HomeMy WebLinkAbout04-15-15 (5) pennsytvania 1505614105
DEFAF-Mr of REVENUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN ��� �I
Harrisburg, PA 17128-0601 RESIDENT DECEDENT C_ "I' i ' 'i
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
._„ 0618.2014 _ 7 01121919
_ .__...._ .__.... ......._ ..........
Decedent's Last Name Suffix Decedent's First Name MI
CHIANOS .. m^ VASILIKE � D
............. . ----- . .. .......... .........--.. - _ _-� ........_ .......__. ...........-_ -....._.... I
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
--....._ L _ L1
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1.Original Return p 2. Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
C=:) 4.Agriculture Exemption(date of C=:) 5. Future Interest Compromise(date of C=:) 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
OD 7. Decedent Died Testate p 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 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 0 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
__.... .......---.... -_....... _ —
STEVE C. NICHOLAS, ESQ. (717) 540-7746
First Line of Address
2215 FOREST HILLS DRIVE
Second Line of Address
SUITE 37
City or Post Office State ZIP Code
f"
HARRISBURG PA 17112
M
M n.
Correspondent's email address: CJ --In' C O
REGISTER"W iS:UUSE ONLY —^I
r-- I-- r r+ rTI
REGISTER OF WILLS USE ONLY i m cn ..7
cl
DATE FILED MMDDYYYY CJ>
— !—A
DATE FITC D STAMP CO
PLEASE USE ORIGINAL FORM ONLY
Side 1
561410 1505614105
J 1505614205
REV-1500 EX(FI) Decedent's Social Security Number
.._..........- ..... -...... - .,.--........-........_.........�
Decedent's Name: CHIANOS, VASILIKE D.
RECAPITULATION
1. Real Estate(Schedule A). ..................... ....................... 1. I 167,500.0
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. 1
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 5,795.20
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 23,310.89 I
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. 196,606.09
t
9. Funeral Expenses and Administrative Costs(Schedule H)............. ...... 9. 17,220.77 i
i
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............ ... 10. 5,344.40
11. Total Deductions(total Lines 9 and 10). . .............. ................. 11. �- 22,565.17
12. Net Value of Estate(Line 8 minus Line 11) ............... ............... 12. 174,040.92
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. 174,040.92
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 45 174,040.92 16. 7,831.84
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. 7,831.84
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
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.
Si RSONPMP IBLVI` NG RETURN DATE
04/15/2015
ADDR SS
1705 LAUREL ROAD, HARRISBURG, PA 17112
SIGNATUR gA�IE,I�TyAt� ER RESPONSIBLE FOR FILING THE RETURN DATE
04/15/2015
ADDRESS
2215 FOREST HILLS DRIVE, SUITE 37, HARRISBURG, PA 17112
1lli111111ll111111111Nil[1iti 1111111111111111111111111111 Side 2
1 5 4205 1505614205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
VASILIKE D. CHIANOS
STREETADDRESS
136 LANCASTER BLVD.
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 7,831.84
2. Credits/Payments
A.Prior Payments
B.Discount
(See instructions.) Total Credits(A+B) (2)
3. Interest
(3) 18.62
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 I +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 7,850.46
Make check payable to: REGISTER OF WILLS, AGENT.
F I P
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred................._................................... .........................
❑
b. retain the right to designate who shall use the property transferred or its income .......................................
c. retain a reversionary interest.............._..........................................._......................................................... Q E
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?.............................................................................................................. ❑ 0
3. Did decedent own an"in trust foe'or payable-upon-death bank account or security at his or her death?.............. El 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation? ....................................................................................................................... El 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.
fi
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 F2 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 decedents 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+(02-15)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CHIANOS,VASILIKE D. 21 14-0610
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
F136 Lancaster Boulevard,Mechanicsburg,PA 17055 �— 167,500.00#;
Lower Allen Township,Cumberland County
_ ( yTax Parcel#13-24-0793-002
==77
-_-�;
I
-- j
TOTAL(Also enter on Line 1, Recapitulation.) $�I 167,500.00
If more space is needed,use additional sheets of paper of the same size.
REV-iso8 EX+(o8-s2)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CHIANOS, VASILIKE D. 21 14-0610
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. JPNC Bank Savings Acct#5130164807 4,301.66
2,1 ;Miscellaneous household furniture 500.00'
3,; Credits from sale of 136 Lancaster Blvd(See HUD-1 Settlement Statement)
a. 2014 County/Township tax proration 64.66 i
b. 2014-15 School tax proration
.54
c. Q4 2014 sewer proration^ - - ,- - — -- 21.301
d. 04 2014 trash proration 16.04
I'
I
•
I,
,
I ;
I
I .
s
I
TOTAL(Also enter on Line 5, Recapitulation) $ 5,795.20 ;
If more space is needed,use additional sheets of paper of the same size.
REV-1509 EX+ (02-15)
pennsylvania SCHEDULE F
DEPARTMENTCETAXRETURN JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CHIANOS,VASILIKE D. 21 14-0610
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.Frank W.Chianos 1 11705 Laurel Road, Harrisburg, PA 17112 ;Son
' ! I
_i
C. _ _
� i
,._.. ... .. .-_. -... 1. __ ..-__.._..- ...... .... .:... ... ._..l ' .. .�
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT"SINTEREST
1. A. ,01/12/09 ` PNC Bank Acct#5140247294 4 __4,6.621.77 I 50%� i. 23 310.89
_ .. ._ _ _...._ _ . _
4
L I II h
4
1 f i77'
,
I ,
�- 23,310.89
TOTAL(Also enter on Line 6, Recapitulation)
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (02-15)
117 pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHIANOS, VASILIKE D. 21 14-0610
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' 'Funeral-Neill Funeral Home 8,465.99
Memorial stone-Romberger Memorials ^ - — — -^ _ 312.50
3.1 Funeral luncheon-Angie's Diner 1,052.00
fL J4. Postage(thank you cards) 10.00
5., 40-Day Service-Holy Trinity Greek Orthodox Cathedral-- _ - -�� T 60.00
6.1 40-Day Service coffee hour-Philoptochos 40.00 '
7.1 40-Day Service Koliva-Sophia Kaldes _ —120.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) "
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney fees:
6,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) `I _
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 348.50 "
5. Accountant Fees:
6. Tax Return Preparer Fees:
7• _Advertising-Cumberland Law Journal and Evening Sentinel --_ ,v - _ 286.78
8.; !Postage,copies, Notary-Nicholas Law Offices,PC —� �,LL 25.00
TOTAL(Also enter on Line 9, Recapitulation) $ 17,220.77
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(02-15)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHIANOS,VASILIKE D. 21 14-0610
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• West Shore School District-2014-15 School tax 1,557.00
2. PPL-Open account 1,313.00
3. PA American Water-Open account 119.00
4. Lower Allen Twp Authority-Open account 245.40
5. Lawn maintenance 300.00
6. Electrical repairs 730.00
7. Expenses from sale of 136 Lancaster Blvd.(See HUD-1 Settlement Statement)
a. 1%Transfer Tax 1,060.00
b. Real estate tax certification 20.00
TOTAL(Also enter on Line 10, Recapitulation) $ 5,344.40
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(02-15)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CHIANOS,VASILIKE D. 21 14-0610
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).]
I. :Frank W.Chianos, 1705 Laurel Road,Harrisburg,PA 17112 Son 25%
2.. James W.Chianos, 14 Raspberry Drive,Mechanicsburg,PA 17050 Son 25%
3.1 Jesse M.Chianos, 136 Lancaster Blvd.,Mechanicsburg,PA 17055 Grandson 25%
4. James V.Chianos,6 Rife Ddve,Mechanicsburg,PA 17050 Grandson 25%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
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.
chiancs Bessie will scn/wills
LAST WILL AND TESTAMENT
OF
BESSIE CHIANOS
I, BESSIE CHIANOS of 136 Lancaster Boulevard, Mechanicsburg,
Cumberland County, Pennsylvania 17055-3509, declare this to be my
Last Will and revoke any Will or Codicil previously made by me.
ITEM 1 : 1 direct that all expenses of my last illness and
funeral, including my grave marker and perpetual care, shall be
paid from my residuary estate as soon as practicable after my
decease as a part of the expense of the administration of my
estate .
ITEM II : I direct that all taxes that may be assessed in
consequence of my death, of whatever nature and by whatever
jurisdiction imposed, shall be paid from my residuary estate as a
part of the expense of the administration of my estate, without
apportionment .
ITEM III : I give, devise and bequeath all the rest, residue,
and remainder of my Estate of every nature and wherever situate,
in equal shares, share and share alike, as follows :
a. one equal share to my son, FRANK W. CHIANOS, providing
that he survives me by thirty (30) days; and
b. one equal share to my son, James W. CHIANOS, providing
that he survives me by thirty (30) days; and
C . one equal share to my grandson, JESSE M. CHIANOS,
providing that he survives me by thirty (30) days; and
d. One equal share to my grandson, JAMES V. CHIANOS,
providing that he survives me by thirty (30) days .
ITEM IV: I hereby authorize and empower my Executor
hereinafter named to sell all of the real property and any or all
of the personal property not specifically bequeathed herein,
which I may own or to which I. am entitled at the time of my
1
death, in the sole discretion of my Executor at private or public
sale, without an Order of Court, at such time or times and upon
such terms as the said Executor shall deem proper for the best
interests of my estate or of my beneficiaries, thereby converting
the same into cash. I further authorize and empower my said
Executor to execute, acknowledge and deliver all proper writings
and deeds of conveyance and transfer thereof .
ITEM V: The principal and income of any bequests created
hereunder shall be free from anticipation, assignment, pledge or
obligation of any beneficiaries and shall not be subject to any
execution or attachment or to voluntary or involuntary
alienation.
ITEM VI : I appoint my son, FRANK W. CHIANOS, Executor of
this, my . Last Will . Should FRANK W. CHIANOS fail to qualify or
cease to act as Executor, I appoint my son, JAMES W. CHIANOS,
Executor of this, my Last Will .
ITEM VII : I direct that my Executor or his successors shall
not be required to give bond for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal the
171h day of February_ 2004 .
BESSIE CHIANOS
2
The preceding instrument, consisting of this and two (2)
other typewritten pages, identified by the signature of the
Testatrix, was on the day and date thereof signed, published and
declared by BESSIE CHIANOS, the Testatrix therein named, as and
for her Last Will, in the presence of us, who, at her request and
in her presence and in the presence of each other, have
subscribed our names as witnesses hereto.
L
of
of 7'OA
3
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
ss .
COUNTY OF DAUPHIN
I, BESSIE CHIANOS, 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 ; and that I signed it
willingly and as my free and voluntary act for the purposes
therein expressed.
Sworn to or affirmed and acknowledged before me by BESSIE
CHIANOS this 17th day of February 2004 .
BESSIE CHIANOS
Notary Public
NOTARIAL SEAL
CHRISTINA L.NICHOLAS,Notary Public
Susquehanna Twp.,Dauphin County
My Commission Expires June 20,2005
4
COMMONWEALTH OF PENNSYLVANIA
SS .
COUNTY OF DAUPHIN
WE, the undersigned 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 free and
voluntary act 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 time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and subscribed before me by the
undersigned witnesses, this 17th day of February 2004 .
dr
Witness
Witness
�u-c LLD,
Notary Public
NOTARIAL SEAL
CHRISTINA L.NICHOLAS,Notary Public
Susquehanna Twp.,Dauphin Count
My Commission Expires June 20,20&
5
::._....:. Jul. 29, 2014' 1 :30PM--_:. PNC Bank: ........:. :.:..... .:. .::.No. 8909...: ;'-P. 1/2
-� a 1 f
July 29, 2014
Frank Chianos
Nicholas Law Offices P_C-
2215 Forest Hill Dr Ste 37
Harrisburg,PA 17112
RE: Vasilike Chianos
SSN:
DOD: 06-18-2014
Dear Mr. Chianos:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show rhe following:
Checking Account
Account# 5140247294 Established: 01-12-2009
VASaz,1KE CHIANOS
FRANK W CHLANOS
DOD balance: $46,621.69+0.08 accrued interest
Savings Account
Account#5130164807 Established: 12-20-1984
BESSIE Cli ANOS
DOD balance: $4,301.66 + 0.00 accrued interest
Please note ihat this office provides date of death balances for deposit accounts(IRAs,CDs, Checking and
Savings)_ We do not process any financial transactions or provide statements. If you need assistance with
any of these items,please call 1-888-PNC-BANK.(1-888-762-2265) or slop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A.
Member FDIC
Page 1 of 2
-,Jul. 29. 2014.:. 1 :30PVr. . -.PNC Bank ............. No. 8909..::._P 2/2
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged, confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient,you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited. If you have received this
communication in error,please note me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
i
I
Page 2 of 2
U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT PAGE 2
700. Total R . 'Paid fYom :-Paid From
Division of Commission(line 7 as follows: ".'Borrower's,' Se11er's
701, t TtitadsAt ; ., Fein ds At
02. to Setdemenit' Settlement
703. Commission traid at Settlement
704. to
800...Items Pa abie.Tn Connection With Loan
801. Our origination c (from GFE#1)
802, Your credit or charge(points)for the specific interest tate chosen $ from GFE 42
903 Your adjusted ori ' tion ch (from GFE#A) 595,00
904- Appmisal fee to from GFE 43
(from GFE#3)
906 Tax servine t (from GFE#3)
907 Flood certification to (from GFE 43)
Rog to
809- to
910 to-
a. mRequired Lender To'.Be Paid Tn_Advance..
901. Daily interest charges from to /da fry GFE#10} 2RI 56
02. Morto da a insurance Prem' m f t m FE 13)
903. Homeowner's Insurance for I years to RTaam 1nsffienoe Inc (from GFE#11) 50,100
04. ears to
905- years to
1000:.Reserves Depasft6d With.Lender, .:
1001.Initial deposit w account (from GFE#9) 1-216.84
1002.Homeowmees insurance- $ 1k2.00
1003. ort a ran e monthA p=month S
4.Propelly taxes monthsa mmorith S
05.Annual messments $ _
006. $ 79792 _
07.School Prop Tax 7 monthsg 13140 per month $ 926.80
1008. months@ per month S
1009. -S 666.78
1100.'ritle-Chai7es.
1101,Title services and lender's title insurance from GFE#4
102. $ 5.00
1103. (from GFE#5) 13450
1 04 S 795-50
5. n 's tWe policy limit 5 .81-000-00
Owntfs title, filimit S 106 000 DO
07.A ent's portion of the total title insurance premium
1108.Underwriter's portion of the total title insurance premium
1109. to $243.00
1110.Closing Service Ltr to Stewart Title Guaranty Company $125.00
IIII. a to 518.00
1112. to
1113. to
1200.Government'Recordin --andTransfer.'Cha. es- '. .77"
1201.Government recording charges from GFE# 1940
12a2. _
1203_Transfertaxes ( em GFS#8) 1,060.00
1204. 530.00
1205-State tax/stamps-Dottd!91,1160 06-1,_-MWgageW -SzMnrtizagds) 530.Q0
1206. to
1207. to
1300.Additional:Settiemeut'Cha es
1301. (from GFE#6)
1302.Tax Certification to LowmAllen lip Tax Collector $ 20.00
1303. t S 4 770.Oa
1304. t
1305. to
1306. t
1307. to
1308. to
1309. t
11400.Total Settlement Charges (enter on lines 103.Scction I and i02.
5,620.40 5,850.00
CERTIFICATION DATE: 12/312014
1 have ca;efully reviewed the HUD-I Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disburse ents made o y unt or by me in this transaction. I fin-ther certify that I have received a copy of the HUD-t Settlement Statement
Estate of.V Chianos a/k/a Bess
Seller
Borrower
4 ,, a o5,Indv •'
Borrower; o' -- Seller
JVe ..Chianos Frank W.Chianos, eeutnr&Frank'
` James W Chian , esse M Clean s,lam C anp
The HUD-1 Settlement StatemjtW . l hav repo ed is a true and accur�ccount of this trans ion.I have caused ' ds to be disbursed in accord-
ance with this statement. -- 7IL�(�OLRS 1AW OFFICES,P.C.
Settlement Agent 12/3/2014 Date
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar farm. Penalties upon conviction can include a
fine and imprisonment.For details see:Title 18 U.S.Code Section 100I and Section 1010. Page 2 of 3 CHiANOS
'C6inipiiisofi"d Ga;6$FaithEsiipimt6(r;FF)a"Ild[Rulb'I"Charges' Good Faith Estimate' j .". IIUD-i
Charges That Cannot Increase HUD-1 Line Number
Our origination charge #801 595.00 595.00
Your credit or charge(points)for the specific interest rate chosen #802
Your adjusted origination charges #803 595.00 595.00
Transfer taxes #1203 11 1,060.00 1 1,060.00
GhargeS;Thst in Total Can>itof]ncrease More Than 10%:, �" :„ ,',..�_ :.`'��6 Good.Faith'EstrmaEe,,,;==_ :;THUD-1 r,,,:,.
Government recording charges #1201 238.00 194.00
Appraisal fee #804 425.00 42500
Total 663.00 619.00
Increase between GFE and llUD-1 Charges I$ (44.00) or -6.6365%
Charges.Th- C"-n�*tlia4ii-,--',,,',P�,,','I
T.- Good Faith,Estimite Hl(YD
That 2 �7
Initial deposit for your escrow account #1001 433.34 1,216.84
Daily interest charges #901 $ 9.7089 /day 159.78 281.56
Homeowner's insurance #903 500.00 507.00
Title services and lender's title insurance #1101 1,388.75 1,206.50
Owner's title insurance 91103 125.00 134.50
Loan Terms
Your Initial loan amount is $ 81,000.00
Your Loan term is 30.00 years
Your initial interest rate is 4.375 %
Your initial monthly amount owed for principal,interest,and $ 404.43 includes
any mortgage insurance is 91 Principal
FK1 interest
E Mortgage Insurance
Can your interest rate rise? KI No. El Yes,it can rise to a maximum of %.The first change will be
an and can change again every after
,Every change date,your interest rate can increase or decrease
by %.Over the life of the loan,your interest rate is guaranteed to never be
lower than %or higher than %.
Even if you make payments on time,can your loan balance rise? ®No. E]Yes,it can rise to a maximum of$
Even if you make payments on time,can your monthly ®No. El Yes,the first increase can be on and the monthly amount
amount owed for principal,interest,and mortgage insurance rise? owed can rise to$
The maximum it can ever rise to is$
Does your loan have a prepayment penalty? RIM. 0 Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? FK]No. []Yes,you have a balloon payment of$ due in
years on
Total monthly amount owed including escrow account payments E)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.
FKI You have an additional monthly escrow payment of$ 246.27
that results in a total initial monthly amount owed of$ 650.70 .This includes
principal,interest,any mortgage insurance and any items checked below:
®Property taxes Homeowner's insurance
E]Flood insurance ❑
Note:Ifyou have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
File:CIIIANOS
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