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Home My WebLink About02-06-15 REV-1500 EX(02-11) 1!� 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes OrPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 14 429 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 04 16 2014 12 25 1928 Decedent's Last Name Suffix Decedent's First Name MI BRUNNER DOROTHY 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 nX 1. Original Return ❑ 2. Supplemental Return3. Remainder Return(Date of Death n Prior to 12-13-82) ❑ 4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) n 6. Decedent Died Testate ❑ 7. Decedeat MaintYned a Living Trust 0 nX (Attach Copy of Will) (Attach opy of rust) - 8, Total Number of Safe Deposit Boxes n 9. Litigation Proceeds Received ❑ 10.Sgousal Povert��reditjl)ate of Death ❑ 11.Election to tax under Sec.9113(A) b tween 12-31- and n (Attach Schedule 0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number SCOTT ALAN MITCHELL ESO 717 233 5731 C=:> REGIS51ER OF WILL"SE"L TTI M. UD First Line of Address rri PO BOX 1146 M Second Line of Address 73 .3 <D City or Post Office - TE FILA State ZIP Code ' DA HARRISBURG PA 171081146 Correspondent's e-mail address: smitchell(cDrhoads-sinon.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 RESPONSI LE OR FILING RETURN ATE &Atwl� 0— Barbara A.Stone <�a D,01 ADDRESS —c/o Rhoads & Sinon LLP, Harrisburg, PA 17108 SIGNATURE OF PREPARER 0TH PREPARETHAN REPRESENTATIVE DATE Scott A. Mitchell ADDRESS —Rhoads & Sinon LLP, Harrisburg, PA 17108 Side 1 1505610143 1505610143 1 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Brunner, Dorothy E. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 127 , 000 . 00 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 7 , 051 . 58 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneoush}nn Probate Property (Schedule G) U Separate Billing Requested............ 7. 45 , 688 . 30 8. Total Gross Assets (total Lines 1 through 7)........................................................ 8. 179, 739 . 88 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 3 6, 712 . 78 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 295 . 53 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 37 , 008 . 31 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 142 , 731 . 57 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. 142 , 731 . 57 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0 . 00 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable 142 , 731 . 57 16. 6 , 422 . 92 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 6, 422 . 92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 1505610243 1505610243 ,� REV-1500 EX Page 3 File Number 21-14-429 Decedent's Complete Address: DECEDENT'S NAME Brunner, Dorothy E. STREET ADDRESS 10 Adams Road CITY ZIP Carlisle STATE PA 17015 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) 6,422.92 2. Credits/Payments A. Prior Payments 0.00 B. Discount 0.00 Total Credits(A +8) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line I +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 6,422.92 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;... ...........__....... ................ Fx_1 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 Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............__....__........_...........................__............... .........._......_. ❑ 51 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... El Fi] 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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent 172P.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) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 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 Include a copy of the deed showing decedent's Interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 10 Adams Road,Carlisle, South Middleton Township, Cumberland County, PA-Valued at 127,000.00 selling price. See attached HUD-1. TOTAL(Also enter on Line 1, Recapitulation) 127,000.00 (if more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10) Rev-1508 EX+(I 1-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC.- DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH I M&T Bank Decedent Checking Account-Account#9860633446 opened 5110/13 in decedent's 3,657.80 name alone. See attached valuation. Accrued interest on Item I through date of death 0.01 2 M&T Bank Decedent Savings Account-Account#15004208552065 opened 6/23/1987 in 2,494.96 decendant's name alone. See attached valuation. Accrued interest on Item 2 through date of death 0.02 3 Carlise Propane-Refund of excess propane. 57.72 4 Centuryl-ink-Refund for telephone service. 11-63 5 Comcast-Refund for cable service. 1.59 6 Dennis F. Hufnagle, III -Reimbursement for school taxes at settlement. 547.90 7 Department of Treasury-Rebate 250.00 8 Medicalert-Refund for services. 29.95 TOTAL(Also enter on Line 5, Recapitulation) 7,051.58 (if more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF RANSFERSATTACH THEIR CO COPY THE DEEDFORFFOR REAL ESTATE. VALUE OF ASSET NT AND INTEREST (IF APPLICABLE) VALUE 1 Western&Southern Life Annuity-Contract 45,613.30 45,613.30 #W0020598827; beneficiary of annuity in equal shares is Barbara Stone and Linda Thumma. See attached valuation. Accrued income on Item 1 through date of death 75.00 75.00 TOTAL(Also enter on Line 7, Recapitulation) 45,688.30 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1511 EX+(10-09) SCHEDULE H pennsylvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DEC DENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: , See continuation schedule(s)attached 3,728.95 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(s)Commission Paid 2. Attorney's Fees Rhoads & Sinon LLP 7,571.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip RelationshiD of Claimant to Decedent 4. Probate Fees 353.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 25,059.33 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 36,712.78 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Church of God Home-Payment for funeral service. 148.00 2 Eby Granite Works -Payment for engraving of headstone. 130.00 3 Ewing Brothers Funeral Home-Payment for funeral. 301.96 4 Ewing Brothers Funeral Home-Payment for funeral. 3,010.00 5 Hallmark-Payment for thank you cards and envelopes. 13.99 6 Huntsvale Women's Fellowship-Payment for funeral meal. 125.00 H-A 3,728.95 Other Administrative Costs 7 Advanced Disposal -Payment for disposal to clean out real estate. 42.09 8 Barristers Land Abstract-Payment of escrow fee. 25.00 9 Barristers Land Abstract-Reimbursement for tax certification and postage. 10.48 10 BHHS Homesale Realty-Payment of real estate commission. 4,160.00 11 BIS Home Inspection -Payment in preparation of sale of real estate. 325.00 12 Cumberland County Recorder of Deeds -Payment of transfer tax. 1,270.00 13 Cumberland Law Journal -Payment for estate advertising. 75.00 14 Dennis F. Hufnagle, III-Seller assist at real estate settlement. 4,000.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 ITEM NUMBER DESCRIPTION AMOUNT 15 Dennis F. Hufnagle, III -Payment to buyer at settlement for unpaid county taxes from 111/15 19.34 to 1/20/15. 16 Don Heishman -Payment for lawn service. 90.00 17 Don Heishman -Payment for lawn service. 60.00 18 Don Heishman-Payment for lawn service. 60.00 19 Don Heishman-Payment for lawn service. 60.00 20 First American Home Buyers Protection-Payment for home warranty. 365.00 21 Hershman-Payment for lawn mowing. 90.00 22 Hershman -Payment for lawn mowing. 90.00 23 Howard Hanna Carlisle-Payment of real estate commission. 3,915.00 24 Jennifer Varner Tax Collector-Payment of school real estate taxes for 2014. 1,209.77 25 Jennifer Varner Tax Collector-Payment of real estate taxes. 1,209.77 26 John Osborn -Payment for renovations to real estate in preparation for sale. 800.00 27 Linda Thumma-payment for miscellaneous expenses for administration of the estate. 10.59 28 Linda Thumma-payment for miscellaneous expenses for administration of the estate. 41.84 29 Lowes-Payment to Barbara Stone as reimbursement for home improvement purchases. 61.07 30 Lowes-Payment to Barbara Stone as reimbursement for home improvement purchases. 110.14 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 ITEM NUMBER DESCRIPTION AMOUNT 31 M&T Bank Decedent Savings Account-Payment of service charge at closing of account. 10.00 32 Met-Ed -Payment for electric service. 34.71 33 Met-Ed -Payment for electric service. 13.39 34 Met-Ed-Payment for electric service. 32.30 35 Met-Ed -Payment for electric service. 138.54 36 Met-Ed -Payment for electric service. 44.45 37 Met-Ed-Payment for electric service. 59.83 38 Met-Ed-Payment for electric service. 3.29 39 Met-Ed-Payment for electric service. 44.04 40 Neidlinger Fine Homes -Payment for fuel oil. 200.00 41 Osborn Renovation-Payment for renovations to real estate in preparation for sale. 780.00 42 Penn National-Payment for home insurance premium. 167.50 43 Rhoads&Sinon LLP-Escrow for administrative costs to close estate. 1,000.00 44 Rodger Conrad-Payment to remove debris from real estate in preparation for sale. 400.00 45 Sherry Wenger-Payment for cleaning of real estate in preparation for sale. 100.00 46• Sherry Wenger-Payment for cleaning of real estate in preparation for sale. 70.00 47 South Middleton Municipal Authority-Payment of water and sewer. 135.22 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 ITEM NUMBER DESCRIPTION AMOUNT 48 South Middleton Municipal Authority-Payment of water and sewer. 135.22 49 South Middleton Municipal Authority-Payment of final water and sewer. 167.62 50 United States Postal Service-Payment for stamps. 9.80 51 Unknown payee-Payment to Barbara Stone as reimbursement for home improvement 753.33 purchases. 52 Vincent LaPorte Jr.-Payment to paint house in preparation for sale. 1,600.00 53 Washinger Electric-Payment for electric repairs. 1,060.00 1-1-137 25,059.33 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 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 1 Centuryl-ink-Payment for telephone service. 44.04 2 Medicalert-Payment for service for time period prior to death. 29.95 3 Medicalert-Payment for service for time period prior to death. 20.32 4 Sherry Wenger-Payment for caretaking services rendered. 60.00 5 South Middleton Municipal Authority-Payment of water and sewer. 135.22 6 United States Treasury-Payment for 2013 personal income tax. 6.00 TOTAL(Also enter on Line 10, Recapitulation) 295.53 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Brunner, Dorothy E. 21-14-429 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trust e s I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Nancy P. LaPorte Daughter One quarter of 24,260.82 500 Alden Street Estate. Harrisburg, PA 17109 2 Barbara A. Stone Daughter One quarter of 47,104.97 1517 W.Trindle Road Estate. Carlisle, PA 17015 3 Linda K.Thumma Daughter One quarter of 47,104.97 110 Church Road Estate. Carlisle, PA 17015 4 Connie L.Townsend Daughter One quarter of 24,260.82 2670 Geryville Pike Estate. Pennsburg, PA 18073 Total 142,731.58 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) LAW OPPICPS STEPHEN J. HOGG K37011NEY AY'LAW 19 S.1IANOVJ.7_�3')21:13T-SUITE 10J �'�.• CARLISCI,PENNSYLVANIA 17013 (717)245-2698•FAX(717)245-0829 WILL OF DOROTHY E. BRUNNER I, Dorothy E. Brunner, of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and .hereby revoke all prior Wills and Codicils. 1. 1 direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. 1 dire(.`:that all .inheritar-ce, estrate, transfer, succession and death taxRs of any kind whatsoeVEO'which I,• ay be payable by reason cf my death :-,hall be paid out of any residuary estate. 3. 1 direct that my entire estate be distributed as follow: A. I direct that my entire estato be sold and d'ijided equally among my four chi,dren, Conr, e L. Townsend, Linda K. ThUmma, Nancy P. Laporte, and Barbara Ann Stone. 'B. I choose to not leave anything to my son, Richard D. Brunner 4. 1 appoint Barbara tinn Stene as Exer:ut ix of this my last Will, If she should pledecea5e me or cease 'Lo act in such capacity, I appoint Linda K. Thumma as alternate. 5. The Executrix of this Will shall have the sower to distribute my estate in kind or in cash, or partly in either. 6. 1 direct that no Executrix actir•g under this Will shall be required to enter bond in any jurisdiction, IN I NESS WHE F, I have hereunto set my hand this— day of, �r, 2011. LAW OFMCesor• STEPHEN J. HOGG Dorothy E runner 19 S.HANOVER STREET SUITE 101 CARLISLE,PA 17013 t1 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by Dorothy E. Brunner, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. 1 WITNESS "J WITNESS LAW OFFICFSOF ►TEPHEN J. HOGG 19 S.HANOVER STREET SUITE 101 CARLISLE,PA 17013 --ACKNOWLEDUMENT' State of Pennsylvania ss County of Cumberland 1, Dorothy E. Brunner, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Dorothy WBrunner Sworn to or affirmed and cknowledged before me)D-y--Dorothy ,x� i.s day of aWallle� r-, e S 1 a I rdix,this 011. AF NAL SEAL ftephen J.Ifogg,F40jery pubua dand Co.PA my �mvq Nota�r" Public/Att"n y AFFIDAVIT State of Pennsylvania ss County of Cumberland We L (:�j-S�hRla n d v-6, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and oxecuted it as her free and volunl-ar,-, art for the purposes,therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowledge the testatrix was at that tlm)p-�18 or more years of age, of S�dmind ay u der no consttraintWu Sworn to or affir and subspribed to b ore me by witnesses, this —:72day of 201 LAW OFFICES OF N-OTARRAL SEAL STEPHEN J. HOGG J.Hogg,psaft 19 S.HANOVER STREET uy fry qubfic/Attorney SUITE 101 ROY comyMerskm ropliw CARLISLE,PA 17013 COPYPproval No.2502-0265 A. Settlement Statement (HUD-1) I.m Old 1.f-1 FHA 2.Q.RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: 14-01-36725 MBG1406049697 4.❑VA 5.❑Con4.Ins. C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents 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&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: Dennis F.Hufnagle,III Estate of Dorothy E.Brunner Residential Mortgage Services,Inc. 128 Race Street,Boiling Springs,PA 17007 10 Adams Road,Carlisle,PA 17015 ISAOA ATIMA,24 Christopher Toppi Drive, South Portland,ME 04106 G.Property Location: H.Settlement Agent: 1.Settlement Date:0112012015 10 Adams Road *Barristers Land Abstract Company Disbursement Date:01120/2015 Carlisle,PA 17015 163 N.Hanover Street,Carlisle,PA 17013 South Middleton Township r163 e of Settlement: TitleExpress N.Hanover Street,Carlisle,PA 17013 Printed 0119/2015 at 5:49 pm by JE 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contract sales price 127,000.00 401. Contract sales price 127,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower(line 1400) 8,839.36 403.. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes to 407.' County taxes to 108. School Taxes 0112012015 to 0613012015 547.90 408. School Taxes 0112012015 to 0613012015 547.90 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 136,387.26 420. Gross Amount Due to Seller 127,547.90 200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due to Seller 201. Deposit or earnest money 500.00 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 129,591.00 502. Settlement charges to seller(line 1400) 18,113.10 203. Existing loa s taken subject to 503. Existing loa s taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. Seller Assist 4,000.00 507. Seller Assist 4,000.00 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. Cilyitown taxes to, 211. County taxes 0110112015 to 0112012015 19.34 511. County taxes 0110112015 to 0112012015 19.34 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518, 219. 519. Z20• Total Paid by/for Borrower 134,110.34 520. Total Reduction Amount Due Seller 22,132.44 300. Cash at Settlement from/to Borrower 600. Cash at Settlement tolfrom Seller 301. Gross amount due from borrower(line 120) 136,387.26 601, Gross amount due to seller(line 420) 127,547.90 302. Less amounts paid by/for borrower(line 220) 134,110.34 602. Less reductions in amount due seller(line 520) 22,132.44 303. Cash ❑X From ❑ To Borrower 2,276.92 603. Cash ❑X To ❑ From Seller 105,415.46 Dnp •n a ,f • on ,n or ,on • s Der response a rp,nv,•vnnp,• orm•io,• yy n r r• corn IMs form,unless p EI•P•ss• -1v-N oms control mxnMr.Na eonpd•MI•plY H•ssunp;II,N,lbdosun b m•np•tory.1Tb b p••ipnW ro PmNC•1M P•nNs to i eE9PA mvr•E inm•dlon Mh Inlamullon uMp IM Previous editions are obsolete Page 1 of 4 HUD-1 700. Total Real Estate Broker Fees $8,300.00 Paid From Paid From Division of commission line 700 as follows: Borrower's Seller's 701• $3,915.00 to Howard Hanna Carlisle office Funds at Funds at 702. $4,385.00 to BHHS Homesale Really Settlement Settlement 703. Commission paid at settlement 225.00 8,075.00 800. Items Payable in Connection with Loan 801. Our originalion charge (Includes Origination Point 0.000%or$0.00) $974.00 (from GFE#1) 802. Your credit or charge(points)for the specific interest rale chosen $ (from GFE#2) 803. Your adjusted origination charges (from GFE A) 974.00 804. Appraisal fee to Charles E.Garner (from GFE#3) 475.00 805. Credit report to Birchwood Credit Services,Inc. (from GFE#3) 93.95 806. Tax service to from GFE 43 607. Flood certification to Altisource flood (from GFE#3) 11.00 808. Guarantee Fee to Residential Mortgage Services,Inc. (from GFE#3) 2,591.82 900. Items Required by Lender to be Paid In Advance 901. Daily interest charges from from 01/20/2015 to 02/0112015 @$13.31411day (from GFE#10) 159.77 902. Mortgage insurance premium for months to 903. Homeowner's insurance for 12 years to Fetterman Insurance Agency (from GFE#11) 517.00 904. months to from GFE#11 1000. Reserves Deposited with Lender 1001. Initial deposit for your escrow account (from GFE#9) 662.64 1002.Homeowner's insurance 4 months @$ 43.08/month $172.32 to Residential Mortgage Services 1003.Mortgage insurance months 0$ 0.00/month $ to Residential Mortgage Services 1004.Property taxes months*@,) 0.00/month $ to Residential Mortgage Services 1005.County/Township taxes 11 months $ 30.331month $333.63 to Residential Mortgage Services 1006:School Taxes 8 months @$ 100.811/month $806.48 to Residential Mort a e Services 1007.USDA Annual Fee 2 months P$ 53.541month $107.08 to Residential Mortgage Services 1008.Aggregate Adjustment $-756.87 to Residential Mortgage Services 1100.Title Charges 1101.Title services and lender's title insurance $ from GFE#4 1,584.18 1102. Settlement or closing fee to $ 1103.Owner's title insurance-First American Title Insurance Co-Hbg $ from GFE#5 1104. Lender's title Insurance-First American Title Insurance Co-Hbg $1,480.00 1105. Lender's title policy limit$129,591.00 Lender's Policy 1106. Owner's title policy limit$127,000.00 Owner's Policy 1107.Agent's portion of the total title insurance premium $1,219.50 1108. Undenariler's portion of the total title Insurance premium $260.50 1109. Escrow Fee to Barristers Land Abstract 25.00 _ General-Hb 1200. Govemment Recording and Transfer Charges 1201.Government recording charges $ (from GFE#7) 180.00 1202• Deed$79.00 Mort a e$101.00 Release$ to Cumberland County Recorder 1203.Transfer taxes $ (from GFE 48) 1,270.00 1204.City/County tax/stamps Deed$1270.00 Mortgage$ to Cumberland County Recorder 1205.Slate Ta stamps Deed$1,270.00 Mortgage$ to Cumberland County Recorder 1,270.00 1206.Deed$ Mortgage$ Release$ to 1300.Additional Settlement Charges '1301.Required services that you can shop for (from GFE#6) 1302, Home Warranty to First American Home Buyers Protection 365.00 1303.Pest Inspection to Gilbert's Professional Pest Control Inc. 95.00 1304.Final SewerMater to South Middleton Twp.Municipal Authority 167.62 1305. Inheritance Tax Escrow to Banisters Land Abstract Escrow-Hbq 8,000.00 1306.Tax Cert/Postage Reimbursement to Barristers Land Abstract Cost-Hbq 10.48 1307. Fuel Oil to Neldlin er Fine Homes 200.00 1308. to 1309. to KEW - r r 8,839.36 18,113.10 "Paid outside of closing by(B)orrower,(S)eller,(L)ender;(I)nveslor,Bro(IQer."Credit by lender shown on'page 1.-Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 Comaarison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUM Char es That Cannot Increase HUD-1 Line Number Ouroriginationcharge # 801 974.00 974.00 Your credit or charge(points)for the specific interest rate chosen # 802 0.00 L0.00 Your adjusted origination charges # 803 974.001 974.00 Transfer taxes # 1203 1,270.001 1,270.00 Charges That In Total Cannot Increase More Than 10% Good Faith Estimate HUD-1 Government recording charges # 1201 175.00 180.00 Appraisal fee #804 475.00 475.00 Credit report # 805 65.00 93.95 Flood certification # 807 15.00 11.00 Guarantee Fee # 808 2,591.82 2,591.82 Title services and lenders title insurance # 1101 1,468.00 1,584.18 Owners title Insurance-First American Title Insurance Co-Hbg # 1103 100.00 0.00 # 4,889.82 4,935.95 $ 46.13 or 0.9434% Charges That Can Chane Good Faith Estimate HUM Initial deposit for your escrow account # 1001 1,773.08 662.64 Daily Interest charges from # 901 $13.21MIday 159.77 159.77 Homeowners insurance #903 492.00 517.00 Loan Terms Your initial loan amount is $129,591.00 Your loan term is 30.years Your initial interest rate Is 3.7500% Your initial monthly amount owed for principal,Interest,and any mortgage $600.16 includes insurance is M Principal ❑X Interest ❑Mortgage Insurance Can ybur interest rate rise? ❑X No. ❑Yes,it can rise to a maximum of %.The first change will be on I I and can change again every years after f I . Every change date,your interest rate can increase or decrease by °/. Over the life of the loan,your interest rale is guaranteed to never be lower than %or higher than %. Even it you make payments on time,can your loan balance rise? ❑X No. ❑Yes,it can rise to a maximum of$ Even if you make payments on time,can your monthly amount owed for ❑X No. ❑Yes,the first increase can be on I I and the monthly principal,interest,and mortgage insurance rise? amount owed can rise to$ The maximum it can ever rise to is$ Does your Than have a prepayment penalty? ❑X No. ❑Yes,your maximum prepayment penalty is$ 0oes your loan have a balloon payment? 0 No. ❑Yes,you have a balloon payment of$ due in years on I I Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes and homeowners Insurance. You must pay these items directly yourself. X❑You have an additional monthly escrow payment of$227.76 that results in a total initial monthly amount owed of$827.92:This Includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes ❑Homeowners insurance ❑X Flood insuranceX❑USDA Annual Fee Q Homeowners Insurance ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. Previous editions are obsolete Page 3 of 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction.I further certify that I have received a copy of the HUD-1 Settlement Statement 'L . Dennis F.Hufnagle,III v' ESTATE OF DOROTHY E.B/R�UNNER 2 f. Barbara Ann Slone alkla Barbara A.Stone,Executrix, The HUD-1 Settlement Statement which 1 have prepared is a true'and accurate account of this transaction.I have caused or will.Cause the fund's to be disbursed In accordance with this statement. SET LE T AGENT. DTE 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. Previous editions are obsolete Page 4 of 4 HUD-1 Name of Borrower: Name of Seller: File Number Dennis F.Hufnagle,111 Estate of Dorothy E.Brunner 14-01-36725 TitleExpress Prepared 01/19/2015 at 6:42 pm Note: This page is furnished to give you an itemization of the amounts shown on tPaid'FfO.m ! ''P.21dtFroms.. Lines 1101, 1103 and 1104 of the Settlement Statement(HUD-1).This page `,Bofrower's%:'''* ..mow. Seller's;„ accompanies but is not a part of the settlement statement. If a discrepancy !Funds at ;Fun,ds';ati '. exists,the information shown on the Settlement Statement(HUD-1)applies. :8ettleliietif ":Settlement d 'Amounts Included'f.;fo. •,r,;,;t,:.: :;F.�;;. �• <<• :: ,:'t?: 1100. Title Chargee in Line 1101 1101. Title services and lender's title insurance 1,584.18 a.Notary Fee $ 30.00 b.Wire Fee 5.00 c. Overnight fee 24.18 d.Electronic Doc Delivery 45.00 $ 104.18 1102. Settlement or closing fee 1103. Owner's title Insurance 1104. Lender's title Insurance (policy) 1,155.00 $ 1,480.00 a.Closing Service Letter 125.00 b.Exp Cov Res Short 200.00 (Total 1103+1104) 1105. Lenders title policy.limit$129,591.00 1106. Owners title policy limit$127,000.00 1107. Agent's portion of.the total title insurance premium •.$.1,219.50.. 1108. Underwriters portion of the total'title.insurance prem. 260.50 .(Total 1107+1108) S 1.480.00 1109. 1110. • 1111. 1112. •Total ;;•r"•';Borrower s� tiBorrower Selley 1100. Title Char es with Pa ee POC-or Credit �'Lme 1101 1101. Title services and lenders title insurance $ a.Notary Fee to Joyce Ehrich 30.00 30.00 b.Wire Fee to Barristers Land Abstract Wire.-Hbg 5.00 5.00 c. Overnight fee to Barristers Land Abstract Postage-Hbg 24.18 24.18 d.Electronic Doc Delivery to Barristers Land Abstract General-Hbg 45.00 45.00 1104. Lenders title insurance to Barristers Land Abstract Company 1,480.00 1,480.00 '1584:18'1"' .-c.s•::.-. 0 M&TBank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-5024349 F ax (302)934-2955 May 27,2014 Rhoads & Sinon LLP One South Market Square, 12`h Floor P.O. Box 1146 Harrisburg,PA 17108-1146 Re: Estate of Dorothy E. Brunner Social Security: Date of Death:April 16,2014 Dear Sir or Madam: Per your inquiry on May 19,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 9860633446 Ownership(Names oj) Dorothy E.Brunner Barbara A.Stone(POA) Linda K. Thumma(POA) Opening Date 0511012013 Balance on Date of Death $ 3,657.80 Accrued Interest $ .01 Total $ 3,657.81 2. Type ofAccount Savings Account Account Number 15004208552065 Ownership(Names o)) Dorothy E.Brunner Barbara A.Stone(POA) Linda K Thumma(POA) Opening Date 0612311987 Balance on Date of Death $ 2,494.96 Accrued Interest $ .02 Total $ 2,494.98 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Stonehedge at 717-2404524. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Adjustment Services Annuity Operations Western & Southern Life PO Box 2918 Cincinnati,OH 45201-2918 free 800.926.1702 A member of Western&Southern Financial Group tollfax 513.362.2353 July 23, 2014 RHOADS & SINON ATTN KELLY SHUFFELBOTTOM ONE SOUTH MARKET ST 12TH FL PO BOX 1146 HARRISBURG PA 17108 Dear Ms. Shuffelbottom: Thank you for your request for information on the annuity contract. I hope the following contract information is helpful to you. Annuitant: DOROTHY BRUNNER Owner: DOROTHY BRUNNER Western-Southern Life Assurance Company Contract Number: W0020598827 Date of death value as of April 16, 2014 is $45,613.30. Total value paid out was $45,688.30. If you have any questions, please call our Annuity Operations Department at 1- 800-926-1702. A representative will be happy to help you. Sincerely, Q Teresa Fleisch Annuity Operations Department DC0331-1306 - Western-Southern Life Assurance Company /