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HomeMy WebLinkAbout05-07-15 (2) 1505610140 REV-1500 EX (02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 0 2 3 2 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 1 1 2 2 0 1 2 1 2 1 3 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI F R A K E R F L 0 R A (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 a 2. Supplemental Return F-1 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received ❑ 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED,ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number J 0 H N B F O W L E R I I I 7 1 7 2 4 3 3 3 4 1 REGISTER OF WILLS L&ONLY C rn O M First Line of Address r M� �Jr� c {�� 1 0 E A S T H I G H S T R E E T _ 1mma Second Line of Address c City or Post Office State ZIP Code .DATE FILED w1A F- M C A R L I S L E P A 1 7 0 1 3 -, o a� Correspondent's e-mail address: MOWLERPMARTSONLAW.COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRE 225 NORT MARKET STREET MECHANICSBURG PA 17055 SIG AT F PREP R TH H EPRESENTATIVE `D TE DR S 10 AAST HIGH STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J \n\ 6V Continuation of REV-1500 Inheritance Tax Return Resident Decedent FLORA MAKER 21 13 0232 Decedent's Name Page 2 File Number Correspondents Name Daytime Telephone Number First line of address Second line of address City or Post Office State ZIP Code Correspondent's e-mail address: Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. NATURE OFPERSON PONSIB FOR FILING RETURN DA E � L 5TESS MEADE DRIVE CARLISLE PA 17013 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: FLORA F R A K E R RECAPITULATION 1. Real Estate(Schedule A) 1. 9 5 0 0 0 . 0 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. 5. Cash,Bank Deposits and Miscellaneous Personal Property Schedule E 2 4 8 0 . 5 5 P P Y( ). . . . . . . 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets total Lines 1 through 7 8. 9 7 4 8 0 • 5 5 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 2 6 9 1 1 . 5 7 10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 0 . 0 0 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 6 9 1 1 . 5 7 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 7 0 5 6 8 . 9 8 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. 7 0 5 6 8 . 9 8 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X.045 7 0 5 6 8 . 9 8 16. 3 1 7 5 . 6 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 1 7 5 . 6 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X Side 2 1505610240 1505610240 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 13 0232 DECEDENT'S NAME FLORA FRAKER STREET ADDRESS 141 OLD GAP ROAD CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 3,175.60 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,175.60 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 ...................................................................... ❑ ❑ b. retain the right to designate who shall use the property transferred or its income ............................... ❑ ❑ c. retain a reversionary interest ..................................................................................................... E] 1771d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... El 113. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑ ❑ 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)(11)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in p2 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) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: FLORA FRAKER 21 13 0232 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. Real estate improved with brick ranch type dwelling house and detached two car garage and 95,000.00 located at 141 Old Gap Road,North Middleton Township,Cumberland County,PA,known as Tax Parcel No.29-07-0471-029,being described in Deed dated 10/05/1987 and recorded in Cumberland County,PA,Deed Book Y32,Page 1068,and being conveyed to William A.Fraker and Flora A.Fraker,his wife. William A.Fraker died on 9/28/1999 leaving title solely vested in Flora A. Fraker. See attached Settlement Sheet. TOTAL(Also enter on Line 1,Recapitulation.) $ 95 000.00 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: FLORA FRAKER 21 13 0232 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. Century Link-telephone refund 16.60 2. Additional proceeds from sale of personal property at public auction 1,461.00 3. Prorated county taxes 422.55 4. Prorated school taxes 580.40 TOTAL(Also enter on Line 5,Recapitulation) $ 2,480.55 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERRESIDENT EDENAX TURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER FLORA FRAKER 21 13 0232 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, 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: Martson Law Offices(estimated) 9,693.00 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: 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Melanie A. Strickland,Tax Collector-pending disposition of real estate(2014 spring taxes) 532.16 8. PPL Electric-pending disposition of real estate 807.66 9. Melanie A. Strickland, Tax Collector-pending disposition of real estate(2014 fall taxes) 2,401.88 10. Susquehanna Oil-pending disposition of real estate 433.50 11. Carlisle Petroleum,Inc. -pending disposition of real estate 231.28 12. Mainhart Mechanical-pending disposition of real estate(plumber) 634.20 13. Paint interior of home-pending disposition of real estate 970.69 14. Doug Landis HVAC&Electrical-pending disposition of real estate 160.00 15, Bouder's Trash Removal&Hauling Services-pending disposition of real estate 4,512.22 16. Rosenberry's Septic Services-pending disposition of real estate 180.00 17. Shearer Security Devices(locksmith) 75.00 18. Commission paid at settlement 4,750.00 TOTAL(Also enter on Line 9,Recapitulation) $ 26 911.57 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent FLORA FRAKER 21 13 0232 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses &Administrative Costs -137. ITEM NUMBER DESCRIPTION AMOUNT 19. Transfer tax paid at settlement 950.00 20. 2015 County/Township Taxes 544.98 21. Tax Certification 10.00 22. Notary Fees 10.00 23. Register of Wills-filing fee 15.00 SUBTOTAL SCHEDULE H-B7 1,529.98 REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: FLORA FRAKER 21 13 0232 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. James E. Fraker Lineal 14,113.80 58 Meade Drive 1/5 of residue Carlisle,PA 17013 2. Phyllis J.Minnich Lineal 14,113.80 225 North Market Street 1/5 of residue Mechanicsburg,PA 17055 3. Carl L.Fraker Lineal 14,113.79 9007 Scarlet Creek 1/5 of residue Universal City,TX 78148 4. Diane E.Harrold Lineal 14,113.79 816 Honeysuckle Drive 1/5 of residue Carlisle,PA 17013 5. Elizabeth A.Quigley Lineal 4,704.60 81 Honeysuckle Drive 1115 of residue Mechanicsburg,PA 17050 6. Deanna R. Salisbury Lineal 4,704.60 4029 Carlisle Road 1/15 of residue Gardners,PA 17324 7. Jenni R.Fraker Lineal 4,704.60 6 Fox Hollow Lane 1/15 of residue Carlisle,PA 17015 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. OMB Approval No.2502-0265 A. Settlement Statement (HUD-1) of Loan 1.❑FHA 2.❑RHS 3.❑Conv.Unins. 6,File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: CS15-01472 4.❑VA 5.❑Conv.Ins, C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked "(p.o.cy'were paid outside the closing;they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: WILLIAM YIENGST,NICHOLAS YIENGST THE ESTATE OF FLORA A.FRAKER 1343 Old Mill Rd.,Mechanicsburg,PA 17050 G.Property Location: H.Settlement Agent: I.Settlement Date:03/24/2015 141 OLD GAP ROAD,NORTH MIDDLETON Homesale Settlement Services Disbursement Date:03/24/2015 TOWNSHIP 4000 Crums Mill Road,Suite 101,Harrisburg,PA 17112 CARLISLE,PA 17013 North Middleton Township Phone:717-671-9876 Fax:717.671.9676 Place of Settlement: TitleExpress BHHS HomeSale Services,801 Belvedere Street,Carlisle, Printed 03/24/2015 at 1:11 pm PA 17013 by SH U Summary of Borrower's 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seiler 101, Contract sales price 95,000.00 401. Contract sales price 95,000.00 102, Personal pioperty 402. Personal property 103. Settlement charges to borrower(line 1400) 2,135.50 403. 104. 404, 105, 405. Adjustments for Items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes 03/24/2015 to 12131/2015 422.55 407. County taxes 03/24/2015 to 12/31/2015 422.55 108, School taxes 03124/2015 to 06/30/2015 580.40 408. School taxes 03/24/2015 to 06/30/2015 580.40 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 98,138.45 420. Gross Amount Due to Seller 96,002.95 200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due to Seller 201. Deposit or earnest money 1,000.00 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller(line 1400) 20,944.98 203, Existing t s taken subject to 503. Existing loan(s) taken subject to 204. 504, Payoff of first mortgage loan 205, 505. Payoff of second mortgage loan 206. 506. 207, 507. 208, 508. 209. 509. Adjustments for items unpaid by seller Ad ustments for items unpaid b seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212, School taxes to 512. School taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220• Total Paid by/for Borrower 1,000.00 520. Total Reduction Amount Due Seller 20,944.98 300. Cash at Settlement fromlto Borrower 600. Cash at Settlement tolfrom Seller 301, Gross amount due from borrower(tine 120) 98,138.45 601, Gross amount due to seller(line 420) 96,002.95 3p2, Less amounts paid by/for borrower(line 220) 1,000.00 602. Less reductions in amount due seller(line 520) 20,944.98 303, Cash Q From ❑To Borrower 97,138.45 603. CashX❑ To ❑ From Seller 75,057.97 u m u en ar s e mno m son s e m e per refpon rw np,revisrnnp,s a xp a s. epenry now a rmsion,. yy IMsfefl,,,unless lto 9pleyf•wrreMly�etk OMB wnlrol numhr.ND wnBeenB.lily It euurM:IMS tlsdowrols mentletory.Teb la tlaelpnee to pevlOe ll,a Wrllm lo•REBPA coverca lnnsscliw VAll,Inlermelbn eMpltle settlomonl prowsf. Previous editions are obsolete Page 1 of 4 HUD-1 L.Settlement Charges 700. Total Real Estate Broker Fees $4,750.00 Paid From Paid From 'Uvision of commission(line 700)as follows: Borrower's Seller's 791, $2,375.00 to WOLFE&COMPANY REALTORS Funds at Funds at 702. $2,375.00 to Berkshire Hathaway HomeServices Settlement Settlement 703. Commission paid at settlement 4,750.00 704. Broker Fee to Berkshire Hathaway HomeServices 225.00 800, Items Payable in Connection with Loan 801, Our origination charge (Includes Origination Point 0.000%or$0.00) $ (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2) 803. Your adjusted origination charges (from GFE A) 804. Appraisal fee to from GFE#3) 805. Credit report to from GFE#3) 806, Tax service to from GFE#3) 807. Flood certification to from GFE#3) 1808. to 900. Items Required by Lender to be Paid In Advance 901. Daily interest charges from from 03/24/2015 to 04/01/2015 @$0.00/day (from GFE#10) 902. Mortgage insurance premium months to from GFE#3) 903. Homeowner's insurance months to from GFE#11) 904. months to from GFE 9111 1000.Reserves Deposited with Lender 1001.Initial deposit for your escrow account (from GFE#9) 1002,Homeowner's Insurance months Q$ /month 1003. Mortgage insurance months a$ /month 1004.Property taxes months @$ /month 1005.County taxes months $ 45.421month $ 1006.School taxes months $ 178.32/month $ 1007.Aggregate Adjustment $ 1100,Title Charges 1101.Title services and lender's title insurance $ from GFE#4) 1102.Settlement or closing fee to $ 1103.Owner's title insurance-First American Title Insurance Company $ from GFE#5) 872.50 1104.Lender's title Insurance-First American Title Insurance Company $ 1105,Lender's title policy limit$0,00 Lender's Policy 1106.Owner's title policy limit$95,000.00 Owner's Policy 1107.Agent's portion of the total title insurance premium $776.52 to Homesale Settlement Services 1108. Underwriter's portion of the total title insurance premium $95.98 to First American Tide Insurance Company 1109. 1200.Government Recording and Transfer Charges 1201,Government recording charges $ (from GFE#7) $3.00 1202. Deed$83.00 Mortgage$ Release$ 1201 Transfer taxes $ (from GFE#8) 950k4 1204.City/County taxistamps Deed$950.00 Mortgage$ 1205.State Tax/stamps Dead$950.00 Mortgage$ 950.00 1206. Deed$ Mortgage$ 1207. $ 1300.Additional Settlement Char - 1301.Required services that you can shop for (from-GFE#6) 1302. to 1303.Settees Attorney Fees to Martson Law Offices POC 1304.2015 Countyrrwp Taxes to Melanie A.Strickland,Tax Collector 544.99 73-075T-ax Carl to Homesale Settlement Services 10.00 1306.Notary Fees to Notary Public 5.05 10.00 1307.Septic Cert to Rosenberry's Septic Services -180.00 1308. Inheritance Tax,etc.Escrow to Manson Law Offices 14,500.00 OWN ..101URI 2,135.50 20,9�,98 *Paid outside of closing by(B)orrower,(S)eller,(L)ender,(l)nvestor,Bro(K)er."Credit by lender shown on page 1,-Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 Comparison of Good Faith Estimate GF and HUD-1 Charges Good Faith Estimate HUD-1 Charges That Cannot Increase HUM Line Number Our origination cha e #801 0.00 000 Your credit or charge(points)for the specific interest rate chosen # 802 0.00 0.00 Your adjusted origination charges # 803 0.00 0.00 Transfer taxes # 1203 0.00 950.00 Charges That in Total Cannot Increase More Than 14/a Good Faith aith Estimate HUD-1 Government recording charges # 1201 0.00 _ 83.00 Title services and lender's title Insurance # 1101 0.00 0.00 Owner's title Insurance # 1103 0.00 872.50 # # # 0.00 955.50 Increzise betwebri'GFE and HUD-1 Ch • $ 955.50 or 999.9999% Charges That Can Chane Good Faith Estimate HUD-1 Initial deposit for your escrow account # 1001 0.00 0.00 Daily interest charges from # 901 $ /diy 0.00 i _ 0.00 Homeowner's Insurance #903 0.00 ' U0 Loan Terms Your initial loan amount is $ Your loan term is years Your initial Interest rate Is % Your initial monthly amount owed for principal,interest,and any mortgage $ Includes insurance Is 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 ! t and can change again every years after t i . 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 amount owed for 0 No. ❑Yes,the first increase can be on I i and the monthly principal,interest,and mortgage insurance rise? amount owed can rise to$ The maximum it can ever rise to is$ Does your loan have a prepayment penalty? El No. ❑Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? Q No. ❑Yes,you have a balloon payment of$ due in years on t / . Total monthly amount owed Including escrow account payments [X]You do not have a monthly escrow payment for items,such as property taxes and homeownees insurance. You must pay these items directly yourself. ❑You have an additional monthly escrow payment of$ that results in a total initial monthly amount owed of$ This includes principal,interest,any mortgage Insurance and any items checked below: ❑Property taxes ❑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. Previous editions are obsolete Page 3 of 4 HUD-1 Itemization of Your Loan Oriciination Charcies Name of Borrower: Name of Seller File Number: WILLIAM YIENGST THE ESTATE OF FLORA A.FRAKER CS15.01472 NICHOLAS YIENGST Prepared 0312412015 at 1:11 pm Note:This page displays an itemization of the adjusted origination charges shown in section 800 of the HUD-1 Settlement Statemen This page accompanies but Is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. Your Loan Origination Charges Borrower Seller 801. Our origination charge (Includes Origination Point 0.000%or$0.00) to $ 0.00 802. Your credit or charge(points)for the specific interest rate chosen to $ 0.00 803. Your adjusted origination charges 0.001 OAO Itemization of Lifie.1101' Name of Borrower: Name of Seller: File Number. WILLIAM YIENGST THE ESTATE OF FLORA A.FRAKER CS15-01472 NICHOLAS YIENGST Prepared 03/24/2015 at 1:11 pm Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 Settlement Statement.This page accompanies but is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. 1100.Title Charges Total Charge Borrower Seller 1101.Title services and lenders title insurance to 1102.Settlement or closing fee to $ 0.00 1104.Lenders title insurance-First American Tit to First American Title Insurance Ci$ 0.00 Totals: $ 0.00 0.00 0.00 0.00 Seller/Lender credits shown on page 1 POC=Paid Outside Closing CR=Lender Credit Previous editions are obsolete Page 1 of 1 HUD-1 Signature Page 0 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction I further certify that I have received a copy of the HUD-1 Settlement Statement. WILLIAM YIENGST NIC LA I T THE ESTATE OF FLORA A.FRAKER Settlement Agent The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be disbursed in accordance with this statement. i SETTLEME` N�A6ENT DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD-1