HomeMy WebLinkAbout08-31-15 (2) Pennsylvania
150561860 , 4W46473.000
DEPARRAEN70F REVENUE EX(03-14)(TP)
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 ] I 2161
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08102014 09191945
Decedent's Last Name Suffix Decedent's First Name MI
RUSSELL TERRY L
(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
IN1. Original Return r 2. Supplemental Return F13. Remainder Return(date of death
prior to 12-13-82)
ED4. Agriculture 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 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
0 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
THOMAS R KEHLER
First Line of Address
457 ELDER TRIAL
Second Line of Address
City or Post Office State ZIP Code
NEW CUMBERLAND PA 17070
Correspondent's email address:
REGISTER OF WILLS USE ONLY
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY
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1505618601 1505618601 J
J 150561860 , 4W46473.000
pennsylvania
DERPRRAENT OF REVENUE Fx(03-14)(TP)
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 j ( I 2161
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08102014 09191945
Decedent's Last Name Suffix Decedent's First Name MI
RUSSELL TERRY L
(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 F7 2. Supplemental Return F7 3. Remainder Return(date of death
prior to 12-13-82)
EJ4. Agriculture 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 0 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 El 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
THOMAS R KEHLER
First Line of Address
457 ELDER TRIAL
Second Line of Address
City or Post Office State ZIP Code
NEW CUMBERLAND PA 17070
Correspondent's email address:
REGISTER OF WILLS USE ONLY
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY
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I(IIIII IIIII VIII I'I'I IIIII IIIII IIIII IIIII IIIII IIIII(III(III
1505618601 1505618601
J 1505618619
REV-1500 EX(TP)
Decedent's Social Security Number
Decedent's NameTERRY L RUSSEL
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 142500. 00
2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . . 2. 0. 00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C). . . . 3. 0. 00
4. Mortgages and Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . 4. 0, 00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E). . . . . 5. 30166. 77
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested. . . . . 6. 0. 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. . . . . .7. 0. 00
8. Total Gross Assets (total Lines 1 through 7). . . . . . . . . . . . . . . . . . . 8. 172666. 77
9. Funeral Expenses and Administrative Costs (Schedule H). . . . . . . . . . . . . 9. 20892. 73
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1) . . , . . , . . . 10. 38503. 53
11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. 59396. 26
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . 12. 113270. 51
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . 13. 0. 00
14. Net Value Subject to Tax(Line 12 minus Line 13). . . . . . . . . . . . . . . 14. 113270. 51
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.o_ 0. 00 15. 0. 00
16. Amount of Line 14 taxable O. OO
at lineal rate X.0-_- 0. 00 16.
17• Amount of Line 14 taxable
at sibling rate x.12 56635. 26 17. 6796. 23
18. Amount of Line 14 taxable
at collateral rate X.15 56635. 25 18. 8495. 29
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 15291. 52
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the person responsible for filling the return is based on all information of which preparer has
any knowledge.
SIGNATU SON R OR FILI �N DATE
08/26/2015
ADDRESS
457 ELDE_4 TRIAL, NEW CUMBERLAND, PA 17070
SIGNATU ER ERSON RESPONSIBLE FOR FILING THE RETURN DATE
08/26/2015
ADDR S
5006 E TRINDLE RD.., MECHANICSBURG, PA 17050
11 It Side 2
1505618619
4W4648 5.000
REV-1500 EX(TP) Page 3 File Number 2014-00901
Decedent's Complete Address:
DECEDENTS NAME
ESTATE OF TERRY L RUSSELL
STREET ADDRESS
457 ELDER TRIAL
CITY STATE ZIP
NEW CUMBERLAND PA 17070
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 15292.
2. Credits/Payments
A.Prior Payments 0
B.Discount 0.
(See instructions.) Total Credits(A+B) (2) 0,
3. Interest
(3) 0.
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4) 0.
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 15292.
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 . . . . . . . . . . . . . . . . . . . . . . . . .❑ FN
b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . .❑ FN
c. retain a reversionary interest , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,❑ 13
d. receive the promise for life of either payments,benefits or care? , , , , , , , , , , , , , , , , , , ,❑ FN
2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?. . . . . . . . . . . . . . . . . .❑ FN
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?. .❑ Pq
4. Did decedent own an individual retirement account, annuity, or other non-probate property,which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FX❑
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 Jan. 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.59116 (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.591 16(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.
4w4671 2.000
REV-,502 EX+(12-12) SCHEDULE A
pennsylvania
DEPARTMEN QF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
TERRY L RUSSELL 2114-0901
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.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
I. PERSONAL RESIDENCE — 3100 MORNINGSIDE DRIVE, CAMP HILL, 142,500.00
CUNPERLAND COUNTY, PENNSYLVANIA
TOTAL (Also enter on Line 1,Recapitulation.) S 142, 500.00
4W4695 1.000 If more space is needed, use additional sheets of paper of the same size.
REV-1508 EX+(08-12)
Pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX
RESIDENTDECEDENTTURN PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
TERRY L RUSSELL 2114-0901
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property ointl owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1. METRO BAMK — CHECKING ACCOUNT # 0032032534 3,737.47
2. MEMBERS 1ST FEDERAL CREDIT UNION — CHECKING ACCOUNT # XXXXXXX934 11, 969.03
3. MEMBERS 1ST FEDERAL CREDIT UNION — SAVINGS # XXXXXXX934 5.09
4 MEMBERS 1ST FEDERAL CREDIT UNION — MONEY MANAGEMENT #XXXXXXX934 7, 047.81
5. MEMBERS 1ST FEDERAL CREDIT UNION — M4 MONTH CD 3XXXXXXX934 3, 128.31
6. SALE OF 2201 NISSAN ALMA 2,000.00
7. BURIAL AWARD 300.00
8. VERIZON REFUND 31.49
9. HOLY SPIRIT HOSPITAL REFUND 17.19
10. ESCROW REFUND 374.74
11. PENN TREATY INSURANCE REFUND 674.63
12. REAL ESTATE TAX REFUND 881.01
TOTAL(Also enter on line 5,Recapitulation) $ 30, 166.77
4W48AD 1.000 If more space is needed,use additional sheets of paper of the same size. .
REV-1511 EX+(0&13) SCHEDULE M
pennsylvania
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
TERRY L RUSSELL 2014-00901
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
�. HOOVER BOYER 552. 95
2. WAKE EXPENSE 510.43
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 3, 680.43.
Name(s)of Personal Representative(s)PHOMAS R KEHLER
Street Address 457 ELDER TRIAL
City NEW CUMBERLAND State PA ZIP 17070
Year(s)Commission Paid: 2015
2. Attorney Fees: 1,250.00
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: 370.50
5. Accountant Fees: 5 5 0.0 0
6. Tax Return Preparer Fees:
7. RESIDENCE - PA AMERICAN WATER 281.34
8. RESIDENCE - PPL 293.57
9. RESIDENCE - REAL ESTATE TAX 1, 309.35
10. REFUND AUGUST 2014 DEPT OF VETERN AFFAIRS 577.54
11. BANK FEES 9.00
12. RESIDENCE - LAWN CARE 210.00
13. RESIDENCE - RADON TESTING 950.00
13. RESIDENCE - BASEMENT WINDOWS 250.00
14 . SALE OF RESIDENCE - BROKER FEES 8, 550.00
15. SALE OF RESIDENCE - TRANSFER TAX 1, 425.00
16. RESIDENCE - SEWER AND TRASH FEES 77. 62
17. SALE OF RESIDENSE - TITLE SERVICES 45.00
TOTAL(Also enter on Line 9,Recapitulation) $ 20, 892.73
4W46AG 1.000 If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
TERRY L RUSSELL 2114-0901
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. CHAMPION MORTGAGE #107688 ON PERSONAL RESIDENCE 38, 500.00
2. CHASE CREDIT CARD 3.53
TOTAL(Also enter on Line 10,Recapitulation) $ 38,503.53
4w46AH 1.000 If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10) SCHEDULE J
pennsylvania
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF, FILE NUMBER:
TERRY L RUSSELL 2114-0901
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1, NANCY R KEHLER, 5229 WINDSOR BLVD, MECHANISCBURG, PA 17055 SISTER 25.00%
1.
2, SUSAN R. THOMAS, 2357 .E SHREWSBURG RUN, COLLIERVILLE, VA 38calSTER 25.00%
3, THOMAS KEHLER, 457 ELDER TRIAL, NEW CUMBERLAND, PA 17070 NEPHEW 5.00%
4. NANETTE KEHLER, 702 S 24TH ST. HARRISBURG, PA 17104 NIECE 5.00%
5. JOHN KEHLER, 50 FIELDING WAY, ETTERS, PA 17339 NEPHEW 5.OQ%
7. MELISSA BROWN, 4165 ROBINSON CROSSING, OLIVE BRANCH, MS 3 6NIECE 5.00%
B. MEREDITH DUERBECK. 3803 PUMPKIN SEED LANE, GLEN ALLEN, VA 2191ECE 5.QO%
9. MADELINE KEHLER, 457 ELDER TRAIL, NEW CUMBERLAND, PA 1707. GRAND—NIECE 4.17%
10, MICHOLAS KEHLER, 457 ELDER TRAIL, NEW CUMBERLAND, PA 1707C GRAND—NEPHEW 4.17%
11. HUDSON BROWN. 4165 ROBINSON CROSSING, OLIVE BRANCH, MS 38 5CRAND—NEPHEW 4 .17%
12. HARRISON BROWN, 4165 ROBINSON CROSSING, OLIVE BRANCH, MS 8(GRAND—NEPHEW 4 .17%
13. GAGE DUERBECK, 3803 PUMPKIN SEED LAND, GLEN ALLEN, VA 230 o GRAND—NEPHEW 4.16%
14. CHANDLER DUERBECK, 3803 PUMPKIN SEED LANE, GLEN ALLEN, VA 231911,ND NEPHEW 4 .16%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
4W46AI 1.000 - If more space is needed, use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
TERRY L. RUSSELL
I, TERRY L. RUSSELL, having my legal residence at 3100 Morningside Drive, Camp Hill,
Cumberland County, Pennsylvania, 17011, do hereby declare this to be my Last Will and Testament,
revoking all other Wills and Codicils heretofore made by me.
I declare that I am single and that I have two sisters, Nancy R. Kehler and Susan R. Thomas and
that all references to my sisters are to them. I further declare that I have five (5) nieces and nephews,
Nanette R. Kehler, John R. Kehler, Thomas R. Kehler, Melissa T. Brown, and Meredith T. Duribeck and
that all references to my nieces and nephews are to them.
ITEM ONE: I direct that all my valid debts and the expenses of my last illness and funeral
be paid from my estate as soon as practicable after my death.
ITEM TWO: I give and bequeath all of my tangible personal property to my residuary heirs
under Item Four, below as follows:
A. All items of tangible personal property shall be inventoried and valued at a fair market value.
B. I may leave a Memorandum listing some of the items of my tangible personal property which
I wish certain persons to have and request that my wishes as set forth in the memorandum be
observed by my Personal Representative. Any items of tangible personal property not so
designated shall be divided and distributed among my residuary heirs as follows:
1. Each of my heirs may select one item, in rotation, in order determined by lot, until such
time at which the items chosen by each heir reach such heir's proportionate share of the
total value of my estate, or until such time as each heir wishes to make no further
selections.
1
2. Any items not selected shall be sold and the net proceeds added to the residue of my
estate.
3. To the extent my heirs are unable to agree, the decision as to what may constitute "one
item"for purposes of this selection shall be made by my Personal Representative(s).
4. Any disputes concerning this method of allocation shall be resolved by my Personal
Representative(s) in my Personal Representative's sole discretion.
5. To the extent my Personal Representative is unable to resolve a dispute among two or
more of my heirs concerning the in-kind distribution of any of my personal property, I
direct my Personal Representative to sell the disputed property and the net proceeds
there from shall be added to the residue of my estate.
ITEM THREE: I direct that any interest I may own in any real property together with the
insurance thereon shall pass with the residue of my estate. My Personal Representative may either
distribute any real property at its then fair market value to one or more of my residuary heirs under and
in accordance with Item Four below, or may sell any such real property and the net proceeds there from
shall be added to the residue of my estate.
ITEM FOUR: I give, bequeath and devise all the residue of my estate, of whatsoever nature
and wheresoever situate,to my beneficiaries as follows:
1. To my sister, NANCY R. KEHLER, I give TWENTY FIVE PERCENT (25%) of the residue of my
estate. In the event my sister fails to survive me, this gift shall lapse and I give her share to her then-
living issue in equal shares per stirpes. In the event my sister has no then-living issue, I give her share in
equal shares per stirpes to my remaining beneficiaries under this Item Four.
2. To my sister, SUSAN R. THOMAS, I give TWENTY FIVE PERCENT (25%) of the residue of my
estate. In the event my sister fails to survive me, this gift shall lapse and I give her share to her then-
living issue in equal shares per stirpes. In the event my sister has no then-living issue, I give her share in
equal shares per stirpes to my remaining beneficiaries under this Item Four.
3. To my nieces and nephews, NANETTE R. KEHLER, JOHN R. KEHLER, THOMAS R. KEHLER,
MELISSA T. BROWN, AND MEREDITH T. DURIBECK, I give TWENTY FIVE PERCENT (25%)
2
of the residue of my estate in equal shares per stirpes. In the event one of my nieces and/or nephews fails
to survive me and that niece or nephew has no then-living issue, I give his or her share in equal shares
per stirpes to my remaining beneficiaries under this Item Four.
4. To my grand-nieces and grand-nephews, MADELINE KEHLER, NICHOLAS HUNTER KEHLER,
HUDSON THOMAS BROWN, HARRISON BROWN, GAGE DURIBECK, CHANDLER JANE
DURIBECK, and any grand-nieces and/or grand-nephews that are born between the time period that is
after the execution of this will and prior to my death, I give TWENTY FIVE PERCENT (25%) of the
residue of my estate in equal shares per stirpes. In the event one of my grand-nieces and/or grand-
nephews fails to survive me and that grand-niece or grand-nephew has no then-living issue, I give his or
her share in equal shares per stirpes to my remaining beneficiaries under this Item Four.
In determining the value of a beneficiary's share of my residuary estate, I direct that the value of my
residuary estate be augmented by the value of any personal and real property distributed in-kind under
Items Two and Three, above.
ITEM FIVE: Should any beneficiary of mine be under the age of twenty-five (25)years, my
Personal Representative shall hold such beneficiary's share of my estate, as Trustee, IN TRUST and
shall invest, reinvest and distribute the principal and net income of such beneficiary's share as follows:
A. Until such beneficiary attains the age of twenty-five(25)years,my Trustee, in my Trustee's sole
but reasonable discretion, may pay or apply the income and any or all of the principal of such
beneficiary's share for the health, maintenance, support and education of such beneficiary
considering all other sources of income available to such beneficiary and known to my Trustee.
Upon such beneficiary attaining the age of twenty-five (25) years, my Trustee shall distribute
the balance of the principal and accumulated income, if any, of each such beneficiary's share to
such beneficiary.
B. Should the principal of the Trust Estate, in the sole opinion of my Trustee, be or become too
small to warrant placing or continuing of such fund in trust or should its administration be or
become impractical for any other reason, my Trustee, in the exercise of their sole discretion,
may pay such share absolutely to the person maintaining such beneficiary or may place such
shares in the beneficiary's name in an interest-bearing deposit in any bank, bank and trust
3
D
company or national banking association of his choosing, payable to the beneficiary at majority,
or if said beneficiary has reached his or her majority,then to him or her directly.
C. All shares of principal and income hereby given shall be free from anticipation, assignment,
pledge or obligation of my beneficiary(s), and shall not be subject to any execution or attach-
ment.
ITEM SIX: I appoint, my nephew, THOMAS R. KEHLER, my Personal Representative
of this my Will. In the event my nephew is unable or unwilling to act or continue to act as my Personal
Representative, I appoint my sister,NANCY R. KEHLER, my Personal Representative.
ITEM SEVEN: I appoint my duly appointed Personal Representative(s) Trustee(s) of the
Trust(s) created pursuant to Item Five, above.
ITEM EIGHT: No bond shall be required of any fiduciary hereunder in any jurisdiction. No
fiduciary hereunder shall have any liability for any mistake or error of judgment made in good faith.
ITEM NINE: I authorize my Personal Representative(s) and Trustee(s) to exercise the
following powers in addition to those given by law,to be exercised in their sole discretion:
A. To retain any or all of the assets of my estate, without regard to any principle of
diversification, risk or productivity;
B. To invest in all forms of property without restriction to investments authorized for any type of
fiduciary;
C. To compromise any claim or controversy;
D. To loan money to or buy property from my estate;
E. To borrow money from any person, including any Executor or Trustee, and to mortgage or
pledge any real or personal property;
F. 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, all for such prices and
upon such terms and conditions as they deem proper;
G. To allocate receipts and expenses to principal or income or partly to each as they deem proper;
H. To repair,alter or improve any real or personal property;
I. To distribute in cash or in kind or partly in each at valuations fixed by them;
J. To keep reasonable amounts of cash in a bank uninvested if deemed advisable for the protection
of the principal;
4
K. To subscribe for or to exercise options for stocks,bonds or other investments;to join in any plan
of lease, mortgage, merger, consolidation, reorganization, foreclosure or voting trust and to
deposit securities thereunder, and to generally exercise all the rights of security holders or
employees of any corporation;
L. To register securities in the name of a nominee or in such manner that title shall pass by
delivery;
A To add to the principal of any trust created by this instrument any real or personal property
received from any person by Deed,Will or in any other manner;
N. To exercise all power, authority and discretion given by this instrument after the termination of
any trust created herein until the same is fully distributed;
O. To use their sole discretion in deciding whether stock dividends on stock they hold in trust
should be apportioned to principal or income, except stock dividends of regulated investment
companies which shall be added to principal;
P. To commingle the assets of any trust estate created by this Will in any one or more common
funds for greater convenience and flexibility;
Q. To employ agents, accountants, engineers and such other persons, professional or otherwise, as
may be necessary for the proper administration of this estate or trust and to pay their
compensation from such funds; and
R. To disclaim all or any interest in a property passing to me or my estate.
ITEM TEN: I realize that Personal Representatives are given discretion by law to make
various elections which affect the income and estate taxes payable by estates and beneficiaries, as well
as the relative shares of beneficiaries, such as taking administration expenses as deductions for either
estate or income tax purposes, selecting options for the payment of employee death benefits, electing to
take a qualified terminable interest as part of the marital deduction, selecting alternate valuation dates,
postponing the payment of taxes, filing joint income tax or gift tax returns and redeeming corporate
stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not
subject to question by, any affected persons. I rely upon my fiduciaries to take into consideration the
total income and estate taxes payable by reason of their decisions including those payable by my
survivors, and they are authorized in their discretion, but not required, to make adjustments between
income and principal as a result thereof.
ITEM ELEVEN: I direct that all estate, inheritance and other taxes in the nature thereof,
together with any interest and penalties thereon, becoming payable because of my death with respect to
the property constituting my gross estate for death tax purposes, whether or not such property passes
under this my Last Will and Testament, shall be paid from the principal of my residuary estate, and no
5
person receiving or having a beneficial interest in any such property, whether under this my Last Will
and Testament or otherwise, shall at any time be required to contribute to or refund any part thereof,
PROVIDED, however, that this direction shall not apply to the taxes on any property included in my
estate solely because of a power of appointment thereover which I possess but have not exercised or on
any qualified terminable interest or to any generation-skipping transfer taxes.
ITEM TWELVE: No gift or beneficial interest shall be subject to anticipation,
assignment,pledge, obligation, or alienation of my beneficiary(s), whether voluntary or involuntary, and
the income and principal thereof shall not be subject to any execution or attachment.
ITEM THIRTEEN: If any beneficiary, person or entity in any manner, directly or indirectly,
contests or attacks this Will or any of its provisions, or objects to the accounts or actions of my fiduciaries,
without probable cause, such beneficiary, person or entity shall pay all costs, including but not limited to
attorneys' fees, arising in connection with such contest, attack or objection incurred by my estate, such trust
or such fiduciary personally. In the event that such beneficiary, person or entity does not prevail in such
action, any share or interest in my estate or such trust which would otherwise pass to such beneficiary,
person, entity or remainderman under this Will shall be revoked and the property consisting of such share
shall be disposed of in the manner provided herein as if that contesting person or entity had predeceased me
without surviving issue.
ITEM FOURTEEN: Should any of the provisions of my Will be for any reason declared
invalid, such invalidity shall not affect any of the other provisions of this Will and all invalid provisions
shall be wholly disregarded in interpreting this Will.
ITEM FIFTEEN: This Will shall be construed, regulated and governed by and in
accordance with the laws of the Commonwealth of Pennsylvania.
6
x
SELF-PROVING AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND
We, TERRY L. RUSSELL, —S--,--9r�\M and
l lu d & the Testator and the witnesses
respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the Testator signed and executed the instrument as his
Last Will and Testament that he had signed willingly (or willingly directed another to sign for him), and
that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of
their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no
constraints or undue influence.
TERRY . RUSSELL
WITNESS
WITNESS
Subscribed, sworn to and acknowledged before me by TERRY L. RUSSELL, the Testator
and the witnesses, on January 24, 2012.
Notary Public
NOTARIAL SEAL
MARCIA M NESBIT
Notary Public
UPPER ALLEN TWP.CUMBERLAND COUNTY
My Commission Expires Jun 4.2014
8
Description of Property Beneficiary
13. 13.
14. 14.
15. 15.
16. 16.
17. 17.
18. 18.
19. 19.
20. 20.
21. 21.
22. 22.
23. 23.
24. 24.
25. 25.
Other Directions To My Family:
JUL-31-2015 FRI 02: 15 PM FAX NO, ++++++++++++++++++++ P. 03
METROMetro Bank
3801 Paxton Street
BANK Harrisburg PA 17111-1418
1-888-937-DO04
mymetrobankcorn
>01899 4503191 001 092140
TERRY L.RUSSELL
3100 MORNINGSIDE DR
-CAMP HILL PA 17011
Wolfe here 7 days a week,24 hours a day at 1.088.937-ootl4.
50 PLUS CHECKING 0032032534
Ilk
iiiam laxrj 43W
a5- Wia kLL
WIN
N
3�1
Transactions Ely Date
Data Descri tion Debit Credit Balance44
WERE lllii�
Interest Summary
IitVTW"_
Fees Summary
Total Overdraft Fees Year to Date $0.00
Total Returned ftern Fees Year to Date
For your convenience,a summary of overdraft and returned item I'm appears on your monthly statement. Please note that the overdraft fee
summary includes non-sufficient funds fees,uncollected funds fees and unavailable funds fees. The summary does not reflect refunded or waived
Items credited to your account.
CYC40 Page I of 2 W2140Rol L07/11
NOTE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION Member FDIC
JUL-31-2015 FRI 02:15 PM FAX NO, ++++++++++++++++++++ P. 04
Metro sank
T RO 3801 Paxton Street
BANK Harrisburg PA 17111-1418
1-888-937-0004
mymetrobank,com
>011314 4594608 001 092140
TERRY L RUSSELL
3100 MORNINGSIDE DR
CAMP HILL PA 17011
We're here 7 days a ween,24 hours a day at 1-W-937-OW4.
amp_—_ 50 PLUS CHECKING 0032032534
00 4.......
3,13
Transactions By Date
Date DescriptionDebit credit Balance
Ap
Interest Summary.
,pfp7t
Fees Summary
N 4 _;.-!'T=
Total Overdraft Foos Year to Date $0.00
W
.17orrRaW. .F
Total Returned Item Fear.Year to Date $0.00
For your convenience,a summary of overdraft and returned item fees appears on your monthly statement, Please note that the overdraft fee
summary includes non-sufficient funds fees,uncollected tunds fees and unavailable funds fees. The summary does not reflect refunded or waived
Items credited to your account.
Kick start your holiday savings for next year by opening a Holiday Club account today.Establish a goal,and,then choose your
savings amount and frequency.Payments can be automatically withdrawn from your Metro Bank Checking or Savings account
or paid by coupon.To open a Holiday Club account,stop by your nearest Metro Bank store, visit myrnetrobank.com or call
888-937.0004.
Make a trip to the bank without the trip thanks to the Mobile Deposit feature of Metro Bank Mobile.Snap a photo of a check
and deposit it electronically from anywhi6re,at anytime. Download the free app today at mynnetrobank.corn/mobile.
Coming Soon:This November,we open the doors of our new Metro Bank location on Lincoln Highway East in Lancasterl
Enjoy the same great hours and customer service of our other locations,Visit mymetrobank.com to find a Metro Bank near
you.
a cycle Page I of 2 02140 ROLL 07A i
NOTE SEE REVERSE SIDE FOR IMPORTANT INFORMATION 1—
JUL-31-2015 FRI 02:16 PM H YYY M YYYYYYYYYYYYYYY FAX NO, ++++++++++++++++++++ P. 05
DATE FROhl DATE TO PAGE ACCOUNT NUIVIL)l
St Memlx;rs Int Ft:dcral Creclit union 07101/2014 07/31/2012 j XXXXXXX934
5OW Louisa:LVive
P.0.%x 40
M4chaniv;buTg PA 17055.0040
m
(800)2,37-7288 — —
h�E"MBERS {717}697-5312(fiwrirsg Etctpaiscci)
PENN
r=.ar
A6caenrruNlON w _.mcMbers1S[.urg
w, .*... STATE
rQ FOOTBALL
`�
TERRY L RUSSELL - TICKET GIVEAWA
3100 MORNINGSIDE OR tri=;
CAMP HILL PA 1.7011
Trips. . .
>New York City - "Day on Your Own"
1, .B >kSaturday, October 11, 2014
> Cardinals vs Phillies C>New Fork City - "Day on Your Own"
Saturday, August 23, 2014 Saturday, December 6, 2014
For Details: www.memberslst.org/bus-trips
ACCOUNT , GLANCE
Your current Member Loyalty Rewards level is Gold. Your aggregate balance as of July 1 st is$21,360.80.
An'aggregate balance of$35,000 and having 3 products will,move you tq'the Platinum levet.
CHEM NG 11,580.96
SAVINGS 7,051.72
CERTIFICATES 3140.81
LOANS 0.00
CHECKING (0011)
�_. . -
- 'BIW'Gi1NN1TNG(3AI.411fCE: .. • '$1Q,59d_63 ._...
Eff. Post
Date gate Description Deposits Withdrawals Balance
07/01 07/01 Deposit ACH XXVA SENEF 577.54 11,172.17
ID: 3111036002 CO:XXVA SENEF
07/01 07/01 Check 000254 Tracer 1030394369 41.70 11,130.47
Processed Check-UH10 5840 TYPE:D PREMIUM ID:
9000447048
07102 07/02 Check 000256 Tracer 00002517899 35.00 11,095.47
07/03 07/03 Deposit by Check 300,00 11,395.47
07/16 07/16 Deposit Transfer From Share 0000 974.00 12,369.47
07/16 07/16 Check 000257 Tracer 0000260923 35.00 12,334.47
07/22 07/22 Check 000259 Tracer 0019732306 319,00 12,015.47
Processed Check-ERIE INSURANCE TYPE: 1256038677 ID:
1256038677
07124 07124 Check 000258 Tracer 0000261264 400.00 11,615.47
07/31 07/31 Check 000262 Tracer 0000296730 35.00 11,680.47
07/31 07/31 Deposit Dividend 0.050% 0.49 11,580.96
JUL-31-2015 FRI 02: 16 PM FAX NO, ++++++++++++++++++++ P. 06
N st r— I
MEMBERS V DATE FkOM DATE TO PAGE ACCOUNT NUMB'--I
-PI-PERALC"brr UNION 107/31/2014 2 of 2 XXXXXXX934
Eff. Post
Date Date Description Deposits Withdrawals Balance
Annual Percentage Yield Earned 0.050%from 07/01/14 through
07/31/14
ENDING BALANCE- $11,680.96
Check 0 Date Amount Check# Date Amount Check 0 Date --A—Mou
254 07101 41.70 256* 07/02 35.00 257 07/16 35.1
268 07/24 400,00 259 07122 319,00 262* 07/31 35.1
Indicates check out of sequence 6 Checks Cleared for 865-70
Total Deposits 1,852.03 Aveltigs Daily'Balance 1,654.63
Tptal Withdrawals 665.70,
L
REGULAR SAVINGS (0000)
BEGINNING BALANCE; $5.09
Eff. Post
Date Date Description Deposits Withdrawals Balance
07116 07/16 Deposit ACH XXSOC SEC 974,00 979.09
ID:9031736013 CO:XXSOC SEC
07/16 07/16 Withdrawal Transfer To Share 0011 974.00 5.09
ENDING BALANCE; $6.09
Total Deposits 974,00 Total WthdraWals 974.00
MONEY MANAGEMENT(0005)
BEGINNING BALANCE., $7,046.03
Eff. Post
Date Date Description Deposits Withdrawals Balance
07131 07/31 Deposit Dividend Tiered Rate 0.60 7,046.63
Annual Percentage Yield Earned 0.100%from 07/01/14 through
07/31/14
ENDING BALANCE: $7,046.63
Total Deposits 0.60
24 MONTH CERT (0046)
BEGINNING BALANCE: $3,1 37.51
Eff. Post
Description — - - - Deposits Withdrawals Balance
07/31 07/31 Deposit Dividend 1,240% 3.30 3,140.81
Annual Percentage Yield Earned 1.260%from 07/01/14 through
07/31/14
ENDING BALANCE: $3,140-81
Total Deposits 3,30 . Maturity Date 10/16115
YTD SUMMARY
TOTAL DIVIDENDS PAID
0000 REGULAR SAVINGS 0.00
0005 MONEY MANAGEMENT 4.40
0011 CHECKING 3.36
0046 24 MONTH CERT 22.52
Total Year to Date Dividends Paid(includes Closed Shares) 30.28
JUL-31-2016 FRI 02: 16 I'M YMYYYYYYYYYYYYYYYYY yyy FAX NO, ++++++++++++++++++++ P. 07
DATE FROM DATE TO PAGE ACCOUNTNUMS
lSt Wrnbers,I st F,-dcral Credit Union 011 1 of 2 XXXXXXX934
50(A)1A)uise Drivr- 1,��101 I"
vP.O.Rox 40 i. NAeaGitunicsburg PA 17055-0040 l (800)237-7298
MEMBERS is, (717)697-5312(Rcaring Impaired)
FEWDERALCUM LNM www.membt:rs1q.*zg
12"
TERRY L RUSSELL
C/O THOMAS R KEHLER
457 ELDER TRAIL
NEW CUMBERLAND PA 17070
PRO FOOTBALL CHALLENGE
WITH WGAL NEWS 8'S MIKE HOSTETLER
I WINNER EACH WEEK $50 GRAND PRIZEWINNER $2,500
VISA Gift Card
Details Here: http://www.membersIst.org/promotions/football-challenge
ACCOUNT BALANCES AT A GLANCE
Your aggregate balance as.of.06iober:1st is'$22,169.25.
An aggregate balaripp of$2,500 an4'hav!hg 3 piodpots will pla6e you in the Silver MLR level.
CHECKING 0.00
SAVINGS 0,00
CERTIFICATES 0.00
LOANS 0.00
CHECKING (0011)
§rzdINNINa BALANCE:
Eff. Post
Date Date Description Deposits Withdrawals Balance
10101 10/01 Withdrawal Transfer To Share 0000 11,969,03 0.00
10101 CHECKING CLOSED
*This is the final statement presenting information on this product
Please retain this final statement for tax reporting purposes.
ENDING BALANCE: $0.00
.Total WAbdrawais .11,969.03
REGULAR SAVINGS (0000)
—BEGINNING BA—LAI46115--. — $5.09--
Eff. Post
Date Date Description Deposits Withdrawals Balance
10/01 10/01 Deposit Transfer From Share 0005 7,047.81 7,052.90
10/01 10/01 Deposit Transfer From Share 0011 11,969.03 19,021.93
10/01 10/01 Deposit Transfer From Share 0046 3,128.31 22,160.24
JUL-31-2015 FRI 02:16 PM YYYYYHYHYYYYYyyyyy FAX NO, ++++++++++++++++++++ P. 08
DATE FROM DATE TO PAGE ACCOUNT NUM13
MEMBERS 1"
N4PFD9RUCMff(fNiON 10/01/2514 10/31J20i4 2 oft-7 XXXXXXX934 -
Eff. Post
Date Date Description Deposits Withdrawals Balance
10/01 10/01 Withdrawal by Check 22,150-24 0.00
Check 00 956602 Disbursed 22,150.24
10/01 REGULAR SAVINGS CLOSED
is the final statement presenting information on this product
W :This
Please retain this final statement for tax reporting purposes.
ENDING BALANCE: $0.00
Total Deposits 22,145.16 Total Withdrawals 22,150.24
MONEY MANAGEMENT(0005)
BEGINNING BALANCE: $7,047.81
Eff. Post
Date Date Description Deposits Withdrawals Balance
10/01 10/01 Withdrawal Transfer To Share 0000 7,047.81 0.00
10/01 MONEY MANAGEMENT CLOSED
*This is the-final statement presenting information on this product
Please retain this final statement for tax reporting purposes,
ENDING BALANCE; $0.00
Total Withdrawals 7,047.81
24 MONTH CERT (0046)
BEGINNING BALANCE:
Eff. Post
Date Date Description Deposits Withdrawals Balance
10/01 10/01 Withdrawal Transfer To Share 0000 Early W/D Penalty 3,147.32 0.00
10/01 24 MONTH CERT CLOSED
'This is the final statement presenting information on this product
Please retain this final statement for tax reporting purposes.
ENDING BALANCE: $0.00
Penalties Assessed Year to Date 19.01 Total Withdrawals 3,147,32
YTD SUMMARY
TOTAL DIVIDENDS PAID
0000 REGULAR SAVINGS 0.00
0005 MONEY MANAGEMENT 5.58
0011 CHECKING 4.36
0046 24 MONTH CERT 29.03
Total Year to Date Dividends Paid(includes Closed Shares) 38.97
Total Year to Date Penalties Assessed 19.01
c��P�prvr�ydm OMB Approval No.2502-0265
I o
N
A. Settlement Statement (HUD-1)
qsx oe�r:�oT
B. Type of Loan
1,E]FHA 2.Q RHS 3.N Conv.Unins. [HOLLINGHURST-CSC-201
, File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.Q VA 5.Q Conv.Ins. 3804021207
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:
Karin Hollinghurst Estate of Terry L.Russell Maverick Funding Corp.
305 Thomas Drive,Apt.1 3100 Morningside Drive 9 Entin Road,Suite 200
Mechanicsburg,PA 17050 Camp Hill,PA 17011 Parsippany,NJ 07054
G. Property Location: H. Settlement Agent: I. Settlement Date:
3100 Morningside Drive Charter Settlement Company
Camp Hill,PA 17011 1200 Camp Hill Bypass,Suite 205 November 18,2014
Cumberland County,Pennsylvania Camp Hill,PA 17011 Ph. (717)234-3289
Place of Settlement:
3 Lemoyne Drive
Lemoyne,PA 17043
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 142,500.00 401. Contract sales price 142,500.00
102. Personal property 402. Personal roperty
103. Settlement Charges to Borrower Line 1400 6,127.18 403.
104. 404.
105. 405.
Ad ustments for Items paid by Seller in advance Adjustments for items paid by Seller in advance
106. School Taxes 11/19/14 to 07/01/15 797.41 406. School Taxes 11/19/14 to 07/01/15 797.41
107. County Taxes 11/19/14 to 01/01/15 83.60 407.County Taxes 11/19/14 to 01/01/15 83.60
108. Assessments to 408.Assessments to
109. 409.
110. 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 149,508.19 420.Gross Amount Due to Seller 143,381.01
200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due Seller.
201. Deposit or earnest money 1,000.00 501. Excess deposit see instructions
202. Principal amount of new loans 114 000.00 502. Settlement charges to Seller Line 1400 20,097.62
203. Existing loans taken subject to 503. Existing loans taken subject to
204. 504. Payoff First Mortgage to Champion Mortgage/#107688 38,500.00
205. 505. Payoff Second Mortgage
206. 506.
207. 507.(Deposit disb.asproceeds)
208. 508.
209. 509.
Adjustments for items unpaid by Seller Adjustments for items unpaid by Seller
210. School Taxes to 510. School Taxes to
211. County Taxes to 511. CountyTaxes to
212. Assessments to 512.Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517,
218. 518.
219. 519.
j 220. Total Paid by/for Borrower 115,000.00 520. Total Reduction Amount Due Seller 58,597.62
300. Cash at Settlement from/to Borrower 600. Cash at settlement tolfrom Seller
s 301. Gross amount due from Borrower line 120 149,508.19 601. Gross amount due to Seller line 420 143 381.01
302. Less amount paid by/for Borrower line 220) ( 115,000.00) 602! Less reductions due Seller(line 520) ( 58,597.6
303. Cash O From El To Borrower 34,508.19 603. Cash [g]To From Seller 84,783.39
•Paid outside of closing by borrower(B),seller(S),lender(L),or third-party(T)
The undersigned hereby acknowledge receipt of a completed copy of this statement&any attachments referred to herein
Borrower ` Seller
Estate T rry L.Russell //
Karin Hollinghurst BY: <y�.oru Vektc-41N
Thomas R.Kehler,Executor
The Public Reporting Burden for this collection of Intormation Is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may not collect this Information,and you are
not required to complete this form,unless It displays a currently valid OMB control number.No confidentiality Is assured;this disclosure Is mandatory.This Is designed to provide the parties to a RESR4covered
transaction with Inrormatlon during the settlementprocess.
Page 1 of 3 HUD-1
(HO LLING HURST-CSC-2014.PFD/HOLLINGHURST-CSC-201/14
L.Settlement Charges
700.Total'Real Estate Broker Fees $8,551).00 Paid From Paid From
Division of commission(line 700)as follows: Borrowers Sellers
701.$4,275.00 to RSR Realtors Funds at Funds at
702.$ 4,275.00 to Lawyers Realty Settlement Settlement
703.Commission Paid at settlement 8,550.00
704.
705.
800.Items Payable In Connection,with Loan
801.Our origination charge $ 1,245.00 from GFE#1
802.Your credit or charge(points)for the specific interest rate chosen -158.46 from GFE#2
803.Your ad'usted origination charges from GFE#A 1,086.54
804.ADDraisal fee to Appraisal Nation from GFE#3) P.O.C. 25.00 B'
805.Credit Report to Credit Pius from GFE#3 44.00
806.Tax service to Maverick Funding Corp. from GFE#3 84.00
807.Flood certification to Kroll Factual Data from GFE#3 9.00
808. from GFE#3
809. from GFE#3
810, from GFE#3
811. (from GFE#3)
900.Items Required by Lender to Be Paid In'Advance
901.Daily interest charges from 11/18/14 to 12/01/14 13 @ $14.050000/da from GFE#10 182.65
902.Mortgage insurance premium for months to (from GFE#3)
903.Homeowner's insurance for 1.0 years to All State Insurance (from GFE#11) 234.24
904. (from GFE#11)
905. (from GFE#11)
1000.Reserves Deposited with Lender,
1001.Initial deposit for your escrow account (from GFE#9) 887.40
1002.Homeowner's insurance 3.000 months @ $ 19.52 per month $ 58.56
1003.Mortgage insurance months @ $ per month $
1004.Property taxes $ 1,300.22
County/TownshipCounty/Township Taxes 11.000 months @ $ 59.14 per month
School Taxes 6.000 months @ $ 108.28 per month
City Taxes months @ $ per month
1005. $
School Taxes months @ $ per month
County Taxes months er month
1006. months @ $ per month $
1007. months @ $ per month $
1008. $
1009.Aggregate Adjustment $ -471.38
1100.Title Charges
1101. Title services and lender's title insurance (from GFE#4) 1,292.00 45.00
1102. Settlement or closing fee $
1103. Owner's title insurance to Old Republic National Title Insurance Company (from GFE#5) 145.00
1104. Lender's title insurance to Old Republic National Title Insurance Company $ 1,120.00
1105. Lender's title policy limit $ 114,000.00
1106. Owner's title policy limit $ 142,500.00
1107. Agent's portion of title insurance premium to Charter Settlement Company $ 1,087.90
1108. Underwriter's portion of title premium to Old Republic National Title Insurance Comp: $ 177.10
1109. $
1110. Charter Settlement Company $
1111. Charter Settlement Company $
1112. Charter Settlement Company $
1113. $
1200.Government Recording and Transfer Charges
1201.Government recording charges to Mid-Penn Recording from GFE#7 195.00
1202.Deed $ 83.50 Mortgage $ 111.50 Releases $ Other $
1203.Transfer taxes to Mid-Penn Recording (from GFE#8) 1,425.00
1204.Cit/Count tax/stamps Deed $ 1,425.00 Mortgage$
1205.State tax/stamps Deed $ 1,425.00 Mortgage$ 1,425.00
1206.
1207.
1300.Additional Settlement Charges
1301.Required services that you can shop for (from GFE#6)
1302. Home Inspection to A'nS Company Inc. $ 485.00
1303. 4th Quarter Sewer to Lower Allen Township Authority $ 32.72 44.28
1304.4th Quarter Trash to Lower Allen Township Authority $ 24.63 33.34
1305. Inheritance Tax Escrow to Charter Settlement Company $ 10,000.00
1400.Total Settlement Charges(enter on lines 103,Section J nand 502,Section K) 6,127.18 20,097.62
Palo outside of closing by borrower(B),seller(S),lender(L),or third-party(T)
By signing page 1 of this statement,the signatories acknowledge recelptof a completed copyofpage 2&3 of Nis three page statement
Charter Settlement Cops any'Settl�Agent
Page 2 of 3 HUD-1
(ROLLING HURST-CSC-2014.PFD/HO LLINGHURST-CSC-201/14