HomeMy WebLinkAbout03-10-15 ` C
J pennsylvania 1505614105
DEVAPTMENTO1F PEVENVE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURNnnI
Harrisburg, PA 17128-0601 RESIDENT DECEDENT d vl
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW
7 07122014 [05111931
Decedent's Last Name Suffix Decedent's First Name MI
Heeter � [Ned �� J❑
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL:IN APPROPRIATE OVALS BELOW
OD 1.Original Return O 2. Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of 0 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
m 7. Decedent Died Testate O 8. Decedent Maintained a Living Trust Q 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
C=:) 10. Litigation Proceeds Received p 11.Non-Probate Transferee Return p 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets O 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Crystal K. Martin, EA (717) 533-5154
First Line of Address
Smoker, Smith &Assoc
Second Line of Address
339 W Governor Rd
City or Post Office State ZIP Code
Hershey PA 17033
Correspondent's email address: Cmartin@SmokerSmith.Com
REGISTER OF WILLS USE ONLY
f'�1 r7"I
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY t:7
DATE FILED STAMP i
....i r^
4Y
PLEASE USE ORIGINAL FORM ONLY
Side 1
1 0�iiiii
614105 1505614105
U�
1505614205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Ned J. Heeter
RECAPITULATION
1. Real Estate(Schedule A). ............................. ............... 1. 162,500.00
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. 10,749.40
6. Jointly Owned Property(Schedule F) O 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. 173,249.40
9. Funeral Expenses and Administrative Costs(Schedule H)............. ...... 9. 13,071.92
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 128,849.61
11. Total Deductions(total Lines 9 and 10)........ ....................... .. 11. 141,921.53
12. Net Value of Estate(Line 8 minus Line 11) ............... ............... 12. 31,327.87
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. 31,327.87
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- 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 31,327.87 16. 1,409.75
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE . .................................................... .... 19. 1,409.75
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE OF. S ESPO I !BI F .4N6-RU.RN DAT
ADDRESS
112 Kim Acres Dr, Mechanicsburg, PA 17055
SI ATU E F SPARER OT ER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DTE
ADDRES
Smok r, Smith &Associates, 339 W Governor Rd, Hershey, PA 17033
11111111111111111111�gill Li�i111y,1111111111111111111111 Side
4 05 1505614205
REV-1500 E�X (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Ned J. Heeter
STREETADDRESS
606 Park Hills Dr
CITY STATE 717055
Mechanicsburg PA
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,409.75
2. Credits/Payments
A.Prior Payments
B.Discount
(See instructions.) Total Credits(A+B) (2)
3. Interest
(3)
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) 1,409.75
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ E
c. retain a reversionary interest .............................................................................................................................. ❑ 0
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?.............................................................................................................. ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ E
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑ 0
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 step-parent 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)
10 pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ned Heeter zt _I,( _ot,Zg
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' Residential Real Estate,606 Park Hills Dr,Mechanicsburg, PA 17055 162,500.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 162,500.00
If more space is needed,use additional sheets of paper of the same size.
REV-i5o8 EX+(o8-l2)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF:` ' FILE NUMBER:
Ned J Heeter 21-14-0678
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER' DESCRIPTION OF DEATH
1. ,PSECU checking account#0306 8,609.40
I�_2J Cash 140.00
3. Household Furnishings 2,000.00
f
I
I
F
1
E
TOTAL(Also enter on Line 5, Recapitulation) $ 10,749.40
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
i pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ned J. Heeter 21-14-0678
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Malpezzi Funeral Home 3,580.80
8 Market Plaza Way, Mechanicsburg, PA 17055
2 Rolling Green Cemetary 1,100.00
Carlisle Rd,Camp Hill, PA
3 Funeral Services(Organist,Minister,Alter Guild,Flower Guild, Custodian,Ushers) 450.00
4 Reception,Citizens Fire Company 462.15
5 Priests 250.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 2,500.00
Name(s)of Personal Representative(s) Richard Heeter
Street Address 112 Kim Acres Dr
City Mechanicsburg State PA ZIP 17055
Year(s)Commission Paid: 2015
2. 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: 243.50'
5. Accountant Fees: 1,500.00
6. Tax Return Preparer Fees:
7. Title Services 578.00
8 Legal Notices 225.00
9 Paid at Settlement,Escrow Overdraft, Recording fee&Late Charge 554.41
10 Real Estate Taxes less Reimbursement at Settlement 713.00
11 Real Estate Market Analysis 100.00
12 Utilities&Maint to real estate less sewer reimb at settlement 815.06
TOTAL(Also enter on Line 9, Recapitulation) $ 13,071.92
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
i pennsylvania SCHEDULE I
° DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN 'MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ned J. Heeter 21-14-0678
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
i. {CitiMortgage, Inc.,Account#0652336779 Mortgage Debt,Principals 111,003.46
y,
jplus prorated interest due at date of death 224.40
dd
C 2.' MBank of America AAA Credit Card Acct#4264296996585987 619.66
I 3. 'PSECU Visa Credit Card Acct#0306 10,091.61
F4jl. ;Wells Fargo Visa Credit Card Acct#4705000349028506 3,696 39
F-51 Citibank Sears Master Credit Card Acct#5121072065932453 �'; 2,474.75
6 iWest Shore EMS f' 168.0311
{PP&L,United Water,UGI,Republic Waste,Verizon&Verizon Wireless W i 571.31
�W
4
Ll L
- - I
TOTAL(Also enter on Line 10, Recapitulation)' $++! 128,849.61
If more space is needed,insert additional sheets of the same size.
REV-1510 EX+(08-09)
10 pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. _ VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
3
s
J 3
i
TOTAL(Also enter on Line 7, Recapitulation) $ 0.00
If more space is needed,use additional sheets of paper of the same size. _
REV-1513 EX+(01-10)
pennsylvania SCHEDULE ]
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ned Heeter 21-14-0678
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).] _
1. Richard Heeter Son 11 t 50%Residual
112 Kim Acres Dr,Mechanicsburg,PA 17055 �� —
1,
—_21 }Paul A Heeter [Son a 50%Residual
1606 Park Hills Dr,Mechanicsburg,PA 17055 {
F1
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
F1
C _
C F
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
El
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.
C-)
LAST WILL AND TESTAMENT =.
OF rn ;
NED J. HEETER
I, NED J. HEETER of Mechanicsburg, Upper Allen Twp., Cumberland Comfy;
Pennsylvania, being of sound mind, memory and understanding, do make and publish this, myr" T'
Last Will and Testament, hereby revoking all wills and codicils by me at any time heretofore
made.
ITEM 1: I direct my Executor hereinafter named, to pay the expenses of my last
illness and funeral expenses from the property passing under this Will as an expense and cost
of administering my estate.
ITEM 2: All expenses of administering my estate and all inheritance, estate and
succession taxes, including interest and penalties payable by reason of my death, which may be
assessed or imposed with respect to my estate, or any part thereof, wheresoever situate,
whether or not passing under my Will, including the taxable value of all policies of insurance
on my life and of all transfers, powers, rights or interests includible in my estate for the
purposes of such taxes and duties, shall be paid out of my residuary estate as an expense of
administering and with apportionment, and shall not be prorated or charged against any other
gifts in this Will or against property not passing under this Will.
ITEM 3: 1 give, devise and bequeath unto my beloved sons, RICHARD A.
HEETER of Mechanicsburg, Pennsylvania, and PAUL A. HEETER, of Mechanicsburg,
Pennsylvania, in equal shares, the rest, residue and remainder of my estate, real, personal and
mixed, whatsoever nature and kind and wheresoever situate.
In the event either son predeceases the other, then that son's share shall
go to the other.
ITEM 4: In the event any beneficiary and I die under such circumstances that the
order of our deaths cannot be established by proof, or should any beneficiary and I die as the
result of a common disaster, it shall be conclusively determined for all purposes of this Will
that I survived the beneficiary.
ITEM 5: I hereby nominate, constitute and appoint my son, RICHARD A.
HEETER, of Mechanicsburg, Pennsylvania, to be my Executor of this my Last Will and
Testament.
ITEM b: I hereby nominate, constitute and appoint my son, PAUL A. HEETER,
of Mechanicsburg, Pennsylvania, to be my Contingent Executor of this my Last Will and
Testament.
IN WITNESS WHEREOF, I have signed this Will on this day of
2005.
A r.
TESTATOR
Signed, sealed, published and declared by the above Testator, NED J. HEETER, as
and for the last Will thereof, in the presence of us, who, at the request of and in the presence
of NED J. HEETER, and in the presence of each other, have hereunto subscribed our names
as witnesses thereto.
V r
Witness Address
1 / ;
Witness Address
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN :
I, NED J. HEETER, Testator, 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 that I signed it as
my free and voluntary act for the purposes therein expressed.
TESTAT W
We, �'1Cz� �j C2u- .��,� - and \� i �'� C. ('�. �. , the witnesses
whose names are signeld to the attached or fore—going'instrument,"being duly qualified according
to law, do depose and say that we were present and saw the Testator sign and execute the
instrument as Testator's Last Will; that NED J. HEETER signed willingly and that NED J.
HEETER executed it as Testator's free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to
the best of our knowledge the Testator was at that time eighteen(18) or more years of age, of
sound mind and under no constraint or undue influence.
n
ITNESS
s.
W ESS
Subscribed to and sworn or affirmed before me by the above-named witnesses, and
subsggibed to and acknowledged before me by the above-named Testator, this day of
Ua�. , 2005.
NOTARY PUBLIC
u6N!MpN' A1v H OF ?V,' "Ylv�i�f!�
F�RBAR,A
OTARIAL SEAL
E. PALMER, Notary 'Public
rrisburg, Dauphin County
sinn r0res May 23, 2009
�QaH}MaN*pey0
° cs OM' Iroval No.2602-0265
A. Settlement Statement HUD-1
$aN oEJE�d
B. Type of Loan
6. File Number: 7, Loan Number: 8. Mortgage Insurance Case Number:
1.❑FHA 2.Q RHS 3.0 Conv.Unins. HEETER FAT 14-16 6800797544
4.Q VA 5.Q Conv,Ins.
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:
PAULA.HEETER ESTATE OF NED J.HEETER
DEBRAA.HEETER MEMBERS 1ST FCU
606 PARK HILLS DRIVE PO BOX 40
MECHANICSBURG,RA 17055 Mechanicsburg,PA 17055
G. Property Location: H. Settlement Agent: 25-1802264
606 PARK HILLS DRIVE Chesapeake Abstract Company Settlement Date:
MECHANICSBURG,PA 17055 17 South Second Street,6th Floor
Cumberland County,Pennsylvania Harrisburg,PA 17101 November 20,2014
Ph. (717)233-1000
Place of Settlement:
17 South Second Street,6th Floor
Harrisbur ,PA 17101
J. Summary of Borrower's transaction
K. Summary of Seller' ---transaction
100. Gross Amount Due from Borrower:
101. Contract sales price 400. GrossAmoum Due to Seller:
102. Personal property ert 162 500.00 401. Contract sales rice 162,500.00
103. Settiement Charges to Borrower Line 1400 402. Personal ra
104 4 390.30 403.
105. 404.
Adjustments for items Raid by Seller in ad405
vance .
106. C tjAmount
11/20/14 to 12!31/14 Adjustments for items aid b Seller in advance
75.76 446. C' !Town Taxes 11/24114 to 12131/14 75.76
107. Coto 407, Court Taxes
108. Sc11!20114 to 06!34!15 1,225.34 408. SchooETaxes 11/24114 to 06130/15
to
109. Se01/01115 74.06 409, Sewer 11/21/14 to 01/01/15 1,225.34
i14.
111, 410. 74.06
112. 411.
412,
124. Groue from Borrower 168,265.46 420,Gross Amount Due to Seller
200. Amounts Paid b or in Behalf of Borrower 163,875.16
201. De osit or earnest money600. Reductions in Amount Due Seiler:
Naesetss da os' see instructions
202. Prin"ai amount of new loans 130,000.00 ment char es to Seller Line 1400203. Existin loan s ta578.06204. A raisal Fee in loans taken subject to205 425.00 ff First Mortgage to Citimortgage,Inc./#06523 114,275.58206. ff Second Mort a e207 208.209.Adjustments for items un aid b Seller
210. C frown TaxesAdjustments for items unpaid b Seller
to 510. C frown Taxes to
211. Coun# Taxes to 511. County Taxes
212. School Taxes to 512. School Taxes to
213. to
214, 513.
215 514.
216. 515.
217.
218 17. Escrow for Inheritance Taxes to Chesa eakeAbstrac 3,150.00
219, 5
519,
220. Total Paid by/for Borrower 94130,425.00 520. Total Reduction Amount Due Seller
300. Cash at Settlement from/to Borrower 118,003.64
301. Gross amount due from Borrower Qine 120 600. Cash at settlement tolfrom Seller
168 265.46 641. Gross amount due to Seller line 420 163 87516
302. Less amount paid by/for Borrower(line 220) ( 130,425.00} 602. Less reductions due Seller line 520
( ) ( 118,003.64
343. Cash �X From To Borrower 37,840.46 603. Cash X]To From Seiler
45,871.52
The undersigned herebyoc�owiedge recces ipt of a completed copy of this statement&any attachments referred to herein
Borrower (.c'q C , (' , Seller
IBRAA.
A�HEETER ESTAT F ED J.HEETER
Ml By:NEE ER RICHARD A.HEETER,EXECUTOR
The Public Reporting Burden far tris collection of irfamatim is estimated at 35minutes,per response far collecting,reviewing,and reporting the data This agency may not CWIaCt this information,and you we"required to compete
this form
process,unless it displays a currently valid OMB control Number.No Corfidentiality I s assured;this daplpa V e is Mandalay,This Is designed toprwide the parties to a RESPAcover ad transwomwith irfam sum duringhe seta merg
Page 1 of 3 HUD-1
(HEETER FAT 14-16.PFD/HEETER FAT 14-16/32)
L.Settlement Charges
100.Total Rdal Estate Broker Fees Pdd F,=
Division of commission(line 700)as follows., Bort OW% sell"
701.$ to Fundt ed. Funds at
702.$ to S.9-Ord
703,Commission paid at settlement
704.
705.
800.Items Payable in Connection with Loan
801.Our origination charge $ 595.00 from GFE#1) t
802.Your credit or charge(points)for the specific interest rate chosen (from GFE#2)
803,Your adjusted origination charges
from GFE#N 595.00 7
804.Appraisal fee to MEMBERS 1ST FEDERAL CREDIT UNION from GFE#3) 425.00 E'
805.Credit Report to from GFE#3) E--
806.Tax service to (from GFE#3)
807.Flood certification to (from GFE#3)
608. (from GFE#3)
809,
(from GFE#3)
810.
(from GFE#3)
811. from GFE#3)
900.Items Required by Lender to Be Paid In Advance
901.Daily interest charges from _ 11/20/14 to 12/01114 11 @ $16.027400tday (from GFE#10) 176,30,F7---'77
902.Mortgage insurance premium for months to from GFE#3)
903.Homeowner's insurance for 1.0 years to Erie Insurance Company from GFE#11) #QSP-7002441 461.00
904. from GFE#11)
905. (from GFE#11)
1000.Reserves Deposited with Lender
1001,Initial deposit for your escrow account (from GFE#9) 1,114.00
1002.Homeowner's insurance 3.000 months @ $ 38.42 per month $ 115,26
1003.Mortgage insurance months qR $ per month $
1004,Property taxes $
City/Town Taxes months @ $ per month r
Assessments months @ $ per month
1005,CountyfTwp.Taxes $ 56210
County1TWp Taxes 1U00 months @ $ 56,21 per month
1006. months @ $ per month $
1007.School Taxes 6.000 months @ $ 167.89 per month $ 1,00734
1008.
1009.Aggregate Adjustment $ -570,70
1100.Title Charges
1101. Title services and tender's title insurance (from GFE#4) 210.00 578.06
1102. Settlement or dosing fee $
1103. Owner's title insurance to First American Title Insurance Company from GFE#3) 1,215.00,
1104. Lender's titte insurance to First American Title Insurance Company $ 150.00
1105. Lenders title policy limit $ 130,000.00
1106. Owner's title policy limit S 162,500.00
1107. Agent's portion of the total title insurance premium to Chesapeake Abstract Company $ 1,132,9%
1108. Underwriter's portion of the total title insurance premium to First American Title Insurance Company $ 232.05 V.7- -, 7
1109.
1110.
11,11.
1112,
1113,
1200.Government Recording and Transfer Charges
1201.Government recording charges to Cumberland County Recorder of Deeds from GFE#7) 194.00 ti
1202.Deed $ 79,00 Mortgage $ 115.00 Releases$ Other $
1203.Transfer taxes (from GFE#8) 7
1204.City/County tax/stamps $ $
1205.State tax/stamps $ $
1206,
1207.
1300.Additional Settlement Charges
1301.Required services that you can shop for from GFE#6)
1302.
1303.
1304,
1305.
1400.Total Settlement Charges(enter on lines 103,Section J and 502,Section K) 4.390.10 578.06
By sliptirg page I d this sttcr eM Te sWodes ackwMelgD receipt d acmplated cwy d page 2&3dhe Wee
Chesapedke Abstract Company,Settlement Agent
Page 2 of 3 HUD-1
(HEETER FAT 14-16.PFD/HEETER FAT 14-16/32)
Comparison of Good Faith Estimate(GFE)and HUD-1 Ch Good Faith Estima HUD-1
i harges Thdt Cannot Increase HUD-1 Line Number
Our origination charge #801 595.00 595.00
Your credit or charge(points)for the specific interest rate chosen #802
Your adjusted origination charges #803 595.00 595.00
Transfer taxes #1203
Charges That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1
Government recording charges #1201 238.00 194.00
Appraisal fee # 804 425.00 J 425.00
Total 663.00 619.00
Increase between GFE and MUD-1 Charges $ -44.00 or -6.641/1
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account #1001 550.00 1,114.00
Daily interest charges #901 $ 16.027400/day 256.44 176.30
Homeowner's insurance #903 600.00 461.00
Title services and lender's title insurance #1101 1,673.75 210.00
Owner's title insurance to First American Title Insurance Company #1103 162.50 1,215.00
Loan Terms
Your initial loan amount is $130,000.00
Your loan term is 30 years
Your initial interest rate is 4.5000
Your Initial monthly amount owed for principal,interest and $658.69 includes
any mortgage insurance is [Z] Principal
O Interest
❑ Mortgage insurance
Can your interest rate rise? ❑X No ❑ Yes,it can rise to a maximum of %. The first
change will be on and can change again every_months after
Every change date,your interest rate can increase or decrease
by %. Over the Iffe of the loan,your interest rate is guaranteed
to never be lower than °/a or higher than
Even if you make payments on time,can your loan balance rise? ❑X No ❑ Yes,k can rise to a maximum of$
i
Even if you make payments on time,can your monthly ❑X No ❑ Yes,the first increase can be on and the monthly
amount owed for principal,interest,and mortgage insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
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.
I ❑X You have an additional monthly escrow payment of$262.52 that results
in a total initial monthly amount owed of$921.21. This includes
principal,interest,any mortgage insurance and any items checked below:
t 0 Property taxes Q Homeowner's insurance
❑ Flood insurance ❑
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
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Page 3 of 3 HUD-1
(HEETER FAT 14-16.PFD/HEETER FAT 14-16/32)
r1UD-1 Attachment
Borroweqs):PAULA. HEETER and DEBRAA. Selle(s): ESTATE OF NED J. HEETER
HEETER
606 PARK HILLS DRIVE
MECHANICSBURG, PA 17055
Lender:MEMBERS 1 ST FCU
Settlement Agent:Chesapeake Abstract Company
(717)233-1000
Place of Settlement:17 South Second Street,6th Floor
Harrisburg,PA 17101
Settlement Date:November 20,2014
Property Location:606 PARK HILLS DRIVE
MECHANICSBURG, PA 17055
Cumberland County, Pennsylvania
Additional Adjustments For Items Paid By Seller In Advance(Borrower Debit)
Description Amount From/Through Prorated Amount
Sewer 112.00 10/31/14 through 12/31114 74.06
Total Line 109/409 74.06
Seller Loan Payoff Details
Payoff First Mortgage to Citimortgage,Inc. Re:#0652336779-2
Loan Payoff As of
Total Additional Interest days @ Per Diem
Total Loan Payoff 114,275.58
Adjusted Origination Charge Details
Origination Charge
Origination Fee 595.00
to MEMBERS 1ST FCU, ISAOA/ATIMA
Total $ 595.00
Origination Credit/Charge(points)for the specific interest rate chosen
Total $
Adjusted Origination Charges $ 595.00
Reserves Deposited with Lender
Homeowner's Insurance 115.26
3.000 at 38.42 per month
County/Twp Taxes 562.10
10,000 at 56,21 per month
School Taxes 1,007.34
6.000 at167.89 per month
Aggregate Adjustment -570.70
month
Total $ 1,114.00
Title Services and Lender's Title Insurance Details BORROWER SELLER
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.
(HEETER FAT 14-16.PFDIHEETER FAT 14-16/32)
- ^ *uo4xouc^'-.u' Continued
Tax Certification 15.00
to Chesapeake Abstract Company
Notary Fee 15o0 000
to sxa,|amsznnodmn. LLC
Overnight Mail'loan docs MOO
to Chesapeake Abstract Company
Document Download fee'loan 25.00
to Chesapeake Abstract Company
Wire fee for payoff 12.00
to Chesapeake Abstract Company
Deed Preparation /75o0
to 8retKieu|ing. Esq.
Final Sewer 2nd-4mQoo 371M
to Uppar/4|onlownuhip
Lender's title insurance 150.00
to RrstAnohnmnTitle Insurance Company
Total 210.00 $ 578.06
Owner's Title Insurance BORROWER SELLER
Owner's Policy Premium 1.215,00
to First American Title Insurance Company
Total $
Lender's Title Insurance BORROWER SELLER
*fees also shown above in Title Services and Lender's Title Insurance Details
Lender's Endorsement Charges 150,00
Endorsement Endorsement Charge
Total $ 150.00 * 0.00
'
WARNING: uisacrime to knowingly me false statements mthe United States v this or any similar mnn. Penalties upon conviction can
include afine and imprisonment. For details see: Title muuCode Section 1001 and Section 1010.
PSECt
Document Number: 2852000
Account 0306XXXXXX HEETER,NED J Effect: 07/31/14 Post: 07/31/14 Tlr: 0166
ID DUE DATE PRINCIPAL INTEREST FEES NEW BALANCE TRAN AMOUNT SEQ
------------------------------------------------------------------------------
Withdrawal from REGULAR SHARES Prev Bal: 8,609.40
01 8,609.40- 0.00 0.00 0.00 8,609.40 1160699
------------------------------------------------------------------------------
Check Disbursed ESTATE OF NED J HEETER 8, 609..40-
NED J HEETER
606 PARK HILLS DR
MECHANICSBURG PA 17055-4966
Document Number: 2852000
Account 0306XXXXXX •HEETER,NED J Effect: 07/31/14 Post: 07/31/14 Tlr: 0166
ID DUE DATE PRINCIPAL INTEREST FEES NEW BALANCE TRAN AMOUNT SEQ
- -
Withdrawal from REGULAR� SHARES PrevPrevBal: 8,609:40 -
01 8,609.40 0.00,; 0:00 0.00 8,6`09.40 1160699 yRJ
------- _-• -------- ----------- , , --- --'- -,---
Check 'Disbursed- , ESTATE OF•NED•J',HEETER. 8,609.-40 t
`
NOn'STOP PAYMENT PERMITTED
2wriV--':7328.
PSEC( -is�-obligated'to"paychis Cashier,
Check .according to its,t'erms'af,the tiMe it r
wasissued.,,I �If-the check,is lost; `stolen or'destroyed,please• contact us'at'I80d)- ;15
nationwide..
I r ,x .,4•,80-8111/2313 -•}', " "'fit
PA STATE-EMPLOYEES CREDIT UNION.
''' 1500 ELMERTON AVENUE
' Y, `HARRISBURG;PA 17110-9214 •c "i. 1 '+` 1 rt r '" r. .E�'.
Si'E'
.f
.......::.. .YS�;k .....:.... ....:.
1600 ELMERTON AVENUE,HARRISBURG, PA 17110-9214
=0) 237-7328 NATIONWIDE.
07/31•/14, 00 2852000
CAS'HIER'S CHECK'�, '
$8609 40 €
** EIGHT THOUSAND SIX HUNDRED NINE DOLLARS AND 40 CENTS '
PA STATE EMPLOYEES CREDIT UNION
ESTATE OF NED J HEETER '
PAY
TO THE
ORDER
OF " ! Treaau A
�. .
11' 213 5 200011' 1: 2 3 1 313 1 1 161: 6 1 26 1 26 1 2411'
11/ 1'S/ GV1Y 1 GJ 1G Yl7 -VUVV V111 YLiVL. L VI' :J
• �'�® CitiMortgag
CItl PO Box 624_ if Statementoff
Sioux Falls,SD 57117-6243 Statement Date: November 14,2014
ACCOUNT NUMBER: 0652336779
Loan Type: CONVENTIONAL
Payoff Good Through., November 21,2014
Customer Name and Address:
NED J HEETER
ESTATE OF
C/O RICHARD A HEETER
MECHANICSBURG PA 17055-5533
Property Address:
FAX;17172336740 606 PARK HILLS DR
Llsa Freese • MECHANICSBURG PA 17055
Llsa Freese
TEL:717-233-6740
VIA us at www.citimortgage.com
Payoff
Principal Balance as of 07/01/14 $111,003:46 )$ ?O
Interest from 07/01/14 to 11/21/14 .Z"E4$_3I 2,692.71,—
Escrow Overdraft 370.09.v*
1L 12-
Late Charge(s) 116.82 ✓
Recording Fee 67.50,v" '`� Z '�t 7
Total Secured by Mortgage 114,250.58 .25�`
t.
Total to Pay Loan in Full $114,275.58 .�
Interest per diem at 6.25%:S19.01, Escrow Interest:SO.00 L
If the current months payment has not been recelved by CltMortgage on or before 15 days after the due date,please Include a late fee of:538.94 In
the payoff amount.
IMPORTANT; Please refer to the reverse side of this statement for important information.This Payoff amount is good through the date shown above,unless
additional account activity occurs prior to this date.(Refer to reverse of statement.)Please call 1-800-283-7918-to confirm the amount priorto
sending Payoff.Monthly mortgage payment must be made as scheduled.Please send a copy of the Payoff statement with the payoff funds.TTY
services available:dial 711 from the United States;dial 1-866-2ao-2050 from Puerto Rico,
Escrow Information
Escrow Balance -370.09 PLEASE INCLUDE THE FORWARDING ADDRESS FOR
THE CUSTOMER WITH THE PAYOFF TO ENSURE PROPER
Type of Bill Next Due Amount MAILING OF ANY REFUNDS OR DOCUMENTS
�1�•a..Q I±A. 14ee-lej. C
NAME
//2 I</M Ar-tes ��/r•
ADDRESS
CITY
STATE ZIP
Tax and Insurance payment(s)may be made during the Payoff Statemcnt.period.We are
responsible for and will pay any Tax/Insurance bill(s)we rcecivc before the payoff.We will
look to the closing agents for total funds if duplicate tax payment occurs.The above
information covers a 60-day period from this statement date.The Mortgagor,not
CitiMortgage,Inc.,will be responsible for their own Tax and Insurance payments after payoff
of the loan.
See reverse side for wire instructions.Closing agents,please provide a copy of this statement to our borrower.
*Calls arc randomly monitored and recorded to ensure quality service.