HomeMy WebLinkAbout06-07-06
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
OFFICIAL USE ONLY
REV-1500 EX (6-00)
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21
COUNTY CODE
05
YEAR
1021
NUMBER
DATE OF DEATH (MM-DD- YEAR)
Novernber15,2005
DATE OF BIRTH (MM-DD-YEAR)
June 30, 1927
SOCIAL SECURITY NUMBER
162-22-2146
1lIS RETURN MUST BE FLED IN DUPLICATE WITH THE
REGISTER OF WILLS
DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAl)
Gettle, Velva A.
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
X 1. Original Return
4. limited Estate
2. Supplemental Retum
4a. Future Interest Comprise (date of death after 12-12-82)
3. Remainder Retum (DMeofdelllh priorm 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate (Attach copy of Will)
9. Litigation Proceeds Received
7. Decedent Maintained a Living Trust (Attach a copy of Trust)
10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Alt"t-h ~,.h nl
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
FRANCES H. DEL DUCA
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
.- Sd6 s: (#"'~~-4!$.
Carlisle. PA 17013 e/l~c:.../~f:.- ~
<<5"',.
TELEPHONE NUMBER
1. Real Estate (Schedule A)
(1)
110.000.00 l
c:)
296,910.7YF
$ 0.00 ~
$ 0.00 ~
69,491.18 ~
$ 0.00~.
OFFICIAL USE ONLY
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
(2)
(3)
(4)
(5)
(6)
c_
,
2. Stocks and Bonds (Schedule B)
4. Mortgages & Notes Receivable (Schedule D)
I
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5. Cash, Bank Deposits & Misc. Personal Property (Schedule E)
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6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
\.0
(7)
74,973.51 ~
U1
N
(8)
551,375.46
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities & Liens (Schedule I)
(9)
(10)
69,589.49
$ 0.00
11. Total Deductions (total Lines 9 & 10)
(11)
69,589.49
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
(13)
481.785.97
308,255.48
12. Net Value of Estate (Line 8 minus Line 11)
(12)
m::lri~ {~,.hMIII~ .1\
14. Net Value Subject to Tax (Line 12 minus line 13)
(14)
173,530.49
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x
(15)
(16)
(17)
(18)
$ 0.00
$ 0.00
9,140.17
16. Arnount of Line 14 taxable at lineal rate
x
17. Amount of Line 14 taxable at sibling rate
76,168.01 x .12
97,362.48 x .15
14,604.38
18. Amount of Line 14 taxabfe at collateral rate
19. Tax Due
20D
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
23.744.55
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address
STREET ADDRESS
54 West Main Sl
CITY I STATE IZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
23,744.55
20.800.00
1.040.00
Total Credits (A + B + C) (2)
21,840.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnterestlPenaltv (0 + E) (3)
If line 2 is areater than line 1 + line 3. enter the difference. This is the OVERPAYMENT
Check box on Page 1 Line 20 to request a refund (4)
$ 0.00
$ 0.00
5.
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
1,904.55
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE (58)
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
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 revisionary 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 on year of death
without receiving adequate consideration? c=J
3. Did decedent own an "in trust fo( or payable upon death bank acx:ount or seaJrily at his or her death? c=J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ~ c==J
F 1lE ANSWER TO MY a=1lEAEK:NE QlES1IONS IS YES, YOU NlJST CONFI..ETE SQEDlLE G Nm FLE rr AS PART a= 1lE RETURN.
No
~
B
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowtedge and belief, it is true, correct, and complete.
Declaration of preparer other than the personal representative is based on all the information of which preparer has any knowledge.
DATE
cOC
~i.
s
6<..Lt~-!
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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 .5. 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 exemDt 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.$. 9116(a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs 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 .5. 9116(a)(1.3)]. A sibling is defined, under Section
9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Velva A. Gettle
FILE NUMBER
21"()5-1 021
All real property owned sOlely or as a tenant In common must be reported at fair market Y8lue. 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 which Is jolntly-owned with right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Residence - 54 West Main Street, Newville, PA, 17241
Sold 5126/06 - HUD Fonn enclosed
VALUE AT DATE
OF DEATH
110,000.00
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
110,000.00
REV-1503EX + (6-98)
*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Velva A. Gettle
FILE NUMBER
21-05-1021
All property joinUy-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
64,736.72
Gibb Financial Service
One Giant Lane, Carlisle, PA - Acct. statement attached
Cadaret Grant & C.D./Pershing 43C784139
2.
Pursell Associates, Inc.
205 York Road. Carlisle. PA
Wachovia Acct No. 3680-3807
232,174.05
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
296,910.77
REV-1508 EX ... (6-98)
~~
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Velva A. Gettle
FILE NUMBER
21-05-1021
Include the ~ c;llitigation and the da1e the procseds were reaWed by the estate. AI property joIndy-owned with the rtgtt d survIvonIhIp must be c:IscIo8ed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Farmers National Bank of Newville
P.O. 156, Newville, PA
Acct. # 11757-9
Acct. #1596217 - 46,497.50 plus 57.22 interest
Statement enclosed
323.79
46,554.72
American Progressive #ON5057932R - refund
American Progressive #045057934 - refund
65.67
71.99
Vehicle
10,500.00
Furniture (chest, settee)
500.00
Com cast - refund
20.76
Erie Insurance - refund
104.00
Household
9,890.25
Carlisle Regional Medical Center - refund
912.00
IRS refund for 2005
548.00
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
69,491.18
REV-1510 EX + (6-98)
~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
VelV8 A. Gettle
21~5-0121
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF DECO'S
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH INTEREST EXCLUSION TAXABLE
NUMBER ATTACH A copy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET (IF APPLICABlE) VALUE
1. Sovereign Bank - #2898167420 C/O IRA - fonnerly York Federal
Savings & Loan -74,806.60 w/accrued into of 166.91 74,973.51 37,486.76 37,486.76
Beneficiaries as of March 30, 1994
Ruth V. Stouffer, sister of decedent
First Church of God, Newville
TOTAL (Also enter on line 7, Recapitulation) 37,486.76
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+(12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Velva A. Gettle
21..05-1021
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ronan Funeral Home 7,721.50
2. Westminister Cemetery 1,045.00
3. Lisa's Floral Shop 253.29
4. Death date plaque 130.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions Barbara Wickard - 12,500.00
Name of Personal Representative (s) Eugene Smith - 12,500.00
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
-
Year(s) Commission Paid:
2. Attorney Fees FRANCES H. DEL DUCA 22,000.00
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 360.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 90.00
7. Sentinel 151.55
8. Cumberland Law Journal 75.00
9. Kough's Oil Service 754.12
10. PP&L 246.43
11. Sprint 138.44
12 Erie Insurance (vehicle 157.00
13. Frances H. Del Duca - short certificates 24.00
14. Carlisle Regional Medical Center 912.00
15. Newville Water & Sewer 209.22
16. Sale Expenses - Personal Property 2,562.32
17. Reserve 300.00
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
t~
CONTINUATION PAGE
SCHEDULE _H_
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Velva A. Gettle
FILE NUMBER
21-05-1021
ITEM
NUMBER
18.
19.
20.
21.
22.
DESCRIPTION
VALUE AT DATE
OF DEATH
6,714.61
201.00
291.00
249.01
28.00
Real Estate sale expenses
PA Department of Revenue
Erie Insurance
Real Estate tax
Short Certificates
TOTAL
69,589.49
REV-1513 EX + (9-00))
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Velva A. Gettle
FILE NUMBER
21-05-1021
RELATIONSHIP TO DECEDENT .MMJLNTOR
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SK6R:
ClFFm"AlF
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
I transfers under Sec. 9116 (a) (1.2)]
1. Smith, Eugene & Connie Smith Neighbor $20,000.00
56 West Main St., Newville, PA
2. Barbara Wickard Niece 10% residue
117 Flintstone Dr., Newville, PA
3. Ruth V. Stouffer Sister 10% residue
103 Conodogulnet Mobile Estates, Newville, PA
4. David Gettle Nephew 5% residue
5 Penn Drive, Newville, PA
5. Diane Porter Niece 5% residue
152 Conodoguinet Mobile Estates, Newville, PA
EN1ER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOVVNAWJVE ON UfES 15TI-ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS: Charitable
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. First Church of God, Pastor Wayne Good 70% residue
475 Shippensburg Rd., Newville, PA
2. Church of God Home
801 Harrisburg Pike, Carlisle, PA
3. Doubling Gap Center, Inc. (Camp YoliJwa)
1550 Doubling Gap Rd., Newville, PA
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - ENTER TOTAL NON- TAXABlE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
-
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~ FARMERS NATIONAL BANK
OF NEWVILLE A Division of Adams County N.'1tlonal Bank
December 8, 2005
Frances H. Del Duce, Esquire
10 West High Street
Carlisle, PA 17013
RE: Estate of Velva Gettle
Date of death: November 15, 2005
Dear Ms. Del Duca:
Velva Gettle had a checking account #11-757-9 with this bank which was opened
March 1, 1947. The account has always been in her name alone and a balance as of
November 15 of $323.79. It is a non-interest-bearing account.
She also had a money market account #1596217 which was opened January 2,
2003. This account was also in her name alone and had a November 14 balance
of $46,497.50 plus $57.22 accrued interest.
Sincerely yours,
~::::H
Executive Vice President
PO. Box 156, Ne~rville, PA 17241 · (717) 7765312
GIBB FINANCIAL SERVICES, a Division of Orrsto~vn Bank
1 Giant Lane, Carlisle, PA 17013
(717) 249-3737
FAX (717) 249-8010
January 4, 2006
Frances H. Del Duca
Attorney at Law
lOWest High Street
Carlisle P A 17013
RE: Estate of Vel va A. Gettle
Dear Frances,
Weare writing in response to your letter dated November 22, 2005 regarding
the Estate of Velva A. Gettle. Enclosed is the paperwork to be completed to by the executors to
open an estate account. Please complete all areas high lighted and sign as indicated.
Ms. Gettle's account with PershinglCadaret Grant~3C 157906 was opened as an
Individual account on November 3, 1995. Following is a list of holdings in the account and date
of death values for each item.
Total Market Value as of 11/15/2005 $64,736.72
Symbol TYPE Quantity Security Value as of
Description 11/15/2005
FCR MMKT Fed Cap Res $1.70
ACNB STOCK 100 sh @ $21.00 ACNB Corp $2100.00
Com
WTR STOCK 976 sh @$33.56 ,- AQUA America $32754.56
Inc Com
COSIX MUTUAL 1365.868@$6.03 Colwnbia $8236.18
FUND Strategic Income
Fund
Bond $9000 face FNMA GTD $9391.32
REMIC
Bond $16000 face General Mtrs $12,252.96
Acceo Corp
~~'I)~
Lisa Riggleman
Registered Sales Assistant
Securities and other investment products offered through Cadaret Grant & Co., Inc., a securities broker dealer, member SIPC and
NASD. The Orrstown Bank and Cadaret Grant are not affiliated.
NOT A DEPOSIT NOT FDIC INSURED NO BANK GUARANTEE NOT FEDERAL GOVT AGENCY INSURED MAY LOSE VALUE
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Velva A Gettle
162-22-2146
November 15, 2005
Account #: 2898167420 Type: CDIIRA Open date: 4/14/1995
In the name of: Velva A Gettle
Date of Death Balance: $74,806.60
Int.(YTD) from 1/1/2005 to 10/31/2005 $3,098.56
Accrued interest to date of death: $166.91
Other Info: Beneficiary: Ruth V Stouffer 50% & First Church of God 50%
Page 1 of 1
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Financial Consultants
December 7, 2005
Frances H. Del Duca
10 W. High Street
Carlisle, PAl 7013
Dear Attorney Del Duca:
Per your request, I am providing you with the information concerning Velva A. Gettle's
holdings with_ us.
Velva A. Gettle, Individual
DOD 11/15/2005
3680-3807
QTY DESCRIPTION PRICE ACCRUED V ALUE*
200 Bristol Myers Squibb Co 21.521 4,304.20
400 Kilroy Realty Corp 25.185 10,074.00
367 MCI Inc 19.756 7,250.45
200 Martha Stewart Living 18.176 3,635.20
400 Microsoft Corp 26.980 10,792.00
400 Penn National Gaming Inc 30.474 12,189.60
100 Time Wamer Inc 1 7.700 1,770.00
34,000 GMAC 6.5010 5/15/2019 77.222 .00 26,255.48
35,000 GM Corp7.40% 9/1/2025 63.000 539.28 32,370.03
20,000 GMAC 70/0 10/15/2011 90.945 118.90 18,307.90
23,000 Lehman Bros 5.5% 8/27/2019 98.175 65.85 22,646.10
10,000 Rite Aid 6.875% 8/15/2013 81.250 173.24 8,298.24
1 7,000 Provident Bk CD 5.5% 10/30/2022 97.481 40.99 16,612.76
15,000 Sprint 6.875% 11/15/2028 108.517 .00 16,277.55
20,000 Treasury 5.5% 7/28/2025 95.070 54.24 19,068.24
10,000 Xerox Credits 6.5% 4/29/2013 97.125 32.05 9,744.55
10,000 Xerox 7.625% 6/15/2013 104.500 319.62 10,769.62
1808.13 Cash 1,808.13
Date of Death Value ** $232,174.05
fy
, ~ ~
In order to proceed further, we will need to have an Estate account opened for Ms. Gettie.
This will require a New Account application to be completed. We will need to have a'
205 York Road · Carlisle, PA 17013 · (717) 243-0619 · 1-866-443-0619 . Fax (717) 243-3216
Securities products offered through Wachovia Securities Financial Network, LLC, (WSFN), Member NASD /SIPC
Pusell Associates is a separate entity from WSFN
Death Certificate, Short Certificate, Affidavit of Domicile and a letter of instruction
stating that all assets are to be moved from the Individual account to the Estate account.
Additionally, some of the above listed holdings have a Death Put benefit available to
them. Exercising this benefit will require additional paperwork. Please have the
executors contact me to discuss the distribution and/or dissolution of the Estate Account.
If you have any additional questions, please feel free to give me a call at 717-243-0619.
Sincerely,
C!~ (j)wud-t~"
Richard B. Pursell, President r
Pursell Associates, Inc.
* The afore listed summary of prices/quotes/statistics has been obtained from sources believed to be reliable, but
is not necessarily complete and cannot be guaranteed. Prices may not reflect the value at which securities
could be sold. This summary is for informational purposes only. Past results do not indicate future performance.
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ELECTION OF BENEFICIARY
This election of Beneficiary will supersede any existing documents now on file.
VELVA A GETTLE
Customer Name (please type)
Primary
NAME
RUTH V STaJFFER
ADDRESS 43 Hilltop Ln, Newville, PA 17241
Street and Number City and State
Zip
-~=-------------- - --M-S-00IAL SEetfRlT~{ NO. - - 16~ 2--Z=Zt47
RELATIONSHIP sister
% GRANTED 50
tf_L r c!f PRIMARY
NAME FIRST CHURCH OF GOD NEWVILLE
NAME
ADDRESS 4 75 Shippensburg Rd., Newville ADDRESS
TAX 10
~ # 25-1398741 SaC.SEC. #
RELATIONSHIP
church
RELATIONSHIP
% GRANTED
50
% GRANTED
NAME
NAME
ADDRESS
ADDRESS
saC.SEC. #
SOC.SEC. #
RELATIONSHIP
RELATIONSHIP
% GRANTED
% GRANTED
The Grantor shall have the right to change this designation at any time or times during his or her lifetime by filing
a new Election of Beneficiary with the Trustee.
3/30/94
Office
, 2J.vJl----- i2' : ~ (J-m:'
Customer Signature
9t4./.J y ~) /1-Ct;;
Witnessed! Accepted By
Date
Carlisle
1667
.
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A. Settlement Statement
U.S. Department of Housinq
and Urban Development ~
,r
B. Type of Loan
1. 0 FHA
4. OVA
OMS No. 2502-0265
2. 0 FmHA
5. 0 Cony. Ins.
3. I8l Cony. Unins File Number
06-19
Loan Number
11538303
Mortgage Insurance Case Number
C. NOTE:This form is fU~~ish~ to give ~ou a s.tatement ~f actual settlement costs. Amounts paid to and by the settlement agent are shown
Items marked p.o.c were paid outSIde of closing; they are shown here for informational purposes and are not included in the totals.
D. NAME AND ADDRESS OF BORROWER: Bobbl Ann Olson
5240 Westgage Drive, Girard, PA 16417
E. NAME AND ADDRESS OF SELLER:
Estate of Velva Gettle
54 West Main Street, Newville, PA 17241
F. NAME AND ADDRESS OF LENDER:
M& T Mortgage Corporation
One Fountam Plaza, Post Closing/6th Floor, Buffalo, NY 14203
G.PROPERTY
LOCATION:
54 West Main Street
Newville, PA 17241
H. SETTLEMENT AGENT:
PLACE OF SETTLEMENT:
TIN:
I. SETTLEMENT DATE:
Law Office of Andrew H. Shaw
61 West Louther Street, Carlisle, PA 17013
33-1098509
0512612006 I RESCISSION DATE:
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 SUO 000.00 401. Contract Sales Price $1l0 000.00
102. Personal Property 402. Personal property
103. Settlements charges to borrower: 403.
(from Une 1400) $5,358.72
104. 404.
105. 405.
ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE:
106. Cityltown taxes to 406. City/town Taxes to
107. County Taxes OS/26/2006 to 01/01/2007 $152.49 407 County Taxes OS/26/2006 to 01/01/2007 $152.49
108. Assessments OS/26/2006 to 07/01/2006 $78.44 408. Assessments OS/26/2006 to 07/01/2006 $78.44
109. 409.
110. 410
111 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER: $115,589.65 420. GROSS AMOUNT DUE TO SELLER: $110,230.93
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201, Deposit or earnest money $2,000.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) $104,500.00 502. Settlement charges to seller (line 1400) $6,71.4.61
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204, 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206 506.
207 507.
208. SOB.
209. 509.
ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER:
210. City/town taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
213. 513,
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519
220. TOTAL PAID BY/FOR $1.06,500.00 520. TOTAL REDUCTIONS $6,714.61
BORROWER: IN AMOUNT DUE TO SELLER:
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER
301. Gross amount due from borrower (line 120) $11.5,589.65 601. Gross amount due to seller (line 420) $11.0,230.93
302. Less amount paid bylfor borrower (line 220) $106,500.00 602 Less reductions in amt. due seller (line 520) $6,71.4.61
303. CASH ( (gl FROM) ( D TO ) BORROWER: $9,089.65 603, CASH ( 0 FROM) ( ~TO) SELLER: $103,516.32
HUD-1 (3-86) - RESPA, HB 4305.2
PAGE 1
,
.. ---,..
HUD-1 (Re~. 3/B6)
L.
SETTLEMENT CHARGES
OMS No 2502-0265
700. TOTAL SALES/BROKER'S COMMISSION
BASED ON PRICE $UO, 000. 00 5 %: $5,500.00 PAID FROM PAID FROM
@
BORROWER'S SELLER'S
DIVISION OF COMMISSION (LINE 700) AS FOLLOWS; FUNDS FUNDS
701 to Georae L. Ebener & ABsoci.ates AT AT
702 10 Georae L. Ebener & Assooiates SETTLEMENT SETTLEMENT
70J 10
104. to
705 Commission paid at se1tlement
706 $5,500.00
800. ITEMS P"AYABLE IN ONNECTION WITH LOAN:
801. loan origination fE/II % to M&T Mortgage Corporation
802. loan discount 2.0000 % to M&T Mortgage Corporati.on
803. AppraiSal fae to: M&T Mortgage Corpora tion $250.80
( $330.00 P.oc.) ($10.00)
804. Credi1 report to: M&T Mortgage Corporation
805. lender's inspection lee M&T Mortgage Corporation
806. Mortgage Insurance applicallan foe 10 M&T Mortgage Co.rpora tion
807. Assumption foe M&T Mortgage Corporation
BOB. Post Closing Inspection to Appraisa~. cam $75. 00
B09. Tax Service Fee tc First American RETS
611. Flood Cert Fee to First Amerioan FDS $76.00
812 App~ica tion Fes to MliT ($100.00 POCB) $8.00
e13 Processing Fee to M&T
814 Doc Prep Fee to M&T $195.00
615 Comp~etion Escrow to M&T $400.00
$900.00
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVA
901. Interest trom
OS 26/2006 to
NeE.
06/01/2006
$115.95
$19.33 I day
@
902 Mortgage insurance premium for
903 Hazard insurance premium lor
904 Flood Insurence premium lor
905
mos. to
yrs. to
yrs. to
p
1007.
1000.
1009
D R:
3. 00 months @
months @
months @
12. 00 months @
12. 00 months @
months @
months @:!!
months @
M~..~il~i ll~x~~n..ni '~~iJli'f l1~j~.'m...i
. TITLE
rni,t71
1001. Hazard Insurance
$27. 75 per month
per month
per month
$20. 75 per month
$63.52 per month
per month
p5[ month
per month
$83.25
1002. Mortgage insurance
1003. CIty property taxes
1004. County property taxes
1005 Annual assessments
1006. Flood insurance
$249.00
$762.24
1101. Setllemenl or clOsing fee to LaW' O:f:fi ce or Andrew H. Snaw
1102. Abstract or liUe search to
1103. Title el(3minatlon to
1104. Tille insurance binder to
1105 Document preparation to
1106. Notary fees to Andrs.". H. ShaW' $20. 00 $10.00
1 107. Attorney's fees 10
.. n f;t t:"',~~~4. - I .. .
~
" 14'" r ">-=l~ :r' \0 l', f)' . ,
I' , , i .
1112. Closing Protection Letter $35.00
1113
1200. GOVERNMENT-REGaRDING AND TRANSFER CHARGES:
1201. Recording lees: Deed $38. SO : Mortgage $64.50 ; Releases $103.00
1202. Cily/counly lax/stamps Deed $1,100.00. Mortgage $1,100.00
'203. State Inxlstamp&' Deed $1,100. 00 : Mortgage ; Olher $1,100.00
1204
1205
13{fO. ADDIi IONAL SETTLEMENT CHARGES:
1301 SUNSY to
1302. Pesllnspectian 10
1303 Overnight Fee $20.00
1304 Final Wa ter/Sewer Bi~l $104.61
1305.
1306.
1307
1400. TOTAL SETTLEMENT CHARGES $5,358.72 $6,714.61
(inclUdes above items NUmbers:
1108. Tille insurance to secur:ity Tit:.le Guarantee COIporatioJ:l
{inciUdl'!s abol/O Items Numbers: 1102, 1104, 1107, 1108
1109. lender's coverage
1110. Owner's coverage
1111 Endorsements 100, 300, 8.1
$104,500.00 )
$
I have carefully reviewed the HUD-1 Settlement Statement and to the Dest of my knowledge and belief, il 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 copy of the HUD-1 Settlement Statement.
" I'
Date: __ ~:~~:or ~LV1.viAIL- j '-fj /I.1.R () Ad
, Estate of Velva Gettle
Seiler or ,1') -(- () - .,1/ /
Agent {~~C .~~_L --f'.,A.
The HUD.1 Settlement Statement which I have prepared IS a true and accurate acr...ount of this transaction I na/v~j1aUSed or W/"~/Pa~Ule Ine jnl to be dIsbursed In accordance
with this statement. .t-J I
II~ 1;y ~~
Borro\Wr. ,-L~~ ~j1'\ C\;~
Bobbi Ann Olson
Date:" 5'- -;;.? ~ --6?
Borrower:
Date.
Date
5----,;;t.
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