day of May, 2014, the instrument dated March 25, 2014, was admitted to probate as the Last Will of Marion E. Waggoner a/k/a Marion Starry Waggoner late of North Middleton Township, who died on the 11th day of May, 2014, and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, 1, Lisa M. Grayson, Esq., Register of Wills in and for the County of Cumberland, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters Testamentary to Kim E. March and Donna March, a/k/a Louise Donna March who duly qualified as Co-Executors and who agreed to administer the estate according to law, all of which fully appears of record in my office at Carlisle, Pennsylvania. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seal of my office the 22nd day of May, 2014.. �794ister of#11S Y-"Zrl�z P--- **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TE5TAMMVT OF c. CD C� ry N) .71 MARIO,ffl E —ER CD WA 6 6 ONE :�ZD CO r- rTJ q C> Com.) Gy 1,Marion E. Waggoner, a resident of Pennsylvania,hereby declare this ti'be my Last.-Will and revoke any Wills and Codicils previously made by me. ITEM 1: 1 appoint Mr. Kim March or his wife, Donna March as Co-Executors of my estate. Either of these Executors has the power to act individually as though they were named as a sole Executor. In the event that both Mr.Kim March or Donna March are unable or unwilling to serve as Executors, I then appoint, Marion Gayer and Wanda Wright to be Co-Executrices of my estate. ITEM 11: Except as otherwise specified in this Will, I direct my named Executrix or Executor to pay all of my legally enforceable debts, funeral expenses and costs of administering my estate,together with any federal, state, or other death taxes payable because of my death with respect to the property forming my gross estate for tax purposes,whether or not such property passes under this Will. The said items are to be paid from the remainder of my estate without apportionment or the right of reimbursement from any of the beneficiaries of this Will. ITEM III: It is my desire that my second cousin, Marion Goyer,of Cordova,Tennessee, have all diamond jewelry which may be owned by me at the time of my death. ITEM IV: It is my desire that any automobile owned by me at the time of my death be given to my friend, Wanda Wright, of Mechanicsburg, Pennsylvania. Page 1 of 3 ITEM V: To Lorena Schaffner I bequeath the sum of$3,000.00. ITEM VI: I devise and bequeath the remainder of my estate as follows: one-third(1/3)to my dear friends, Kim and Donna March; and two-thirds (2/3) to the Trindle Spring Lutheran Church of Mechanicsburg, Pennsylvania. ITEM VII: It is my wish that my Executor or Executrix shall accept all compensation to which he or she is legally entitled as the personal representative of my estate. ITEM VIII: No Executor or Executrix, or trustee of the estate or person of a minor or incompetent named in this Will shall be required to give bond or other security for the performance of his or her duties. IN WITNESS WHEREOF, I have signed and sealed this Will on this day of INCu(,E't_. 52014. (SEAL) Mariddf. Waggoner Signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. J dk�J of ffa4AAA Page 2 of 3 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND We, Marion E. Waggoner, Testatrix, Jeh r1 t�t t' L. �Pk wtcm and J U Sz��t ►ec: , witnesses, respectively,whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly,and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of their knowledge,the Testatrix was at that time eighteen(18) years of age or older, of sound mind and under no constraint or undue influence. W-�tIL111-�' Marion E. Waggoner Testatrix 1 Subscribed, sworn to and acknowledged before me this Z-5 day of MafcV , 2014. Notary Public COMMONVVEpLTii OF PENNSYLVANIA NOTARIAL SEAL Melissa A.Poling,Notary Public Lower Paxton Township,Dauphin County page 3 of 3 My commission expires tember 30,2015 e rs 93uhrig ��. Customer.: , t Kim and Leslie March NNVOICE 299 Old Stonehouse Road Boiling Springs, PA 17007 Invoice Number: 11191 Invoice Date: May 13, 2014 Page: 1 Name of Deceased Date of Death Payment Terms Funeral Director i Marion Waggoner May 11, 2014 Net 30 Days William L. Christopher Item Number Quantity Description Unit Price Amount PS Professional Services $ 5,840.00 I FSE Facilities, Staff and Equipment $ 2,250.00 V Vehicles $ 1,201.00 M Merchandise $ 1,855.00 CA Cash Advances $ 3,730.00 CA Cash Advances Adjustments ($ 5.00) Terms discount of$930.00 has been applied. I Tl� ank you for allowing us to serve You and Your family. Subtotal $ 14,871.00 We gladly accept the following forms of payment: Shipping $ 0.00 Cash, Check, Visa, MasterCard, Discover,American Express Sales Tax $ 0.00 Kindly make your check payable to: Total Invoice Amount $ _ 14,871.00 Myers- Buhrig Funeral Home and Crematory Payment/Credit Applied $ 14',871.00 Past due accounts are subject to interest charges of 1.5% per month. TOTAL DUE 0.00 Walking with Those in Grief Robert`Bob"L.Buhrig,Jr.,FD,Supervisor•William"Bill"L.Christopher,FD Phone: (717)766.3421 • Fax: (717)795.7291 • 37 East Main Street • Mechanicsburg,PA 17055 • www.Myers-Buhrig.com Directors(-Myers-Buhrig.com OMB Approval No.2502-0265 a r I� II ho A• Settlement Statement (HUD-1) a9:n a�qe B. Type of Loan 1.❑FHA 2.Q RHS 3.❑X Conv.Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4. VA 5. Conv.Ins. GABFAM.14-0 33333205 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: Charles E.Swartz and Marion E.Waggoner Estate Metro Bank Azlynn N.Swartz 159 Simmons Road 3801 Paxton Street 162 Meadow Lane Mechanicsburg,PA 17055 Harrisburg,PA 17111 Mechanicsburg,PA 17055 G. Property Location: H. Settlement Agent: I. Settlement Date: 159 Simmons Road GUARANTEED ABSTRACT SERVICES,INC. Mechanicsburg,PA 17055 3813 MARKET STREET August 4,2014 Cumberland County,Pennsylvania CAMP HILL PA 17011 Ph. (717)724-8758 Place of Settlement: GUARANTEED ABSTRACT SERVICES,INC. 3813 MARKET ST,CAMP HILL PA 17011 J. Summary of Borrowers transaction K. Summary of Sellers transaction 100. GrossAmount Due from Borrower: 400. GrossAmount Due to Seller: 101. Contract sales price 176,000.00 401. Contract sales price 176,000.00 102. Personal property402. Personal property 103. Settlement Charges to Borrower Line 1400) 8,556.11 403. 104. 404. 105. 405. Adjustments for items paid by Seller in advance Adjustments for items paid by Seller in advance 106. COUNTY/TOWNSHIP 08/04/14 to 12/31/14 228.75 406. COUNTYITOWNSHIP 08/04/14 to 12/31/14 228.75 107. CITY TAX to 407. CITY TAX to 108. SCHOOL TAX 08/04/14 to 06/30/15 1,475.75 408. SCHOOLTAX 08/04/14 to 06/30/15 1,475.75 109. Sewer Fees 08/04/14 to 09/30/14 192.07 409. Sewer Fees 08/04/14 to 09/30/14 192.07 110. 410. 111. 411. 112, 412. 120. Gross Amount Due from Borrower 186,452.68 420. Gross Amount Due to Seller 177,896.57 200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due Seller: 201. Deposit or earnest money 1,600.00 501. Excess deposit(see instructions 202. Principal amount of new loans 167,000.00 502. Settlement charges to Seller(Line 1400) 23,914.72 203. Existing loans taken subject to 503. Existing loans taken subject to 204. 504, Payoff First Mortgage to PNC Bank 21,091.08 205. 505. Payoff Second Mortgage to PNC Bank 3,833.57 206. 506. 207. 507. (Deposit disb.as proceeds 208. 508. 209. 509. Adjustments for items unpaid by Seller Adjustments for items unpaid by Seller 210. COUNTY/TOWNSHIP to 510. COUNTY/TOWNSHIP to 211. CITY TAX to 511. CITY TAX to 212. SCHOOL TAX to 512. SCHOOL TAX to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid by/for Borrower 168,600.00 520. Total Reduction Amount Due Seller 48,839.37 300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller 301. Gross amount due from Borrower line 120 186,452.68 601. Gross amount due to Seller line 420 177,896.57 302. Less amount paid by/for Borrower(line 220) ( 168,600.00)1 602. Less reductions due Seller(line 520) ( 48,839.37 303. Cash O From ❑ To.Borrower 17,852.68 603. Cash a To From Seller 129,057.20 'Paid outside of closing by borroler(B),sellers),lender(L),or tNrd-parly(T) The undersigned hereby ackknno�wledge recei t of a com`leted copy of this statement&any attachments referred to herein Borrower / Seller Marion E.W ggoner Estate .� C-harles E.Swartz BY: CXTIZ Azynn artz The Pubic Reporting Burden for Vs collection of information is estimated at 35 minutes per response for collecting,revieMng,and reporting the data.This agency may not collect this information,and you are not required to compete this form,unless it displays a currently valid OMB control number.No corf dentiality is assured;tis dsclosur a is mandatory.TNs is designed to provide the parties to a RESRncover ed Iran-lin,Kith inform ation durirgthe seluem ent process, Page 1 of 3 HUD-1 (S WART Z2.PFD/SWARTZ2/40) L.Settlement Charges 700.Total Real Estate Broker Fees $10,560.00 Paid From Paid From Division of commission(line 700)as follows: Borrowers Sellers 701.$5,505.00 to Berkshire Hathaway HomeServices Funds at Funds at Note:Line 701 Includes Adjustment of 225.00 For Broker Fee Settlement Settlement 702.$ 5,280.00 to Thompson Wood Real Estate 703.Commission paid at settlement 10 785.00 704. 705. 706.Additional Commission to Thompson Wood Real Estate 500.00 800.Items Payable in Connection with Loan 801.Our origination charge $ 995.00 from GFE#1 802.Your credit or charge(points)for the specific interest rate chosen $ 1,670.00 (from GFE#2) 803.Your adjusted origination charges from GFE#A 2,665.00 804.Appraisal fee to Mark Heckman Real Estate Appraisers (from GFE#3) $375.00 POC B 805.Credit Report to Equifax Mortgage Solutions from GFE#3 25.66 806.Tax service to (from GFE#3) 807.Flood certification to Wolters Kluwer from GFE#3 6.00 808.Appraisal-Additional Col Appraisal Solutions (from GFE#3) $375 POC B 809.Lien Search-Additional( to FA Business Services from GFE#3 52.00 810.Flood Cert-Additional C, to Wolters Kluwer Financial Services (from GFE#3) 6.00 811. (from GFE#3) 900.Items Required by Lender to Be Paid in Advance 901.Daily interest charges from to @ $25.513900/da from GFE#10 902.Mortgage insurance premium for months to from GFE#3) 903.Homeowner's insurance for 1.0 years to American Zurich Insurance from GFE#11 $1,512 POC B 904. Flood Insurance 1.0 years to Franklin Homeowners Assurance from GFE#11 $368 POC B 905. HOI-Additional Collateral Motorists Mutual (from GFE#11) $747 POC B 1000.Reserves Deposited with Lender 1001.Initial deposit for your escrow account (from GFE#9) 1,554.95 1002.Homeowner's insurance 6.000 months @ $ 126.00 per month $ 756.00 1003.Mortgage insurance months P $ per month $ 1004.Property taxes S 1,111.23 COUNTY TAX months $ per month CITY TAX 9.000 months $ 46.57 per month SCHOOL TAX 5.000 months P S 138.42 per month 1005. $ COUNTYlfOWNSHIP months P $ per month SCHOOL TAX months $ per month 1006. months @ $ per month $ 1007. Flood Insurance months @ $ per month $ 1008. $ 1009.AGGREGATE ADJUSTMENT $ -312.28 1100.Title Charges 1101. Title services and lender's title insurance from GFE#4 1;620.00 1102. Settlement or closing fee $ 1103. Owner's title insurance to FIRST AMERICAN TITLE INS.CO. from GFE#5 15.00 1104. Lender's title insurance to FIRST AMERICAN TITLE INS.CO. $ 1,435.00 1105. Lender's title policy limit S 167 000.00 1106. Owner's title policy limit $ 176,000.00 1107. Agent's portion of the total title insurance premium to GUARANTEED ABSTRACT SERVICES 1 $ 1,232.50 1108. Underwriter's portion of the total title insurance premium to FIRST AMERICAN TITLE INS.CO. $ 217.50 1109. Notary Fee to GUARANTEED ABSTRACT SERVICES,INC$ 10.00 1110. Payoff/Overnight Fee to GUARANTEED ABSTRACT SERVICES,INC$ 30.00 1111. Tax Cert Reimbursement to GUARANTEED ABSTRACT SERVICES,INC$ 20.00 1112. Deed Preparation to GUARANTEED ABSTRACT SERVICES,INC$ 150.00 1113. $ 1200.Government Recording and Transfer Charges 1201.Government recording charges to RECORDER OF DEEDS (from GFE#7) 351.50 1202.Deed $ 77.50 Mortgage S 131.00 Releases S Other $ 143.00 1203.Transfer taxes to RECORDER OF DEEDS from GFE#8 1,760.00 1204.Cit/Count tax/stamps S 1,760.00 $ 1,760.00 1205.State tax/stamps $ 1,760.00 $ 1206. 1207. 1300.Additional Settlement Charge's 1301.Required services that you can shop for (from GFE#6) 1302. 2014 School Tax to Mary A.Murray,Tax Collector $ 1,627.80 1303. 3rd Quarter Sewer Fees to Monroe Township Sewer Authoril $ #1348 310.00 1304. Inheritance Tax Escrow to Guaranteed Abstract Services $ 9,221.92 1305. $ 1400.Total Settlement Charges(enter on lines 103,Section J and 502,Section K) 8,556.11 23,914.72 Paid outside of closirg by borroxer(B),sellw(S),lender(L),or Ihrd-party(T) + By signing page 1 of ths statement the signatories acknogedge receipt of a competed copy of page 2&3 of the 0-page ale enl. GUARANTEED A ST CT SERVICES,INC.,Settlement Agent Certified to be a true copy. Page 2 of 3 HUD-1 (SWART Z2.PFD/SWARTZ2/40) Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD-1 Charges That Cannot Increase HUD-1 Line Number Our origination charge # 801 995.00 995.00 Your credit or charge(points)for the specific rate chosen # 802 1,670.00 1,670.00 Your adjusted origination charges # 803 2,665.00 2,665.00 Transfer taxes #1203 1 5,020.00 1,760.00 Charges That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1 Government recording charges #1201 400.00 351.50 Appraisal fee # 804 600.00 375.00 Credit report # 805 25.66 25.66 Flood certification # 807 6.00 6.00 Appraisal-Additional Collateral # 808 600.00 375.00 Lien Search-Additional Collateral # 809 5200. 52.00 Flood Cert-Additional Collateral # 810 6.00 6.00 Total 1,689.66 1 1,191.16 Increase between GFE and HUD-1 Charges $ -498.50 or -29.50 Charges That Can Change Good Faith Estimate HUD-1 Initial deposit for your escrow account #1001 3,500.00 1,554.95 Homeowner's insurance # 903 1,200.00 1,512.00 Flood Insurance # 904 1,800.00 368.00 HOI-Additional Collateral # 905 720.00 747.00 Title services and lender's title insurance #1101 1,700.00 1,620.00 Owner's title insurance to FIRST AMERICAN TITLE INS.CO. #1103 420.00 15.00 Loan Terms Your initial loan amount is $167,000.00 Your loan term is 29.00 years Your initial interest rate is 5.5000 Your initial monthly amount owed for principal,interest and $961.16 includes any mortgage insurance is Q Principal Interest ❑ Mortgage Insurance Can your interest rate rise? ❑ No X❑ Yes,it can rise to a maximum of 11.50000%. The first change will be on 08/04/2020 and can change again every 12 months after 08/04/2020. Every change date,your interest rate can increase or decrease by 2.00000%. Over the life of the loan,your interest rate is guaranteed to never be lower than 5.50000%or higher than 11.50000%. Even if you make payments on time,can your loan balance rise? ❑X No ❑ Yes,it can rise to a maximum of$ Even if you make payments on time,can your monthly ❑ No ❑X Yes,the first increase can be on 09/04/2020 and the monthly amount owed for principal,interest,and mortgage insurance rise? amount owed can rise to$1,150.77. The maximum it can ever rise to is$1,555.45. Does your loan have a prepayment penalty? ❑X No ❑ Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? ❑X No ❑ Yes,you have a balloon payment of$ 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. ❑X You have an additional monthly escrow payment of$310.99 that results in a total initial monthly amount owed of$1,272.15. This includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes ❑X Homeowner's insurance ❑ Flood insurance ❑X School Tax 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 (SWART Z2.PFDSW ARTZ2/39) HUD-1 Attachment Borrower(s):Charles E. Swartz and Azlynn N. Swartz Sellel(s): Marion E.Waggoner Estate 162 Meadow Lane 159 Simmons Road Mechanicsburg, PA 17055 Mechanicsburg, PA 17055 Lender:Metro Bank Settlement Agent:GUARANTEED ABSTRACT SERVICES, INC. (717)724-8758 Place of Settlement:GUARANTEED ABSTRACT SERVICES, INC. 3813 MARKET ST,CAMP HILL PA 17011 Settlement Date:August 4,2014 Property Location:159 Simmons Road Mechanicsburg, PA 17055 Cumberland County, Pennsylvania Additional Adjustments For Items Paid By Seller In Advance(Borrower Debit) Description Amount From/Through Prorated Amount Sewer Fees 310.00 08/04/14 through 09/29/14 192.07 Total Line 109/409 192.07 Seller Loan Payoff Details Payoff First Mortgage to PNC Bank Loan Payoff 21,076.91 As of 07/31/14 Total Additional Interest 14.17 9 days @ 1.574100 Per Diem Total Loan Payoff 21,091.08 Payoff Second Mortgage to PNC Bank Loan Payoff 3,827.95 As of 07/31/14 Total Additional Interest 5.62 9 days @ 0.624000 Per Diem Total Loan Payoff 3,833.57 Adjusted Origination Charge Details Origination Charge Origination Fee 995.00 to Metro Bank Total $ 995.00 Origination Credit/Charge(points)for the specific interest rate chosen Credit/Charge 1,670.00 to Metro Bank Total $ 1,670.00 Adjusted Origination Charges $ 2,665.00 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. For details see: Title 18 U.S.Code Section 1001 and Section 1010. (SWART Z2.PF D/S WARTZ2/40) HUD-1 Attachment- Continued Reserves Deposited with Lender Homeowner's Insurance 756.00 6.000 at 126.00 per month C ITY TAX 419.13 9.000 at . 46.57 per month SCHOOL TAX 692.10 5.000 at 138.42 per month AGGREGATE ADJUSTMENT -312.28 Total $ 1,554.95 Title Services and Lender's Title Insurance Details BORROWER SELLER CPL to First American Title In 75.00 to FirstAmerican Title Insurance Company Email Document Retrieval 50.00 to GUARANTEED ABSTRACT SERVICES, INC. Notary Fee 20.00 to GUARANTEED ABSTRACT SERVICES, INC. Overnight Fee/Package 25.00 to GUARANTEED ABSTRACT SERVICES, INC. Incoming Wire Fee 15.00 to GUARANTEED ABSTRACT SERVICES, INC. Lender's title insurance 1,435.00 to FIRST AMERICAN TITLE INS. CO. Total $ 1,620.00 $ 0.00 Owner's Title Insurance BORROWER SELLER Owner's Policy Premium 15.00 to FIRST AMERICAN TITLE INS. CO. Total $ 15.00 $ 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above in Title Services and Lenders Title Insurance Details Lender's Policy Premium 1,235.00 to FIRST AMERICAN TITLE INS.CO. Lender's Endorsement Charges 200.00 Endorsement Endorsement Charge END 100 50.00 END 300 50.00 END 900 50.00 ALTA Endorsement Form 6(Variable Rate Mortgage) 50.00 Total $ 1,435.00 $ 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. For details see: Title 18 U.S.Code Section 1001 and Section 1010. (SWART Z2.PFD/S WARTZ2/40) Premium Money Market Statement (3. PNC BANK PNC Bank Primary account number:50-0487-5923 Page 1 of 3 For the period 05/08/2014 to 06/06/2014 Number of enclosures:0 A 000300 r=_1 For 24-hour banking,and transaction or MARION E WAGGONER DECD interest rate information,sign on to 299 OLD STONEHOUSE RD S PNC Bank Online Banking at pnc.com. BOILING SPRINGS PA 17007-9693 For customer service call 1-888-PNC-BANK Monday-Friday:7 AM-10 PM ET Saturday&Sunday: 8 AM-5 PM ET Para servicio en espafiol,1-866-HOLA-PNC Moving? Please contact us at 1-888-PNC-BANK CED Write to:Customer Service PO Box 609 Pittsburgh PA 15230-9738 07 Visit us at PNC.corn j!��k TOD terminal: 1-800-531-1648 For hearing impaired clients only Premium Money Market Account Summary Marion E Waggoner Decd Account number: 50-0487-5923 Overdraft Coverage-Your account is currently0pted-Out. You or your joint owner may revoke your opt-in or opt-out choice at any time. To learn more about PNC Overdraft Solutions visit us online at pne.com/overdraftsolutions. Call 1-877-588-3605,visit any branch,or Sign on to PNC Online Banking,and selectthe"Overdraft Solutions'link underthe Account Services section to manage both your Overdraft Coverage and Overdraft Protection settings. Balance Summary Beginning Deposits and Checks and other Ending balance other additions: deductions balance 21,706.83 .78 21,707.04 .57 Average monthly Charges balance and fees 15,918.36 .00 Transaction Summary Checks paid/ Check Card POS Check Card/Bankcard withdrawals signed transactions POS PIN transactions 1 0 0 Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Interest Summary As of 06/06,a total of$6.33 in interest was Annual Percentage Number of days Average collected Interest Paid paid this year. Yield Earned(APYE) in interest period balance for APYE this period 0.067. 30 15,91836 .78 Withholding Interest earned Withholding this period year-to-date year-to-date .21 6.33 .21 PNDMLT01-JOB45268-N40-YNNNNN-002-000561 Premium Money Market Statement For the period 05/08/2014 to 06/06/2014 For 24-hour information,sign onto PNC Bank Online Banking MARION E WAGGONER DECD on pne.com. Primary account number:50-0487-5923 Account number:50-0487-5923-continued Page 2 of 3 Activity Detail Deposits and Other Additions There was 1 Deposit or Other Addition Date Amount Description totaling$.78. 06/06 .78 Interest Payment Other Deductions There were 2 Other Deductions totaling Date Amount Description $21,707.04. 05/30 21,706.83 Withdrawal Reference No. 049225543 06/06 .21 Interest Withholding Daily Balance Detail Date Balance Date Balance Date Balance 05/08 21,706.83 05/30 .00 06/06 .57 Are you someone who likes to be in control of your finances? Introducing PNC Total Insight(sm)from PNC Investments.Offering hands-on control and professional guidance.Bringing together all of your banking and investing with powerful online tools that give you a 360-degree view of your finances.And you'll always have a dedicated PNC Investments Financial Advisor nearby to help when you need it. For your consultation with a PNC Investments Financial Advisor, simply visit your local branch or call 1-855-PNC-8682 for information on PNC Total Insight. IMPORTANT INVESTOR INFORMATION:Brokerage and insurance products are: Not FDIC Insured--Not Bank Guaranteed--Not a Deposit Not Insured By Any Federal Government Agency--May Lose Value Securities and brokerage services are provided by PNC Investments LLC,a registered broker-dealer and investment adviser and member FINRA and SIPC. Annuities and other insurance products are offered by PNC Insurance Services,LLC a licensed insurance agency. �I I i I� r �+r�r o-nren!ottaui+. r Premium Plan Statement PNCBANK PNC Bank Primary account number:50-7002-7885 Page 1 of 6 For the period 04/11/2014 to 05/12/2014 Number of enclosures:0 000154 For 24-hour banking,and transaction or MARION E WAGGONER interest rate information,sign on to =ti 299 OLD STONEHOUSE RD S PNC Bank Online Banking at pnc.com. BOILING SPRINGS PA 17007-9693 IT For customer service call 1-888-PNC-BANK Monday-Friday:7 AM-10 PM ET Saturday&Sunday: 8 AM-5 PM ET Para servicio en espafiol, 1-866-HOLA-PNC Moving? Please contact us at 1-888-PNC-BANK ® Write to:Customer Service PO Box 609 Pittsburgh PA 15230-9738 1 Visit us at PNC.com TDD terminal:1-800-531-1648 For hearing impaired clients only Premium Plan Marion E Waggoner Interest Checking Account Summary /Account number: 50-7002-7885 Overdraft Protection Provided By: XXXXXXXXXXXX1666 Overdraft Coverage-Your account is currently Opted-Out. You or your joint owner may revoke your opt-in or opt-out choice at any time. To learn more about PNC Overdraft Solutions visit us online at pnc.com/overdraftsolutions. Call 1-877-588-3605,visit any branch,or Sign on to PNC Online Banking,and seleathe"Overdraft Solutions"link underthe Account Services section to manage both your Overdraft Coverage and Overdraft Protection settings. Balance Summary Beginning Deposits and Checks and other Ending balance other additions deductions balance 15,913.90 7,717.86 20,212.59 3,419.17 Average monthly Charges balance and fees 3,911.45 .00 Transaction Summary Checks paid/ Check Card POS Check Card/Bankcard withdrawals signed transactions POS PIN transactions 1.7 0 0 Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Interest Summary As of 05/12,a total of$.06 in interest was Annual Percentage Number of days Average collected Interest Paid paid this year. .Yield Earned (APYEy in interest period balance for APYE this period 0.01% 32 3,898.95 .04 PNnmI Tf)1-.IOR?RnR6-140-NNNNNN-no,4-onn46R Premium Plan Statement For the period 04/11/2014 to 05/12/2014 (� For 24-hour information,sign onto PNC Bank Online Banking MARION E WAGGONER on pnc.com. Primary account number:50-7002-7885 Account number:50-7002-7885-continued Page 2 of 6 Activity Detail Deposits and Other Additions There were 6 Deposits and Other Additions Date Amount Description totaling$7,717.86. 04/25 2,500.00 Online Transfer From 4003048009261666 05/01 297.82 Direct Deposit-Pens Pmts Taylor-Wharton H XXXXX9490 05/02 1,420.00 Direct Deposit-Xasoc Sec SSA Treas 310 XXXXX4585D 05/06 3,000.00 Online Transfer From 4003048009261666 05/12 500.00 Deposit Reference No. 051057589 05/12 .04 Interest Payment Checks and Substitute Checks Check Date Reference Check Date Reference number Amount paid number number Amount paid number 3307 75.00 04/14 086839807 3318 75.00 05/12 085382313 3309 * 15,000.00 04/15 083381092 3319 1,110.00 05/05 084750148 3310 40.00 04/14 086867629 3320 87.96 05/07 077889447 3312 * 50.00 04/17 076543615 3321 46.81 05/07 086595674 3313 307.06 04/16 084661760 3322 90.00 05/07 086601384 3314 375.00 04/28 049020360 3325 * 840.00 05/07 086601385 3315 45.75 05/08 083043374 3326 705.00 05/07 086601386 3316 780.00 05/08 083070147 3329 * 30.00 05/12 085346246 3317 105.00 05/05 084599293 *Gap in check sequence There were 17 checks listed totaling $19,762.58. Online and Electronic Banking Deductions There were 4 Online or Electronic Banking Date Amount Description Deductions totaling$202.05. 05/05 83.15 Direct Payment-Amount Due Guarantee Trust Gta1168134 05/05 4.95 Direct Payment-6 Ins Prem Ad&D XXXXX2953 4492781 05/06 62.52 Direct Payment-ACH Firstenergy Opco XXXXXXXX1075 05/12 51.43 Direct Payment-XXXXXX8863 Medico Dxxxx3=3=0400 Other Deductions There was 1 Other Deduction totaling Date Amount Description $247.96. 04/21 247.96 Loan Payment 00000 4001008110703168 Daily Balance Detail Date Balance Date Balance Date Balance Date Balance 04/11 15,913.90 04/17 441.84 05/01 2,616.70 05/07 3,901.31 04/14 15,798.90 04/21 193.88 05/02 4,036.70 05/08 3,075.56 04/15 798.90 04/25 2,693.88 05/05 2,733.60 05/12 3,419.17 04/16 491.84 04/28 2,318.88 05/06 5,671.08 f�Hr4�•tiex•�,,, ,-Owl Kelley Blas Book The Trusted Resource uppor�,the American Red Cross, rb Adverbsernent Why ads? 2004 Jeep Liberty Pricing Report Style:Sport UtrTity 4D Mileage: 102000 �4 Gccj Ver;wood t_:, Candt�� Condition v ter,5 t;-'., $6,318 Ezct.l-�t Nti .rt Very Good Condition Private Party Values valid for your area through 7/31/2014 Track this car's values ©1995-2014 Kelley Blue Book Co.6,Inc.All rights reserved. ©2014 Kelley Blue Book Co.,Inc.All rights reserved.7/2512014-713112014 Edition for Penns yivania 17055.The specific information required to determine the value for this particular vehicle was supplied by the person generating this report.Vehicle valuations are opinions and may vary from vehicle to vehicle.Actual valuations will vary based upon market conditions, specifications,vehicle condition or other particular circumstances pertinent to this particular vehicle or the transaction or the parties to the transaction.This report is intended for the individual use of the person generating this report only and shall not be sold or transmitted to another party.Kelley Blue Book assumes no responsibility for errors or omissions.(v.14074) 1