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Home My WebLink About07-31-06 -.J 15056051058 REV-1500 EX (06-05) PA Deparbnent of Revenue '* Bureau of Individual Taxes . PO BOX 280601 Harrisburg, PA 1712~601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 06 0124 Date of Birth 178-16-1991 01/27/2006 05/30/1923 Decedent's Last Name Suffix Decedent's First Name MI MacGregor Margaret E (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix First Name MI Spouse's Social Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return <=> 4. Limited Estate <=> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required <=> 2. Supplemental Return <=> <=> <=> 4a. Future Interest Compromise (date of death after 12-12-82) <=> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) <=> 10. Spousal Poverty Credit (date of death <=> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes <=> David C. Gority, VP (717) 240-45Cj.5) "'" ':;,",.:':"') -------cC:::;,~ REGISTER OF.Wtt.LS USE Q/"'!!:Y -l , I Firm Name M & T Bank . , (,,) First line of address _/~, One West High Street or Post Office State ZIP Code DATE FILED (!l W ,\ .1.. ~~, ~"' ) -'Tl Second line of address Carlisle, PA 17013 Correspondent's e-mail address:dgority@mandtbank.com Under penalties of pe~ury, 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. NSIBLE FOR FILING RETURN Vf~ ~ c:.- DATE JUL 3 12006 SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 -.J~ v; -I 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: Margaret E MacGregor 1713-16-1991 RECAPITULATION 1. Real estate (Schedule A). 1. 186,204.87 17,205.68 2. Stocks and Bonds (Schedule B) . . . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) . . . 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 90,342.35 0.00 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 0.00 8. Total Gross Assets (total Lines 1-7). 8. 293,752.90 34,611.58 25,875.02 60,486.60 233,266.30 225,141.30 8,125.00 9. Funeral Expenses & Administrative Costs (Schedule H). 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . ..10. 11. Total Deductions (total Lines 9 & 10).... . . . . . . . ... . . .. 11. 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) . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - 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 .0_ 16. Amount of Line 14 taxable at lineal rate X 0 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 8,125.00 15. 0.00 16. 0.00 17. 0.00 18. 1,218.75 19. 1,218.75 19. TAX DUE 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 --.J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Margaret E MacGregor 1---... STREET ADDRESS 150 West Pomfret Street 1---.. ----. 21 06 0124 DECEDENT'S SOCIAL SECURITY NUMBER 178-16-1991 CITY Carlisle 1 STATE-----r ZIP-" _u__ ---- I PA I 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,218.75 1,157.82 60.93 Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 1,218.75 --- Total Interest/Penalty ( 0 + E ) (3) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 0.00 A. Enter the interest on the tax due. 0.00 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;........................................................................................ ~ :iJ b. retain the right to designate who shall use the property transferred or its income; ......................................... ~ :iJ c. retain a reversionary interest; or......................................................................................................... ............ ~ :iJ d. receive the promise for life of either payments, benefits or care? ..................................................................... ~ :iJ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................................... ~ :iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?. ............ ~ :iJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ :iJ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. S9116 (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 zero (0) percent [72 P.S. S9116 (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 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 zero (0) percent [72 P.S. s9116(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 four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. s9116(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-1502 EX+ (6-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 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 which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Net Proceeds sale of 150 West Pomfret Street, Cumberland County, Boro of Carlisle, PA VALUE AT DATE OF DEATH 186,204.87 Settlement Sheet Attached TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 186,204.87 REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 6,650 Face Value United States of America Savings Bonds, Series E & Series EE VALUE AT DATE OF DEATH 17,205.68 TOTAL (Also enter on line 2, Recapitulation) $ 17,205.68 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER NUMBER DESCRIPTION 1. None VALUE AT DATE OF DEATH 0.00 _L TOTAL (Also enter on line 3, Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH None 0.00 TOTAL (Also enter on line 4, Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-150B EX+ (6-9B) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION M & T Bank Checking Account 2672026032 @ DaD 2 M & T Bank Certificate of Deposit # 031003910307923 @ DaD VALUE AT DATE OF DEATH 5,428.19 17,468.83 3 Interest Accrued to DaD on Item # 2 346.20 4 M & T Bank Certificate of Deposit # 031003910580652@ DaD 10,000.00 5 Interest Accrued to DaD on Item # 4 19.52 6 Members First FCU Savings Account # 50761-00 @ DaD 16,112.92 7 Interest Accrued to DaD on Item # 6 11.48 8 Members First FCU Certificate of Deposit # 50761-41 @ DaD 2,000.00 9 Interest Accrued to DaD on Item # 8 4.07 10 Member First FCU IRA Account # 50761-10 @ DaD 12,649.60 11 Interest Accrued to DaD on Item # 10 15.68 12 Cash Found at 150 West Pomfret Street, Carlisle, PA 17013 121.13 13 Refunds - Various Magazine Subscriptions 80.45 14 Refund - Travelers Insurance Premium 717.00 15 Proceeds Sale of 1995 Buick LaSabre 4,730.00 17,796.40 426.00 16 Proceeds Sale of Personal Property 17 Refund - 2005 Federal Income Tax 18 CSF Lump Sum Payment 2,414.88 TOTAL (Also enter on line 5, Recapitulation) $ 90,342.35 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) SCHEDULE F JOINTlY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 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. B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER DR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 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 ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. 0.00 TOTAL (Also enter on line 7 Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. AMOUNT DESCRIPTION 1. FUNERAL EXPENSES: Ewing Brothers Funeral Home, Funeral Expenses Central Mausoleum Trust Fund, Care of Crypt St. Matthews Lutheran Church, Care of Grave 7,847.65 2,000.00 1,000.00 2 3 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Manufacturers & Traders Trust Company 12,200.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address One West High Street City Carlisle Year(s) Commission Paid: 2006 State PA Zip 17013 2. Attorney Fees 8,500.00 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 310.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills - Short Certificates S.w. Barrett Real Estate - Appraisal Fee M. Rutland - Appraisal Fee The Sentinel - Advertising Letters Testamentary Cumberland Law Journal- Advertising Letters Testamentary Misc Filing & Closing Costs 20.00 400.00 121.90 137.03 75.00 2,000.00 8 9 10 11 12 34,611.58 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PP & L - Electric Service 206.84 2 Comcast - Cable Service Balance due 47.82 3 UGI - Gas Service 1,677.28 4 Sprint - Telephone Service, Balance due 95.17 5 Borough of Carlisle - Water & Sewer Service 107.03 6 CitiBank - Credit Card Balance due 136.80 7 West Shore EMS - Medical Transportation 32.00 8 Hilton Lock Service - Balance due 289.52 9 Bankers Life Insurance Company - Premium Due 159.36 10 UPMC Physician Service - Balance due 59.87 11 Borough of Carlisle - Real Estate Taxes 150 West Pomfret Street, Carlisle, PA 814.84 10 David Sheibley - Trash Removal @ 150 West Pomfret Street, Carlisle, PA 1,100.00 11 BMS Performance & Repair - Balance due for repairs to 1995 Buick 74.26 12 McLarens Auto Detailing - Prepare 1995 Buick for sale 328.00 13 Smith, Elliott Kearns & Company, Preparation 2005 Federal & State Income Tax Returns 210.00 14 Anderson Painting, Repairs and Painting @ 150 West Pomfret Street, Carlisle, Pa 6,745.00 15 Janet Lloyd - Cleaning @ 150 West Pomfret Street, Carlisle, PA 150.00 16 Fluss Flooring, Repairs @ 150 West Pomfret Street, Carlisle, PA 1,487.13 5,900.00 6,005.00 17 Signature Flooring, Repairs @ 150 West Pomfret Street, Carlisle, PA 18 Shirley Chamberlain, Medical and Care expenses for dog 19 Thomas Oiler, Lawn Care @ 150 West Pomfret Street, Carlisle, PA 249.10 TOTAL (Also enter on line 10, Recapitulation) $ 25,875.02 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret E. MacGregor SCHEDULE J BENEFICIARIES FILE NUMBER 21-06-0124 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustl~e(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Mary R. Foster, 606 South Hanover Street, Carlisle, PA Friend $2,050.00 2 Mary Swartz Leedom, 1013 Northfield Drive, Carlisle, PA Friend $2,075.00 3 Virginia C. Shope, 203 Pisgah State Road, Shermans Dale, PA 17090 Friend $2,000.00 4 Connie Dawson Keeley, 716 Third Street, Cresson, PA Friend $1,000.00 5 Wanda Bowers, 1028 Alexander Springs Road, Carlisle, Pa Friend $1,000.00 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 MADI: 1 First Evangelical Lutheran Church, 100 East High Street, Carlisle, PA $56,28532 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 2 Cumberland County Historical Society, 21 North Pitt Street, Carlisle, PA $56,285.32 3 Humane Society of Harrisburg, 7790 Grayson Road, Harrisburg, PA $56,285.32 4 Dickinson College, P.O. Box 1773, Carlisle, PA $22,514,13 5 Carlisle Area Health & Wellness Foundation, 274 Wilson Street, Carlisle, PA $22,514.13 6 Carlisle YWCA, 301 "G" Street, Carlisle, PA $11,257.08 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 225,141.30 (If more space is needed, insert additional sheets of the same size) REV-1514 EX+ (12-03) SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4 on REV-1500 Cover Sheet) ESTATE OF Margaret E. MacGregor FILE NUMBER 21-06-0124 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. o Will 0 Intervivos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH LIFE ESTATE IS PAYABLE None o Life or o Term of Years - o Life or o Term of Years - o Life or o Term of Years o Life or o Term of Years o Life or o Term of Years 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Actuarial factor per appropriate table ................................................. Interest table rate - 031/2% 06% 0 10% 0 Variable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) ......................................$ 0.00 ANNUITY INTEREST CALCULATION NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE None o Life or o Term of Years - o Life or o Term of Years - o Life or o Term of Years - o Life or o Term of Years - 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......... ....$ 2. Check appropriate block below and enter corresponding (number) Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) o Monthly (12) o Other ( ) 3. Amount of payout per period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ............$ 4. Aggregate annual payment, Line 2 multiplied by Line 3 ................................... 5. Annuity Factor (see instructions) Interest table rate - 031/2% 06% 0 10% 0 Variable Rate % 6. Adjustment Factor (see instructions) .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity - If using 31/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . .$ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 ..................................................$ 0.00 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, insert additional sheets of the same size) ,-x' OMB NO. 2502-0265 ~ - / B. TYPE OF LOAN: ;:;/ 1.QFHA 2.oFmHA 3.DcONv. UNINS. 4. OVA 5.!ElCONV. INS. ? ';DEPAATMENT OF HOUSING & URBAN DEVELOPMENT 6. FILE NUMBER: 17. LOAN NUMBER: / / SETTLEMENT STATEMENT 06078CAP / 8. MORTGAGE INS CASE NUMBER: C. NOTE; This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settJement agent are shown. Items marked "[Poe)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 (06078CAP.PFOI06078CAPI19) D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: i HOWARD S. ROSEN ESTATE OF MARGARET E MacGREGOR LEA A. ROSEN 2447 N. 3rd Street Harrisburg, PA 17110 G. PROPERTY LOCATION: H. SETILEMENT AGENT: 25-1722090 I. SETTLEMENT DATE: 150 W. Pomfret Street Barristers Land Abstract Co. Carlisle, PA 17013 July 11, 2006 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 3310 Market Street Camp Hill, PA 17011 , ,J. SUMMARY OF BUYER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SE:LLER: 101. Contract Sales Price 199,900.00 401. Contract Sales Price '. 199,900.00 102. Personal Property 402. Personal Propertv I , 103. Settlement Charoes to Buver (line 1400\ 3,391.38 403. " 104. 404. 105. 405. Adiustments For /terns Paid Bv Seller in advance Adiustments, For /terns Paid Bv Seller in advance 106. Citv Taxes to 406. Citv Taxes to 107. CountvTaxes 07/11/06 to 01/01/07 396.37 407. Countv Taxes 07/1'1/06 to 01/01107 396.37 108. School Taxes 07/11/06 to 07/01/07 1,922.10 408. School Taxes 07/1 '1/06 to 07/01/07 1,922.10 109. 409. 110. .410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BUYER 205,609.85 420. GROSS AMOUNT DUE TO SElLER 202,218.47 200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,000.00 501. Excess Deposit (See Instructions) 202. Principal Amount of New Loan(s) 502. Settlement Charoes to Seller (line 1400) 16,013.60 ~03. Existino loan(s) taken subject to 503. Existino loan(s) taken subiect to ~04. 504. Payeffof first Mortgage m5. 505. Pavoff of second Mortoaoe m6. 506. ~07. 507. ~08. 508. ~09. 509. Adjustments For Items Unoaid Bv Seller Adiustments For Items Unpaid Bv Seller !10. CltVTaxes to 510. Citv Taxes to ~11. County Taxes to 511. CountvTaxes to ~12. School Taxes to 512. School Taxes to ~13. 513. ~14. 514. ~15. 515. ~16. 516. ~17. 517. :18. 518. 19. 519. '20. TOTAL PAID BY/FOR BUYER , 1,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 16,013.60 00. CASH AT SETTLEMENT FROMfTO BUYER: 600. CASH AT SETTLEMENT TOIFAlOM SELLER: 01. Gross Amount Due From Buyer (Line 120) 205,609.85 601. Gross Amount Due To Seller (Line 420\ 202,218.47 02. Less Amount Paid BylFor Buyer (Line 220) ( 1,000.00) 602. Less Reductions Due Seller (line 520) ( 16,013.60 03. CASH ( X FROM) ( TO) BUYER 204,609.85 603. CASH ( X TO) ( FROM) SELLER 186,204.87 The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein. Boy,,, ~ ~~ L A. ROSEN S,,,,, EST~R":RET E MaoGREGOR BY: ~'l/1. ,'X"i?r~ 707 /2;-/ 6~~ oq;?:~ L. SETTLEMENT CHARGES .~ ~ roTAL COMMISSION Based on Price $ 199,900.00 @ 6.0000 % 11,994.00 PAID FROM PAID FROM Division of Commission (line 700) as Follows: BUYER'S SELLER'S I> 6,022.00 to Hooke, Hooke & Eckman FUNDS AT FUNDS AT I> 5,972.00 to HOWARD HANNA REAL ESTATE SERVICES SETILEMEoNT SETTlEMENT :::ommission Paid at Settlement 11,994.00 Transaction Fee to Howard Hanna Real Estate Services t25.00 TEMS PAYABLE IN CONNECTION WITH LOAN .oan Oriaination Fee % to .oan Discount % to Appraisal Fee to Credit Report to Lender's Inspection Fee to Mortaaae Ins. ADO. Fee to Assumption Fee to Document Prep. Fee ITEMS REQUIRED BY LENDER TO BE PAlO IN ADVANCE nterest From to @ $ !day ( days 'Yo) Mortaage Insurance Premium for months to -lazard Insurance Premium for years to , RESERVES DEPOSITED WITH LENDER . Hazard Insurance @ $ oer . Morlnane Insurance @ $ cer . Citv Taxes @ $ cer CountvTaxes @ $ oer School Taxes @ $ per @ $ oer @ $ per Aoareoate Adiustment @ $ oer , TITLE CHARGES . Tax Cert to Barristers Land Abstract Co. 2.00 Final SewerlWater to Carlise Borouoh Municical Authoritv 32.36 . 2006 School Taxes to Borouoh of Carlisle Tax Account 1,976.24 Tille Insurance Binder to Document preoaralion to Notarv Fees to Jovce Ehrich 5.00 10.00 . Attorney's Fees . to 7tncludes above item numbers: ) Tille Insurance to Barristers Land Abstract Co. re-issue '1 222.88 -fincJudes above item numbers: ) . Lender's Coverage $ . Owner's Coverage $ 199,900.00 Barristers Land Abstract Co. Deed Preparation Barristers Land Abstract Co. . Overnight Barristers Land Abstract Co. , GOVERNMENT RECORDING AND TRANSFER CHARGES , Recording Fees: Deed $ 39.50; Mortgage $ ; Releases $ 39.50 . Citv!CounlvTaxlStamos: Deed 1,999.00' Mortaaae 1,999.00 . State Tax/Stamos: Deed 1,999.00; Mortoaae 1,999.00 . Record Mortqaqe Assiqnment Recorder of Deeds . ADDITIONAL SETTLEMENT CHARGES Survev to Pest Insoection to Wire Fee Barristers Land Abstract Co. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) /'f 3,391.38 16,013.60 ,ning page 1 ollhis statement, lOe signalodes acknOYAe~ge receipt 01 a campieted copy ~f page 2 allhis two page~- /1~M~ B~e~:nd Abstract Co. 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