HomeMy WebLinkAbout06-23-15 (3) permsYlvania 1505618403
Thy'j,R DEPMTMEM OFREV tX(03-14)
REV-15010 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 15 00147
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
05 20 2014 06 17 1963
Decedent's Last Name Suffix Decedent's First Name MI
DONNELLY KIM M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name Ml
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)
EJ4. 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)
7. Decedent Died Testate 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
❑ 10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
13. 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
MARK A MATEYA 717 241 6500
First Line of Address
55 W CHURCH AVENUE
Second Line of Address
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's email address: mam(ar>mateyalaw.com - fir-- G� c
REGISTER OF WILLS U§F,9NLY"';
r_ r�
REGISTER OF WILLS USE ONLYCD
DATE FILED MMDDYYYY CD '
4-)
C3
co I" M
DATE FILED STAIAP
Side 1
1111111111111111111 IN
1505618403 1505618403
1505618411
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Donnelly, Kim Marie
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 17,500 - 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. 3,243 - 36
6. Jointly Owned Property(Schedule F) El Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............ 7. 5-,214 . 26
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 25,957 . 6 2
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 12,111 - 44
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 4-,966 . 16
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 17-,077 . 60
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 8,880 . 0 2
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. 8-,880 - 02
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 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 81880 - 02 16. 399 - 60
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 . 110
19. TAX DUE................................................................................................................ 19. 399 - 60
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury,I 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.
SIGNATURE OF�RESP IBLE FOR FILING RETURN Michael Donnelly DATE
ADDRESS
25 Saria Lane, Carlisle, PA 17015
SIGNATURE 0F„PF�EPgREREJOTHE-FffHAN REPRESENTATIVE Mark A. MateyaPATE J
! 22 1
ADDRESS
55 W. Church Avenue, Carlisle, PA
11111 III 1111111111 II II III 11111111 IN Side 2
1505618411 1505618411 '
REV-1500 EX Page 3 File Number 21-15-00147
Decedent's Complete Address:
DECEDENT'S NAME
Donnelly, Kim Marie
STREET ADDRESS
424 Fiarground Ave
CITY STATE ZIP
Carlisle PA 17013
:�
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 399.60
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) 399.60
Make Check Payable to: REGISTER OF WILLS AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;............................................................................... ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ NX
c. retain a reversionary interest;or............................................................................................................... ❑
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 0
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ 0
3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?.................................................................................................................. x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21ears 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
Donnelly, Kim Marie 21-15-00147
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate-Located at 424 Fairground Ave,Carlisle, PA PIN#06-20-1798-317;See Attached 17,500.00
Settlement Sheet
TOTAL(Also enter on Line 1, Recapitulation) 17,500.00
(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 OFPERSONAL PROPERTY .
INHERITANCE TAXAXRETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donnelly, Kim Marie 21-15-00147
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 Cornerstone Federal Credit Union-Savings account No. 3781-01 39.36
2 Tangible Personal Property-2004 Nissan Sentra automobile-Kelley Blue Book valuation 3,000.00
based on fair to good condition(See attached)
3 Foremost Insurance-Refund for cancelled property insurance due to sale of real estate 84.82
4 PHEAA -Refund on payment of student loan Account No. 8805726686 119.18
TOTAL(Also enter on Line 5, Recapitulation) 3,243.36
(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-1510 EX+(08-09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donnelly, Kim Marie 21-15-00147
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 THINCLUDE
DATE OF TROANSFER TRANSFEREE,
A COPY F THE THEIR DEIED FOR P TO EREAL ESEDENTTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Federal Employees Retirement System-Proceeds 939.00 939.00
from decedent's retirement fund
2 Thrift Savings Plan-Retirement Savings Plan 4,275.26 4,275.26
through federal employment
TOTAL(Also enter on Line 7, Recapitulation) 5,214.26
(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+(0&13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERRESIDENT
EDENAX TURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donnelly, Kim Marie 21-15-00147
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 4,554.74
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State ZiD
Year(s)Commission Paid
2. Attorney's Fees Mateya Law Firm 2,600.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 235.50
5. Accountant's Fees 175.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 4,546.20
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 12,111.44
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
Donnelly, Kim Marie 21-15-00147
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Ronan Funeral Home-Funeral Expenses 4,554.74
H-A 4,554.74
Other Administrative Costs
2 Andrew H Shaw, P.C.-Real Estate Settlement Charges-See Attached Settlement Sheet 2,522.30
3 Andrew H.Shaw, P.C.-Deed Prep for sale of real estate-See attached Settlement Sheet 150.00
4 Borough of Carlisle-Water/sewer service at residence 70.68
5 Borough of Carlisle-Past due water/sewer fees-See attached Settlement Sheet 145.50
6 Charles Holtry-County/Boro Taxes-See attached Settlement Sheet 271.74
7 Citizens Bank-Checkbook Fee 27.25
8 Cumberland County Recorder of Deeds-State Tax/Transfer Fee 175.00
9 Cumberland County Tax Claim Bureau-Delinquent real estate taxes-See attached 588.06
Settlement Sheet
10 Cumberland Law Journal-Legal Advertisement 75.00
11 Foremost Insurance-Homeowner's Insurance Premium 138.82
12 Sarah Dieckman-Notary Fees for real estate transaction-See attached settlement sheet 10.00
13 The Sentinel-Legal Advertisement for Estate Administration 201.16
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
Donnelly, Kim Marie 21-15-00147
ITEM
NUMBER DESCRIPTION AMOUNT
14 UGI Utilities-Heating expense at residence 133.69
15 UGI Utilities-Heating expense at residence 37.00
H-B7 4,546.20
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-12)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OFMORTGAGE LIABILITIES AND LIENS
RET
INHERITANCE TAXAXRETURRNN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donnelly, Kim Marie 21-15-00147
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 AT&T-Telephone service of decedent-Account 464007789530 252.16
2 Capital One-Credit card expense of Decedent-Account No. xxxxxxxxxxxx2161 286.18
3 Capital One-Visa Credit Card Acct 4676 3,302.28
4 Cornerstone Federal Credit Union-Outstanding Loan No. 3781-06 1,094.54
5 Cumberland County Tax Bureau-2014 Personal Local Tax 31.00
TOTAL(Also enter on Line 10, Recapitulation) 4,966.16
(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 BENEFICIARIES INHERITANCE TAX RETURN BENEFIC/�IARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Donnelly, Kim Marie 21-15-00147
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
D NotListT teaki
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Michael Donnelly Child 8,880.02
25 Saria Lane
Carlisle,PA 17015
Total 8,880.02
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
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)
R. Settlement Statement U.S.Department of Housing and Urban Development
B.Type of Loan OMB Approval No.2502-0265
1. OFHA 2. DFmHA 3. DConv.Unins. 6.File Number 7,Loan Number 8.Mortgage Insurance Case Number
4. DVA 5. []Conv.ins. 15.31
INSIorth IS turnothed togwe you a s amen ac u se amen s s. moon s paid to and by the settlement agent are an awIt.
C.Note: Items marked-p.o,c.)-were paid outside the closing;they are shown here for information purposes and are not included in the totals. Tltl@Express Settlement System
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 to u.5.Code section 1001 and Section 1010. Printed 03/12/2015 at 16:37 SDD
D.NAME OF BORROWER: Neidlinger Rentals LLC
ADDRESS; 589 Greason Road Carlisle PA 17015
E.NAME OF SELLER: Estate of Kim M.Donnelly
ADDRESS:
F.NAME OF LENDER: TRSI,Inc.
ADDRESS:
G.PROPERTY ADDRESS: 424 Fairground Avenue,Carlisle,PA 17013
Carlisle Borough
H.SETTLEMENT AGENT: The Law Office of Andrew H.Shaw,PC
PLACE OF SETTLEMENT: 200 S.Spring Garden Street Suite 11 Carlisle PA 17013
i.SETTLEMENT DATE: 03/1312015
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 17,500.00 401. Contract sales price 17 500.00
102. Personal property 402. Personal property
103. Settlement charges to borrower line 1400 885.00 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. Cit ltown taxes 406. Cit/town taxes
107. County taxes 03113115 to 12/31115 218.88 407. County taxes 03113115 to 12131115 218.88
108. School taxes 03113115 to 06130115 152.51 408. School taxes 03113115 to 06130115 152.51 f
109. 409,
110. 410.
111. 1411.
112. 1412.
120.GROSS AMOUNT DUE FROM BORROWER 1 18,756.39 420.GROSS AMOUNT DUE TO SELLER 17,87T.39
200,AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500.REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deposit or earnest money 501. Excess Deposit see instructions) /
202. Principal amount of new loans 35 000.00 502. Settlement charges to seller line 1400 21522.30 +/
203. Existing loans taken subject to 503. Existing loans taken subject to
204. 504. Payoff of First Mortgage Loan
205. 505. Payoff of second mortgage loan
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. Cit/town taxes 510. Cit(town taxes
211. County taxes 511. County taxes
212. School taxes 512. School taxes
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519,
220.TOTAL PAID BYIFOR BORROWER 35 000.00 520.TOTAL REDUCTION AMOUNT DUE SELLER 2,522.30
300,CASH AT SETTLEMENT FROM OR TO BORROWER 600.CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower line 120 18J56.39 1 601, Gross amount due to seller line 420 17,8139
302. Less amounts paid by/for borrower line 220 35 000.00 1 602. Less reduction amount due seller line 520 21522'30
303.CASH TO BORROWER 16t243.61 1 603.CASH TO SELLER 15 349.09
SUBSTITUTE FORM 1099 SELLER STATEMENT:The information Contained herein is important tax information and is being furnished to the Internal Revenue Service.If you are required to 81e a return,
a negtigemw penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported.The Contract Sales Price described on
line 401 above constitutes the Gross Proceeds of this transaction.
You are required by law to provide the settlement agent(Fed.Tax ID No:261544555)with your Correct taxpayer identification number.If you do not provide your Correct taxpayer identification
number,you may be subject to civil or criminal penalties imposed by law.Under penalties of perjury,I certify that the number shown on this statement is my correct taxpayer identification number.
SELLER(S)SIGNATURE(S): I
SELLER(S)NEW MAILING ADDRESS:
SELLER(S)PHONE NUMBERS: (H) (W)
s are Obsolete
S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
L. SETTLEMENT CHARGES Flle Number.15.31 Corm HUD-1(3188}ref Handbgo 4305,2
700. TOTAL SALES/BROKER'S TitleEx rens Settlement S stem Printed 03!12!2015 at 16:37 SDD PAGE 2
Division of commission tine 7000 s follows.SS N based on rice 1:1 500.00
701. $ PAID FROM
PAID FROM
702, to BORROWER'S SELLER'S
703. COMM,SS-0 aid at Settlement 10 BHHS Homesale RealtyFUNDS AT FUNDS AT
800.ITEMS PAYABLE!N CONNECTION WITH LOAN SETTLEMENT SETTLEMENT
801. Loan On inafion Fee °!e
802. Loan Discount
803, AJDPraisal Fee °!o
804. Credit Re ort
805.
806,
807,
808,
809.
810.
811,
900.ITEMS REQtJiRED BY LENDER TO BE PAID iN ADVANCE
901. Interest From
902. Mort a e Insurance Premium foro
903. Hazard Insurance Premium for t, /da
904. I,
905,
1000.RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard insurance
1002. Mort a e Insurance mo.ca
1003.Cit Pro erf Tax mo. $ /mO
1004.Count Pro ert Tax mo• /mo
1005.School taxes mo. $ /mo
1009.A re ate Anel sis Ad'usfinent m0 $ /mo
1100.TITLE CHARGES lino
1101.Settlement or losing Fee
1102.Abstractor Title Search 0.00 0 00
1103. Title Examination
1104. Title Insurance Binder
1105. Document Pre aration
1106. Nota Fees
1107.Attorne 's fees to Sarah Dieckman
includes above items No:
1108, Title Insurance 20.00 10.00
includes above items No: to AHSWLTtC
1109.Lender's Polic
1110.Owner's P0 ICY 500.00
1111.Deed Pre . 17 500.00 •500 00
1112. to The Law Office of Andrew H.Shaw PC
1113,
120. GOVERNMENT RECORDING AND TRANSFER CHARGES 150.00
1201.Recprdin Fees Deed$111,00 Mort a e 79.00
1202.Cit/Count tax tam s
1203.State Taxlstem s Deed 175,00 Release
Deed Mort a a
1204. UP!Fee $175.00 'Mort a e 190.00
1205. Deed Deed Mort age 1
175.00
1300.ADDITIONAL SETTLEMENT CHARGES a e$ Release 175.00
1302. Delin went Taxes
1303.2015 Count tBoro,Taxes io Cumberland Count Tax Claim Bureau
1304, Past Due watertSewer tO Charles Holt
f
1305, Estate Tdx Escrow to Borou h of Carlisle 588.08
e EV/
to Rster of Wills A ent 2171 74 ✓
1400.TOTAL SETTLEMENT CHARGES145.50 V
enter on lines 103 Section J and 502 1 182.00
t have carefully reviewed the H HUD CERTIFICATION Section K
UD-1 Settlement Statement antl tq the b��ndbp�jiafjtjs.bu.
OF BUYER AND SELLER 88S 00
or by me in this rensapcon.I rurmet
certify that I nave recerveq a copy e antl a 2522.30
enL accurate statement of ail receipts and disbursements made on
etc ng a s P
my account
sae
WARNING-IT IS A
R TO
UNITED STATES C TH S OR ANY SIMILAR R FORM.LY MAKE LSE STT UPON TON THE
CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAILS S
U.5.CODE SECTOR 7001 AND NY SI The HUD-1 Settlement
ON 1010. EE TITLE 18: transaction. I have caused ornw ll whxCh i nave r !s t
Will the/ paper a nd ac r
to
cu ate accqunt of this
se In accomance with this statement
SETTLEMENT AGENT
DATE'
2004 Nissan Sentra Sedan 4D Used Car Prices - Kelley Blue Book Page 1 of 2
ZIP CODE:1701S i Sign in(or Sign up)
Home Car Values Cars for Sale ( Car Reviews Awards 6 Top 10s I Research Toots
LEAMNOWE Popular at KBB,com
100,000 MILE 10 Best Car Deals of the Month
LL'1 EpWARRAMrY. >
CERTIFIED
ii°iiF� - Mj.Wm
Advetmmmt Why ads?
Nissan Sentra X2004 Go
Home>Car Values> Nissan>Sentra>2004>Styie>Options>Condition>Sedan 40 _ �-
2.0_04 Nissan Sentra
2003 2004 2005 New 2015 Style: Sedan 4D
View all I Mileage:128,000 Change! e r
Edit options ; Change style Mom4photos
"�' `�
pricing photos specs kbb expert review t consumer reviews ratingscompare I
Used Car Prices i See Trade-In/Sell Values iii
/100,000 MILE
'Buy from _ Buy Certified_Buy from a IrEI�WARRANTY.
a Dealer from a Dealer Private Party Print report
Fait Purchase Price Consider a New Car
$3,368 • Full new-car warranty
(567/month)' Latest technology
• Never been driven r:
Research and price
i Advertisement Why ads?
f
Get a Free VIN Check
Have questions about a used car's
history?Get answers.
89�
Show at
ftetaA vdn
others paid rr ,'A " ft#Aof H �or o n
u-..
($67/month)* Enter VIN(optional) Go
Na VIN?No Problem!
( Based an Good Condition orBetter i
Fair Purchase Price valid far your area thmugh2)5/2015 .
Find This Car Near You
View actual photos Search
and compare prices.
866-385-6672
*Illustrated prices,rates and monthly payments are estimates only and do not represent offers to sell Advertisement why ads?
vehicles or provide financing,
i) Next Steps to Buying Smart
I
Shop as a Cash Buyer - --
Loans starting at 2.19%*APR from .,rr*.jGHTS7fWAM I Apply for a loan
L!ghtStream,a division of SunTrust "G •-* *��
Rano
Recently Viewed rs i My Saved Cars Save car
h4://www.kbb.corn/nissan/sentra/2004-nissan-sentra/sedan-4d/?condition=good&vehicleid... 2/5/2015