HomeMy WebLinkAbout05-27-15 REV-1500 Ex(02-11' 1505610143
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes OEFARTMENT OF REVEMIE
Po Box.280601 INHERITANCE TAX RETURN 21 14 0990
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
09 01 2014 04 20 1929
Decedent's Last Name Suffix Decedent's First Name MI
DILLE ROBERT E
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
DILLE MILDRED
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X❑ 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)
6 Decedent Died Testate ❑ 7. Dnceden oMaiof�jned)a Living Trust g. Total Number of Safe Deposit Boxes
(Attach Copy of Will) G pyrust
g. Litigation Proceeds Received ❑ 10.between 123 ndCrediit rDat so f Death ❑ 11 Election to tax under Sec.9113(A)
9 (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L BANGS 717 730 7310
REGISTER OF WILLS USE ONLY '
First Line of Address17
429 SOUTH 18TH STREET r
Second Line of Address = f— (y i
-3 1 r 1
DATE FILED r, t
City or Post Office State ZIP Code , 1
CAMP HILL PA 17 011
r-ri
sverizon.net `J
Correspondent's e-mail address: mikeban 9
Under penalties of pedury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is tru correct andAmpl9te.Peclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
T PE 0 BLE FOR FILING RETURN DAT
SIG
�� (Of John M Dille
AD RESS
1502 Marlton Road, Mechanicsburg, PA 17050
SIGNATURE OF PREPARER OTHER T REPRESENTATIVE _ DATE
I... Michael L. Bangs
ADDRESS
429 South 18th Street, Camp Hill, PA 17011
Side 1
1505610143 1505610143 J
s�/
REV-1500 EX Page 3 File Number 21-14-0990
Decedent's Complete Address:
DECEDENT'S NAME
Dille, Robert E _
STREET ADDRESS
6 Donald Street
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,569.40
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
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. (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) 3,569.40
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;... ........................................................................... ❑ -jI
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ �u
c. retain a reversionary interest;or.......................................................................................................... ....
x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ 51
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ 5
4. Did decedent own an individual retrement account,annuity,or other non-probate property which ❑ 7xcontains 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)(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.
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Dille, Robert E
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 87 , 619. 59
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. 2 , 648 . 03
6. Jointly Owned Property(Schedule F) ❑ Separate Billinq Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) u Separate Billinq Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8, 90 ,267 . 62
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 9, 117 . 07
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 1 , 830 46
11. Total Deductions(total Lines 9 and 10)................................................................ 11 10 , 947 53
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 79,320 . 09
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. 79, 320 . 09
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 0 . 00 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 79, 320 . 09 16. 3 ,569 . 40
at lineal rate X .045
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. 3 , 569 . 40
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243 J
Rev-1502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
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 decedents interest H owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate-6 Donald Street, Hampden Township. Tax ID No. 10-20-1842-025. Property was 87,619.59
sold on December 8,2014(see HUD attached). $11,000.00 is being held in escrow by the title
company pending approval of this inheritance tax return.
TOTAL(Also enter on Line 1, Recapitulation) 87,619.59
(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 OFPERSONAL PROPERTY
INHERITANCE TAXAXRETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
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 Automobile-1999 Ford Taurus Wagon 1,300.00
2 Refund from Citimortgage-balance of escrow after sale of real estate 1,151.68
3 Refund from Pinnacle Health Emergency 10.00
4 Refund of homeowners insurance 186.35
TOTAL(Also enter on Line 5, Recapitulation) 2,648.03
(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•1611 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DEC D NTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
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 ZiD
Year(s)Commission Paid
2. Attomev's Fees Michael L. Bangs 7,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
RelationshiD of Claimant to Decedent
4. Probate Fees 360.50
5. Accountant's Fees 1,000.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 256.57
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 9,117.07
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Cumberland Law Journal-estate advertisement 75.00
2 Postmaster-mailing of 2014 income tax returns 3.79
3 The Patriot News Co.-estate advertisement 177.78
H-B7 256.57
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE I
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF
MORTGAGE LIABILITIES AND LIENS
RET
INHERITANCE TAXAXRETURRNN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
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 Chase Credit Card 272.76
2 PA American Water Company-10/22/14 to 11/20/14 74.76
3 PA American Water Company-11/21/14 to 12/7/14 10.24
4 Pinnacle Health Emergency-account#PH83005560 12.27
5 Pinnacle Health Hospital Services 57.93
6 PNC Bank-reimbursement of autopay amount 437.76
7 PP&L Electric-11/5/14 to 12/5/14 162.54
8 Pulmonary and Critical Care-2/4/15 60.88
9 Pulmonary and Critical Care-316/15 40.07
10 U.S.Treasury-2014 personal income tax due 442.00
11 UGI-9/29114 to 10/28/14 36.31
12 UGI-10/28/14 to 12/8/14 118.74
13 Verizon 104.20
TOTAL(Also enter on Line 10, Recapitulation) 1,830.46
(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-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dille, Robert E 21-14-0990
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(sl
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
John M. Dille Son 79,320.09
1502 Marlton Road
Mechanicsburg,PA 17050
Mildred W. Dille Spouse
235 Rabbit Run Road
Boone, NC 28607
Total 79,320.09
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet as appiopriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART If-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)
f 1111-1." OMB Approval No.2502-0265
A. Settlement Statement (HUD-1)
8.,Type of Loan
-N
6,File umber: 7.Loan Number: age insurance Case Number:
I FHA 2,F�RHS 3, Conv.Unins, 1 Ol
4.❑VA 5,F1 Conv,Ins. 14-01-36427 6010939
C.Note:This form is furnished to give you.statement of-Wual settlement costs.Amounts paid to and by the settlement agents are shown Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Eric D.Meyers,Sherry L.Meyers Estate of Robert Dille a/k/a Robed E.Dille Meridian Bank
25 Rebecca Drive,York Haven,PA 17370 6 Donald Street,Mechanicsburg,PA 17050 920 Germantown Pike,Suite 102,Plymouth
Meeting,PA 19462
G.Properly Location: H.Settlement Agent: I.Settlement Date:12/0812014
6 Donald Street Barristers Land Abstract Company Disbursement Date:1=812014
Mechanicsburg,PA 17050 3310 Market Street,Camp Hill,PA 17011
Hampden Township
717-761-6190
Place of Settlement: TitleExpress
3310 Market Street,Camp Hill,PA 17011 Printed 11210812014 at 12:55 torn
by JE
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 150,500,00 401, Contract sales price 150,500.00
102. Personal property 402. Personal property
103. Settlement charges to borrower(line 1400) 6,567.62 401
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 12108/2014 to 12131/2014 27,75 407, County taxes 12/08/2014 to 12/31/2014 27,75
108. School Taxes 12/08/2014 to 06/30/2015 813,46 t408. School Taxes 12/08/2014 to 06/30/2015 813.46
109. Sewer and Trash 12108/2014 to 12/31/2014 40.45 409. Sewer and Trash 12108/2014 to 12/31/2014 40.45
110. 410,
'I'll, 411.
112. 411
120. Gross Amount Due from Borrower 157,949.28 420. Gross Amount Due to Seller 151,381.66
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) 120,400.00 502. Settlement charges to seller(line 1400) 21,66748
203. Existing loan(s)taken subject to 501 Existing loar(s)taken subject to
204. 504, Payoff of first mortgage loan#0006385457 to 48,594.59
CitiMortMe _
205. 505. Payoff of second mortgage loan
206. 506.
207, Seller Assist 4,500.00 507 Seller Assist 4,500.00
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to 510. CityAawn taxes to
211. County taxes to 511, County taxes to
212. School Taxes to 512. School Taxes to
213. 513,
214. 514,
215. 516,
216. 516.
217. 517.
218. 518.
219. 519.
220. Total Paid by/for Borrower t25,900.00 520. Total Reduction Amount Due Seller 74,762.07
300. Cash at Settlement fromho Borrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from borrower(line 120) 157,949,28 601, Gross amount due to seller(line 420) 151,381.66
302. Less amounts paid by/for borrower(line 220) 125,900.00 602. Less reductions in amount due seller(line 520) 74,762.07
303. Cash nX From R To Borrower 32,049-28, 603. Cash 0 To ❑ From Seiler 76,619.59
revious editions are obsolete Page 1 of 4 HUD-1
EK-MOR M-1
700. Total Real Estate Broker Fees $9,350.00 Paid From Paid From
Division of commission line 700 as follows: Borrower's Seller's
701• $4,675.00 to Century 21 Realty Services Funds at Funds at
T0-2. $4,675,00 to Howard Hanna Colonial Park Settlement Settlement
703. Commission paid at settlement 295.00 9,055.00
800, Items Payable in Connection with Loan
801. Our origination charge (includes origination Point 0.000%or$0.00) $795.00 (from GFE-#I)
802 Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2)
803. Your adjusted origination charges (from GFE A) 795.00
804. Appraisal fee to Appraisal Logistics Solutions (from GFE#3) 450.00
805. Credit report to Credit Plus (from GFE#3) 64.90
806. Tax service to from GFE#3
807, Flood certification to Corel is (from GFE#3) 11.50
808. to
900. Items Required by Lender to be Paid in Advance
901. Daily interest charges from from 12/08/2014 to 01/01/2015 @$13.6100/day (from GFE#10) 326.64
902. Mortgage Ins.Premium for months to (from GFE#3)
903. Homeowner's insurance for 12 months to Allstate Insurance (from GFE#11) 353.01
904. months to from GFE#1 t
1000, Reserves Deposited vAth Lender
1001. Initial deposit for your escrow account (from GFE#9) 943.99
1002.Homeowner's insurance 3 months@$ 29.42/month $88.26 to Meridian Bank
1003.Mortgage Insurance months @$ 0.00/month $ to
1004.City Property Tax months @$ 0.00/month $ to
1005.County Property Tax 11 months @$ 35.17/month $386.87 to Meridian Bank
1006.School Taxes 7 months @$ 120.70/month $844.90 to Meridian Bank
1007.Aggregate Adjustment $-376.04 to Meridian Bank
1100.Title Charges
1101.Title services and lender's title insurance $ from GFE#4y 1,486.58
1102. Settlement or closing fee to $
1103. Owner's title insurance-Stewart Title Guaranty Company $ from GFE#5 150.00
1104. Lender's title insurance-Stewart Title Guaranty Company $1,395.50
1105.Lender's title policy limit$120,400.00 Lender's Policy
1106.Owner's title policy limit$150,500.00 Owner's Policy
1107.Agent's portion of the total title insurance premium $1,207.42
1108. Underwriter's portion of the total title insurance premium $33808
1109. Escrow Fee to Barristers Land Abstract 25.06
General-Hbg
1200.Government Recording and Transfer Charges
1201. Government recording charges $ (from GFE#7) 186.00
1201 Deed$79,00 Mortgage$107.00 Release$ to Cumberland County Recorder
1201 Transfer taxes $ (from GFE#8) 1,505.00
1204.City/County tax/stamps Deed$1,505.00 Mortgage$ to Cumberland County Recorder
1205.State Tax/stamps Deed$1,505.00 Mortgage$ to Cumberland County Recorder 1,505.00
1206.Deed$ Mortgage$ Release$ to
1207. $ to
1300.Additional Settlement Charges
1301.Required services that you can shop for (from GFE#6)
1302.Notary Fee to Linda McBeth 12.
6-0
1303.Home&Pest Inspection to Mike Sheely Home Inspections $315.00 P.O.C.B`
1304.Tax Cert/Postage Reimbursement to Banisters Land Abstract Cost-Hbg 10.4
1305.Mtg Release Tracking/Search Fee to reQuire
1306. Inheritance Tax Escrow to Barristers Land Abstract Escrow-Hbg 11,000•
1307.Wire Fee(Payoff) to Barristers Land Abstract Wire-Hbg 25.
r rrIMM r r 6,567.62 21,667.48
`Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)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 Fifth Estimate GF and HUD-1 Charges Good Faith EsUmate HUD-1
Cha es That Cannot Increase HUD-1 Line Number
Our origination charge. # 801 795.00 795.00
Your credit or charge(points)for the specdfic interest rate chosen # 802 0,00 000
Your adjusted origination charges # 803 79500 79500
Transfer taxes 1203 1,505.00 1,505.00
Charges That in Total Cannot Increase-More Than 10% Good Faith Estimate HUD-1
Government recording charges # 1201 . 175.00 186.00
Appraisal fee
# 804 450.00 450.00
Credit report, #805 40.00 64.90
Flood certification # 807 11.50 11.50
#
#
#
#
676.50 712.40
$ 35.90 or 5.3067%
.Charges That Can Chane Good Faith Estimate HUD-1
Initial deposit for your escrow account # 1001 2,019.70 943.99
Daily interest charges from # 901 $13.6100/day 326.64 326.64
Homeowner's insurance #903 549.96 353.01
Title services and lender's title insurance # 1101 1,445.00 1,486.58
Owners title insurance-Stewart Title Guaranty Company # 1103 150.00 150.00
Home-&Pest Inspection # 1303 0.001 315.00
Loan Terms
Your initial loan amount is $120,400.00
Your loan term is 30.years
Your initial interest rate is 4.1250%
Your initial monthly amount owed for principal,interest,and any mortgage $583.52 includes
insurance is Q principal
❑Interest
❑Mortgage Insurance
Can your interest rate rise? ❑X No. ❑Yes,it can rise to a maximum of %. The first change
will be on / / and can change again every years after I I Every
change date,your interest rate can increase or decrease by °1°. Over the life of
the loan,your interest rate is guaranteed to never be lower than %or higher
than %.
Even'd you make payments on time,can your loan balance rise? Q No. ❑Yes,it can rise to a maximum of$ "
Even if you make payments on time,can your monthly amount owed for 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? ❑X 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 ❑You do not have a monthly escrow payment for items,such as property taxes
and homeowners insurance. You must pay these items directly yourself.
�]X You have an additional monthly escrow payment of$185.29
that results in a total initial monthly amount owed of$768.81.This includes
principal,interest,any mortgage insurance and any items checked below:
Q Property taxes Q Homeowners insurance
x ❑Flood insurance ❑X School Taxes
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender,
'revious editions are obsolete Page 3 of 4 HUD-1
ignatur6 Page
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,
Enc D.Meyers
Sherry L.Meyers
ESTATE OF ROBERT DILLE A/IU OBERT DILLE }—
/# G �G
John .Diile,Executor,
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this trahsadtion.1 have caused or will cause the funds to be
disbursed in accordance with this statement
/W' Ulltl
SETTLEME NT DATE
/ARNING:IT 1S A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON
ONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1014.
-evious editions are obsolete Page 4 of 4 HUD-1
)ternization of Lines 1101,1103 and 1104
Name of Borrower. Name of Seller: File Number
Eric D.Meyers Estate of Robert Dille We Robert E.Dille 14-01-36427
Sherry L.Meyers
TitleExpress
Prepared 12/08/2014 at 12:56 pm
Note: This page is furnished to give you an Itemization of the amounts shown on 0.—ai-dI'1 Fro—n-i-,
Lines 1101, 1103 and 1104 of the Settlement Statement(HUD-1).This page r
accompanies but is not a part of the settlement statement. If a discrepancy
exists,the Information shown on the Settlement Statement(HUD-1)applies. t Ine ldn— fit
rn' -MZ40666ts lfidud6ld
q:
11OUTIOe Charge A
use -OVAII'�.xM6' � '9024
R
0;�4 I L I n'e'.!
1101. Title services and lender's title insurance 1,486.58
a.Notary Fees $ 30.00
b,Wire Fee 5.00
c.Ovemight Fee 11.08
d.Electronic Doc Transmittal Fee 45.00
$ 91.08
1102. Settlement or dosing fee
1103. Owner's title insurance (policy) $ 150.00 150.00
1104. Lender's title insurance (policy) 1,005,00 $ 1,395.50
a.Endorsement 900 EPL-Residential 50.00
b.Endorsement 1030 REM 115,50
c.Closing Service Letter 125.00
d.ALTA Short Form Loan 100A0
(Total 1103+1104)
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a.Notary Fees to Unda McBeth 30.00 30.00
b.Wire Fee to Barristers Land Abstract Wire-Hbg 5.00 5,00
c.Ovemight Fee to Barristers Land Abstract Postage-Hbg 11.08 11.08
d.Electronic Doc Transmittal Fee to Barristers Land Abstract General-Hbg 45.00 45.00
1104. Lender's title insurance to Banisters Land Abstract Company 1,395.50 1,395.50
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C�7/)ff-
I, ROBERT E. DILLE, of Hampden Township, Cumberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles,jewelry, and all
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my son, JOHN M. DILLE, provided he survives my
death by thirty (30) days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my son, JOHN M. DILLE,
provided he survives my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM V. I appoint my son. JOHN M. DILLE, Executor of this my last will.
1
ITEM VT. In addition to the other powers and authorities granted to my personal
representatives by Peruisylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS.WHEREOF, I have hereunto set my hand this day of
2002.
ROBERT E. DILLE
2
The preceding instrument_consisting of this and'T90 other typew itten pages,each
identified by the signature of the testator was on the date thereof signed, published, and declared
by ROBERT E. DILLE, the testator therein named, as and for his last will, in the presence of us,
who at his request, in his presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
3
COMMO'NA EALTH OF'PqNS N'A.qA )
COUNTY OF CUMBERLAND )
The undersigned, being the testator whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, does hereby acknowledgethat I signed and executed the
foregoing 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. v�
Sworn or affirmed to and acknowledged
before me bytestator nar ed above
this - da of , 2002.
Notary Public
Riot'.ZAL tE L a
WENDY S. CHUM,F'ictur;P. "•k
Lowor Men Twp., C.urnWMI-3 CWs*
t _ SLVANIA )
( SS:
COUNTY OF CUMBERLAND 'J )
WE, l'�.�i�, ( ���( and the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the testator sign and execute the instrument as his last will;
that he signed it willingly and that he executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and that to
the best of our knowledge, the.testator was at that time 18 or more years of age, of sound mind,and under
no constraint or undue influence. N
Sworn or affirmed to and
acknowle ed beore me this
1 day ell'
. 2002.
ota Public
AWIAL.r-..pe4.
LWENDY 5.CW ,LawaN Twp.,Csrms cs yrr ww E 499 May 10, �
4