HomeMy WebLinkAbout04-23-15 REV-1500 Ex(02-11) � 1505610143
1 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 01181
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
02 15 2014 01 29 1930
Decedent's Last Name Suffix Decedent's First Name MI
BRYAN SALLY A
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix . Spouse's First Name MI
Spouse's Social Security Number
a- THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ❑ 2. Supplemental Return ❑ 3,Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate ❑ 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® 8 Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust B. 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
ry
ROBERT P KLINE 717 7,7�0 2 5 4 CF.
Lin rn
REGISTER709,�VhS U-_-'�ONio
;? r— fV 7
First Line of Address r- M W
714 BRIDGE STREET
=1 F
Second Line of Address
PO BOX 461 cn ,
QATE FILED Cn
City or Post Office State ZIP Code
NEW CUMBERLAND PA 17070 I
Correspondent's e-mail address: rkIIne@kIineIawoffice.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 OFPERSON RESPONSIBLE FOR FILING RETURN DATE
Bradley M. Bryan b/V7
ADDRESS
824 Belle Vista Drive, Enola, PA 17025
SIGNAT OF EPAREROVER THAN REPRESENTATIVE DATE
Robert P Kline A
ADDRESS
Kline Law Office
I 714 Bridge Street, New Cumberland, PA 17070
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: BRYAN, SALLY ANN
RECAPITULATION
1. Real Estate(Schedule A)........................................................................................... 1. 232 , 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5.
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. 232 , 000 . 00
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 12 , 698 . 81
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 160 , 293 . 05
11. Total Deductions(total Lines 9 and 10)..................................................................11. 172 , 991 86
12. Net Value of Estate(Line 8 minus Line 11)...................................................:.........12. 59 , 008 1 4
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. 59 , 008 . 14
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.
16. Amount of Line 14 taxable
at lineal rate X .045 59 , 008 14 16. 2 , 655 . 37
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. 2 , 655 . 37
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21 - 14 - 01181
Decedent's Complete Address:
DECEDENT'S NAME
Bryan, Sally Ann
STREET ADDRESS
824 Belle Vista Drive
CITY STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 2,655.37
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +B) (2) 0.00
3. Interest (3) 0.00
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) 2,655.37
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............................................................................................................... .. x
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
receiving adequate consideration?.....................................................................................................................0 0
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... D 7
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?...................................................................................................................El ❑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 21yyears 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 taxrate 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 bloo or adoption.
-; pennsylvania
1 DEPARTMENT OF REVENUE SCHEDULE A
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Bryan, Sally Ann 21 - 14 -01181
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 which 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 OF
NUMBER DESCRIPTION DEATH
1 824 Belle Vista Drive, East Pennsboro Twp, Cumberland Co, PA Parcel#09-11-3007-012 232,000.00
(appraisal attached)
TOTAL(Also enter on Line 1, Recapitulation) 232,000.00
REV-1509 EX-(01-10) SEPARATE BILLING REQUESTED
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE F
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bryan, Sally Ann 21 - 14-01181
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
Bradley M. Bryan 824 Belle Vista Drive Son
A Enola, PA 17025
JOINTLY OWNED PROPERTY: EE� N o p
ITEM LETTER DATE Include name oTina cllal inOstNituu9lon anOd bank account numb rDATE OF DEATH %OF DATE OF DEATH
NUMBER FOR JOINT MADE or similar identifying number.Attach deed forjointl -held real VALUE OF ASSET DECD'S VALUE OF
TENANT JOINT 9 t Y INTEREST DECEDENT'S INTEREST
estate.
1 A PNC Bank#10-1434-1396 17,141.64 50% 8,570.82
TOTAL(Also enter on line 6, Recapitulation) 8,570.82.
REV=151oEXF(o9-09) SEPARATE BILLING REQUESTED
Pennsylvania
DEPARTMENT OF REVENUE SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Bryan, Sally Ann FILE NUMBER
21 - 14-01181
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE
NUMBER Include the name of the transferee,their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE)
and the date of transfer. Attach a copy of the deed for real estate. INTEREST
1 Morgan Stanley#410-895058 542,861.39 100% 542,861.39
Beneficiary: Bradley M. Bryan (son), 824 Belle Vista
Drive, Enola, PA 17025
2 Morgan Stanley#410-895151 80,180.47 100% 80,180.47
Beneficiary: Bradley M. Bryan (son), 824 Belle Vista
Drive, Enola, PA 17025
TOTAL(Also enter on line 7, Recapitulation) 623,041.86
REV4511 EX-(10-09)
: pennsylvania ��c�pS�C�HMUL cHC
DEPARTMENT OF REVENUE IlIYMAL D�IVSES MD
INHERITANCE TAX
RESIDENT DECEDENTTURN A ry�pNSMA�WM
/1UIYU��/h7 rW �W �7 FILE NUMBER
ESTATE OF Bryan, Sally Ann 21 - 14 -01181
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Richardson Funeral Home, Inc., Enola, PA 4,385.44
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees Kline Law Office 5,000.00
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 Register of Wills 500.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Expenses, adjusted for pro-rated taxes, related to sale of real property (HUD-1 2,587.87
attacehed)
See attached 225.00
TOTAL(Also enter on line 9, Recapitulation) 12,698.81
Schedule H
Funeral E)enses&
COMMONWEALTHINHERITANCE RETURN PENNSYLVANIA AdjTgn1,4"native C sts confined
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Bryan, Sally Ann 21 - 14-01181
2 P. Scott Archibald Appraisals 225.00
Page 2 of Schedule H
zs - pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT, MORTGAGE
RESIDENT DECEDENT LIABILITIES & LIENS
FILE NUMBER
ESTATE OF Bryan, Sally Ann 21 - 14- 01181
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 BB&T Mortgage#6996086095 143,929:16
2 FIA Card Services#xxxxxxxxxx9680 16,363.89
TOTAL(Also enter on Line 10, Recapitulation) 160,293.05
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WILL OF
fV M
SALLY ANN BRYAN r o
rn l
I, SALLY ANN BRYAN, domiciled and residing in Westmoreland County,
Commonwealth of Pennsylvania,declare that this is my Will. I revoke all my other wills and
codicils.
I. IDENTITIES
I am married to Frank S. Bryan(herein "my Husband"). We have three children: Patricia
M. Bryan, David N. Bryan, and Bradley M. Bryan,whom I will refer to together herein as "my
Children."
H. APPOINTMENT OF EXECUTOR
A. I appoint Bradley M. Bryan as the Executor of my Estate. If he is or becomes
unable or unwilling to serve, I appoint Patricia M. Bryan to serve as my successor or alternate
Executor.
B. I direct that no Executor appointed in this Article will be required to execute or
file any bond, with or without sufficient surety, in any jurisdiction for the faithful performance of
his or her duties as fiduciary.
III. PAYMENT OF EXPENSES AND TAXES
A. I direct my Executor to pay the medical, funeral and estate administration
expenses that are payable at or after my death before making a final distribution of my estate.
B. I further direct that the federal and state estate, inheritance, transfer or succession
taxes, including any interest or penalties thereon(herein"death taxes"), that are imposed on the
property passing under any Article of this Will shall,be paid out of the principal of my Residuary
Estate and charged in the same manner as a general administration expense. However, the death
taxes imposed on any property that passes outside of my Will,whether by beneficiary
designation,.right of survivorship, or otherwise, shall not be the liability of my Residuary Estate
but of the transferee thereof. If for any reason my Executor elects to pay any such death taxes
imposed on non-probate property from the assets of my estate, he or she shall then have the right
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN J.RAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435
Pagel of 11
to compel contribution from such transferees for their pro rata share of such death taxes,
including the right to offset any such transferee's beneficial interest in my estate (if such
transferee is also a beneficiary hereunder)by the amount of such pro rata share.
IV. GIFT OF TANGIBLE PERSONAL PROPERTY
A. I give to my Husband if he survives me all the household goods and tangible
personal property that I may own at my death, including but not limited to my clothes, silver and
jewelry, furniture, and whatever automobile that I may own at my death, together with any
unused premiums on policies of homeowner's and automobile insurance, and any proceeds of
such policies that are undistributed at the time of my death.
B. If my Husband does not survive me,1 give all my remaining tangible personal
property and household goods, as defined in Paragraph A above,to those of my Children who
survive me in such nearly equal shares as they may determine among themselves. In the
composition mposition of such shares my Executor may represent any of my Children who survives me but
is under a legal disability at my death.
V. GIFT OF RESIDUARY ESTATE
A. My"Residuary Estate" is all the property I may own at my death and that remains
after payments are made under Article M and distributions are made under Article IV above,
whether such property is real,personal, or mixed, and whenever obtained and wherever situated.
B. I give my Residuary Estate to my Husband if he survives me..
C. If my Husband does not survive me, I direct my Executor to divide my Residuary
Estate into three equal shares and to distribute such shares, subject to Article VU below, as
follows:
L One share shall be distributed to Patricia M. Bryan, if she survives me, or
to those of her Descendants who survive me if she does not survive me.
2. One share shall be distributed in trust to the Trustee of the Trust for David
N. Bryan created in Article VI below, if my son David survives me, to be held, administered and
distributed for his benefit under the terms of such Article.
3. -One share shall be distributed to Bradley M. Bryan, if he survives me, or
to those of his Descendants who survive me if he does not survive me.
D. If any share described in subparagraphs I - 3 of Paragraph C above cannot take
MARTIN J.RAGAN,ESQUIRE
"W FIRM OF MARTIN J.HAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435
Page 2 of 11
effect because none of the beneficiaries named or referred to in such subparagraph survives me,
such share will be deemed canceled and of no effect, and I direct that my Residuary Estate shall
be distributed equally in the shares that do take effect above, or all of it under the one
subparagraph that takes effect if only one such subparagraph is effective.
E. If neither my Husband,my Children, nor any Descendant of my Children survives
me, I direct that one-half of my Residuary Estate shall be distributed to those persons who
survive me and who would have taken my estate and in the shares they would have taken it, and
the other one-half shall be distributed to those persons who survive me and who would have
taken my Husband's estate, and in the shares they would have taken it,under the intestate laws of
Pennsylvania in effect at my death.
VI. TRUST FOR DAVID N. BRYAN
A. The Trust created in this Article will be effective if my Husband does not survive
me but my son,David N. Bryan(whom I will refer to herein as the"Beneficiary"), does survives
me. The Trustee appointed in Paragraph G below will take receipt of all the property distributable
to this Trust under Article V above, and any other property that may be payable to this Trust from
any source apart from this Will, including all proceeds of retirement accounts, annuities, or
policies of life insurance of which the Trust has been designated as a beneficiary, and shall hold,
administer, and distribute all such property and the income therefrom as the Trust Property under
the terms of this Article.
B. During the term of this Trust, the Trustee may distribute to or on behalf of the
Beneficiary such amounts of the net income or principal or both, and at such times, as the Trustee
in his or her sole discretion determines to be necessary or advisable to provide for the
Beneficiary's comfort,happiness and welfare, including providing him with such goods and
services that will enrich his life and make it more enjoyable. In making or withholding
distributions hereunder, I direct the Trustee to take into' account all the assets, income, and other
resources that are available to the Beneficiary from time to time from all other sources, including
but not limited to benefits available to him under policies of health or medical insurance, and all
forms of assistance, benefits, income maintenance, or services that he maybe eligible to receive
from time to time under any applicable state and/or federal government program. The Trustee
shall be authorized to investigate all potential sources of income, support, maintenance, and other
benefits that may be available to or on behalf of the Beneficiary from all such sources, and may
(but shall not be required to) apply for such benefits on the Beneficiary's behalf. Any net income
of the Trust that is not distributed by the end of the calendar year in which it was received shall
be accumulated and added to principal.
C. Notwithstanding any other provision in this Article to the contrary, in no event
shall any distribution be made from this Trust for a purpose that would constitute the"health,"
"support,"or"maintenance"of the Beneficiary, as such terms are defined under Pennsylvania
law.
MARTIN J.RAGAN,ESQUIRE
LAW FIRM OF MARTIN J.RAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435
Page 3 of 11
D. In exercising the discretionary powers conferred on the Trustee in this Article, the
Trustee shall be guided by the fact that the Beneficiary has a condition that will likely impair his
ability to maintain and support himself independently, and which may make him eligible for
public assistance benefits, such as Supplemental S'ecurity Income (S.S.I.), Medical Assistance,
Social Security Disability Insurance(S.8.D.I.), and other federal and state programs. As a result,
this Trust shall be administered so that it will only supplement all the public assistance benefits
that may be available to the Beneficiary during his lifetime, as well as any applicable medical or
health insurance covering the Beneficiary. In no event will any of the income or principal of the
Trust Property be used to supplant or have priority of payment over any such public assistance
benefits or private insurance.
E. The Trust created herein will terminate at the Beneficiary's death. The Trustee
shall divide all the Trust Property remaining at such time into two equal shares and shall
distribute such shares, subject to Article VU below, as follows:
1. - One share shall be distributed to Patricia M. Bryan, if she survives the
Beneficiary or to those of her Descendants who survive him if she does not survive him.
2. One share shall be distributed to Bradley M. Bryan, if he survives the
Beneficiary, or to those of his Descendants who survive him if he does not survive him.
If either subparagraph Lor 2. above cannot take effect because none of the beneficiaries named
or referred to in such subparagraph survives the Beneficiary, such share will be-deemed canceled
and of no effect, and all of the Trust Property shall pass under the subparagraph that does take
effect above. If neither subparagraph 1. or 2. above can take effect because none of the
beneficiaries named or referred to in either such subparagraph survives the Beneficiary, all of the
remaining Trust Property shall then be distributed in accordance with Paragraph E of Article V
above, the terms of which are incorporated herein by reference;provided,however, that for
purposes hereof any condition of survivorship contained in such Paragraph E will be deemed to
refer to the Beneficiary's death and not to my death.
F. Notwithstanding any provision of Paragraph E above to the contrary, the Trust
created in this Article will terminate at any time prior to the Beneficiary's death if all three of the
following conditions have occurred, as permitted under 20 Pa. Cons. Stat. § 7740.4 (a): (1)the
Trustee has concluded in good faith that the value of the Trust Property has become insufficient
to justify the cost of continuing the administration of the Trust, (2) the Trustee has given written
notice of the Trust's proposed termination to the Trust's "qualified beneficiaries,"as defined in
20 Pa. Cons. Stat.'§ 7703, at least sixty(60) days before the proposed date of termination, and (3)
no such"qualified,beneficiary"has provided the Trustee with a written objection to the proposed
termination by the date specified in the notice. Upon the occurrence of such conditions, the
Trustee shall be authorized to make an immediate distribution of all the Trust Property remaining
at such time to the Beneficiary or to his fiduciary, as provided for in Article IX below, in
complete termination of the Trust. The written receipt and release of the Beneficiary or his
MARTIN J.RAGAN,ESQUIRE
LAW FIRM OF MARTIN J.RAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435
Page 4 of 11
fiduciary will be a sufficient discharge of the Trustee's duty to distribute the Trust Property to the
Beneficiary under this Article, and shall terminate absolutely the rights of all persons who might
otherwise have had a future interest in the Trust,whether vested or contingent,without notice to
them and without the necessity of filing a fiduciary account with any court.
G. I appoint Bradley M. Bryan to serve as the Trustee of the Trust established in this
Article if it becomes effective after my death. If Bradley M.Bryan is initially unable or unwilling
to act as Trustee, or if he later ceases to serve,whether due to death, voluntary resignation, or
becoming incapable of properly exercising the duties of a trustee, as such incapacity shall be
determined by his primary care physician,I appoint Patricia M. Bryan to serve as the alternate or
successor Trustee. The then-serving Trustee will be authorized to appoint one or more additional
individuals or a corporate fiduciary to serve as successor Trustee if both of my children named
herein are or become unable or unwilling to serve, as described above.
H. Notwithstanding any provision.in this Will to the contrary, the interests in the
Trust Property of all the beneficiaries named or referred to herein shall be herd subject to a
spendthrift trust that restrains both the voluntary or involuntary transfer of their interests in the
Trust.No interest of any such beneficiary shall be subject or liable in any manner to involuntary
transfer, including but not limited to attachment, garnishment, execution, sequestration, claims
for alimony,maintenance, or support, or other process,nor to any such beneficiary's own
voluntary anticipation, alienation, assignment, conveyance, sale,pledge, or other transfer. The
Trustee is empowered and directed to disregard and defeat any such involuntary or voluntary act,
or attempt in any manner provided by law.
I. The Trustee will be entitled to reasonable compensation annually,payable from
income,principal, or both, for the services that he or she performs as Trustee. If a corporate
fiduciary is appointed to serve as an alternate or successor Trustee of the Trust, it will be entitled
to receive reasonable compensation in accordance with its standard schedule of fees in effect
from time to time,provided that such compensation shall not exceed the amount that would be
awarded the corporate fiduciary by the Court having jurisdiction over the Trust. The Trustee will
also be entitled to be reimbursed from the Trust Property for all expenses that are properly
incurred in the administration of the trust.
J. Upon executing a written acceptance of the office, a successor Trustee will be
authorized to exercise all the powers granted to the Trustee under this Will, without the necessity
of obtaining the appointment by any Court. A successor Trustee may take receipt and control of
the Trust Property in its condition when delivered to him or her by the prior Trustee, and may
assume for all purposes that the assets so delivered constitute all the assets the successor is
entitled to hold hereunder.
K. The Trustee will not be required to file an accounting of the Trust with any Court.
However, the Trustee is not prohibited from obtaining Court approval of an account for any
purpose, including the discharge of a Trustee at the termination of the Trust or upon a Trustee's
ceasing to serve, and the Trustee or any other party in interest herein may request Court
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN 1.HAGAN LLC
ONE GATEWAY.CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435 Page 5 of 11
instructions or submit a dispute to the Court at any time.
L. No Trustee appointed in this Article will be required to execute or file any bond,
with or without sufficient surety, in anyjurisdictionfor the faithful performance of his or her
duties as fiduciary.
VH. PROVISION FOR MINOR OR INCAPACITATED BENEFICIARIES
A. If at the time for distribution of any property under any Article of this Will there is
a beneficiary entitled to receive such property outright and free of trust but who has not yet
attained age twenty-one (2 1) or is under a legal disability, or who is,in the opinion of a qualified
physician or psychiatrist, unable to prudently manage his or her financial resources, such property
will vest in such beneficiary,but my Executor or the Trustee, as the case may be,will have the
power to distribute that beneficiary's property to his or her guardian, agent,parent, spouse, or
custodian under the Pennsylvania Uniform Transfers to Minors Act or the Uniform Gifts to
Minors Act or the'Uniform Transfers to Minors Act as in effect in the state of such beneficiary's
domicile, or to any other responsible adult with whom the beneficiary resides, or to transfer such
property into trust with such trustee, including my Executor or the Trustee, all as my Executor or
the Trustee in his-or her discretion may select. The receipt of such beneficiary's property by his
or her guardian, agent, parent, spouse, custodian, trustee, or the responsible adult will be a
sufficient discharge of my Executor's or the Trustee's duty to distribute such beneficiary's
property.
B. If such property is placed in trust under Paragraph A above, the trustee shall invest
the principal and shall pay to or for the benefit of the beneficiary so much or all of the net income
or principal, or both, as the trustee deems necessary or advisable from time to time for the
beneficiary's health,maintenance, complete education, and support. Net income not so paid will
be accumulated. The trust created herein will continue until the beneficiary attains age 21, or the
legal disability is removed, or the beneficiary becomes able to prudently manage his or her
financial resources, whichever event is the last to occur, at which time the remaining trust
property shall be distributed outright to the beneficiary, or if he dies prior to such time, then to
his or her estate.
VIII. ADMINISTRATIVE POWERS OF FIDUCIARIES
A. In the management, care, and disposition of my estate and the trusts created
above,my Executor and the Trustee of any Trust created in this Will(including any alternate or
successor fiduciaries)will have the power to do all things and to execute such instruments as
may be necessary or proper, including the following powers, all of which may be exercised
without order of or report to any court:
I To take possession of my property or the trust property, to keep it safely,
MARTIN J.RAGAN,ESQUIRE
LAW FIRM OF MARTIN J.RAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435 Page 6 of 11
and to segregate it from other property.
2. To retain or invest-during the period of estate or trust administration,
consistent with the principles of diversification,risk, and productivity, the assets of my estate or
a trust in real property and all interests in real property, including residential real estate; in bonds,
notes, debentures,mortgages, commercial paper,preferred or common stocks, or other securities;
and in rights or obligations in property, real or personal, including shares or certificates of
participation issued by regulated investment companies or regulated investment trusts, shares or
units of participation in qualified common trust funds or in qualified pooled funds, or in
certificates of deposit or savings accounts in a bank or other savings institution supervised by the
United States or a state,without regard as to whether such are legal uses or investments for a
fiduciary as may be defined by law.
3. To vote in person or by proxy any corporate stock or other security held by
my estate or a trust, and to agree to take any other action in regard to any reorganization, merger,
consolidation, liquidation,bankruptcy, or other procedure or proceeding affecting any such stock,
bond,note, or other security. .
4. To sell and exchange;lease, rent, mortgage,pledge, give options upon, and
partition real and personal property, including undivided interests in real property, at public or
private sale, on whatever terms they find advisable, including the right to lease for any term
notwithstanding the anticipated period of my estate or a trust, and to grant options, including an
option for a period beyond the anticipated duration of my estate or a trust, without notice to or
order of court.
5. To render liquid my estate or a trust, in whole or in part, and to hold cash
or readily marketable securities of little or no yield for whatever period they find advisable.
6. To register any stock,bond, or other security in the name of a nominee,
without the addition of words indicating that such security is held in a fiduciary capacity, but
accurate records will be maintained showing that such security is an estate or a trust asset and my
fiduciaries will be responsible for the acts of such nominee.
7. To prosecute, compromise, or abandon claims held by my estate or a trust,
and to defend,pay, compromise, or abandon claims asserted against my estate or a trust, on
whatever terms my fiduciaries find advisable, without court authority.
8. To use real estate brokers, accountants, investment advisors, attorneys, and
other agents, if such employment be deemed necessary or desirable, and to pay reasonable
compensation for their services.
9. To renew any indebtedness or to borrow money and to secure the same by
mortgaging,pledging, or conveying any property of my estate or a trust, including the power to
borrow from my fiduciaries at a reasonable rate of interest.
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN J.HAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435
Page 7 of 11
B. I direct and authorize my Executor and the Trustee to make all elections available
to my estate or any trust created under this Will for purposes of estate, inheritance, and income
taxes. My fiduciaries will not be required to make adjustments between principal and income or
in the relative interests of the beneficiaries to compensate for the effect of any such election
made.
C. In the distribution of my estate or any trust created in this Will or in any division
into separate shares,my Executor and the Trustee are authorized to make the distribution and
division in money or in kind or in both,regardless of the basis for income tax purposes of any
property distributed or divided in kind, and the distribution and division made and the values
established by my fiduciaries will be binding and conclusive on all persons taking hereunder.
My fiduciaries, in making such distribution or division,may allot undivided interests in the same
property to several trusts or shares.
IX.DEFINITIONS
The following definitions will obtain in any use of the terms in this Will:
A. "Descendants"means the immediate and remote, lawful, lineal descendants of the
person referred to who are in being at the time they must be ascertained in order to give effect to
the reference to them,whether they are born before or after my death or the death of any other
person. Descendants will take by right of representation in accordance with the rule ofper
stirpes distribution, and not under the rule ofper capita distribution. "Descendants" includes
persons legally adopted by the person referred to.
B. "Survive" means that the person referred to must survive.my death or any other
event referred to by thirty(30) days. If the person referred to dies within thirty(30) days of such
event, the reference to him or her will be construed as if he or her had predeceased the event.
C. Wherever the context so requires,references in this Will to the masculine,
feminine, or neuter gender, and the singular or plural number, shall each be deemed to include
the others.
IN TESTIMONY OF WHICH I now sign this Will, in the presence of the witnesses
whose names appear below, having requested that they witness my signature and attest to the
execution of this Will, on this day, January 2012.
Sally AnM3ryan
MARTIN J.HACAN,ESQUIRE
LAW FIRM OF MARTIN J.RAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435 Page 8 of 11
SALLY ANN BRYAN, in our presence, signed this instrument. Before she signed it she
declared to us that it was her Will and requested that we act as witnesses to its execution. We
now in her resence and in the presence of each other sign below as witnesses, all on this day,
January , 2012.
residing at
residing at l
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN J.HAGAN LLC
ONE GATEWAY CENTER-8 SOUTH .
PITTSBURGH,PA 15222-1435
Page 9 of 11
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF WESTMORELAND
L SALLY ANN BRYAN,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 Will, and that I signed it willingly and as my free and
voluntary act for the purposes therein expressed.
Sally��cyan
Sworn to or affirmed and acknowledged before me by Sally Ann Bryan, the testator, this
day, January , 2012.
Notary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Martin 3.Hagan,Notary Public
of Pittsburgh,Allegheny County
Emcyity Commission Expires Dec.12,2013
Member,Pennsylvania Association of Notaries
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN J.HAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435 Page 10 of 11
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF WESTMORELAND
14�1 and 1SX.*,d erg yf vd the witnesses
whose names are signed4o the attached or foregoing 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 her Will; that the testator signed willingly and executed it as her free and voluntary
act for the purposes therein expressed; that each subscribing witness in the hearing and sight of
the testator signed the will as a witness; 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 no constraint or undue influence.
/Witness'
Wi
Sworn to or affirmed and subscribed before me byPiQ-QfL. kt&b�� 6.
witnesses, this day, January 2012.
ti
Notary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Martin 1.Hagan,Notary Public
City of Pittsburgh,Allegheny County
My Commission Expires Dec.12,2013
Member,Pennsvivania Association of Notaries
MARTIN J.HAGAN,ESQUIRE
LAW FIRM OF MARTIN J.HAGAN LLC
ONE GATEWAY CENTER-8 SOUTH
PITTSBURGH,PA 15222-1435 Page 11 of 11
11!0
2OL7
Parcel Number: 09-11-3007-012
File No. BRYAN-SA
Tbt',q �CO, .,he i r"day of /
Between Pathavd-t
HELEN B. HEISEY, WIDOW, 10� Htr-*00. �� "%.%. CAROLE H. LEFEVER, A R&o
(hereinafter called the Grantor), of the one part, and
SALLY A. BRYAN, A SINGLE WOMAN,
also k-am as SALLY ANN BRYAN
(hereinafter called the Grantee), of the other part,
Witnesseth That the said Grantor for and in consideration of the sum of Three Hundred
Thousand and 00/100 Dollars ($300,000.00) lawful money of the United States of America, unto her
well and truly paid by the said Grantee, at or before the seating and delivery hereof, the receipt
whereof is hereby acknowledged, has granted, bargained and sold, released and confirmed, and by
these presents does grant, bargain and sell, release and confirm unto the said Grantee as her heirs and
assigns, t
T—ALL THAT CERTAIN tract or parcel of ground situate in the Township of East Pennsboro, County of
Cumberland and State of Pennsylvania,bounded and described as follows, to wit:
BEGINNING at a point in Mountain Road at land now or late of Ben Eby; thence by land now or late of the said
Ben Eby and through an iron pin, north twenty-four(24)degrees, one(1)minute west a distance of three hundred
eighty-three and twenty-eight one-hundredths (383.28) feet to an iron pipe; thence by same north sixty-eight(68)
degrees, seven (7) minutes east a distance of one hundred three and one one-hundredths (103.01) feet to a pipe;
thence north sixty-eight(68)degrees,twenty-seven(27)minutes east a distance of one hundred thirty-two and five-
tenths (132.5) feet to an iron pin at land of Charles C. Snedeker; thence by same south thirty-three(33) degrees,
twenty-eight (28) minutes east a distance of four hundred eighty-six and eighty-four one-hundredths (486.84) feet
to a point in Mountain Road; thence by same south eighty-four (84) degrees, thirty-nine (39) minutes west, a
distance of three hundred thirty-two and seventy-five one-hundredths(332.75) feet to the place of BEGINNING.
Containing two and sixty-eight one-hundredths (2,68)acres.
The above description is in accordance with a survey trade by D.P. Raffensperger, Registered Surveyor,,
( September 21, 1967.
BEING the same premises which, THE HARRISBURG NATIONAL BANK AND TRUST COMPANY, A
Pennsylvania National Banking Association and ELIZABETH F. EBY, Executors of the Last Will and Testament
02/03/2015 9:24:43 AM CUMBERLAND COUNTY Inst.#201219370-Page 1 of 5
of Ben Eby, by Indenture bearing date October 3, 1967 and recorded October 5, 1967 in the Office of the
Recorder of Deeds, in and for the County of Cumberland Deed Book. No. 22N, page 486 etc., granted and
conveyed unto KENNETH H. HEISEY and HELEN B. HEISEY, HIS WIPE, in fee.
The said Kenneth H. Heisey died November 14, 1998 as referenced in Death Certificate No. 5284078, thereby
vesting sole title unto Helen B. Heisey.
The said Helen B. Heisey has appointed her Power of Attorney to Carole H. LeFever by Power dated October 6,
2010.
02/03/2015 9:24:43 AM CUMBERLAND COUNTY Inst.#201219370-Page 2 of 5
Together with all and singular the buildings improvements, ways, streets, alleys, driveways, passages,
waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever unto the
hereby granted premises belonging, or in anywise appertaining, and the reversions and remainders, rents,
issues, and profits thereof; and all the estate, right, title, interest, property, claim and demand whatsoever of
the said Grantor, as well at law as in equity, of, in and to the same.
To have and to hold the said lot or piece of ground described hereditaments and premises
hereby granted, or mentioned and intended so to be, with the appurtenances, unto the said Grantee, her heirs
and assigns, to and for the only proper use and behoof of the said Grantee,her heirs and assigns, forever.
And the said Grantor, her heirs, executors and administrators do covenant, promise and agree, to and with
the said Grantee, her heirs and assigns, by these presents, that the said Grantor, her heirs, all and singular the
hereditaments and premises hereby granted or mentioned and intended so to be, with appurtenances, unto the
said Grantee,her heirs and assigns, against the said Grantor and her heirs, and against all and every person and
persons whosoever lawfully claiming or to claim the same or any part thereof, by, from or under or any of
them, shall and will
SPECIALLY WARRANT and forever DEFEND.
In Witness Whereof, the party of the first part hereunto set her hand and seal. Dated the day
and year first above written.
Sealed and Delivered
IN THE PRESENCE OF US:
1G �Z. Lk( SEAL)
HELEN B. HEISEY AAIN pst 6q
Carole H. LeFver�+44
02(0312015 9:24:43 AM CUMBERLAND COUNTY Inst.#201219370-Page 3 of 5
Commonwe th of Pennsylvania
County of ss:
On this the 15 (lay of 91it—, �l� before me, a Notary Public, the undersigned Officer,Sj� personally appeared CA►R LE . LEFEVER, HELEN B. HEISEY,4t
WIDOW known to me (or satisfactorily proven) the per nRwhose name is subscribed to the
within instrument, and acknowledged that she executed the same for the purposes therein contained.
I hereunto set my hand and official seal.
Notary Public
My Commission Expires: _
ft*Keys,+votary pups
RaMPden Twp,Cuftwimw
R MOMS AM 17 20 6
oaanon of aaraues
The address of theaboy -n;mid Grantee
0—nb--ehJD0f th Grantees
02/03/2015 9:24:43 AM CUMBERLAND COUNTY Inst.#201219370-Page 4 of 5
ROBERT P. ZIEGLER
RECORDER OF DEEDS
CUMBERLAND COUNTY
1 COURTHOUSE SQUARE
CARLISLE, PA 17013 -
717-240-6370 = '
Instrument Number-201219370
Recorded On 6/29/2012 At 8:40:08 AM *Total Pages-5
*Instrument Type-DEED
Invoice Number- 111592 User ID-KW
*Grantor-HEISEY,HELEN B
*Grantee-BRYAN,SALLY A
*Customer-SECURED LAND
*FEES
STATE TRANSFER TAX $3,000.00 Certification Page
STATE WRIT TAR $0.50
STATE JCS/ACCESS TO $23.50 DO NOT DETACH
JUSTICE
RECORDING FEES - $11.50 P
now page a e is art
RECORDER OF DEEDS P
PARCEL CERTIFICATION $10.00 of this legal document.
FEES
AFFORDABLE HOUSING $11.50
COUNTY ARCHIVES FEE $2.00
ROD ARCHIVES FEE $3.00
EAST PENNSBORO $1,500.00
SCHOOL DISTRICT
EAST PENNSBORO $1,500.00
TOWNSHIP
TOTAL PAID $6,062.00
I Certify this to be recorded
in Cumberland County PA
a .
RECORDER O D EDS
tmo
"-Information denoted by an asterisk may change during
the verification process and may not be reflected on this page.
00201-7
,111lllllllllllllllllllllllll
02/03/2015 9:24:43 AM CUMBERLAND COUNTY Inst.#201219370-Page 5 of 5
MUD-1 UNIFORM SETTLEMENT STATEMENT OMB Approval No.2502-0265
A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT
B. TYPE OF LOAN 6.File Number: 7.Loan Number:
1. ❑FHA 2.❑FmHA 3.❑Conv,Unins br an N/A
4.❑VA 5.❑Conv.Ins 8. Mortgage Insurance Case Number
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 closin • they are shown here for informational purposes and are not included in the totals.
D. NAME AND ADDRESS OF BORROWER: E. NAME,ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER:
Bradley A. Bryan Estate Of Sally Ann Bryan None
Barbara Ann Bryan
824 Belle Vista Drive
Enola, PA 17025
G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME,ADDRESS AND TIN
824 Belle Vista Drive
Enola, PA 17025 Robert P. Kline, Esquire 25-1797626
PO Box 461 New Cumberland PA 17070
PLACE OF SETTLEMENT I. SETTLEMENT DATE 02/11/2015
Parcel # 09-11-3007-012 714 Bridge Street FUNDING DATE 02/11/2015
New Cumberland PA 17070
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100.GROSS AMOUNT DUE FROM BORROWER: 400.GROSS AMOUNT DUE TO SELLER:
101.Contract sales price 232 000.00 401.Contract sales price 232 000.00
102.Personal property 402.Persona]property
103.Settlement charges to borrower Line 14002, 649.00 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106.Ci /town taxes 406.Ci /town taxes
107.County taxes 407.Counly taxes
108.Assessments 408.Assessments
109. 409.
110. School Tax 02/11/15-06/30/15 964.62 410. School Tax 02/11/15-06/30/15 964.62
Ill. 411.
112. 412.
120.GROSS AMOUNT DUE FROM BORROWER 235 613.62 420.GROSS AMOUNT DUE TO SELLER 232,964.62
200.AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500.REDUCTIONS IN AMOUNT DUE TO SELLER:
201.Depositor earnest money 501.Excess deposit
202.Principal amount of new loans 502.Settlement charges to seller(Line 1400 2,500.00
203.Existing loans taken sub'ect to 503.Existing loans taken subject to
204. 504. #5196113632 143 929.16
to BB&T Mort a e
205. 505.
206. 506,
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210.Ci /town taxes 510.Ci /town taxes
211.County taxes 01/01/2015-02/11/2015 87.87 51I.County taxes 01/01/2015-02/11/2015 87.87
212.Assessments 512.Assessments
213. 513.
214. 514.
215. 515.
216. 516.
217. 517,
218. 518.
219. 519.
220.TOTAL PAID BY/FOR BORROWER 87.87 520.TOTAL REDUCTION AMOUNT DUE SELLER 146,517.03
300.CASH AT SETTLEMENT FROMITO BORROWER 600.CASH AT SETTLEMENT FROM/TO SELLER
301.Gross amount due from borrower Line 120 235 613.62 601.Gross amount due to seller Line 420 232 964.62
302.Less amount paid by/for borrower Line 220 87.87 602.Less reduction in amount due seller Line 520 146,517.03
303.Cash O From ❑To Borrower 235,52 .75 603.Cash 0 T ❑From Seller 86 447.59
Section 5 of the Real Estate Settlement Procedures Act(RESPA)requires disclosure of all charges imposed upon the borrower and seller.These are
the following: *HUD must develop a Special Information Booklet to help third party disclosures that are designed to provide the borrower with
persons borrowing money to finance the purchase of residential real estate pertinent information during the settlement process in order to be a better
to better understand the nature and costs of real estate settlement services; shopper.
*Each lender must provide the booklet to all applicants from whom it The Public Reporting Burden for this collection of information is estimated
receives or for whom it prepares a written application to borrow money to to average one hour per response,including the time for reviewing instructions,
finance the purchase of residential real estate;*Lenders must prepare and searching existing data sources,gathering and maintaining the data
distribute with the Booklet a Good Faith Estimate of the settlement costs needed,and completing and reviewing the collection of information,
that the borrower is likely to incur in connection with the settlement.These This agency may not collect this information,and you are not required to
disclosures are manadatory. complete this farm,unless it displays a currently valid OMB control number.
Section 4(a)of RESPA mandates that HUD develop and prescribe this The information requested does not lend itself to confidentiality.
standard form to be used at the time of loan settlement to provide full
0 EASY SOFT 2008 Previous editions are obsolete Page 1 form HUD-1 (3/86)ref Handbook 4305.2
L. SETTLEMENT CHARGES
70.TOTAL SALESBROKER's COMMISSION based on price $232 000.00 @ PAID FROM PAID FROM
Division of Commission line 700 as follows: BORROWER'S SELLER'S
701.$ FUNDS AT FUNDS AT
702.$ SETTLEMENT SETTLEMENT
703.Commission paid at Settlement
704.
800.ITEMS PAYABLE IN CONNECTION WITH LOAN
801.Loan Origination Fee
802.Loan Discount
803.Appraisal Fee to
804.Credit report to
805.Lender's Inspection Fee to
806.
807.
808.
809.
810.
811.
812.
813.
900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901.Interest from 02/10/2015-03 01/2015
902.Mortgage Insurance Premium for
903.Hazard insurance Premium for
904.
905.
1000.RESERVES DEPOSITED WFFH LENDER
1001.Hazard insurance
1002.Mortgage insurance
1003.City Property Taxes
1004.County Property Taxes
1005.Annual assessments
1006.
1007.
1008.Aggregate Accountin Ad'ustment 0.00
1100.TITLE CHARGES
1101.Settlement or closing fee toKline Law Office 250.00
1102.Abstract or title search to
1103.Title Examination to
1104.Title insurance binder to
1105.Document preparationtoKline Law Office 150.00
1106.Notary fees to
1107.Attorney's fees to
includes line numbers:
1108.Title Insurance to
includes line numbers:
1109.Lender's coverage Premium 0.00
1110.Owner's coverage Premium 0.00
1111.Wire Fee to Kline Law Office 30.00
1112.
1113.
1200.GOVERNMENT RECORDING AND TRANSFER CHARGES
1201.Recording fees: Deed$ 79.00 Morta e$ Release$ 79.00
1202.City/en tax/stamps: Deed$ Mortgage$
1203.State tax/stamps: Deed$ Mortgage$
1204.Realty Transfer Tax 21320.00 2,320.00
1205.
1300.ADDITIONAL SETTLEMENT CHARGES
1301.Survey to
1302.Pest inspection to
1303.
1304.
1305.
1306. '
1400.TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section 2 649.00 2,500.00
CERTIFICATION: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 an
disbursements made on my account or by me in this transaction. I further certify that I received a copy of the HUD-1 Settlement Statement.
Seller state Of Sally Ann Bryan Bono r Br e y A. m
�
Seller Borrower Barbara Ann Br4-16
The HUD-1 Settleme ent which I have prepared is a true and accurate account of the funds disbursed or to be disbursed by the undersigned as part of the settlement o
this transaction.
a 02/10/2015
Settlement Agent Robert P. Kline Esq Date
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and
imprisonment. For details see: Title 18 U.S.Code Section 1001 and Section 1010.
®EASY SOFT 2008 Previous editions are obsolete Page 2 form HUD-1(3/86)ref Handbook 4305.2