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HomeMy WebLinkAbout10-26-05 I I' FilE NUMBER 21 I COUNTY CODE . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRI~RIIRr:;, ~A 171 'A_O~n1 REV .1500 ex.. (8-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONL'( 05 00611 YEAR NUMBER , DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) j CRANlER, RUTH P I ----___ 'DATEOF DEATH (MM-DD-YEAR) i SOCIAL SECURITY NUMBER 172-36-1578 I- Z W o w U w o DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FilED IN DUPLICATE WITH THE ! 04/25/2005 07/20/1914 REGISTER OF WILLS SOCIAL SECURITY NUMBER i (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) N/A, ~-~ 1. Original Return o 4. Limited Estate 181 iD I o 3. Remainder Return (date of death prior to 12.13-82) o o o o o 2. Supplemental Return W I- ~S<n uO::~ wo..u %:00 uO::..J 0.. III 0.. c( 4a. Future Interest Compromise (date of death after t2.12.82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) .tMi$$E~~'BECQMPiElEDi?EeD"eS !'lAME '0- 'I Hamilton C Davis <nz ~ ~ FIRM NAME (If applicable) O::z 8 ~ Zullinger-Davis, P.C. TELEPHONE NUMBER i 717/532-5713 20 East Burd Street, Suite 6 Shippensburg, PA 17257 (1 ) 25,357.01 (2) None (3) None (4) None (5) 1,609.64 (6) 2,966.60 (7) None (8) (9) 11,730.30 (10) 2,309.10 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) OFFICIAL USE ONLY !~..,..) "") 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal 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) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) z o i= :5 ::::> l- ii: c( u W 0:: 29,933.25 11. Total Deductions (total Lines 9 & 10) (11 ) 14,039.40 12. Net Value of Estate (Line 8 minus Line 11) (12) 15,893.85 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) i 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 15,893.85 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 15,893.85 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x i= c( I- ::::> ~ 17. Amount of Line 14 taxable at sibling rate x .12 (17) :E 0 u )( 18. Amount of Line 14 taxable at collateral rate c( x .15 (18) I- 19. Tax Due (19) 715.22 715.22 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20.0 !f;i:'({ :i,;t;;;t: ';,;:\;;~.j;';i't;%;f~f4'~10lt-~'{:7;;;;;;!"f>~ BE'SUR!lOANSWER'Afr 'QUESn_ONJRMRsl:. SIDE;AHD..CK.i(t~s.-*t~~;4[~;:%~;;t\)~!;t!:);tkt~;*.~~'f#;iJ:'f?;~;:!!l Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) I Ir ~ Decedent's Complete Address: STREET ADDRESS 401 NEWVILLE ROAD CITY NEWBURG I STATE PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditS/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT I ZIP 17240 (1 ) 715.22 (2) 0.00 (3) 0.00 (4) (5) 715.22 (5A) (58) 715.22 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;................................................................................ ~ I ~: ~::::~ ~~e~~~~i~~~~s:~~e~~:;~~. .~~~~~. ~~~.~.~ .~~~~~~ .~~~~~~~~~.~~. ~~ .i~.~. ~~~~~.~;.......: ::....:: :'.:: ::::: ....: ::..:::..::...... 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?................ .................. ............................ .......... ............ ........ .............. ......... D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.................................................................................................................. D ~ 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 perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete. Dedaration 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 LEEE C ER 831 CRESCENT DRIVE SHIPPENSBURG, PA 17257 ADDRESS 26 KOUGH ROAD NEWVILLE, P A 17241 ADDRESS 20 East Burd Street" Suite 6 Shippensburg, PA 17257 DATE DATE DATE Id/II/Oj- 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 of the 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 exemot 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [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%, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REnJRN RESIDENT DECEDENT ESTATE OF CRAMER, RUTH P i I I FILE NUMBER 21 - 05 - 00611 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 whicli is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION ALL THAT CERTAIN TRACT OF LAND SITUATE IN HOPEWELL TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA - SOLD TO AN UNRELATED THIRD PARTY IN ARivlS LENGTH SALE VALUE AT DATE OF DEATH 25,000.00 2 REIMBURSEMENT OF DECEDENT'S PORTION OF REAL ESTATE TAXES FROM SETTLEMENT OF SALE OF RESIDENCE (SEE COPY OF HUD-l SETTLEMENT STATEMENT) 357.01 TOTAL (Also enter on Line 1, Recapitulation) 25,357.01 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETLRN RESIDENT DECEDENT ESTATE OF CRAMER, RUTH P I FILE NUMBER I 21-05-00611 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION M & T BANK - SAVINGS ACCOUNT # 15004206834184 VALUE AT DATE OF DEATH 1,009.45 2 ACCRUED INTEREST ON ACCOUNT #15004206834184 TO DATE OF DEATH 0.19 3 1988 DODGE AIRES K- SOLD TO UNRELATED THIRD PARTY AT ARMS LENGTH SALE 100.00 4 MISCELLANEOUS TANGIBLE PERSONAL PROPERTY OF DECEDENT 500.00 TOTAL (Also enter on Line 5, Recapitulation) 1,609.64 . SCHEDULE F JOINTLY-OWNED PROPERTY , I I I FILE NUMBER 21 - 05 - 0061l COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RFSIC1FNT C1Fr.FC1FNT ESTATE OF CRAMER, RUTH P If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A LEE E CRAMER 831 CRESENT DRIVE SHIPPENSBURG, PA 17257 SON JOINTLY OWNED PROPERTY: ITEM LETTER NUMBER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number DATE OF DEATH i % OF DATE OF DEATH DECD'S VALUE OF lor similar identifying number. Attach deed for jointly-held real VALUE OF ASSET .INTEREST DECEDENTS INTEREST ,estate. A 01128/2080 I M & T BANK - CHECKING ACCOUNT #97178756 ACCRUED INTEREST ON ACCOUNT #97178756 TO DATE OF DEATH 5,933.081 0.11' 50% 2,966.54 0.06 2 50% TOTAL (Also enter on line 6, Recapitulation) 2,966.60 *' SCHEDULEH FUNERAL EXPENSES & AD\t1NSTRAllVECOSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CRAjVIER RUTH P , I FILE NUMBER i 21-05-00611 Debts of decedent must be reported on Schedule I. ITEM I DESCRIPTION NUM~ A. FUNERAL EXPENSES: FOGELSANGER-BRICKER FUNERAL HOl'vIE AMOUNT 8,207.00 2 SPRING H ILL CEl'vIETARY - BURIAL 425.00 3 GREEN SPRING FIRST CHURCH OF GOD - DONATION 75.00 4 BEEDLES' FLOWERS - F AMll.., Y SPRAY 31.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions LEE E. CRAl'vIER RONALD R. CRAl'vIER Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 831 CRESCENT DRIVE City SHIPPENSBURG State PA Zip 17257 Year(s) Commission paid Attorney's Fees HAMil.., TON C. DAVIS, ESQUIRE 1.645.00 -waived- 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. REGISTER OF WILLS OF CUMBERLAND COUNTY 152.00 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs REGISTER OF WILLS OF CUMBERLAND COUNTY - FILE INHERITANCE TAX RETURN 15.00 2 CUMBERLAND LAW JOURNAL - LEGAL ADVERTISEMENT OF LETTERS 75.00 Total of Continuation Schedule(s) 1,104.50 TOTAL (Also enter on line 9, Recapitulation) 11,730.30 . SchedEH Fu1eraI Expel ases& ~c6.eCostsCXJl'1in.sd COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RF>;lnFNT nFr.FrlFNT ESTATE OF CRAMER, RUTH P I FILE NUMBER i 21 - 05 - 00611 3 THE NEWS CHRONICLE COl'vfPANY - LEGAL ADVERTISEMENT OF LETTERS 4 OFFICE OF RECORDER OF DEEDS - 1 % REALTY TRANSFER TAX ON SALE OF RESIDENCE 5 ROSENBERRY SEPTIC TA!\<1<. - SEPTIC TANK INSPECTION FOR PREPARATION OF SALE OF DECEDENT'S RESIDENCE 6 RESERVE FOR CONTINGENCIES AND FINAL COSTS Page 2 of Schedule H 84.50 250.00 270.00 500.00 *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 05 - 00611 ESTATE OF CRAMER, RUTH P Include unreimbursed medical expenses. ITEM NUMBER 1 10 11 12 13 DESCRIPTION ANNETTE HARRISON - HOME NURSING CARE AMOUNT 1,344.00 2 SPRINT - UTILITY - PHONE 26.18 3 HARRY E. KILLIAN, TAX COLLECTOR - 2004 COUNTYrrOWNSHIP REAL ESTATE TAXES 79.53 4 ANNETTE HARRISON - HOME NURSING CARE - FINAL STATEMENT 100.00 5 ADAMS ELECTRIC - UTILITY - ELECTRIC 70.04 6 ROBERT T. HENRY PHARMACY - FINAL MEDICAL - PRESCRIPTIONS 95.38 7 ADAMS ELECTRIC - UTILITY - ELECTRIC 59.81 8 ADAMS ELECTRIC - UTILITY - ELECTRIC 42.37 9 ADA1\1S ELECTRIC - UTILITY - ELECTRIC 32.14 HARRY E. KILLIAN, TAX COLLECTOR - 2005/06 SCHOOL REAL ESTATE TAXES 386.85 FEDERAL EXPRESS - OVERNIGHT DELIVERY FEE 18.00 ADA1\1S ELECTRIC - UTILITY - ELECTRIC 36.79 ADAMS ELECTRIC - UTILITY - ELECTRIC 18.01 TOTAL (Also enter on Line 10, Recapitulation) 2,309.10 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RF~lnFNT nFCFnFNT ESTATE OF CRAt\1ER, RUTH P FILE NUMBER 21 - 05 - 00611 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE OF ESTATE I. I,' TAXABLE DISTRIBUTIONS (include outright spousal distributions) LEE E. CRAMER 831 CRESENT DRIVE iSHIPPENSBURG, PA 17257 SON ONE-FOURTH OF RESIDUE 2 RONALD R. CRAMER SON ONE-FOURTH OF :26 KOUGH ROAD RESIDUE FWVILLE, P A 17241 3 ICAL VIN CRAMER SON ONE-FOURTH OF 5195 NORTH SALEM CHURCH ROAD RESIDUE DOVER.PA 17315 4 (ANICE CRAMER HEBERLIG DAUGHTER ONE-FOURTH OF 213 DEODA TE ROAD RESIDUE MIDDLETOWN, P A 17057 i I Enter dollar amounts for distributions shown above on lines 15 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 PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET i r r LAST WILL AND TESTAMENT i I I i I I. I ! i I I I i I ! I, RUTH P. CRAMER, of Hopewell Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the ./\ administration of my estate. ITEM II: I bequeath those articles of my household furniture and furnishings and those articles of my personal effects and personal property as set forth in a separate memorandum, which I shall place with my will or deposit with my attorney, to the persons therein designated. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares, per stirpes, to my beloved children, LEE CRAMER, JANICE CRAMER HEBERLIG, RONALD CRAMER and CALVIN CRAMER. ITEM IV: Should any of my said children predecease me or die on or before the thirtieth day following my death, I devise and bequeath the such deceased child's share of my estate to his or her issue, per stirpes, living on the thirty-first day following my death and in default of such issue, to my issue, per stirpes, living on the thirty-first day following my death. ITEM V: I appoint DAUPHIN DEPOSIT BANK ~~ TRUST COMPANY, guardian of ~ILTON C. DAVIS ATTORNEY AT LAW 'ILLE & SHIPPEHSBURG PENNA. any property which passes outright either under this will or otherwise to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done se, p~ovided that this a?pci~tment of a ILTON C. DAVIS rTORNEY AT LAW .LE & SHIPPEHSBURG PEHNA. guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including secondary, college education, both graduate and undergraduate, professional and other education) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. ITEM VI: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM VII: I appoint my son. LEE E. CRAMER, and my son, RONALD R. CRAMER, co-executors of this my last will. IN WITNESS WHEREOF. I hereunto set my hand and seal to this my Last Will and Testament, wr~tten on three (3) sheets of paper, dated this ~ day of -1r1 ov. ~ , , 1985. .~~~ fi!.~~) Ruth P. Cramer The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the testatri~. was on the day and date thereof signed, published and declared by the testatrix therein named, as and for her Last Will, in the presence of us, who at her request. in her presence, and in the presence of each other have subscribed 1J;fttt{;:" I I I I I I i I I residing at )~jk I H. / 1/ // ~ /Ye..,;/;//r.J (~. 7!!~"!~_ifRe L~ .A'---J..-I/ . residing at II ".........;,-_,_~.,...,"~.r ~.. ~...'.......... tt rl \; I, ~"! ss. r I' f r COMMONWEALTH OF PENNSYLVANIA COlJ"NTY OF CUMBERLAND I, RUTH P. CRAMER, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. ~.\~ ~ ~~-""''-~) Ruth P. Cramer ..,,~ Sworn to or at?irmed and acknowledged before me by (1~h P. Crt'-r'"7'er-, the testatrix', this I)i-J,.. day of JJ\ "-(' c..J, ' 1985. ))..d oQ ". YJ< - ~ Notary Public VELDA M. SEJ\SE. ,.:ctory Public Shipp:;nsburgt (umberlacd CJ.t Pa. l,^y Commission Expires i....,Jrch 3. 19S6 COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND : lie (or 1). i-h0n ,'/ /." {. ,VA", __ and ~J I f ( ~ ~ . tbe witness(es) whose name(s1 are (is) signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were (I was) present and saw the testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our (my) knowledge the testatrix was at that time eighteen (18) or more years of age an of sound mind and under no constraint or undue influence. ... Sworn to or affirmed and subscribed to before me by f/-An>.; 1~':;1 C IJA v:.s 'I and !\;;,..,...{.:lIC_ Cr~./td'r , witness(es), this J1-A day of yl1 u--c//'" ' 1985. IAMILTON c. DAVIS ATTORNEY AT L"w E'NVILLE & SHIPPENSBURG PENNA. },' r P-zCet / )A( _ ~~ Notary Public VELDAI IV! St t'. (': I Ship...., h ~. .~~. I~otary I='ublic My EO~~~'i~:;~~C~~~'~,:~e~,: :;.~;' to; 7:~ II - _,r A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2.nFmHA 3.0CONV UNINS. 4.0VA 5.0CONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT LINN 8. MORTGAGE INS CASE NUMBER: C. NOTE: This (orm is furnished to give you a statamant o( actual sattlSment costs. Amounts paid to and Dy'ha settlement agent ara shown. Items marked -[pOCr were paid outside the closing; they are shown here (or Informet/onel purposes anC are not mCluCeC In the totals. ,.. "'.. (LINN ~CILINNl1l D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: James Linn and Ruth P. Cramer Estate Deborah Linn , G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-19882B2 I. SETTLEMENT 0/' TE: 401 Newville Road Griest Himes Herrold Schaumann LLP Newburg, PA 17240 August 29. 2005 Cumberland County. PennSylvania PLACE OF SETTLEMENT 129 East Marl<et Street York, PA 17401 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 I 25,000.00 401. Contract Sales Pnce I 25,000.00 102. Personal PropertY I 402. Personal Prooertv I 103. Settlement Charaes to Borrower (Line 1400 i 751.50 403. I 104. I 404. I 105. I 405. I Adjustments For Ilems Paid Bv Seller in advance Ad'ustmenls For ttems Paid Bv Seiter in aelvance 106. CitylTown Taxes 08/29/05 to 01101t06 26.08 406. CitvITpwn Taxes 08/29/05 to 01/01106 2608 107. County Taxes to 407. County Taxes to 108. Sellool Taxes 08129/05 10 07/01/06 I 330.93 40B. School Taxes 08/29105 10 07/01/06 330.93 109. I 409. 110. I 410. 111. I 411. I 112. I 412. 120. GROSS AMOUNT DUE FROM BORROWER , 26,10B.51 420. GROSS AMOUNT DUE TO SELLER 25.357.01 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money I 1,000.00 501. Excess Deoosit (See Instructionsl I 202. Principal Amount at New Loan(s) I 502. Settlement Charaes to Seller (Line 1400 I 654.85 203. Existing loan(s) taken sub'ect to I 503. Existing laan(sltaken subiect to I 204. I 504. Payoff of frrst MQrtgage I 205. I 505. Payoff of second Mortgage 206. I 506. Deposit retained bv seller 1.000.00 207. 507. I 208. 508. I 209. I 509. I Adiustments For Items UnDaid Bv Seller Ad/ustments For Items Unpaid By Seller 210. CitvlTown Taxes to , 510. CitylT own Taxes to 211. County Taxes to I 511. County Taxes to , 212. Senco' Taxes to I 512. School Taxes to I 213. I 513. 214. I 514. 215. I 515. 216. , 516. 217. I 517. I 218. I 518. 219. I 519. I 220. TOTAL PAID BYIFOR BORROWER ! 1,000.00 520. T07AL REDUCTION AMOUNT DUE SELLER I 1,654.85 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amounl Due From Borrower (Line 120) I 26,10S.51 601. Gross Amount Due To Seller (Line 420) 25.357.01 302. Less Amount Paid By/For Borrower (Line 220) I( 1.000.00 602. Less Reductions Due Seller (Line 520) I( 1.654.85 303. CASH ( X FROM) ( TO) BORROWER I 25.108.51 603. CASH ( X TO) ( FROM) SELLER 23.702.16 OMB NO 2502 0265 ~ By Stgntng .o~gtl 2 rJ trill Statement, lhe Slg1\aICltle5 adlnOWleGQe rlCalPt at.. compte18d copy 01 page 1 at ltUI MCl page Slatemenl L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price S t8l % I"A.IO F~OM PAID FROM DIVIsion of Commission (fine 7'QO) as FollOws: BORROWER'S SEL.I...ER"S 701. $ to FUNOS AT FUNDS AT 702. $ to SET":'LEMEN'T SETTlEMENT 703. Commission Paid at Settlement 704. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oncinal,on Fee ., 10 ,. 802. Loan Discount % to 803. Appra,sal Fee 10 804. C'edil Report 10 805. Lende~s Inspection Fee to 806. Mortoaoe Ins. ADD. Fee to 807. Assumpl,on Fee to 808. B09. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to 1lil S Iday ( days %) 902. MIP Tollns. for LiteOfLoan tor months to 903. Hazard Insurance Premium for 1.0 vears 10 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months S oer month 1002. Morteaoe Insurance months S Der month 1003. CitvfTown Taxes months S oer month 1004. Countv Taxes months S oer month 1005. Schoel Taxes months @ S per month 1006. months t8l S oer month 1007. monlhs @ S per month 1008. monlhs t8l S eer month 1100. TITLE CHARGES 1101. SelUement or Cleslno Fee 10 1 102. Aoslract or Title Search 10 Tri-Countv Abstract Service 113.00 1103. TiUe Examination to 1104. TiUe Insurance 8inder to 1105. Documenl Preoaralion te "06. Netary Fees 10 1107. Attorney's Fees to Suzanne H. Griest 350.00 fincJudes above Item numbers: I 1108. TiUe Insurance te (includes above ifem numbers: ) 1109. Lende~s Coverage S 1 110. Owne~s Coverage S 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed S 38.50; Mertgage S ; Releases S 38.50 1202. Citv/Ceunrv Tax/SL1mDs; Deed 250.00. Mert;;ace 250.00 1203. Stale Tax/Stamos: Deed 250.00: Mortoaoe 250.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES . 1301. Survey to 1302. Pesllnseection to 1303. 2005/06 Scheol Taxes to Harrv E. Killian 386.85 1304. Ovemloht Deliverv Fee to United Parcel Service 18.00 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter on L.ine. 103. Section J and 502. Section KI 751.50 654.85 P~ge 2 Certified to be a true cepy. The undersigned hereby acknowledge receipt of a completJed copy of pages 1 &2 ot this stalement & any attachments referred to herein. I HAVE CAREFULLY REVIEWED THE HUD-l SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND ACCURATE STATEMENT OF ALL RECEIPTS AND DISBURSEMENTS MADE ON MY ACCOUNT OR BY ME IN THIS TRANSACTION. I FURTHER CERTIFY THAT I HAVE RECEIVED A PY OF THE HUD-l LEMENT STATEMENT. Seller Ruth P. Cramer ESL1te 8Y: liNT STATEMENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE ILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS H. r t, Esquire enl A nt TO K OWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON UDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010. L-. (1.INN/UNNI2 ) l f l~ r,~J "i l~"_; I);'..... ~ .J. LUvJ m1M&fBank 499 Mitchell Street, Millsboro, DE 19966 August 10, 2005 Law Offices of Zullinger - Davis 20 East Burd Street, Suite 6 P.O. Box 40 Shippensburg, PA 17257 RE: Estate of Ruth P. Cramer Date of Death: April 25, 2005 Social Security Number: 172-36-1578 Dear Mr. Davis: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type......... ..... ............. Checking Account Account Number..... .................. 97178756 Ownership (Names of).............. Lee E. Cramer, Ruth P. Cramer Opening Date.................... ...... .01/28/80 Balance on Date ojDeath.........$5,933.08 Accrued Interest $ 0.11 Total.................................... ...$5,933.19 2. Account Type........................... Savings Account Account Number..... ........... ....... 15004206834184 Ownership (Namesof).............. Ruth P. Cramer Opening Date........... ............... .08/29(02 Balance on Date oj Death.... ... .. $1,009.45 Accrued Interest $ 0.19 Total. ...... .... ..... ... ... ... ...... ........$1,009.64 .. , . Page 2 August 10, 2005 The above named decedent did not have a safe deposit box with this bank. For any additional information on this account please contact our King Street branch at 717-532-4132. Sincerely, {;/2t7LUrJ..> Ua'l/lllrV Charlene Warrington, Records Management 1-888-502-4349