Loading...
HomeMy WebLinkAbout06-23-05 . REV-1500 EX + (6-00) OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 FILE NUMBER II 05 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00174 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Truscott, Cleo Ru by DATE OF DEATH (MM-DD-YEAR) 196-18-6799 .... z w c w u w c DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 02-16-2005 10-21-1925 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) o o o o ~ 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 2. Supplemental Return w .... ",~(I) 01>:'" wELO :>:00 01>:..J ELlIl EL < 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy oITrust) 10 Spousal PovertY Credit (date of death between . 12-31-91 and 1-1-~5) .... 2 W a 2 o EL (I) W I>: I>: o U NAME David J. Lenox FIRM NAME (If applicable) The Wiley Group, PC TELEPHONE NUMBER 717-432-9666 COMPLETE MAILING ADDRESS 130 W. Church Street Dillsburg, PA 17019 (1) 178,600.71 (2) 7,580.45 (3) None (4) None (5) 17,195.97 (6) None (7) None (8) (9) 46,027.66 (10) 1,094.92 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship OFFICIAL USE ONLY 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Pel..onal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) z o i= <( ...J ::J .... 0:: <( u w It: 203,377.13 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) 47,122.58 156,254.55 0.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 156,254.55 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 0 .045 (16) i= 16.Amount of Line 14 taxable at lineal rate 156,254.55 x i5 ::J ll.. I 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ::iE 0 u 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18) x x <( .... 19. Tax Due (19) 0.00 7,031.45 0.00 0.00 7,031.45 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20. [K] Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; Decedent's Complete Address: STREET ADDRESS 304 Deanhurst Ave. CITY Camp Hill STATE P A ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 7,031.45 7,200.00 351.57 Total Credits (A + B + C) (2) 7,551.57 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 520.12. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No o ~ o ~ o ~ o ~ o ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?...................................................................................................................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, 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 personal representative is based on all infonnation of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS J Craig Eberly 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or................................................................................. .................. ............... d. receive the promise for life of either payments, benefits or care?.............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................................................................................................................... Yes DATE 700 Wellsville Road Wellsville, PA 17365 ~ - (if ~OS- DATE ADDRESS &-IY~O~"-- ADDRESS DATE 130 W. Church Street Dillsburg, PA 17019 The tax rate imposed on the net value of transfers to or for the use of the I defined under Section 9102, as an individual who has at least one parent For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use ofthe surviving spouse is 3% [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% [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 sp~"~- :- .L ~ ~ For dates of death on or after July 1, 2000: ~. ,~ '"2 '0 ,~ The tax rate imposed on the net value of transfers from a deceased child L--^.) -c 0 . \....JL} natural parent, an adoptive parent, or a stepparent of the child is 0% [72 F The tax rate imposed on the net value of transfers to or for the use of the 'Pc\. dloO - OD ~9116 1.2) [72 P.S. 99116 (a) (1)]. AfJ) ~, ath to or for the use of a Kcept as noted in 72 P.S. 50.00 ~~~I :5 (a) (1.3)]. A sibling is f blood or adoption. Rev-15D2 EX+ (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE T AA RETURN RESIDENT DECEDENT Truscott, Cleo Ruby FILE NUMBER 21-05-00174 ESTATE OF All real property owned solely or as a tenant In common must be reported at faIr market value. Fair mar1<et 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 which Is jolntiy-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Sale of real estate situate at 304 Deanhurst Ave., Camp Hill, PA: 178.000.00 2 Tax proration due estate from sale of property: 600.71 TOTAL (Also enter on Line 1, Recapitulation) 178.600.71 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev-1503 EX~ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Truscott, Cleo Ruby FILE NUMBER 21-05-00174 ESTATE OF All property jolntlY-Owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 GE Stock dividend: 46.20 2 Sale of 210 shares of GE Stock: 7.534.25 TOTAL (Also enter on Line 2, Recapitulation) 7.580.45 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Truscott, Cleo Ruby FILE NUMBER 21-05-00174 Include the proceeds of liligaliOf1 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 NUMBER DESCRIPTION 1 AAA Refund: VALUE AT DATE OF DEATH 16.65 2 Homeowners insurance Refund: 126.00 3 Personal Property Auction Proceeds: 358.71 4 Personal Property sold to Buyer of real estate: 700.00 5 PNC Bank Checking Account #51-4012-1034 12,419.61 6 1998 Buick Century (transferred to daughter, Jean Craig Eberly, per Last Will & Testament: 2.790.00 7 Antique brown marble-topped table (to son, T. Charles Truscott, per Last Will & Testament: 35.00 - 8 Diamond jewelry (to daughter, Janis L. Truscott, per Last Will & Testament): 750.00 _ TOTAL (Also enter on Line 5, Recapitulation) 17,195.97 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev 6-98) REV-1151 EX. (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Truscott, Cleo Ruby Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-00174 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 9,117.66 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 10,168.86 2. Attorney's Fees The Wiley Group, PC 10,168.86 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 330.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 16,242.28 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 46,027.66 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Truscott, Cleo Ruby FILE NUMBER 21-05-00174 ITEM NUMBER DESCRIPTION AMOUNT 1 Baughman Memorial Works: 570.00 2 Cemetery Fee: 600.00 3 Funeral Flowers: 377.36 4 Musselman Funeral Home: 7.570.30 Subtotal 9.117.66 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6.98) . SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Truscott, Cleo Ruby FILE NUMBER 21-05-00174 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Certified Mailings: 9.53 2 Cumberland Law Journal (estate advertising): 75.00 3 Dan Eberly (ceiling repair): 231.90 4 Final Medical Bills: 1.914.97 5 George DeFrain (lawn service): 100.00 6 House sale advertisement: 89.00 7 Real estate sale - closing costs: 13.650.33 8 Register of Wills (filing fee): 20.00 9 The Sentinel (estate advertising): 151.55 Subtotal 16.242.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Truscott, Cleo Ruby FILE NUMBER 21-05-00174 ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 PA American Water: VALUE AT DATE OF DEATH 142.32 2 PPL (electric): 109.50 3 Sewer Authority: 60.00 4 Travelers Indemnity (home and car insurance): 64.17 5 UGI (gas): 685.17 6 Verizon (phone): 33.76 TOTAL (Also enter on Line 10, Recapitulation) 1,094.92 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV 1513 EX+ (9 DO) , SCHEDULE ~ COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Truscott, Cleo Ruby 21-05-00174 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Ust Trustee(sl I. TAXABLE DISTRIBUTIONS [include outright srrousal distributions, and ransfers under Sec. 9116(a)(1.2)] Jean Craig Eberly Daughter 91,790.00 PA Janis L. Truscott Daughter 89,750.00 PA T. Charles Truscott Son 35.00 PA Total 181,575.00 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PARTII- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TEST AMENT OF CLEO RUBY TRUSCOTT I, CLEO RUBY TRUSCOTT, an umemarried widow, currently of 304 Deanhurst Avenue, Borough of Camp Hill, Cumberland County, Pennsylvania, 17011 being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by .me at any time heretofore made. l. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I give and devise my lot of ground and my residence erected thereon to my daughters, JEAN CRAIG EBERLY and JANIS L. TRUSCOTT. In the event either of my said daughters predeceases me, then her share in this devise shall go to the other of my said daughters who does survive me. In the event that both of my said daughters predecease me then this devise shall lapse and shall become part of the residue .of my estate. It is my understanding and my desire that any death taxes due upon this specific devise be paid from the residue of my estate. 3. In the event that I am determined to have and to hold any ownership interest in the farm of my late husband, Thomas C. Truscott, located in the State of Illinois, I hereby give and devise all and any such interest to my three (3) sons, STEVEN T. TRUSCOTT, T. CHARLES TRUSCOTT, and THOMAS MATTHEW TRUSCOTT, in equal shares. Any expenses of transmitting or conveying such ownership interest, including any death taxes thereon shall be borne by my said three (3) sons. 4. I give and bequeath my antique brown marble~topped table to my son, T. CHARLES TRUSCOTT. In the event he predeceases me, this gift shall lapse and become part of the residue of my estate. It is lily understanding and my desire that any death taxes due upon this specific bequest be paid from the residue of my estate. 5. I give and bequeath any automobiles that I own at the time of my death to my daughter, JEAN CRAIG EBERLY. In the event she predeceases me, this gift shall lapse and become part of the residue of my estate. It is my understanding and my desire that any death taxes due upon this specific bequest be paid from the residue of my estate. 5.a. I give and bequeath my diamond engagement ring and my pair of diamond earrings to my daughter, JANIS L. TRUSTCOTT. In the event she predeceases me, this gift shall lapse and become part of the residue of my estate. It is my understanding and my desire that any death taxes due upon this specific bequest be paid from the residue of my estate. ~ J7~ ~~ . , 6. I give, devise, and bequeath all the rest, residue and remainder of my estate, real, personal, and mixed, whatsoever and wheresoever situate, to be divided and distributed equally among my five (5) children named in this paragraph, to wit: A. STEVEN T. TRUSCOTT B. T. CHARLES TRUSCOTT C. JEAN CRAIG EBERLY D. JANIS L. TRUSCOTT E. THOMAS MATTHEW TRUSCOTT In the event that any of my said five (5) above-named children predeceases me and is survived by issue, then his or her share shall go to his or her issue as the case may be. In the event that any of my said five (5) above-named children predeceases me and is not survived by issue, then his or her share shall be proportionally divided among those of my said five (5) above-named children who survive me, or, in the event of any having predeceased me and having left issue surviving, then such issue shall take his or her or their parents' proportional share. 7. I have purposely not provided for my son, JAMES KNAUB, in this my last will and testament because I have provided for him during my lifetime, having given him DuPont stock some years ago. Accordingly, he is not to share in any inheritance, including by an lL!d~ distribution or by way of representation. 8. I nominate, constitute and appoint my daughter, JEAN CRAIG EBERLY, to be the Executrix of this my Last Will and Testament. In the event that she is unable or unwilling to act as Executrix, I appoint my son, T. CHARLES TRUSCOTT to be the Executor in her place and stead. In the event that he is unable or unwilling to act as Executor, I appoint my son, STEVEN T. TRUSCOTT, to be the Executor in his place and stead. I further direct that they shall not be required to file bond or other security in the Office ot the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ili- day of fnfj , A.D. 2002. ~#~ ~~~,"1"~ (SEAL) EO RUBY TR COTT Signed, sealed, published and declared by the above-named CLEO RUBY TRUSCOTT, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. !JkJJ t.U~ ~~~/~ ---"'- ""......, ,."'. 'JV"""V.c.u,,", I. A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.DFHA 2.0FmHA 3.l!ICONV. UNINS. 4-DVA 5. OCONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT 05-323 826853291 8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER: 6.875%\A\1052 JSG 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 "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 (DIEBOLD,PFDI05.323J11 ) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: JAMES A. DIEBOLD, JR. ESTATE OF CLEO RUBY TRUSCOTT SOVEREIGN BANK 304 DEANHURST AVENUE 1130 BERKSHIRE BLVD. CAMP HILL, PA 17011 WYOMISSING, PA 19610 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1857112 I. SETTLEMENT DATE: 304 DEANHURST AVENUE Midstate Abstract Company CAMP HILL, PA 17011 May 25, 2005 Cumberland Counly. Pennsylvania PLACE OF SETTLEMENT 2331 Market Street Camp Hill, PA 17011 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 178,000.00 401. Contract Sales Price 178,000.00 102. Personal Properly 402. Personal Properly 103. Settlement CharQes to Borrower (Line 1400) 6,682.37 403. 104. 404. 105. 405. Ad'ustments For Items Paid Bv Seller in advance Ad'ustments For Items Paid Bv Seller in advance 106. CilyfTown Taxes to 406. CilyfTown Taxes to 107. County Taxes OS/25/05 to 01/01/06 394.37 407. Counly Taxes OS/25/05 to 01/01106 394.37 108. School Taxes OS/25/05 to 07/01/05 194.07 408. School Taxes OS/25/05 to 07/01/05 194.07 109. Sewer Proration OS/25/05 to 07/01/05 12.27 409. Sewer Proration OS/25/05 to 07/01/05 12.27 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 185,283.08 420. GROSS AMOUNT DUE TO SELLER 178,600.71 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deoosit or earnest monev 5,000.00 501. Excess Deposit (See Instructions 202. Princioal Amount of New Loan s) 160,200.00 502. Settlement Charoes to Seller ILlne 1400 13,650.33 203. Existina loanls) taken subiect to 503. Existina loanls) taken sub'ect to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortgage 206. 506. 207. 507. (Deposit dlsb. as proceeds) 208. 508. 209. 509. Ad'ustments For Items Unoaid Bv Seller Ad'ustments For Items Unpaid By Seller 210. CilyfTown Taxes to 510. CilyfTown Taxes to 211. County Taxes to 511. County Taxes to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 165,200.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 13,650.33 300. CASH AT SETTLEMENT FROMfTO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower ILlne 120l 185,283.08 601. Gross Amount Due To Seller (Line 420) 178,600.71 302. Less Amount Paid By/For Borrower (Line 220) ( 165,200.00) 602. Less Reductions Due Seller (Line 520) ( 13,650.33 303. CASH ( X FROM) ( TO) BORROWER 20,083.08 603. CASH ( X TO) ( FROM) SELLER 164,950.38 The undersigned hereby ac {owled~ receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein. ~ , -----x Seller (), AAL Borrower /L; .A ~. &f ;;; JAtrBOLD, JR. ~TATE OF CLEO Rljl5YTRVSCOTT /1A. jJ stc.~ ;je S{et (J. ) I () I ( / S/:zs(o 5- is/ 1 (1'-0 p<tj 1/&" cof! Itf.7s0 56. . , L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ 178,000.00 @ 6.0000 % 10,680.00 PAID FROM PAID fROM Division of Commission (line 700) as Follows: BORROWER'S SELLER'S 701. $ 10,680.00 to ERA-NRT, INC. FUNDS AT FUNDS AT 702. $ to SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 10,680.00 704. to BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % to 802. Loan Discount % to 803. Appraisai Fee to AARROW MORTGAGE GROUP 300.00 804. Credit Report to AARROW MORTGAGE GROUP 57.24 805. Commitment Fee to SOVEREIGN BANK 650.00 806. Broker Fee from Sovereion to AARROW MORTGAGE GROUP POC $2,403.00l 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From OS/25/05 to 06/01/05 @ $ 30.593750/day ( 7 days %) 214.16 902. Mortea e Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months $ 35.97 oer month 107.91 1002. Mortgage Insurance months $ 166.88 oer month 1003. CityfTown Taxes months $ oer month 1004. County Taxes 4.000 months $ 53.19 per month 212.76 1005. School Taxes 12.000 months @ $ 156.35 per month 1,876.20 1006. months @. $ oer month 1007. months @ $ oer month 1008. Aooreoate Adiustment months @ $ oer month -320.65 1100. TITLE CHARGES 1101. SettlementorClasino Fee to 1102. Abstract or Titie Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Electronic Document Preo. to Midstate Abstract Companv 50.00 1106. Closina Service letter ta Midstate Abstract Comoanv 35.00 1107. Attorney's Fees to includes above item numbers: ) 1108. Title Insurance to MIDSTATE ABSTRACT 1 248.75 includes above item numbers.11 02, 1103 & 1104 1109. lender's Coverage $ 160,200.00 1110. Owner's Coverage $ 178,000.00 1,248.75 1111. Endorsements 100, 300, 8.1,710 to Midstate Abstract Company 200.00 1112. Notary Fee to Midstate Abstract Company. 10.00 1113. Notary Fee to Midstate Abstract Company 5.00 1114. Overnight Fee to Midstate Abstract Company 15.00 1115. Wire Fee to Midstate Abstract Company 10.00 1116. 1117. 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage $ 72.50; Releases $ 111.00 1202. CitvlCountv Tax/Stamos: Deed 1,780.00' Mortaaae 1,780.00 1203. State Tax/Stamos: Deed 1,780.00; Mortaaae 1,780.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Insoection to 1303. Transaction Fee to ERA-NRT, INC. 125.00 125.00 1304. Home Warranty to AON 409.00 1305. 2005 County/Borough Taxes to JANET l. MillER, TREASURER ~ 651.33 1400, TOTAL SETTLEMENT CHARGES (Enter on lines 103, Section J and 502, Section K)/ /L-.. ~ / 6,682.37 13,650.33 By signing page' of Ih;s slalemenl, Ihe s;gnalones acknowledge ",celpl of a compleled copy 01 page 2 of Ih;, two page sr;;:~. /~ ~?;:: ~ _ :" Certified to be a true copy. Mldstate Abstract Company Settlement Agent ( 05~323 I 05.323 ( 11 ) . Kelte)"Blue Book - Trade-In Pricing Report - Buick, Century Page 1 of2 Kelley Blue Book THE TRUSTED RESOURCE "<<<<w~ HOME ;:w CARS .,~., REViEWS & RATINGS ']:E1fu . -- - !"D~.DliJGII advertisement . Seard'l iJ!l&d Car L!SIJngs laCROSSE THE NEXT BUICK CUCk TO muRIl j BLUE BOOK'" TRA.DE-IN VALUE Pennsylvania. May 14, 2005 1998 Buick Century Limited Sedan 40 << " ~ Search Listings for ThisCar List Your C;:IJ For Sale Ooline Quick New Car Price ~ote free CARFAXJ~~cord Ch~cls Auto Loans from 4.49% 8ER Insurance Quot~ Payment Calculator " . '=~ z Engine: V6 3.1 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 29,000 Equipment Air Conditioning Power Steering Power Windows Power Door Locks Tilt Wheel AM/FM Stereo Dual Front Air Bags ABS (4-Wheel) Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean titl~ history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Trade-In Value List Your Car ~Qr Sale Qnline $2,790 Trade-in Value is what consumers can expect to receive from a dealer for a trade-in vehicle assuming an accurate appraisal of condition. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. NEXT STEP:. Get New Car Pricing BLUE BOOK CLASSlfll (ar for For one low price YOl appear on both kbb.l cars.com, Plus over: websites. advertiseme ~. <:>~)ji 4f ' << , . / http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;532167;P A 133&;sed+t&907;Buick; 1998 Century... 5/1412005 05!14!~005 09:40 . 7177538423 Free Checking Account Statement g For 24-hour customer servlee information, slg~l'l to Accoun! linle ~ by Web on pllcbanle.eom or call Hl88-PNC-BANK Account number: 51-4012-1034 - continued Checks and Substitute Ch8C~$ Check Dale number Amount pllld 1267 T 100.00 02/18 1375 . 50.00 02/11 1376 T 100.00 02/08 1377 45.00 02/17 1378 T 100.00 02/11 1379 100.00 02/15 Re~nce number O~72979113 028113e1Cl 027681l121l 028064096 026651lO51l 02847!l1l6'1 . Gap III cheek sequence "T" Teller Cashed Check Banking/Check Card Withdrawals and Purchases Date Amount De.~eri~tlon 02/17 125.00 8817 Check Card Purchase .l\merican Home Medical PNC BANK III Choek nvmbar 1380 1381 1384 . 1385 1386 1387 Online and Electronic Banking Deductions D"Il' A"'<lUnl Descrtptlon 02107 31.65 Direct Payment. Elee Bill Pp XXXXXX2008Ws 02106 42.13 Direct Payment - Payment P AWe 0635428 03'08 38.08 Direct Payment - Payment PAWC 0635428 03'08 36.83 Direct Payment - Elec Bill Pp XXXXXX2008Ws Amnun( Other Deductions Date DescriptIOn Tmsfr Fr Interest Cheeleing 02/22 12.150.79 ~aily Balance Detail DBle B*:m<;ll 02105 13.143.39 02/07 13.111.74 02108 12,969.61 Oare 02/11 02/15 f02116 Bnlance 12.819.61 12,719.61 12,419.61 Ollie 02117 02118 02122 Balance 12,249.61 12.149.61 1,251.18 PAGE 03 For the period 02/0512005 to 0310812005 CLEO R TRUSCOTT DECO PrImary account number: 51-4012-1034 Pag& 2 of 2 T T Oats RnfN'Qn~e AmO\Jr'lt paid n\.Mber 50.00 02/16 0253822B2 50.00 03/02 0:19877712 50.00 02/22 026211091 250.00 02/16 02~6811 67.83 02/23 026718418 10,849.61 02122 1J7.4544595 There were 12 checks listed totaling $11,812,44 Thera was 1 other Banking Machine/Check Card deductions totaling $125.00 . Thel'll _re 4 Online or electron!e Banking Deduelions totaling $148.69 . There was 1 Ot/1er Deduelion totalln9 $12,150.79 Dalll Balance 02/23 1.183.35 03/02 1,133.35 03/08 1,058.44 Glenda Farner Strasbaugh Register of Wiils and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Ki~S.Sohonage) Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 421 6/23/2005 CLEO RUBY TRUSCOTI 21-05-0174 DAVID J. LENOX, ESQ 130 W. CHURCH ST JA DILLSBURG, PA 17019 Qty 1 Fee Description Additional Probate Fee Total 50.00 $50.00 Total: $50.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you.