HomeMy WebLinkAbout06-05-15 pennsylvania 1505618403
DEPARTMENT OF...IX(03-14)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 14 0217
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01 20 2014 12 17 1958
Decedent's Last Name Suffix Decedent's First Name MI
TODT BENEDICT E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return 1:12. Supplemental Return 1:13. Remainder Return(date of death
prior to 12-13-82)
❑ 4, Agricultural Exemption(date of 5. Future Interest Compromise(date of ❑ 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
L__I 7. Decedent Died Testate 8. Decedent Maintained a Living Trust9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
EJ10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
EJ13. Business Assets 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
SHARON E MYERS 717 259 9592
First Line of Address
106 HARRISBURG ST
Second Line of Address
City or Post Office State ZIP Code
EAST BERLIN PA 17316
o �
Correspondent's email address: smyers;cD_cgalaw.corn `r' 1 ;=
e-) C:)
REGISTEOF WILLSif ONLY ^0
REGISTER OF WILLS USE ONLY (-n 1 I^". C1
DATE FILED MMDDYYYY
DATE FILED STAM5
Cly
Side 1
1505618403 1505618403
J1505618411
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: TOdt, Benedict Eugene
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 115 ,500 - 00
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).......... 5. 521794 - 44
6. Jointly Owned Property(Schedule F) FX Separate Billing Requested............ 6. 0 . 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) [:] Separate Billing Requested............ 7. 101471 • 36
8. Total Gross Assets (total Lines 1 through 7)........................................................ 8. 178 ,765 • 80
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 47 -1772 • 61
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 116 1898 • 69
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 164 -,671 • 30
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 14 ,0 9 4 • 50
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. 14 ,094 - 50
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.00 15. 0 . 011
16. Amount of Line 14 taxable
at lineal rate X .045 14 ,094 - 50 16. 634 - 25
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, 11 - 00
19. TAX DUE................................................................................................................ 19. 634 - 25
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury,1 declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNAfi PEgSON SPONSIBLE FOR FILING RETURN Janet E. Todt DATE
VLC
ADDRVFtS
1015 Lake Meade Road, East Berlin, PA 17316
SIGNATU F EPAR SENTATIVE Sharon E Myers DATE
�-
ADDRESS
1061fairrisburg St., ast B
1111111111 II III IN Side 2
1505618411 1505618411
REV-1500 EX Page 3 File Number 21-14-0217
Decedent's Complete Address:
DECEDENT'S NAME
Todt, Benedict Eugene
STREET ADDRESS
828 Torway Road
CITY STATE ZIP
Gardners PA 17324
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 634.25
2. Credits/Payments
A. Prior Payments 3,000.00
B. Discount 31.71
Total Credits(A +B) (2) 3,031.71
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 2,397.46
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)
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?.................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑x ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
Far 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 step-parent of the child is 0 percent(72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 EX+(12-12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 828 Torway Road, Gardners PA 17324-9046 ID#08-16-0210-126-Real Estate; See attached 115,500.00
copy of settlement sheet
TOTAL(Also enter on Line 1, Recapitulation) 115,500.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
Rev-1508 EX+(08.12)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
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
1 828 Torway Road, Gardners PA 17324-9046 ID#08-16-0210-126-Reimbursement for 452.47
proration of taxes; Line 406&408 of attached copy of settlement sheet
2 Members 1st Federal Credit Union-Checking Act.406696-11 1,379.75
3 Members 1st Federal Credit Union-Savings Act.406696-00 37,004.86
Accrued interest on Item 3 through date of death 2.85
4 1980s Truck-sale of truck 700.00
5 1994 Pontiac-sale of car 250.00
6 Guns 3,201.00
7 Sale of Personal Property 2,129.28
8 Sale of Tools 7,674.23
TOTAL(Also enter on Line 5, Recapitulation) 52,794.44
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12)
Rev-1509 Ex+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
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
A. Darla M. Todt address unknown ex-wife
B. Kaitlyn E. Rhinehart address unknown step-daughter
C.
JOINTLY OWNED PROPERTY:
LETTER DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM VALUE OF
FOR JOINT MADE (NCLUDE NUMBER OR SEMILAROF NDENTIFY NG ANCIAL INSTITUTION
ER.ATTACH D EDOUNT FOR DATE OF DEATH DECD'S DECE ENT'S NTEREST
NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST
1 B unknown FOR INFORMATION ONLY: 2001 Honda Civic 0.00 50.000% 0.00
-Value unknown. The car belonged to step
daughter. Title never transferred from
decedent prior to death.
2 A unknown FOR INFORMATION ONLY: 2004 Chevy 0.00 50.000% 0.00
Colorado-Value Unknown. In joint names
with ex-wife(Darla);Seperate billing
requested
3 A 04/14/2009 FOR INFORMATION ONLY: ACNB - 0.00 50.000% 0.00
Passbook Savings Act.9680241 -joint with
ex-wife; Date of Death Balance$675.25;
separate billing requested
4 A unknown FOR INFORMATION ONLY: Coleman Camper 0.00 50.000% 0.00
-Value Unknown. In joint names with ex-wife
(Darla);Seperate billing requested
TOTAL(Also enter on Line 6, Recapitulation) 0.00
(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 F(Rev.01-10)
Rev-1510 EX+(08-09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OFMISC. NON-PROBATE PROPERTY
RET
INHERITANCE TAXAX RETURRNN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TCLUDE NAMERANSFERSATTACN A COPY OF THE DEED FOR REAL ESTATE, VALUE OF ASSET TIONSHIP TO DECEDENT AND INTEREST (IF APPLICABLE) VALUE
1 New York Life Annuity-Account#: 5,693.15 5,693.15
N P385491/397531001
2 The Baltimore Life Insurance&Annuity Company- 4,778.21 4,778.21
Account#: 01001021797
TOTAL(Also enter on Line 7, Recapitulation) 10,471.36
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev. 08-09)
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 668.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Janet E. Todt
Street Address 1015 Lake Meade Road
City East Berlin State PA zio 17316
Year(s)Commission Paid 2015 15,984.52
2. Attorney's Fees CGA Law Firm 15,000.00
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 363.50
5. Accountant's Fees 158.00
6. Tax Return Preparer's Fees 133.00
7. Other Administrative Costs 15,465.59
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 47,772.61
Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex ea nses
- 1 Feiser Funeral Home-funeral 668.00
H-A 668.00
Other Administrative Costs
2 828 Torway Road,Gardners PA 17324-9046 ID#08-16-0210-126-Closing costs; Line 520 of 8,105.00
settlement sheet
3 Advanced Disposal-trash bill 89.52
4 Carolyn McQuillen,tax collector 1,977.63
5 CGA Law Firm-Allowance for final administration expenses and expenses . 3,000.00
6 CGA Law Firm -Notary fee 5.00
7 CGA Law Firm -on-line legal research 1.43
8 Comcast-Utility bill 14.29
9 Commonwealth of PA 50.00
10 Cumberland Law Journal-Advertise estate 75.00
11 Janet E.Todt-reimbursement for payment of electric bills 175.07
12 Kleppers -Opening of safe 135.00
13 Members 1st Federal Credit Union 5.78
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
ITEM
NUMBER DESCRIPTION AMOUNT
14 MetEd-Utility bill 213.76
15 MetEd -Utility bill 50.69
16 MetEd -Utility bill 117.96
17 MetEd -Utility bill 40.66
18 MetEd-Utility bill 33.48
19 MetEd-Utility bill 35.24
20 MetEd -Utility bill 20.03
21 Miller-Hanover 6.00
22 Miller-Hanover 10.00
23 Sprint-telephone 138.12
24 StateFarm -homeowners insurance 924.00
25 Surburban Propane -Utility bill 72.63
26 The Sentinel -Advertise estate 169.30
H-137 15,465.59
Copyright(c)2002 form software only The Lackner Group,.Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12.12)
SCHEDULE
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
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 Bank of America-Mortgage on real estate 114,955.84
2 Members 1st Fed Credit Union -VISA Credit Card Act.4999500000004865 1,942.85
TOTAL(Also enter on Line 10, Recapitulation) 116,898.69
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-12)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Todt, Benedict Eugene 21-14-0217
RELATIONSHIP TO
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S)RECEIVING PROPERTY Do Not Last Trustee(sl (Words) ($$$)
I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Janet E.Todt Mother see Sch. G
1015 Lake Meade Road
East Berlin, PA 17316
Christopher Todt Son 50% Residue
4414 Windward Lane
Norcross, GA
33093
Daniel H. Todt Son 50%Residue
PO Box 671292
Houston,TX 77267
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appopriate.
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 II -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)
. �rpSMEr�>'gih
OMB Approval No.2502-0265
A. Settlement Statement (HUD-1)
B. Type of Loan
1.Q FHA 2.Q RHS 3. Conv.Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.Q VA 5.®Conv.Ins. RUSSOLINDA15 27021347
C. Note:. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked"(p.o.c.)"were paid outside the closing;they,are shown here for informational purposes and are not included in the totals..
D. Name and Address of Borrower: E. Name and Address of Seller: F. Name and Address of Lender:
Linda S.Russo and Estate of Benedict E.Todt GMH Mortgage Services LLC
Ryan C.Russo 1015 Lake Meade Rd. 625 W.Ridge Pike,Building C,Ste 100
285 Orchard Lane East Berlin,PA 17316 Conshohocken,PA 19428
Aspers,PA 17304
G. Property Location: H. Settlement Agent: 1. Settlement Date:
828 Torway Rd. Real Estate Settlement Company
Gardners,PA 17324 1157 Eichelberger Street,Ste.5 May 22,2015
Cumberland County,Pennsylvania Hanover,PA 17331 Ph. (717)632-5480
Place of Settlement:
18 Carlisle St.
Gettysburg,PA 17325
J. Summary of Borrower's transaction K. Summary of Sellers transaction
100. Gross Amount Due from Borrower: 400. Gross Amount Due to Seller:
101. Contract sales price 115,500.00 401. Contract sales price 115 500.00
102. Personal property 402. Personal property
103. Settlement Charges to Borrower Line 1400 7,345.50 403.
104. 404.
105. 405.
Adjustments for Items paid by Seller in advance Adjustments for items paid by Seller In advance
106. County/Twp Tax 05/23/15 to 01/01/16 241.16 406.Coun /Twp Tax 05/23/15 to 01/01/16 241.1
107. xxxx to 407.)o= to
108. School Taxes 05/23/15 to 07/01/15 211.31 408. School Taxes 05/23/15 to 07/01/15 211.31
109. 409.
110. 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 123,297.97 420.Gross Amount Due to Seller 115,952.47
200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due Seller.
201. Deposit or earnest money 501. Excess de osit see instructions
202. Principal amount of new loans 109 725.00 502. Settlement charges to Seller Line 1400 8,105.00
203. Existing loans taken subject to 503. EAsti loans taken subject to
204. 504. Payoff First Mortgage
205. 505. Payoff Second Mortgage
206. 506.
207. 507.
208. 508.
209. Seller Paid Closing Cost 509. Seller Paid Closing Cost
Ad ustments for Items unpaid b Seller Adjustments for Items unpaid by Seller
210. Countyfrwp Tax to 510. Countvfrwp Tax to
211. xxxx to 511. xxxx 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 109,725.00 520. Total Reduction Amount Due Seller 8,105.00
300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller
301. Gross amount due from Borrower line 120 123,297.97 601. Gross amount due to Seller line 420 115 952.47
302. Less amount aid b/for Borrower line 220 ( 109725.00) 602. Less reductions due Seller line 520) ( 8,105.00
303. Cash E From To Borrower 13,572.97 603. Cash To From Seller 107,847.47
'Paid outside ofctosing by bomoemr(B),seller(S).lander(L),or third-party(T)
The undersigned hereby ac m�wledge receipt of a mplated copy of this statement&any attachments referred to herein
Borrower / Seller Estate of Benedict E.Todt
R� ,Russo
BY: ►L
Ryan COrRusso
The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,mMewing,and reporting the data.This agency may not collect this Information,and you are
not required to complete this form,unless It displays currently valid OMB control number.No confidentiality Is assured;this disclosure is mandatory.This Is designed to provide the pantos to a RESPAwwred
transaction with Information during the settiementprocess.
Page 1 of 3 HUD-1
(RUSSO LI NDAI5.PF D/RUSSO LIN DA15/10)
L.Settlement Char es
e
Division of commission(line 700)8s follows: Paid From Paid From
Borrower's Sellers
701.$3465.00 to Bell Real Estate Funds at Funds at
702.$ 3,465.00 to ReMax of Gettysburg Settlement Settlement
703.Commission aid at settlement 6 930.00
704.EMD If deducted from comm
705. Broker Fee to ReMax of Gettysburg 195.00
801.Our ori (nation char e $ 995.00 from GFE#1
802.Your credit or char a(points)for the specific interest rate chosen 274.31 from GFE#2
803.Your ad•usted origination char es from GFE#A 1,269.31
804.A raisal fee to Rociers Appraisal Service Inc (from GFE#3 410.00
805.Credit Report to Credit Plus from GFE#3 35.08
806.Tax service to from GFE#3
807.Flood certification to from GFE#3
808. from GFE#3
809• from GFE#3
810• from GFE#3
811. (from GFE#3)
901.Daily interest charges from 05/22/15 to 06/01/15 10 $12.400400/da from GFE#10 124.00
902.Mortgage insurance premium for months to (from GFE#3)
903.Homeowner's insurance for 1.0 years to Erie Insurance (from GFE#11) 0003380068 445.00
904. (from GFE#11)
905. (from GFE#11)
1001.Initial deposit for your escrow account (from GFE#9) 2,148.11
1002.Homeowner's insurance 3.000 months @ $ 37.09 per month. $ 111.27
1003.Mortgage insurance months @ $ 81.38 per month $
1004.Property taxes $
CountyfTwp Tax months Q $ per month
School Taxes months @ $ per month
1005. $ 2,282.52
Property Taxes 4.000 months $ 33.57 per month
School Property Tax 12.000 months 179.02per month
1006. months @ $ per month $
1007. months @ $ per month $
1008. $
1009.Aggregate Adjustment $ -245.68
0 a e
1101. Title services&lender's title ins-Old Republic(OR) (from GFE#4) 1,310.00
1102. Settlement or closing fee $
1103. Owner's title insurance to Old Republic Nat Title Ins Co (from GFE#5) 30.00
1104. Lender's title ins-ORT (w/100,300,900 ends) $ 1,100.00
1105. Lender's titte policy limit $ 109,725.00
1106. Owner's title policy limit $ 115,500.00
1107. Agent's portion of the total title insurance premium to Real Estate Settlement Company $ 960.50
1108. U/W's portion of total title insurance premium to Old Republic Nat Title Ins Co $ 169.50
1109. Deed Preparation Fee $
1110. Notary Fee to Dayna L.Hartman $ 10.00
1111. Attorney Fees $
1112.Wire Fee Real Estate Settlement Company $
1113. Reimburse Tax Certification to Real Estate Settlement Com an $ 10.00
o. mm n
1201.Government recording charges to Recorder of Deeds from GFE# 224.00
1202.Deed $ 79.00 Mortgage $ 111.00 Releases $ Other $ 34.00
1203.Transfer taxes to Recorder of Deeds from GFE#8) 1,155.00
1204.City/County tax(stam s $ 1,155.00 $
1205.State ta)/stamps $ $
1206.State taxlstamps to Recorder of Deeds 1,155.00
1207.
I
1301.Required services that you can shop for (from GFE#6)
1302. $
1303. $
1304. $
1305. $
a0.. e 4, t tl
•Paid outside of dosing by bomwer(B),seller(S),lender(L),or third-pany(n
By signing page t of this statement the signatories acknowledge receiptof a completed copy olpage 2 this three page statement
Real Estate Settlement Co.,Settlement Agent
CERTIFIED TO BEA TRUE COPY.
Page 2 of 3 HUD-1
(RUSSOLI NDA15.PF D/RU SSOLI NDA15/10)
Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD-1
Cha es That Cannot Increase HUD-1 Line Number
Our origination charge #801 995.00 995.00
Your credit or charge(points)for the specific rate chosen #802 274.31. 274.31
Your adjusted origination charges #803 1,269.31 1,269.31
Transfer taxes #1203 1,155.00 1,155.00
Charges That in Total Cannot Increase More than 10°/. Good Faith Estimate HUD-1
Government recording charges #1201 325.00 224.00
Appraisal fee #$04 425.00 410.00
Credit report #805 61.00 35.08
Total 811.00 669.08
increase between GFE and HUD-1 Charges $ -141.92 or 17.50°I
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account #1001 2,150.99 2,148.11
Daily interest charges #901 $ 12.400400/day 124.00 124.00
Homeowner's insurance #903 660.00 445.00
Title services and lender's title insurance #1101 1,456.14 1,310.00
Owner's title insurance to Old Republic Nat Title Ins Co #1103 115.00 30.00
Loan Terms
Your initial loan amount Is $109,725.00
Your loan term Is 30.00 years
Your initial Interest rate Is 4.1250%
Your Initial monthly amount owed for principal,interest and $613.16 includes .
any mortgage insurance Is 0 Principal
Q interest
❑X Mortgage Insurance
Can your interest rate rise? ❑X No ❑ Yes,it can rise to a maximum of %. The first
change will be on and can change again every_months after
Every change date,your interest rate can increase or decrease
by %. Over the life of the loan,your interest rate is guaranteed
to never be lower than %or higher than %.
Even if you make payments on time,can your loan balance rise? ❑X No ❑ Yes,itcan rise to a maximum of$
Even if you make payments on time,can your monthly ❑X No ❑ Yes,the first increase can be on and the monthly
amount owed for principal,Interest,and mortgage Insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
Does your loan have a prepayment penalty? ❑X No ❑ Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? 0 No ❑ Yes,you have a balloon payment of$
due in_years on
Total monthly amount owed including escrow account payments ❑ You do not have a monthly escrow payment for items,such as property
taxes and homeowner's insurance. You must pay these items directly
yourself.
❑X You have an additional monthly escrow payment of$249.68 that results
In a total initial monthly amount owed of$862.84. This includes
principal,interest,any mortgage Insurance and any items checked below:
❑X Property taxes ❑X Homeowner's insurance
❑ Flood insurance ❑
School Tax ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed an this form,please contact your lender.
Page 3 of 3 HUD-1
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106 Harrisburg Street •P.O.Box 606 •East Berlin,Pennsylvania 17316
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Cumberland County
Register of Wills
1 Courthouse Square
Suite 102
Carlisle, PA 17013