HomeMy WebLinkAbout09-06-15 J ��,,,,,,, Lsos61v1os
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REV-1500 OFFICINL IISE OHLY
Bureau of Individual Tazes Gounty Cotle Year Flle M1WrtEer
co eox 2eo6oi INHERITANCE TAX RETURN
Harrisbura, PA I]128-o601 RESIDENT DECEDENT 21 14 1218
EHrER DEGE�EM INFORMATION BELOW
Soaal Sewrity Number Dale of DeaUi MMD�VYYY Oate of Birth MMDUYYYY
12212014 10191934
DecetlenPs Last Name SWfic DecetlanCs First Name MI
Sgrignoli Arthur C
(If Applicable)Enter SurviN�p Spousa's Intomation Balow
Spouse's Last Name SuRx Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Onginal ReNm O Z.Supplemantal ReWm O 3. Remeinaer Relum(date ot tleat�
( pnw b 12-13-82)
� � tl�ea�M on w afler�]�-1�-20�12) �r � 5 tleaN alfler�l2-12A2�ise(tlate of p 6. Fetleral Eslate Tax ReWm Repuiretl
� ].Decetlent Dietl TesUte O e. Dacetlent MainUinetl a Living Teust 0 g, Total Number of Safe DeposR Boxes
(Attarli copy M will.) (Atlarh wpy of irust)
p 10.Litiqetian Proceetls ReceiveE O 11. Non-Pmbaie Transferee Relum O �2_ Deferra�Election of Spousal Tn,s6
(Scl�edule F and G Assets Onty)
O 13. BusinessAssets O i4.Spouse is Sole Beneficiary
(No Vus[imdved)
CORXESPONDEHr- TIIS SELTION YUST BE COMPIEIED.ALL CORRESPoNDENCE RMD CONfIDENML TAX INFqtYRTqN SIqULD BE OINECTEO TO:
Name Daylime THephane Num�er
Lucy Sgrignoli 717-245-2353
First Line of AtlEress
70 Tiftany Dnve
Secontl Line of Adtlrew
Ciry or Post ORice Sta[e ZIP Code
Catlisle PA 17015
corre.po�a�rs.me�iaaa�u: sgrignolil�comcast.net
rsera n ar mus' �� ory� �
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REGSIERGP WILLSUSEONLY ;-�
DAIE FlIID MYODYYYY. —.� .
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DATE FlLED STRMP . '��
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PLEASE USE OR161M11L FORM ONLY
Side 1
L I�nl����61������ 1505614105 J
�
J 1505614205
REV-1500 EX(FI) Decetlenl's Soaal Sewnty Number
oecedenrsr+ama:
RECAPIi11LAilON �
1. RealESUte(ScheduleA). .......... .... .......... ... . ... .... ...... ... 1. 9���0.00
2. 5locks antl Bones(Srheaule B) .. ..................... ............. ... 2.
3. Closely Heltl Corpo�a4on,PaMers�ip or Sole-Propdetaship(Sai�etlule C) ..... 3.
4. Matgag¢s antl Notes Receivable(Sc�eOule�) ........... ... ... .... ...... 4.
5. Cash,Bank Depovls ana Miscellaneous Personal Property(Schedule E).. ... .. 5. �324$0.58
6_ bintty Owned Property(Srhetlule F) O Separate Billiig Repuesletl .. .._.. 6.
]. InlerNvos Trensfers 8 Miscellaneous Non-Probate Pmpery
(Schedule G) O Separate Billing Rcquesled_ ... ... ]. �8538���
8. Total Gross Asaets(mtal Lines i Nrou9h])............ ... .............. 8. 240989.29
9. Funeral Expenses and Administrative CosLs(Schedule H)..... .... ... ... .... 9. 142$6.17
10. Debts of Demdent,Mortgage Lia�ilities ane Liens(Schetlule I). ....... ....... 10. 33�$.��
11. Tmal Ueductio�(total Lines 9 antl 10).. ...... ........ .. .... .... ....... tt 17631.17
12. Nat Valua of Esfate(Line 8 minus Line 11) . . ... .......... ........ ... .... 12. 223358.12
13. Chan�able antl Govemm¢ntal BequesWSea 9113 Tmsis tor which
an election to�ax has not been made(Schetlule J) ... .... ............. .... 13.
10. Net Valua Subjact b Taz(Line 12 minus Line 13) ...... ........... ....... 14_ ZZ3366.�z
TA%CALCULATION-SEE INSTRUCTIONS FOR 11PPLIGABLE RATES
15. Fvnount of Line 141azable
a�the spousal Gx ra[e,w
bansfers under Sec.911fi
(axt2)X 0_ 15.
16- AmauntofLine1d45 ble 223358.12 10051.12
atlinealra�e X.0- �6-
1l. AmountolLine141axable
at ading rale X.12 1].
18- Amount of Line 141axable
at mlla�eral 2le X 15 18.
19. TAXDUE ..... ..... .... .... .......... .. . ... .... .......... ......... 19. 100$7.1$
20. FILL IN THE OVAL IF YOU ARE REpUESTNG A REFIINU OF AN OVERPAYMENT O
UnEw penaXies d�erjury,I de�ia�e I M1ava aumiretl�M1is reW m,intlutli�g ettpnpa�ryirg sdc0uks a�M slalemen6,aM b Me bes�ot my knaWeJge antl Celiaf,
it 4 true,funect aM wmpkYe.OerJe�ation M pepsrer WM1er Nan Me pasm iespansible br filing IM1e reNm 4 based on all MbimaWn d vTVT preperer�u
any k�wwletlge.
SIGNATURE OF PERSON RESPONSIaLE FOR FlLING RETUfEN OATE
`���c�e��c. Sc�v-�=� Eu�c,. 9 -G -1`�
nooaess
10 Tiffany Drive, Carlisle PA 17015
SIGNATU0.E OF PREPRRER OTHER�HAN PERSON RESPONSIBLE FOR FILINGTHE RERIRN �ATE
FD�RE55
L iin�i��!!������iw,� S,de2 �
Lsoselv2os
__ _-- -- -�-- ,..._..._.
Decedent's Complete Address:
DECEOEM'S NAME
Arthur G Sgrignoli . _ _
— ___ _
sm�nooaEss
2230 Brim Lane
_ _ ._-__——_. _ ._
CITY
Enola STp� PA ZIP 17025
Ta�c Payments and Credits:
1. T�Oue(Page 2,Lirie 19) (i) 10051.12
2. CrediWPayments
A.Prior Paymenis
B.Oismunl
�see inswctions.� Total Credils(A+B) �z�
3. Inlerest
(3)
4. R Line 2 is greater U�an Line 1 t G�3,en�er Uie d'Aference. This is ihe OVERPAYIAENT.
Fill in oval an Pape 2,Lina 20 to requeat a refun0. (4)
5. If Line 1 *Line 3 is giealer Man Lir�e 2,enter Ihe diRerence.This is Ihe TAX DUE. (5) 10051.12
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 irensfer and: Ves No
a. ratain�heuseaincameoliheP�MVanskrted......_._................._................._._._............._.................. ❑ � �
b. retain ihe nght�u designate who shall use Me property transferred a its incane ......................_._........_....... ❑ �
c. reqin a reversionary inlerest...._........_.............................._............_............................................._............._.. ❑ �
d. receive�he Praniu for lite ol eiMer PaymenB.beriefiis a pre?............................_._...._...,........................... ❑ �
2. If deaM omrted afler Oec. 12, 7982,Cid decedent Uanshr propeM within one year of aeath
vnllpulreceivinga�e0uatemnside2tion?......................_.................................................._._............................... ❑ �
3. Did deceden�own an"in trusl bf or payable-upon-deaU bank accoun�or security al his or her deaN?...._........ ❑ �
4. Did�ecetlent own an individual retirement accounl,annuity or other non-prohate propeM�'�ich
mn�ainsahe�fciarydesi9natim? ........................_.................,......._...................._....._............_..................._.. � ❑
IF THE ANSWER TO ANY OF 1HE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RENRN.
Fw dates of death on or afler Juty 1,1994,and hefore Jan.1,1995,Ne tax rdte imposea on ihe net value of trans(ers lo or for the use of the surviving spouse
is 3 percent[/2 P.S.§911fi(a)(1.1)(i)J.
For dates of deaM on or after Jan. 1, 1995, ihe tat rate imposetl on �he net value of Vansfers to or for Ihe use of tl�e surviving spouse is 0 percen�
[/2 P.S.§9116(a)(1.1)(ii)].The sWMe tices not exempt a transfer to a surviving spouse from 1�,and ihe slaMory requi2mems tor disdosure of assets and
filing a tax reNm are slill applicable even if the surnving spouse is the onty 6enefidary.
For da�es of dea�h on or after July 1,2000:
• The tax ate imposed on the net value of Iransfers hom a deceased child 21 years of age or younger at death ro or fa Me use of a naNral parent,an
adop6ve parent or a step-parent of the child is 0 peicent�72 P.S.§9116�a)(12)�.
. The tax ate imposed on Ure net value of transiers to or for�he use of Ne deccdenYs lineal beneficianes is 4.5 pe�cent,ezcept as rwted in�72 P.S.§911fi(a)(i�].
• The tae 2te imposed on�he net value of transfers to or for the uu of the decedenYs aWings is 12 percen�[72 P.S.§911fi(a)(1.3)�.A sibling is defined,
under Section 9102,as an intlividual who has at least one parent in common wAh Ne decedent,whether by blood or adopfion.
0.W-150]E%� (02-I5�
� pennsylvania SCHEDULE A
omnnrnExrorx�nuE REAL ESTATE
IMEAIlPNQ iAY RFRRN
0.ESIOEM OEQOfM
ESf1TE OF: FIIF NUMBER:
RII raal OroWM^M'�wleM or u�hmirt�n cammon murt ba nportad el hlr mnlcM niw.Falr market value Iz GeAneA as[he 0�at which property
would Ee eetlian9etl between a willing buyer anA a willinA selle5 neiMer beinq compelleE to buy or sNl,boM having reawnable knowleOqe of the relevan[facts.
Red properry tlut 6 jolMryrownW wIN ri9M of survhanhip must M diaclaad on S�hMub F.
Attadi a copY af Ne settlemenc sheec if[he pmperty has been mk.
�M IntluEe a ropY of the Eeed shawing EtteAmt's inhrert if ownetl as[enant in wmmon. �A�UE AT DATE
NUMBER OF OEAH
DESCRlV110N
1� House-2230 Bnm Lane, Enola PA 77025 90,000.00
TOTAL(nlso en[er an Line 1, Recapitulation.) S �.000.00
I(mare spa�c Is neetled,use aEAdional sheets of pnper of Ne same sire.
. __.__
aev-isoa Ex. (az-is)
pennsyNania SCNEpULE E
oeraarrnexroFne�xue CASH, BANK DEPOSITS&MISC.
�+��*µ�*^�a�� pER50NAL PROPERTY
nes�ocan oeceoErrt
ESTATE OF: FILE NUMBER:
Arthuf G Sgngnoli 2014-01218
IndWe the praeeEs of IiHgaEon aM the Gate Me prarnetls were recelveG W Me esmte.
IUI MoP�Y 3a�Y ownetl wM AYM al aurvivaahiD murt Mlir.loro0 on SN�etluk F.
�M VAWE AT DATE
NUMBER UESCRIP(ION �F OEATH
� Cash 496.00
Z PNCCheckin9AccUt57-0W5-6498' �01,543.80
3 PNC CD AaHF 004031900201882' 20,000.40
4 PNC CD Acctlt 004031000203043' S,000.18
5 PNC CD AccVF 004031100206007` 5,00020
6 Automobile— 98 Chery Tracker 300.00
� Matlress 70.00
8 Retn9eretor 40.00
`PNC Bank,235 N. Enola RoaQ Enola PA 17025
TOTILL(Alw enter on Line 5, RxaPiNlation) S 132,450.58
If more space Is needed,uu additional s�ee6 0/paper of the same size.
REYd9U E%+ (02-15)
� pennsylvania SCHEDULE G
oevnmw�+rovn�xue INTER-VIVOS TRANSFERS AND
ixxcur.�r�*��vax MISC. NON-PROBATE PROPERTY
usmexr occEOExr
ESTATE OF FILE NUMBER
Arihur C. S9rignoli 201401218
Thls schedule must be rompletetl and Bled iF Ne answer ro any ot questlons 1 Mmugh 4 on page Nree ol Me REV-1500 is yes.
DFSCRIP110N OF PROVERTY pATE OF DEATH %OF DKD'S IXCLUSION TAYABIE
I7EM i�raw�rtar�*wiaas�u�unaswmo�aruo VALUEOFASSET IMERESf In VNUE
NUMBER �rtnrtviwna�mia�carm��wnuugmc
� IRA—ColumMa High Yeld Bontl Fund qass A 8,652.74
Acct#0010101187944002 8.85274
IRA—Columbie Inlermetliele BOrM FUntl Class A g,885.97 9.�5�9�
2 AccH10020153376884002
BoM transferred on April 7,2075 to:
Robin Sokoloski,daughter
Linda Rollin,daugOter
Mita Sgrignoli,daugMer
Wcy Sgrgnoli,daughter
Paula Micliaels,daughter
70TAL(Alsa enter on Line 7, Rewpitula[ion) ; 18.538.71
tf more space is nee0e0,uu a00dional sheets of paper of Me same size.
�i�jpennsylvania SCHEDULE H
'i7 oEsrarnvrrar�vauE FUNERAL EXPENSES AND
���E�µ�r��+� ADMINISTRATIVECOSTS
READEM OEQOFM
ESTATE OF FILE NUMBER
Arthur C. Sgngnali 2014-01218
DeceOent's Aebts mus[be repoRM an 3MeAule I.
REM DESCRIPrIOfJ AMOOM
t1UMBER
A. FUNERAI EXPENSES:
�� Richardson Funeral Home 6743.85
2 ResurtecAonCemelery—GraveOpening 1060.00
s FaNer Grab 250.00
a Organist 150.00
9, AOMINISrMTNE COAS:
1, Personal Representztive Commiuions:
rvame�s)of Personai aeDresentaeve(s)
SVeet AGGress
City_ 5[a[e_ZIP_
vearts)[ommission Vaitl:
2. Attorney Fees:
3. Family Eremption'. (If GeceGenPs a0tlress Is no[[he same as tlaimanCs,attach eaplanation.)
Claiman[ . _ . . ..__. _ . . .. . . _ . .—
Street Atltlress _ _. --_. . _____ .. . __—_.
City _. . ._— ___ .... ... __ S[a[e 21P _. ..
RelationshipolClaiman[ro�ecetlent .__ ._. . .._—_ _ - .--_. __.
470.50
4. Pmbate Fees:
5. Acrountan[Fees:
6. Tax Remm Preparer Fees:
7. SettlemenlCosts 4930.00
a EstateNofice—CumbetlandLawJoumal 75.00
s EstateNo6ce—CatlisleSendnel �26.8z
m Lawn Mowing 450.00
TO7�L(Rlso enter on Line 9, Rerapimlation) ; 14256.17
�i�J pennsylvania SCHEDULE I
��� oawarnExrornEvw.� DEBTS OF DECEDENT,
���E�µ�E T�a�a� MORTGAGE LIABILITIES & LIENS
aesmExr occeo[nr
ESTIITE OF FILE NUMBER
Arthur C. Sgrignoli 2014-01218
Report debts IncvrteE by the EeonAent 0�a to Awth that remaiME u�qaiA af the daM ol CesN,iMluOing unrcimburseE meAinl eRpenxs.
REM VAWE AT�ATE
NUMBE0. DESCRIPTION OF DFATN
�� HospiceofCentralPA 3375.00
TOTRL(Also enter on Line 10, RecapiNlatian) S 3375.00
REVQSt3 Ex+ (W-I5)
� pennsylvania SCHEDULE 7
oewxrn�rrovaEVErue BENEFICIARIES
INXERilhHLf TAC PFNRN
aesmexro�o�r
ESTRTE OF: FILE NUMBER:
ArthurG Sgrignoli 2074-01218
REUTIONSHIPTODKE�EM AMOUN100.5HARE
NUMBER NAME AND ADDRESS OF PERSON(5)RELFIVING%IOPERTY Oa Net lis!huqx(s) OF FSTATE
[ �AXABIF DISTRIBMONS[tntluEe ouMght spousal tlis[nbv[ions antl tansFers untler
Sx.9116(a)(1.2).]
1. Robin Sokoloski, 5457 Hunting Hom Dr. daughter ZD�
Ellicotl Ciry MD 21043
2 Linda Rollin, 271 Brooklyn Tumpike tlaughter 20 h
Hampton CT 06247
3 AniW Sgrignoli,56 Willow Creek Lane daughter 20%
Newark DE 79711
4 Lucy Sgngnoli, 10 Trffany Drive daugMer 20%
Carlisle PA 17015
5 Paula Michaels, 1393 Letchworth Road daughter 20%
Camp Hill PA 17011
ENiER DOWR AMOUHIS FOR DIS�NBUr10N5 SHOWN ABOVE OR LINES 15 THROUGH 18 OF REV-SSUO COVER SHEEf,AS APPRO%UATE.
n NON-TA%ABLE OISTWBUi[ONS
p. SPOOSAL DISiP19MON5 UNDER SKTION 9113 F00.WHICN AN ElEQION TO TA%IS NOT TAKEN:
3.
B. CHA0.RABlEAfiDGOVERNMENTALDISTRIBUI10N5:
1.
TOThL OF PART Q-ENTER TOTAL NON-TA%AB�E DI5fRIBUi]ONS ON LINE 13 OF REV-1500 COVER SHEEL s
It more spaa is needeG,use a0ditianal sM1ttts of paper of ine ame sue.
Ameriprise �
Financial
Account Summary for the Estate Settlement of Arthur C Sgrignoli, Client ID 16584465
1)Type at investment: Mutual Fund
Protluct Name: Muival Funtl
Total Account Value(85 Of Dete of Death $8,652.74
Account Number:01010119794 002
Account Reglatration:Ameriprise Tmst Company C/O Anhur C Sgngnoli As Cusid For The Anhur C Sgrignoli Ira
Beneliciary Deslgnatlon:
PRIMARV BENEFICIARV
LNING,LAWFUL CHILDREN W EOUAL SHARES 100.00%
ROBIN SOKOLOSKI DAUGHTER
LINDA ROLLIN DAUGHTER
NNITA SQRIGNOLI DAUGHTEF
WCY LUNSFORO DAUGHTER
PAULA MICHAELS DAUGHTER
How the accouM(s)pra.�eeds will be settled:
We will iransfer assets in ihis axount to an eccount for Ihe beneficiary(ies).
Imporbnt Oetails about Nis acrouM:
WA
2)Type W inveatmeni: Mutuel Fund
Protluct Name:Mutuel FuM
Total Accoufrt Value(as oi Date ot Dealh):$9.885.97
Aceount Number:02015337668 002
Account Negistrstlon:Ameripr'ise Trust Company C/O Arthur C Sgngnoli As Custtl For The Arthur C Sgrignoli Ire
eenefidery Oezi9nation:
PRIMARY BENEFICIARV
LIVING, LAWFUL CHIIDREN IN EQUAL SHARES 100.00%
ROBIN SOKOLOSKI DAUGHTER
LINDA ROWN DAUGHTER
ANITA SORIGNOLI DAUGHTER
LUCV LUNSFORO DAUGHTER
PAULA MICHAEIS DAUGHTER
How the eccount(s)proceeds will Ee setlletl:
We will transfer assets in ihis account to an amount for Me beneficiarvlies).
IIIIPOrtlOt D2I81158bOU1 MIS BCGWOt:
wn
ot g tatement (}�pNCBANK
����: ��:,�,�
Primary auount numbec SL9005-6498
Page 1 of 5
ForNeperiodH/t{/2014to /3H0/Y079 Numberoiencloswes'.0
000I6] �For 29�hou�banking,and Uansatlion or
�MK ARTHl1R C SGRIGNOLI mterestra�einbrmatioqsignon�o
2230 BRIM LN 7NCBankOnlineeankinga�pnccom.
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Relationship Overview
Bank Deposit Accounts
�y���p�o� Acmunl N�TEe[ DeGos�l Bdlanm
Inlereil CLecklnp 5]-000fi.649tl 101 593.&0 �
Ge��ilinec(..)O�De�wrl ToraloCl 5poo_pY
Toiel llepoei� ]Ufi,544.01
IMNOR'fAI1'f ACCOUN'f I�ROItMA'170N
EO'eQive 1'eLruary 22,2015,Ihe infmm-v1lon beloti amt�ds Ihe Accouu!Agreenu-nt for Perravol('l�ecking, Snvings�nnAMonrv Mar*e!
Accowils. 1'Icns'e resd this i�(ortnalion nud rclain it wah you�recoeds.
Clusing Your 9ccounl
lbu or the Bank ean elose yuur Acmiml a�ony Gme by prmidfng wriveu oofice.If we cluse�he Acmum,we e�ill moil you a cM1uk lur[he
linal balunce.Ifyou close Ihe Accwm,yuu will sGll be responsible for nny oulrianding thrcAs��n��en,or service charges or overdrofis
incutred,before,dunng,ur afier�e timn yuu dosed ihe AcwunL We sre not reyuired to cbse the Acto�m�at your eeyues�until all known
au�honzed or ouleYanding ilems(including checAs,ATM,poini-oGsale,ACH and o�her electronic l�ansaclionsJ hove betn paid liom your
accwnt a - y � t:er.u= g � ' +�r�'(ia�luding but not ifmfted m dispules regarJing ele�� onic trnns(ers,ACN tranna<tions o�o:her
unresolved iutemal reseo� h rcyuests,'d�sputes�on�erning thc AccomQ have bren resolved.We wfll mt reopen a closed Account exceg�es
necessa�y Io resolve any oulsmnding dispu�es.Any Fems presen�d for pnymenl ufier an Accou�l hns been ebsed will be retumel m�he payee
and you will be liable for�ny asaociatcd chorges.Any additional depoai�s urdectronic crrdi�s(induding Social Security,pens�on paymeNs
� � � � '-p�y Ild�p `�s�x'llbereLLrnedmtheonginator. __
Premium Plan ANhurCSgngno6
Interest Checking Account Summary
Aceount numbar. SY4005-G498
Ov�rdnfl Prot�cNon has not been established for this accoum.
Please contacl us i!you would like to set up I�is service.
Owrdrah Coverogo- Vour account is currentlyOpbtl-Out.
You or your loint ownei may revoke your opbin or opt-out choice at any time.
Tolee aMutGkCOverdnhSOlWlonsvisilusonLnea�O�� mpve�dnhsoWuons
GIIbB�)�598-3E05,v � anybrancF,or519nontoPNCOnIIneBankiog,andaelettl�e"Overtlnh
Soluhons"lin4 undertM1s Aamunt Serv¢es sechon�o manage bo�F your OverJrah Cove�age antl Overd�ah
Pm�ecllon setlmqs
Yi'!
rjl!
PNDMLTO 1JUB8691]�190-NNNNNN�003�002306
E��.PN CBANK
Acmuntentling tB82
Date 011i22015
Page i ol t
ARTHUR C SGRIGNOLI
�0 TIFFANV DR
CARLISLE, PA 17015-8514
� �. Confirmation of a resent transaclion an yaur PNC
Certificate at Deposit(CD) account.
Here's what happened: We are confirming ihe iransaction tle�ailed below occurred on your PNC
Certificate of Deposit (CD) account.
Here's what you need if ihe transaction is valid and your rewrds agree with the details below, no aclion is
to do: necessary. If you have any concems about ihe legitimacy of Ihe transaction, please
contacl us al the number belaw so we can conduci research immediz�ely.
Here are the details of Accoun� Number: XXXXXXX 1882
ihe iransaclion: lransaction Amount: $20,000.40
Transac�ion Type: Closing
Posting Date: 0�/OS/2015
Here's how to reach We're here to help. If you have ques�ions or need assistance, please contac� us at
us ii you have 1-888-PNC-BANK (1-888-762-2265)
questions or need
assistance:
Thank you for banking with PNC. Your tinanc�al weil-bemg is important to us, .��.
'�.��. and we're committed�to helping�:you achieve:your goals.'r
�2013 The PNC Flnancial Serviws Gmup. Inc. All righis ieserved. PNC Bank, Nallonal AssociaUon. Member F�IC
l pRYlT C'8.13
f�?PNCBANK
acm:iniending ao4�
Daie 011i22015
Page 1 al t
ARTHUR C SGRIGNOLI
10 TIFFANY DR
CARLISLE, PA 17015-8514
� . foniirmation ot � recent traosar,tion on yoar pNr
Certificaie of Deposit(CD) account.
Here's what happened: We are conlirming Ihe iransaction detailed below occurred on your PNC
CeAificate o( �eposit (CD) account.
Here's what you need I�the �ransaction is valid and your records agree with �he delails below, no ac�ion is
to do: necessary. II you have any concems abou� the legi(imacy of the iransaction, please
conlact us at ihe number below so we can conducl research immediafely.
Here are ihe details oi Accounl Number: XXXXXXX 3043
thetransaction: Transac�ionAmount: $5,000.78
TransactionType: Closing
Posling Date: 01/OSl2015
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us ii you have 'I-888-PNC-BANK (1-888�762-2265)
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assistance:
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�� and we�re commitletl.�o helping you achieve�.your goals.-
OO 2��31he PNC Financial Services Group. Inc All rigM1ts reserved. PNC Bank,Na��ona'.Assoaalloa Member PDIC
-^_r.woi ca�ia
d� PNCBANK
Accountentling 6ao)
oa�e oin2rzois
Page� at 1
ARTHUR C SGRIGNOLI
10 TIFFANY DR
CARLISLE, PA 17015-8514
Go;f.;mption of z recer.t Iransac!ion or. your PNC
Certificate o! Deposit(CD) account.
Here's what happened: We aie confirming the�ransaction detailed below ocwrred on your PNC
Certificate of Deposit (CD) accouN.
Here's what you need II ihe transaction is valid and your records agree with ihe delais below, no action is
�o do; necessary. If you have 2ny concems abom the legilimacy of the transaction, ple25e
comact us at ihe nurt�,ber below so we can conduct research immedia�ely.
Here are the details ot Account Number: XXXXXXX 6407
the iransaction: Transac�ion Amount: $5,00020
Transaction Type: Closing
Posting Date: �7lOS/2015
Here'S how�o reach We're here to help. It you have questions or need assistance, please con�act us al
us if you have 1-888-PNC-BANK (1-888-762-2265)
questions or need
assistance:
Thank you for banking with PNC. Your tinancial well-being is impoitant to us,.:��
' and we7e committetl !o helping'you achreve.:your goalsr;
�2013 Tha PNC Financial Servtces Gmup, loc. FII righis reeervetl- PNC 6ank,Naiional Associaiion. Idember F�IC
�� 5�3�
BILL OF SALE
I, �4i�u2 --bRd6NOU (seller), inconsideraRonof �-�Rff �VND¢£�
dollars ($ Z"�' � ),do hereby sell, transfer and convey ro�����
(bi.ryer), the following vehScle:
C+-IEu¢c�t-�r .<..: 1948
Moae�: i¢wekF• a�nl'6� l3(abwl.4v�1 �o
I, the undersigned seller,do sell the above-described vehicle to[he buyer for[he amoun[shown
aod cenify tha[all of[he information provided in this Bill of Sale is[tue and accurate[o[he
bes[of my knawletlge.
L tlie undersigned buyer, acknowledge receipt of this Bill of Sale and understand ihere is no
guaran[ee or wamnty,expressed or implied, wi[h respec[lo [he above-�zscribed property.It is
also undersrood that[he above-sta[ed vehicle is soid in "as is" condi[ion. .
Dated this �_( day of ,qU ,�00 �S.
s.ne.xam�: lo.�mee�2v1�tU2 5GR16uo�1 eur•.wme: 1r.�mea) Lqw�2'e^�[t C�fJ7A4l��-
II 59 �e'YS �eJa 4�'�+�fL. N' 9 ��
otlaeYs ucenu e state: ({� oHver's License a: s�'te:
sve« ae ss� �36 �3e�m U'-� s�aaarcss: (,oyY� �A2�.LS(F Y`�
ry. �.�Ol}F naxr `'N zm: fl�� eb' �F NNwLC33J� sra�e: L R__zir 7Q�
p��w. rnoMr. "st7 — 7L6 � d.�fr`!
LAST WILL AND TESTAMENT OF
ARTHUR C. SGRIGNOLI
I, AR7HUR G SGRIGNOLI, of CUMBERLAND County, Pennsylvania, being of legal age
and ot sound and disposing mind and memory, and not ading under duress, menace, fraud, or
undue influence of any person, do make, declare and publish ihis lo be my Will and hereby
revoke any Will or Codicil I may have made.
I. Marriage and Children
I was married to ARLENE F. SGRIGNOLI, now deceased, and have ihe following aduA
children from said marriage�
Name: ROBIN A. SOKOLOSKI Date of Birth� NOVEMBER 3, 1961
Name: LINDA M. ROLLIN Date of Birth: NOVEMBER 27, 1962
Name: ANITA R. SGRIGNOLI Date of Birth: OCTOBER 28, 1963
Name: LUCY E. SGRIGNOLI Date of Birth: FEBRUARY '12, 1965
Name: PAULA J. MICHAELS Date of Birth: NOVEMBER 26, '1966
II. Debts and Expenses
I direct my Personal Representative to pay all costs and expenses of my last illness and
funeral expenses. I further direct my Personal Representative to pay all of my just debts that
may be allowed against my estate.
III. Homestead or Primary Residence
I Will all my interest in my homestead or pnmary residence, if I own a homestead or
primary residence on ihe date of my death that passes through this Will, to my children, ROBIN
A. SOKOLOSKI, LINDA M. ROLLIN, ANITA R. SGRIGNOLI, WCY E. SGRIGNOLI, AND
PAULA J. MICHAELS. If I have and name more than one child, ihey are to receive the property,
equally, per stirpes.
IV. All Remaining Property — Residuary Clause
I will all Ihe rest of my property and estate of every kind and characfer to My Children,
ROBIN A. SOKOLOSKI, LINDA M. ROLLIN, ANITA R. SGRIGNOLI, LUCY E. SGRIGNOLI,
AND PAULA J. MICHAELS. Ii I have and name more than one child, they are lo receive ihe
property, equally, per stirpes.
V. Appointment of Personal Representative, Executor or Executrix
I hereby appoint WCY E. SGRIGNOLI, as Personal Representative of my estate and
this Will. In the event my Personal Representative shall predecease me, or, for any reason,
shall fail to qualify or cease to act as my Personal Representative, then I hereby appoint ROBW
A. SOKOLOSKI to serve as successor Personal Representative of my estate and Will.
i }/�7
Signed by Tes�atorlTesta�rix�. G � '""� - 1 -
VI. Powers of Personal Representative, Executor and Executrix
I direct that my Personai Representative shall have broad discretion in the adminisiration
of my Estate, without Ihe necessity of Court approval. I grant unto my Personal Representalive,
all powers that are allowed to be exercised by Personal Representatives by the laws of the
State of Pennsylvania
VII. Misc. Provisions
1) I desire a Roman Catholic Puneral mass.
2) I do NOT wish to be cremated.
3) I desire to be buried in the RESURRECTION cemetery in DAUPHIN County,
PENNSYLVANIA.
I, ARTHUR C. SGRIGNOLI, havir�g signed this Will in �he presence of
�-cw�cn�a Qnllmvi�2� and Rr�r Sarranoli whoattested
it at my request' on this the _�3= day L Pr , 20�� at
?�3,�3 M�� Ennla � PA 1��25 (address), declare
this to be my Last Will and Testament.
/-/ � � y(/
� w���i_w_=�r C 1lADMfT`-�
ARTHUR C. SGRIG OL�—
Testator/Testatrix
The above and toregoing Will of ARTHUR C. SGRIGNOLI was declared by ARTHUR C.
SGRIGNOLI in our view and presence lo be his Will and was signed and subscribed by ihe said
ARTHUR C. SGRIGNOLI in our view and presence and at his request and in the view and
presence of ARTHUR C. SGRIGNOLI and in ihe view and presence of each other, we, the
undersigned, witnessed anJ� attested the due execution of the Will of ARTHUR C. SGRIGNOLI
on this the�ay of �-Y-�O b.'f, 20�.
_-f'�.1✓� a ,��/�e�l� V 1 � G • iN'9�u,4i✓W�C.i
Witness�ature Witness Signatur ��-
Print Name: ��,r-,ic f' DD/�1troEye�Print Name: oo�6'E,(� �. .SGi�/CiNoLI
Address: .,�¢3 inA(',g,P(L An Address: / E
,�'iv,T l,o ,�„=,<�,. ENOLA ,.�A. / o�` S
City, State, Zip: City, State,
��; >> � Y�.,-,�s�— z�P: �7��1 - '73� -/a �9
Phone: Phone: _.
Signetl by Testator/Testatrix� - 2 -
Commonwealth of Pennsylvania
County of CUMBERLAND
I I, ARTHUR C. SGRIGNOLI, ihe testatodtestatrix whose name is signed to ihe atlached
or foregoing insirument, having been duly qualified according to law, do hereby acknowledge
that I signed and executed the insirument as my Las� Will; and ihat I signed it willingly and as
my free and voluntary act for the purposes therein expressed.
Sworn to or affirme�nd acknowledged before me by ARTHUR C. SGRIGNOLi, the
teslatodtestatrix, this a3_ day of Qc f1�� r , 20
COMMONVJEnITH OF PENNSYLVANIA � e ' ,l ,
�0 a et 9EnL �+"��/L
Damel J o .r.,�c ary Poblic Testator(festa�rix �
Silver 5 j .b - d Counry
My co n _ u- �n aa zme Typed Name ARTHUR C. SGRIGNOLI
Mexate, iexns�r�ra;�.< ti:scl:.:mx or nou+ei[s
Signature of officer or attomey �
Seal and oHicial capacity of officer
or state of admission of attorney /' �'
Commonwealth of Pennsylvania
County of CUMBERLAND
We, LQVJ�P,(ILf. �ulln�evv� and �'craarr F. ��;ceno�� ,
the wiinesses whose names are sig ed to ihe attached o�fore ing insirument- ei� ng duly
qualified acwrding to law, do depose and say that we were present and saw the testator/
testatrix sign and execute the instrument as his or her Last Will; ihat the testatodtestatrix signed
willingly and executed it as his or her free and voluntary act for the purposes therein expressed;
� that each subscribing witness in the hearing and sight of ihe testatodtestatrix signed ihe will as
a witness; antl that to the best of our knowledge the testatodtestatrix was at that time 18 or
more years of age, of sound mind, and under no consiraint or undue influence.
Swom to or affirmed and subscribed before me by �W�2/ICe UZ��/✓IP�9e/�
and Qoc��/` E. Sar��/; , witnesses, this ��day of Q^}n,_P/' ,
20�_.� �
Witness�„r�o.r,�„ rinOD ��
Witness
coMmor�wen�rN or veHesrwaNin Signature of oHicer or attomey � �
NO1AF'iAl S AL
oa Ei �: �co � . �o� �v P�nr� Seal and official capacity of ofticer
s� <F , � ���e,�a �o��� p
uy =:_u.- M1 a�n;o,zeie or state of admission of attomey NO;fAP _
VH'.'eFt �-_rn.�.v.�n.n�__..�..I'V ��IIO1dPiEi
20 Pa.CSA. § 3132 1 Pennsylvania Self Authenticating Aftidavit
OMB No. 2502-0265
<P�:pl�lll„':-.
=,. �unu�,,:; A. Settlement Statement (HUD-1)
B.T eofLoan
I. ❑ FHA 2. O RHS 3. O Conv Unins 4 Fiie Number 'I.Loan Numbcr 8.Mortgage Ins Case Nnmber
4. ❑VA 5. OO Convins. 6. �SelicrFin ISJ-001]36 ISOT20
'/. 0 CasL Seic.
C.No�r. This(ormisfumishedlogiwyoua9ammrntofacWalselllemen�cosls. Amountspaidmandbylhesd�lementagrntareshowrt Ilemsmarked
' .o.c. "wcrc aia aulsitic Ihc closin :�Lc are sLown Imre for infoimationel u oses and arc wl included in @e�olals.
D.Name&Addrcss of Borro�rer E.Name&Address o(Scllcr F.Namc&Address of Lenaer
OonnaM.Cvans TheCs�ahofArthivC.Sgrignoli Peoples0ank,ACaJorusVnlleyCo.
JJGO Vnllcy RJ No Lucy Sgrignoli 105 Lcader Hcighis RJ.
Cnola,PA V025 IOTi(fanyDrivc York,PA 19d05
Carlisli PA 1]015
G.Propmy Locr�ion H.Sa�lemrnt Agent Name i.Seulemrnt Dm<
� T.A.ofCemral PA,LLC SRBROIS
2E30 6rim 6nnq Enola,PA,I0035,IlampJcn 570 N.Lockrvillmv Avenuc PunQ 8I28ROI5
Tmvnship Harrisbur�,PA 1'/112
]1�-034d120
UnJenvri�ren 6v:first Amcriwn�NJ/PA
ria��ors�wemrn�
Keller W illixms of Cenhxl PA Extt
530 N.Lockwillorv Ave.
Flarrisbur PA 10112
J.Summnry of 6orrmver's Transaction K.Summxry of Sellcr's Trnnsxclion
IOO.Grose Amonnt Due from 6orrmvar 40U.Grose Amonnt Duc m Seller
101. Conlrac[salcspricc 590,0OO.OU COI. ConVactsalcsprice 590,000.00
102. Personal OmO�hY a02. Pcrsonal propcny
103. Seuicmentcharges�obortowcr 56}95.19 � 40J.
104. 404.
105. Held by lendcr forConnruaion Draw 550,000.00 � 605.
Adjns�menu for items pxid by seller in aJvnna AJjna�mcnb for i�ems paid by seller in nJvnntt
IOfi. 3015County& OS129/IS@m13/31/IS Slxa.]0 ' 406. 2015CouNy& 08R9ASIhml2ql/IS 5120.1U
Tmmshi Tozes Tmvnshi Taxu
10). 2015-16SchoolTaca �829IIS�hru06130/16 51,0]4]6 401. 2�15-165choolTaces 0829/IS�hru06/30/16 51,0]4.96
109. TmshdrdQv 0829/IStLm09I10/IS SIfi.GB 408. TruhdraQtr 0829/ISthm09/30/IS 516.68
109. a09.
110. 410.
111. 411.
112. 4¢.
113. 413.
114. 414.
I I5. <I S
116 416.
120.GrossAmo�mtDneFromBorrmver S1/1.601.J3 d20. GrossAmouniDuetoSeller 591,i13.1G
200.Amounis Pxid 6y Or in 6ehnlf Of Oorrmver 500.ReJuclions in Amount Due ro Seller
201. Deposi[oreamestmoney 52,000.�0 501. Excessde0osil(secinsvmtions)
ID2. Principelnmountofnewloan(s) SU],000.00 SW. SeUlcmentcLergesmseller(Iinc1400) 511,930.00
203. Exislingloan(s)mkensubjatto 503. Exis[inglonn(s)taAensubjen�o
204. 504. Payo(foffrstmort6agcloan
205. 505. Payoffofsecondmor�gageloan
20fl 506.
10]. 50I. (EMDS2,OOODisbursedazProcceds7
208. 508.
2W. 509.
A�justments for items nnpaid by sellcr AJjnslmenis far ihms unpxid by seller
210. 2015 Caunty& 51�. 3015 Counry&
Tawnshi Ta<es Townshi Ta<es
LL 2015-IbSchoolTiues 511. 2015-165choolTaxes
212. TrashdrdQu 512. TmshdrdQtr
213 513.
Z�q, 510.
215. 515.
31G. 516.
21 Z 51].
Z�g, SIB.
219. 519.
320.Ta�xlPniJ6 /For6orrmver SU5,000.00 520.TotnlReJuelionAmountDueSeller SI1,9J0.00
300.CasM1 A�Setllcment FromRo Borrmver 600.Gsh M Setllement To/From Shcer
IOLGmssAmountduefiombortowu(Iine120) SIJ],60].33 601.GrossAmoun�duetosellerQine420) 591,'l12.Id
303.Lus amoun�s Oeid bylfor bortower(Iine 220) SIJ5,000.00 602.Less reductions in ain�.due SellerQine 520) 311,930.00
JOl.Cxsh From 6orro�vcr 512.60Z13 G03.Cxsh To Sclicr 599.182.iC
-I lie Public ReOutling 13nrden fort0is colkaion af Inlormmion is<s�inmmd nt li minmes per resl����se lur collwiing.rtv win5�AnJ rc0orting�he dx�n.This agency
may nnt coilwi ihis inlDrtnalinn,and yon nrc nol rc�uimA m caniplcic Ihis Itmm,unicss ii Jisplays a currcntly vuli0 OMB cantmi nnmbcc No contidcniiality is
nssnreA:�his diselomrc is mmidamry.TLis is dsigncJ io prnvidc ihc pnrtics io n R[SPA rovcmd vrnsaeiion wiih infoemation Jnring�Lc sculcmcm proccss.
POC(�)-PuitlOuisideofClosingbyBormwer. POC(5)-PaidOu¢idcofClosingbySel�er. POC(L)-PaitlOutsideofClosin6�YLend<r.
Previous editions are obsolete Page I of 5 xuo-�
L. Setllemenf Chnrgcs
000. Towl Renl Esdte Bmker Fees SJ,500.00 Paid Prom Paid From
Division ofCommission�line]00)as follows: Bortomcr's ScOcfs
]OL 52,250.00 m Kcllcr Willinme ofCenvxl PA Exs� Funds at Funds at
]02. 52.250.00 m KeIlerWilliamsofCeNraIPAEms� Sc�Ocment Seulemem
]03. Commieeion PaiJ x�SetOemmt 50.00 Sd,500.00
JOa. AdditionalCommission m KdlarWillinmsofCenvnlPALast 52]5.00
]O5. AtldilionalCommission lo Ktller�Yilliamsa(CcnM1flIPAEnst 52]5.00 �
800. Ileme Pxyable in Conn¢tion rviM Lonn
8�1. Onrori inationchar e nae.00 (fromG6EMq
8@. Yourcreditorchar e oints fanhes ecificmhchosen So.00 (homCFEM27
803. Vourxtljustedorigimlionclwrges �p ��oplei6ank,ACo�nrvs (fmmGFEA) S]J8.00
Vallv Co.
8�4. Appraisxl Fre �o M1�+�k Httkmxn RL (fmm GFE%3) 5]15.00
A rTisen
SOS. Cre4itre0on m hlerthnnlsCreJit6ureau � (fromGFEp3) SII.43
SOfi. Taxservicc �o ��oplcs6nnk,ACoJnrns (RomGFEpI) 595.00
Valle Ca.
SOZ Floodccrtification to Laretn (RoinGPEMI7 513.00
S�B. InsO<ctionFce 10 pAra{scrsmanRL (GomGFEMJ) 5625.00 -
900. Ircms ReqnireJ by LenJer To Oc PaiJ In AJvan<c
90L Daiiyinmres�chnrgesfmm �o QEI51l9Glday (RoinGPL%107
902. Motl a elnsirzancePremiumfor monlhs to IfmmGFEq3)
903. Homcowncrs insnrance for I years �o Colmville Muaixl Insnranve roqa�vee.00 (from GFE MI p
1000.Rceervc Deposi�eJ With LenJcr
IOOIJnitialDeposit(oryourescro.vncconnl (fmmGfEX9) 51,522.36
1002.Homcownchinsurana 9 monthsQn 545.50 permonth 5589.50
1003.Mortea°einsurance 1 momLsQ 959.85 pcnnonth 559.R5
1004.City OmOcrty laces momhs� per month
IOOS.Conn�yproperty�axes 2 monOu �Q 529.39 Oermon�L 558]0
1006.AsscssmentTaxes mon�hsr�,i> permontL
100].Schooipropeny�a�cs 9 months rQQ 9I0G]8 Ocrmon�L 5961.02
1008.HOA Fecs momhs �Q per monlh
1009- Othertaxes 0 momhs n
1010. Otherlaxcs 0 monlhs r(�i�
101I.Aggrcgam Atljus�mrnt -SIJ6.85
1100. Titic CM1xr <s
i 101.Ti�le servitts and Icndcr's title insurance m T.A.of Cenlml PA,LLC Rmm GFE N4) 51,540.00
1142.Sel�lcmcntorclosinglee �o T.A.ofCenrcnlPA,
LLC
II�J.Own<htitleinmrance �o T.A.ofCemraIPA,LLC (GomGFEMS) 51065U
I 104.Lendcrs title insvance ro T.A.of Canvnl PA,LLC SI,OG5.00
IIOS.Lendcrs�itle0olicyiiinitS 5133,000.00/EJ25.00.
1106.Onner'stiticpolirylimii5 513J,000.00/SI.VI.50
I10].Agrnfsportionof�M1cmmltitleinsmm�tt �o T.A.ofCentraIPA,LLC 51dG5Ji
remium
IIOS.Undenvri�cr'sportionof�herowl�itic �a PirstAmericxn-NJ/PA 5370]7
1109. TY�°oflnsurana2ate'CnhancedPolicy �o
Rr�e
1110. 2cimbursementforTazecnifca�ion �o T.A.afCentrxIPA,LLC 510.00
II11. SeIlcrNo�aryFee �o A64yWenJel 530.00
1112. PA Short Form Policy Prcmium m T.A.of Central PA,LLC SI00.00
III}. PA900Envimmmemal-Res m T.A.ofCentralPA,LLC 550.oa
1114. ClosingProlttlionLctmr ro T.A.ofCmVnIPh1,6C 5125.00
I I I5. PA)t0 Variable Ra�e �o T.A.ofC<nUal PA,LLC 50.00
1116. Decd Prepxn�ion Fee �o Lmv Offi¢of Ln�hcr G � 5125.00
Mils a�v.Jr.
IIIZ PASm�elnheri�anceTaxGscrow �o TitleAllixna-Lscrmv 5G,0'I5.00
A ent
I I I8. Escrow Hold Fee m Titic Absvnct E25.00
1200. Gwernmen[RecorJingendTrxnsferChvges
1201. Govcmmcmrecordingcimrgcs (fmmGFEF]) E224.00
R02. OeeA581.00'.Motlgage5119.00,Release50.00 �oCnmberinnJConnty
RecoNcr of Ueeds
1203. TransfcrtncCs (RomGFEMe) 5900.00 '
Dccd5900.00'.Mongagc �oCnmbcdxn0
120a. City/CaunrytaJsmmps E0.00 CounryRcvorJmof 5900.00
Dads
DeedS900.00:Mortgage �oCumberlanJ
1205. Slalcladstemps 50.00 CountyRttarJerof SOAU
DeeJs
I206. WaiverlS�ipofLienSFilingFce �o CumberlanJCoimty 524A�((m�nGfEp])
PmtM1onomr
1300. AdJitianxlSet�IementChTrges
Previous editions are obsole[e Page 2 of 5 HUD-1
FileNo. 154-00122G
IJ01. Reqnircd scrviccsyoucansM1opfor (RomGFENfi)
1302. 2015Counry&TmpTaecs �o MiehxdLnngan,Tnx rons�nez.�e
Collttlor
1303. 2015-IbSchoolTexes lo MiaM1nelLnngan,Tax roqsi
CoOecmr s�.xei.o�
1304. TmshdrdQv �o HampdenTmvmhip roe�s�ve.eo
IJ00 T I S 1 Ch rQ ( I' 103 S Y n J nnJ 501 SeRon K) 5639,519 SI I 930.00
POC(0)-PaidOmsidcofClosingbyBortower. POC(5)-PaidOutsitleofClosingbyStllec POC(y-PaidOutsideofClosingbyLendcr.
Previous edi[ions are obsolete Pa�e 3 of 5 nuD-�
comna���so�orcoou ra��e¢:cm,�i�ccrr�xnJ FlI!D-1 ChnrCcs GooJ Faith Eslimnic IIUD-1
Charges Thal Gnmt Incrcnsc IIUD-1 Linc Numbcr
OuroriRinationchmsc 801 5]d8.00 S]48.00
Yourcreditorcharee(poinLs)Porthespecificrntechosen 802 50.00 50.00
Yonr adjus�ed originnlion charges 803 3008.00 5]08.00
Trans(ermxes 1203 5900.00 5900.00
Char:cs That in To[al Cannot Inerexse More Thxn 10% Good Railh 6stimate HUD-1
Governmrnl rccorAing charges 1201 5235.00 522�.00
Appmisal Pcc 804 SJ00.00 S3]5.00
Geditreport 805 530.08 SII.J3
Tam seivim 806 S95.00 595.00
Plood certi�calion 80] 513.00 513.00
Inspection Pee 808 5625.00 S63>.00
Tolai 51,398.08 51,343.43
lnercasc bchvicen GfL and HUD-0 CharFcs -SSJ.GS or -79%
Char�csTLa[CanCbanF� GooJPni[hEslimxic IiUD-1
Inilialdcpositforyourescrm.vu¢ount 1001 SI,G76.50 51,52226
Oaily inmresl charges 901 515.3396
d 50.00 50.00
Vlomcowncr's insumnw 903 5315.00 SOR6.00
Titic scrviccs and lendcr's lillc insumnce I 101 51,515.00 SI,500.00
Owncrstiticinsurancc I103 535.00 5106.50
Loan Terms
ro�����eTi io,�,��,o��oi�: s�aa,oao.00
vw��mn�i��,�,�, 30 years
Your initi.I inicrest raic is 4.125%
Your initial momhly ninount owcd for principal,imeresL.nd any martgngc S]0443 includcs
insurana is OO Principol
� Inmrcsl
O Mon a e Insurance
Cnn your inmrest mm rise'? ❑ No. OO Yes,it cnn rise io a masimum of 10.125%.The fm change will
be on 3/I I2019 and can change again every 12 months aller 3/IR019.Gvep�
change dale.your inlcres�ram can increase or decrease by 2 0.Over Ihe li(e
of thc loan.your iNerest inte is guaranlccA lo ncver be lower timn 4.125%or
hi her than 10.125%.
Evcn ifyou muke paymenis on time.can your loan balance rise? 0 No.� Ycs,il can risc lo a mnximum of50.00
Even iFynu makc paymenis on�ime,can your monthly � No.OO Yc;Ihe lirst increase cnn be on 4/12019 and the mumhly
amount owed for principal,imercst,anA monga6c insuranee rise? amount owed can rise w$854.8]The mmimum it can e�¢r rise m is
%I.IR3.]9
Dces your loan hovc n prepnyment penalry? � Nn.p Vcs,your maximum OreO+Ymcnl pcnal�y is 50.00
Docs our loan havc n balloon n ment? OO Na� Ves, ou have a balloon a mcnt of 80A�duc in 0 cars on
Total monthly nmount owed including escro.a accounl paymrnis ❑ You dn nnt have a monthly escrow poyment(or items,such as pro0crty
m�es and homeowner's insurance.Yon musl paY�hese items directly
yonrself.
0 Vou have an additional monthty escrow paymrnt of5201 b5
thn resups in a ioml initial mon�hly amount owcd af 590608.This includes
principal,interat.any mongage insumnce anA any items checlaeA below:
pp Property taxn 0 Homeo�mer's Insurance
❑ Plood insunnce 0 Sd�ool Tases
❑ ❑
Nom: 11'you havc any questions nbout the Seuicmcm Chnrges nnA 6oun Terms lis¢d on this form.piease cnntam your lender.
Previous editions are obsolece Page 4 of 5 xUu-i
PileNo. 154-001226
1 have carefulty reviewed Ihe HUD-I Settlemem Stemment end�o the besl o(my knowlcdge anE bclief,it is a ime and atturam stacemrnt of all receipls and
��—�lisbursemrnts maac on my accounror by mc in[his transaclion 1 fnnher ccrtify�hat I Lnve received a complehd copy ofpa8cs 1,2 an�3 oflhis HUD-I Se�tlement
Smm�l
� �. , 'a;��a�-- x�.-�f.Sx.;r..,,.c�:, Exetutri x
onna By:WcyE.Sgriqnoli,Exwtti o� rthe�teofAtlhurC.Sgrignoli
SETfLEMENT AGENT CERTIFICATION
The HUD-I Seulemcn�Slahinem which 1 heve prepared is a tmc and acwmk
acconn�of ILis tmnsaction. I havc caused tLc funas�o bc Eisburscd in
accoedana i�h this stxmm�� ry
A Z� "�� S
S rn� gcn Dme
W nrning:It is e crimc m Anowingly make false marements m the Uni�ed
Smtesonthisorenyo�Lersimilarfortn. Penalliesu0o��onvictioncan
includc a fine and im0�isonmrni. For de�aiis see:Titic IS U.S.Code Scclimi
1001 nnJ Seclion 1010.
Previous editions are obsolete Page 5 of 5 xUu-i