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HomeMy WebLinkAbout05-04-15 (3) 1505610143 REV-1500 Ex(°2_"' '� + OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 14 0636 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 06 10 2014 09 27 1945 Decedent's Last Name Suffix Decedent's First Name MI ROSENBERRY BARBARA J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ❑ 1. Original Return ❑X 2. Supplemental Return ❑ 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4, Limited Estate ❑ 4a.Future Interest CompromiseF-15. Federal Estate Tax Return Required (date of death after 12-12-82) Y 6 Decedent Died Testate ❑ 7. AtlecheCMaintained a Living Trust B. Total Number of Safe Deposit Boxes (Attach Copy of Will) Copy of Trust) ❑ g. Litigation Proceeds Received ❑ 10 between Po er O editlDatte f Death ❑ 11 Election to tax under Sec.9113(A) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Nur lber t MICHAEL L BANGS 717730 73" �70 rn REGIST:E4F WILLitSE OLjg f?x1 First Line of Addressro 429 SOUTH 18TH STREET t ! Second Line of Address s f—' r- rr City or Post Office State ZIP Code DATE FILED W CAMP HILL PA 17011 Correspondent's e-mail address: mikebangs@yerizon.net 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. SIGNATW,RE OF FERSO RESP NSIBLE F FILING RETURN VATE Juliet R. Ga ADDRES 1399 Letchworth Road Camp Hill PA 17011 SIGNATURE OF PREPARER OTHER THA P.ESENTA IVE DAT41"E Michael L. Bangs all ADDRESS 429 South 18th Street, amp Hill, PA 17011 Side 1 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Rosenberry, Barbara J. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 166, 467 . 28 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. 1 , 477 . 28 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non;Probate Property (Schedule G) L] Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 167 , 944 . 56 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 500 . 00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 13 , 992 . 14 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 14 , 492 . 14 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 153 ,452 42 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. 153 , 452 . 42 TAX COMPUTATION-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.00 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 153 452 . 42 16. 6, 905 . 36 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, 905 . 36 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 REV-1500 EX Page 3 File Number 21-14-0636 Decedent's Complete Address: DECEDENT'S NAME Rosenberry, Barbara J. STREET ADDRESS 708 Alberta Avenue CITY STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,905.36 2. Credits/Payments A. Prior Payments B. Discount Total Credits(A +B) (2) 3. Interest (3) 31.14 4. If Line 2 is greater than Line 1 +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) 6,936.50 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;............................................................................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receivingadequate consideration?.................................................................................................................... ❑ 3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. ❑x ❑ 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 [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in [72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1502 EX+(01-10) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosenberry, Barbara J. 21-14-0636 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 Real Estate-708 Alberta Avenue, East Pennsboro Township. Tax Parcel#09-18-1310-145. 166,467.28 Sold on 3/31/15(see HUD attached). $10,000.00 is being held in escrow pending approval of this supplemental inheritance tax return. TOTAL(Also enter on Line 1, Recapitulation) 166,467.28 (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+(11.10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosenberry, Barbara J. 21-14-0636 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 1 Refund from Citibank-overpayment of payoff of HELOC 19.63 2 Refund from Mortgage Service Center-overpayment of payoff 1,410.53 3 Refund from USAA-homeowners insurance 47.12 TOTAL(Also enter on Line 5, Recapitulation) 1,477.28 (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-1511 EXi(10A9) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DEC DENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Rosenberry, Barbara J. 21-14-0636 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attornev's Fees Michael L. Bangs 500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs TOTAL(Also enter on line 9, Recapitulation) 500.00 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09) 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 Rosenberry, Barbara J. 21-14-0636 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 Citibank-HELOC August and September/2014 204.88 2 Citibank-HELOC July/2014 102.44 3 Citibank-HELOC October 2014 101.65 4 Citibank-HELOC November 2014 99.42 5 Citibank-HELOC January 2015 200.02 6 Citibank-HELOC February 2015 101.65 7 Comcast Cable-7/29/14 421.35 8 Comcast Cable-9/3/14 210.51 9 East Pennsboro Township-sewer bill 7/18/14 138.00 10 East Pennsboro Township-sewer(4th quarter) 151.80 11 East Pennsboro Township-sewer/trash(first quarter) 151.80 12 Mortgage Service Center-loan payment August and September/2014 2,419.22 13 Mortgage Service Center-October 2014 1,209.61 14 Mortgage Service Center-November 2014 1,209.61 15 Mortgage Service Center-December 2014 1,209.61 16 Mortgage Service Center-January 2015 1,209.61 17 Mortgage Service Center-February 2015 1,209.61 Total of Continuation Schedules See attached pages TOTAL(Also enter on Line 10, Recapitulation) 13,992.14 (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-15112 EX+(12-08) SCHEDULE I pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Rosenberry, Barbara J. 21-14-0636 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 18 Mortgage Service Center-March 2015 1,147.99 19 PA American Water Company-5/17114 to 6/17/14 78.93 20 PA American Water Co.-6118/14 to 7/17114 62.75 21 PA American Water Co.-7/18/14 to 8/18/14 60.55 22 PA American Water Co.-8/18/14 to 10/16/14 77.76 23 PA American Water Co.-10/17/14 to 11/18/14 35.16 24 PA American Water Co. -11/19/14 to 12/15/14 35.01 25 PA American Water Co. -1/17/15 to 2/18/15 72.35 26 PA American Water Co. -2/19/15 to 3/18/15 35.57 27 PA American Water Co. -3/19/15 to 3/30/15 15.46 28 PA Department of Revenue-2014 income tax due 3.00 29 PP&L Electric-5130/14 to 6130/14 286.78 30 PP&L Electric-6130114 to 7/30114 286.78 31 PP&L Electric-8/29/14 to 9/30/14 234.10 32 PP&L Electric-7/30114 to 8/29/14 286.78 33 PP&L Electric-11/26/14 to 12/30/14 598.89 34 PP&L Electric-12/30/14 to 1/28/15 124.94 Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule t(Rev, 12-08) Rev-1512 EX+(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Rosenberry, Barbara J. 21-14-0636 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 35 Scott's Lawn Service 198.55 TOTAL(Also enter on Line 10, Recapitulation) 13,992.14 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 Rosenber , Barbara J. 21-14-0636 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY (Words) ($$$) Do Not List Tru TAXABLE DISTRIBUTIONS [include outright spousal • distributions,and transfers under Sec.9116(a)(1.2)] Juliet R.Gay Daughter one-half of estate 1399 Letchworth Road Camp Hill, PA 17011 Charles K. Rosenberry,Jr. Son one-half of estate 7527 Perry Drive Frisco,TX 75035 Total Enter dollar amounts for distributions shown above on lines 15 through 1$on Rev 15 10 cover sheet as appropriate. NON-TAXABLE DISTRIBUTIONS: YI• A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-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) i �Qr4"�eµFO`ti°� OMB Approval No.2502.0265 A. Settlement Statement (HUD-1 9B�'OaJE� B. Type of Loan 1,❑FHA 2.Q RHS 3. Conv.Unins. 16. File Number. TEXT1502075272 Loan Number, 8Mortgage Insurance Case Number: 4.D VA 5.Q Conv.Ins. BU147-15 C 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. 0. Name and Address of Borrower; E. Name and Address of Seller: F. Name and Address of Lender: TRINH T.BUI ESTATE OF BARBARA J.ROSENBERRY RESIDENTIAL MORTGAGE SERVICES, 428 WEST SHADY LANE 708 ALBERTA AVENUE INC. ENOLA,PA 17025 MECHANICSBURG,PA 17050 24 CHRISTOPHER TOPPI DRIVE SOUTH PORTLAND,ME 04106 G. Property Location: H. Settlement Agent: I. Settlement Date: 708 ALBERTA AVENUE TRI-COUNTY ABSTRACT SERVICE/JOHN M.HYAMS,ESO MECHANICSBURG,PA 17050 48 CENTRAL BLVD, March 31,2015 CUMBERLAND County,Pennsylvania CAMP HILL,PA 17011 Ph, (717)761-8870 Place of Settlement: 3045 MARKET STREET CAMP HILL,PA 17011 J. Summary of Borrower's transaction K. Summary of Setter's transaction 100. Gross Amount Due from Borrower: 400. Gross Amount Due to Seller: 101. Contract sales price 234,900.00 401. Contract sales price 234,900.00 102. Personal property 402. Personal property 103. Settlement Charges to Borrower Line 1400 8,710.97 403. 104. 404. 105. 405. Adjustments for items paid by Seller in advance Adjustments for items paid by Seller in advance 106. Ci !Town Taxes 03/31/15 to 01/01/16 59717 406. Ci /Town Taxes 03/31/15 t0 01/01/16 597.17 107. County Taxes to 407. County Taxes to 108. SCHOOL TAXES 03/31/15 to 07/01/15 628.52 408.SCHOOLTAXES 03131/15 to 07101115 628.52 109. SEWER/TRASH 03/31/15 to 04/01/15 1.53 409. SEWER/TRASH 03/31/15 to 04/01/15 1.53 110. 410, 111. 411. 112. 412. 120, Gross Amount Due from Borrower 244,838.19 420.Gross Amount Due to Seller 236,127.22 200. Amounts Paid by or in Behalf of Borrower 500- Reductions In Amount Due Seller. 201. Deposit or earnest money 5,000.00 501. Excess deposit see instructions 202. Principal amount of new loans 187,920.00 S02. Settlement charges to Seller Line 1400 26,319.94 203. Existing loans taken subject to 503. Existing loans taken subject to 204. CURE FOR TRANSFER TAX 49.00 504. Payoff First Mortgage to MORTGAGE SERVICE CENTE 17,588.48 205. EXCESS BORROWER DEPOSIT 65.00 505. Payoff Second Mortgage to CITIMORTGAGE INC./2714, 32,251.52 206. 506. 207. 507. (Deposit dish.asproceeds) 206. 506. 209. SELLERASSIST 3,500.00 509.SELLERASSIST 3,500.00 Adjustments for items unpaid by Seller Adjustments for items unpaid by Seller 210. CI frown Taxes to 510.Ci [Town Taxes to 211. County Taxes to 511. Countv Taxes to 212. SCHOOL TAXES t0 512.SCHOOL TAXES to 213. 513. '214. 514. 215. 515. 216. 516. 217. 517, 218. 518. 219. 519, 220.Total Paid b Ifor Borrower 196,534.00 520, Total Reduction Amount Due Seller 79,659.94 300. Cash at Settlement from/to Borrower 600. Cash at settlement tolfrom Seller 301. Gross amount due from Borrower line 120 244,838.19 601. Gross amount due to Seiler line 420 236,127.22 302. Less amount paid byffor Borrower{line 220) ( 196,534. 602. Less reductions due Seiler(line 520) { 79,659.94 303. Cash o From To 48,304.19 603. Cash Q To From Seller 156,467.28 Paid outside of dosing by ower( a ).lend (Li.or Chir-party(T) The undersigned y ac 1 e 2 of a c mpleted copy of this statement&any attachments referred to herein Borrower Seller ESTATE OF BARBARA �J�.R�OSENBERRY TO THE BEST OF MY KNOWLEDGE,THE HUD-1 SETTLEMENT STATEMENT WHICH I HAVE PREPARED IS UE AN ACCURATE AUNT OFTHE FUNDS WHICH WERE RECEIVED AND HAVE BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART O THE SETT EMENT OF THIS TRANSACTION. (��L'Elvlyr OFFICER,Settlement Agent WARNING: IT ISA CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS 01,401 SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT, FOR DETAILS SEE: TITLE 18 U.S.CODE SECTION Ililtl&SECTION 1010. The Public Reporting Burden for this w1fection of intormaton is 88ama[etl at 35 minutes per response for cotiectfng,rer<ewmg,and taponng the aala.This agency may not coilect this information,and you are not required to complete this form,unless it displays a currently valid OMB Control number.No confidenoallry,s assured.this disclosure is mandatory This is designed to provide the parties to a RESn4covered tan se coon with info rmaaon during Ne so element process. Page 1 of 3 HUD-1 (BU 147.15.PFOBUl47-15110) 1 L.Settlement Charges 700.Total Roal Fstate'BrokerFees $11,570.00 Paid From Paid From Division of commission(line 700)as follows: Borrowers Sellers 701.$5,785.00 to KELLER WILLIAMS OF CENTRAL PA EAST Funds at Funds at 702.$ 5,785.00 to STRAUB&ASSOCIATES Settlement Settlement 703.Commission paid at settlement 11 570.00 704. PROCESSING FEE to STRAUB&ASSOCIATES 295.00 705. ADDITIONAL COMMISSION to KELLER WILLIAMS OF CENTRAL PA EAST 295.00 800.Items Payable In Connection with Loan 801.Our origination charge $ 1,074.00 from GFE#1 802.Your credit or charge(points)for the specific interest rate chosen from GFE#2 803.Your ad'usted origination charges from GFE#A 1,074.00 804.Appraisal fee to FORRESTER&CO.REAL ESTATE APPRAI; from GFE#3 P.O.C. 410.00 B 805.Credit Report to from GFE#3 806.Tax service to from GFE#3 807.Flood certification to ALTISOURCE FLOOD from GFE#3 11.00 808. from GFE#3 809. from GFE#3 810. from GFE#3 811. (from GFE#3) 800.Items Required:by Lenderto Be Paid in Advance 901.Daily interest charges from 03/31/15 to 04/01/15 1 @ $20.594000/da from GFE#10 20.59 902.Mortgage insurance premium for months to (from GFE#3) 903.Homeowner's insurance for 1.0 years to ALLSTATE (from GFE#11) 977752909 687.00 904. (from GFE#11) 905. (from GFE#11) 100b:ReservesDepositod.with,Lender 1001.Initial deposit for your escrow account (from GFE#9) 1,831.88 1002.Homeowner's insurance 3.000 months @ $ 57.25 per month $ 171,75 1003.Mortgage insurance months @ $ per month $ 1004.Pro taxes $ Ci (Town Taxes months @ $ per month SCHOOLTAXES months @ $ per month 1005. 1006. COUNTY/TOWNSHIPTAXES 2.000 months @ $ 65.81 per month $ 131.62 1007. SCHOOLTAXES 10.000 months @ $ 207.80 per month $ 2,078.00 1008. $ 1009.AGGREGATE ESCROW ADJUSTMEI $ -549.49 1100.Title Charges 1101. Title services and lender's title insurance (from GFE 94) 1,975.25 1102. Settlement or closing fee $ 1103. Owner's title insurance to (from GFE#5) END 100 300 8.1 129.25 1104. Lender's title insurance to $ 744.50 1105. Lender's title policy limit $ 187,920.00 5011342-0165716E 1106. Owner's title policy limit $ 234,900.00 5011442-0141327E 1107. Agent's portion of the total title insurance premium to TRI-COUNTY ABSTRACT SERVICE $ 873.75 1108. Underwriter's portion of the total title insurance premium $ 1109. DOCUMENT PREPARATION to BANGS LAW OFFICE LLC $ 150.00 1110. ESCROW FOR INHERITANCE TAX to TRI-COUNTY ABSTRACT SERVICE $ 10,000.00 1111. RE-IMBURSEMENT FOR TAX CERT to TRI-COUNTY ABSTRACT SERVICE $ 10.00 1112. OVERNIGHT FEES to TRI-COUNTY ABSTRACT SERVICE $ 14.50 1113. WIRE FEE PAYOFF to TRI-COUNTY ABSTRACT SERVICE $ 20.00 1200-Govertrment Recording and Transfer Charges 1201.Government recording charges to CUMBERLAND Recorder's Office from GFE#7 190.00 1202.Deed $ 79.00 Mortgage $ 111.00 Releases $ Other $ 1203.Transfer taxes to RECORDER OF DEEDS (from GFE#8) 2,349.00 11204.City/County City/Countytaxistam s $ 2,349.00 $ 2,349.00 1205.State tax/stamps $ 2,349.00 $ 11206. 1207. '1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 1302.TRASH&SEWER-2ND QTR to EAST PENNSBORO TWSP AUTHORIT` $ 708 ALBERTA AVENUE 138.00 1303. CERT FEE to FAST PENNSBORO TWSP.AUTHORIT` $ 708 ALBERTA AVENUE 10.00 1304. PEST TREATMENT to HERSHEY TERMITE&PEST CONTROL $ ACCT NO.1478 132.50 1305. ELECTRICAL SERVICE to MIKE SHEELY HOME INSPECTIONS 708ALSERTA,MECHANICSBURG 1,005.00 1306.2015 COUNTY/TOWNSHIP TAXES to DEBBIE LUPOLD,TAX COLLECTOR BILL#5786 773.94 1400.Total-SottleMent'Chargesl(enter on lines 103,Section J and 502,Section K) 8,710.97 26,319.94 Paid outside of cios)ng by borrower(B),sener(s),lender(L),or third-psrtyj) By signing page t ofthis statement the signatories acknowledge receipt of a compieted copy of page 2&3 ottn inree e s lemant SETTLEME FFICER,SettlementAgenl CERTIFIED,TRUE AND CORRECT Page 2 of 3 HUD-1 (BU 147-15.PF D/BU 147-15/10) I Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD-1 Charges That Cannot Increase HUD-1 Line Number Our origination charge # 801 1,074.00 1,074,00 Your credit or charge(points)for the specific rate chosen If 802 0.00 0.00 Your adjusted origination charges # 603 1,074.00 1,074.00 Transfer taxes #1203 2,300.00 2,349.00 Charges That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1 Government recording charges #1201 150.00 190.00 Appraisal fee # 804 475.00 410.00 Flood certification # 807 11.00 11.00 Title services and lender's title insurance #1101 2,290.00 1,97515 Owner's title insurance to #1103 0.00 129.25 F Total 2,926.00 2,715.50 Increase between GFE and HUD-1 Charges $ -210.50 or -7.19°/ Charges That Can Change Good Faith Estimate MUD-1 Initial deposit for your escrow account #1001 3,464.04 1,831,88 Daily interest charges # 901 $ 20.594000/day 20.59 20.59 Homeowner's insurance # 903 600.00 687.00 Loan Terms Your initial loan amount is $187,920.00 Your loan term is 30.00 years Your initial interest rate is 4.0000% Your initial monthly amount owed for principal,interest and $897.16 includes any mortgage insurance is ❑X Principal ❑ Interest ❑ Mortgage insurance Can your interest rate rise? ❑X No ❑ Yes,it can rise to a maximum of %. The first change will be on and can change again every_months after Every change date,your interest rate can increase or decrease by %. Over the life of the loan,your interest rate is guaranteed to never be lower than %or higher than %. Even if you make payments on time,can your loan balance rise? ❑X No ❑ Yes,it can rise to a maximum of$ 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. ❑X You have an additional monthly escrow payment of$330.86 that results in a total initial monthly amount owed of$1,228.02. This includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes X❑ Homeowner's insurance ❑ Flood insurance ❑ Q SCHOOL TAXES ❑ vote: if you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. Page 3of3 HUD-1 (BU147-15.PFD/8U147.15/10) HUD-1 Attachment Borrower(s):TRINH T BUI Seller(s): ESTATE OF BARBARA J. ROSENBERRY 428 WEST SHADY LANE 708ALBERTAAVENUE ENOLA, PA 17025 MECHANICSBURG, PA 17050 Lender:RESIDENTIAL MORTGAGE SERVICES, INC. Settlement Agent:TRI-COUNTY ABSTRACT SERVICE/JOHN M. HYAMS, ESQ (717)761-8870 Place of Settlement:3045 MARKET STREET CAMP HILL, PA 17011 Settlement Date:March 31,2015 Property Location:708 ALBERTAAVENUE MECHANICSBURG, PA 17050 CUMBERLAND County, Pennsylvania Additional Adjustments For Items Paid By Seller In Advance(Borrower Debit) Description Amount From/Through Prorated Amount SEWER/TRASH 138.00 01/01/15 through03131/15 1.53 Total Line 109/409 1.53 Seller Loan Payoff Details Payoff First Mortgage to MORTGAGE SERVICE CENTER Re:0017307919 Loan Payoff 17,576.68 As of 04/02/15 Total Additional interest 11.80 4 days @ 2.950000 Per Diem Total Loan Payoff 17,588.48 Payoff Second Mortgage to CITIMORTGAGE INC. Re:2714492549 Loan Payoff 32,235.17 As of 04/02/15 Total Additional Interest 16.35 5 days@ 3.270000 Per Diem Total Loan Payoff 32,261.62 Adjusted Origination Charge Details Origination Charge ORIGINATION FEE 1,074.00 to RESIDENTIAL MORTGAGE SERVICES, INC. Total $ 1,074.00 Origination CrediVCharge(points)for the specific interest rate chosen Total $ Adjusted Origination Charges $ 1,074.00 WARNING: It Is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can Include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and Section 1010. (8U147-15,PFD/BU147-15/10) I HUD-1 Attachment- Continued Reserves Deposited with Lender Homeowner's Insurance 171.75 3.000 at 57.25 per month COUNTY/TOWNSHIP TAXES 131.62 2.000 at 65.81 per month SCHOOL TAXES 2,078.00 10.000 at 207.80 per month AGGREGATE ESCROW ADJUSTMENT -549.49 Total $ 1,831.88 Title Services and Lender's Title Insurance Details BORROWER SELLER INSURED CLOSING LETTER CPL 125.00 to FIRST AMERICAN TITLE INSURANCE ELECTRONIC DOCUMENT DELIVERY 25.00 to TRI-COUNTY ABSTRACT SERVICE OVERNIGHT FEES 14.50 to TRI-COUNTY ABSTRACT SERVICE NOTARY FEES 15.00 to CASH SEARCH&HUD PREP 200.00 to TRI-COUNTY ABSTRACT SERVICE ATTORNEY FEES 851.25 to JOHN M. HYAMS, ESQ. Lender's title insurance 744.50 to Total $ 1,975.25 $ 0.00 Owner's Title Insurance BORROWER SELLER Owner's Policy Premium 129.25 to Total $ 129.25 $ 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above In Title Services and Lenders Title Insurance Details Lender's Policy Premium 594.50 to Lender's Endorsement Charges 150.00 Endorsement Endorsement Charge ALTA Endorsement Form 8.1 (Environmental Protection 50.00 Lien) ALTA Endorsement Form 9(Restrictions, 50.00 Encroachments, Min.) PA ENDORSEMENT 300 MTG. SURVEY EXCEPTION 50.00 Total $ 744.50 $ 0.00 WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and Section 1010. (BU 147-15.PF D/BU147-15/10) WILL 0 C C; u� Barbara J. Rosenberry C)C 1, Barbara J. Rosenberry, of Mechanicsburg, Cumberland County County, Pennsylvania, declare this to be my will, and I revoke all other wills and codicils. 1. EXECUTORS A. I appoint Charles K. Rosenberry,Jr.and Juliet R. Gay to serve together as the executors of my estate. B. No executor shall be required to file bond or enter security in any jurisdiction. II. PERSONAL EFFECTS I give all of my jewelry, clothing, books, photographs,furniture and furnishings, appliances, and other personal and household items,together with all policies insuring those items,to my children who survive me by thirty days,to be divided between or among them as they may agree. 111. RESIDUARY ESTATE I give all the rest of my estate to my children, in equal shares. However, the share of each child of mine who does not survive me by thirty days shailbe distributed to his or her issue who survive me by thirty days, those issue to take per stirpes, or, if there is no such issue,the deceased child's share shall be divided among my other children and distributed to them (or their issue). IV. PROTECTIVE PROVISION Until actual distribution to a beneficiary, no income or principal, or any interest in any income or principal, may be sold, assigned, pledged, or otherwise disposed of in any way by the beneficiary,and no income or principal shall be subject to any attachment or other interference by any legal or equitable procedure. ` . V.TAXES ` Myexecutors-shall pay from my residuary estate all death taxes payable byreason ofmydeath with respect toall property and interests passing under mywill.Tothe fullest extent allowable bxlaw mrany governing instrument, my executors shall recover from any property or interest passing outside of my will all other death taxes which my executors may be required to pay by reason of my death. Vi. POWERS OFEXECUTORS in addition to the powers given to them by |avv or by other pmvisions of my will, nnyexecutors shall have the following powers, which they may exercise as often as they consider advisable, and until final distribution,without having toseek orobtain approval from any court: A.To retain any property comprising a part ofnnyestate, and to retain and to invest in all forms ofreal and personal property, regardless of(1)any limitations imposed by law on investments bvexecutors, (2) any principle of law concerning delegation of investment responsibility, and (3) any principle of law concerning investment diversification. B.To sell at public or private sale, to grant options on,to exchange, or otherwise to dispose of any property. C.Torepair,alter, subdivide, orimprove any property. D.To compromise, orsubmit to arbitration, any claims, including any arising as a result of my death. E.Torenew,ortoextend the time for the debtor topay, any obligation. F.To pay the cost of perpetual care of my gravesite asan expense of my estate. ~ iNWITNESS WHEREOF, | have set rnyhand onFebruary 26, ZO14. Barbara J. Rosenberry ' - M our presence,Barbara 1 Rosenberry signed this iry r hent and declared it to be twer will,and we,at her request,in her presence,and in the presence of each titter,tow signed it as witnesses_ Nam ddress ccvy ► Name Address AWKWEDGEMENT CCMIImOwwEALT,H OF PEmmSYLvANtA COUNTY OF Cumberland I, Barbara J. Rosenberry,the 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. U Barbara J. Rose erry Sworn or affirmed to and acknowledged before me by Barbara J. Rosenberry, the testator,this 26th day of February 2014. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Mary B.Zeplin,Notary Public Fast Pennsboro Twp.,Cumberiand county My Commisslon mires Feb. 10,2016 +FMPM N '^ +e 4SSOCIAITON OF NOTARIES (SEAL.} � ` U ~� Notary Public A1-qFMAVTf COMMOMVEALTH OF PENNSYLVANIA COUNTY OF Cumberland We,and,the witnesses whose names are signed to the attached or foregoing instrument, being duty qualified according to law,do depose and say that we were present and saw the testator sign and execute the instrument as his/her last will;that he/she signed willingly and that he/she executed it as his/her 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 the time 18 or more years of age,of sound mind and under ino constraint or undue influence. X�i PA Wit4s Witness Sworn or affirmed to and subscribed to before me by and,witnesses,this 26th day of February,2014. (SEAL) aA-1 J , s4 - t}IVWEAITH OF PENNSYLVANIA ---i— — V —— Notarial SSI ,..� Mary B.Zepinqn,Notary Public Notary Public EaStPennsbom Twp.,cumwand County My CananWon Ares x. 10,2016 M94BEK pg{►6-Vry YANiA kc.&Y LATION Of NOTARIES