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HomeMy WebLinkAbout10-23-06 (3) ..-J J.505605J.047 REV-1500 EX (06-05) PA ()epaI1rnem of Reveooe *' Bureau of IncIviduaI Taxes PO BOX 280601 HarrisblJg, PA 1712&3i01 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY Comty Code Year File NtJnber INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 06 , 00 214 Date of Birth 21020 Decedenfs Last Name 190 7 o 2 1 7 2 00 6 Suffix o 6 2 9 1 925 Decedenfs First Name MI WINGARD KR (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix WEJDELL E Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW cB ,. Original Return c::> c::> 4. Umited Estate c::> 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 2. Supplemental Retum c::> a 6. Decedent Died Testate (Attach Copy of Will) c::> 9. Litigation Proceeds Received c::> 4a. Future Interest Compromise (date of death after 12-12-82) c::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c::> 10. Spousal Poverty Credit (date of death c::> 11. Section 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 8 5~ 8 ~ o 8. Total Number of Safe Deposit Boxes KEITH o BRENNEMAN E S Q 717 N DATE FILED 0 :::::0 11'1 E5 :::J-' C? '-1'1 q c::> -,~ -::m C~) /- i/f,J (,") ,;:-') .'.~l Firm Name (If Applicable) SNELBAKER First line of address & B R E NN E MAN 4 4 W EST KA.I N Second line of address STREET City or Post Office KECHANICSBURG State P A ZIP Code 1 7 055 Correspondent's e-mail address: Under penalties or peljury, I declare that I have examined this return, including accompanying schedules and statemenls, 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. SIGNATURE Of: NSI OR FILING RETURN DATE Executrix ADDRESS 124 E. R1d e Street Carlisle PA 17013 SIGNA~ ~R THAN REPRESENTATIVE ADDRESS 44 West Main Street, Kechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY DATE /.' 7,.1.. 0 , Side 1 L 15056051047 15056051047 .-J cy. \;o\~{OV ~ u\L ~ ~ ~..A.. ~. \.." ~ .-J J.SOSlaOS2046 Rev.1 SOO EX ~NAIM: RICAPtTULATIOM ~ " Rul"'to (Schedule A), .,."."....",...""".""",., . , . , . , . . .. , . 2, StocttI and Bond. (~B) , . . , , . . . . , . . , , . . . . , , . , ;', . , . . . . . . . . , . , ','. 2. 3. CtoHl'1 Held Corpoflltlol., PIu1nefIhlp or SoIe-Propriemhlp (ScMdulo C) . , . .. 3. .. MortQiIQeI" Notea ~ (Schedule D) . , . , , , , , , . . . . , . . ,', , , , . . . . . . .. .. 5. CUh. &.nit 0tp0IIta .. MlaeeIMeoua PorIoMI Property (Sc:hodult E) ,.. . . . ,. S. $. JalntIV OWned Property (Schedwe F) c::> Separate BIlnQ ReqUHted . . . . . .. .It 7. Inw.V\voI ~.. MtacettIMOUI Nan-Probate Property ($chid" G) c::> Sepnte BtIIng Requ..ted~, . . . , '.' "f. 8. Totel aro.a..... (totIlI UnoI '-7). , . . , . . , , , , , , , , , , , , , . . '. . . . . . , . . , , , .. a. g. FUMI'II ~ .. Ad""nlatnltlvo Cotta (Schedule H), , . . . , . . , . . . . . . . . . . .. G. 10, Deb\t of ~, Mortgage L./IlbItItIH. .. LlIna (Schedule I) , , , . . . . . . . . . . . , . 10. 11. Tote. Dtduottona (totIl LlneI9.. 10)",."...,...,.".,.,....".,...... 11, 12. Net VMue of 1._ (Line 8 mtnu8 LIM 11) . . , . . . . . . , , , , . , . , , , . , '. , '. . . , . . . 12. 13, Charitable and Gcwemmen'" BequeatllSec 9113 TNt.. for whlch M ~ to tax hu not bien mD (Schedu" J) . , . . , . . , , . , . . . . . . . . . . . . . 13. 1., Net Vatue SubJect to Tax (Line 12 minus Line 13) " . " " " " .. .. '.. " " . .. 14, TAX COM'UTATtON . III INITRUCTlONS FOR AP'UCAILI RATlS 1&, Amount of Line 14 tuat* at the tpOUuI tax rate, Of tnmIfert unclw See, 9116 (1)(1.2) X .O~ 18, Amount of Une 14 taqbIe ItltnHlrate X ,O~ 17, Amount of Line 14 taubIe It albMng..... X, 12 18, Amount of Line 14 ~ It coIIItenaI rate X, 1 & - 18. 363,137-81 18. . n. . '8. 19, TAX DUE, , . , , , , , , . . . , , . . . , , , . , . , , . , , , , . . , , . . , , , . . . . , . . . . . . . , , , , -. , lG. 20, lItLL IN THI OVAL III YOU ARI RIQUIITlNG A REFUND OP AN OVlRMYMINT 8.de2 L.. J.SOSI.OS2048 Dtctdont'l 800tII 8000nty Numbor 21 0 2 0 1 907 1 4 7\,9 0 0 . 0 0 4 7" 7 7 8. 6 4 - . I 28:500-21 ~ I . 1 ., 9,i 6 4 3 2 .0 i 1 5 0,: 7 4 8. 3 3 3 9 4.,', 5 7 o. 3 8 . 3 l'i 1 7 7. 9 7 \ 2 5 4- 6 0 3 1'14 3 2. 5 7 3 6 ~'i 1 3 7- 8 1 - 3 6 3,,1 3 7. 8,1 . 1 6,3 4 1 . 2 0 . . 1 6,3 4 1 . 2 0 c::> Ja505&.052046 ....J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 -06-00 214 DECEDENTS NAME Wendell E. Wingard STREET ADDRESS 558 F Street - CITY , STATE I ZIP Carlisle ! PA I 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 16,341. 20 15,500.00 775.00 Total Credits (A + 8 + C ) (2) 16,275 . 00 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestJPenalty ( 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, Une 20 to request a refund. (4) 8. Enter the total of Line 5 + 5A. This is the BAlANCE DUE. (5) (SA) (58) "" '0 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. 66.20 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 8. retain the use or income of the property transferred;.......................................................................................... 0 [iJ b. retain the right to designate who shall use the property transfened or i1s income; ............................................ 0 iii c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 Ga 2. If death occuned after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 l:iI 3. Did decedent own an -in trust for" or payable upon death bank account or seaJrity at his or her death? .............. 0 Ga 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. 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. ~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 zero (0) percent [72 P.S. fi9116 (a) (1.1) Oil]. 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 retum 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. ~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 four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent whether by blood or adoption. :;iG:Ajclk1t4,'::t~g:? REV-1S02 ~+ (6.... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Wendell E. Wingard 11-06-0?lu AU ,..1 property owned .oIely or u . tenant In common must be ...porttd .t f.lr market valul. Fair market value is dellned 8S the price at which property would be exchanged between a wiling buyer and a wiling seller, neither being compelled to buy or sea, both having reasonable knowledge of the relevant facts. Rut property whIch Is JoIntly-owned with right of survlvol'lhlp must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION All that certain parcel of land improved with a residential dwelling commonly known as 558 F Street, Borough of Carlisle, Cumberland County, Pennsylvania, more fully described in Cumberland County Deed Book "l''', Vol. 24, Page 405, sales price: VALUE AT DATE OF DEATH $147,900.00 TOTAL (Also enter on line 1, Recapitulation) $147. 900.00 (If more space Is needed, insert additional sheets of the same size) REV-1503 EX. C...... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DeCeDENT SCHEDULE 8 STOCKS & BONDS ESTATE OF Wendell E. Wingard All property Jolntly-owned with right of survivorshIp must be disclosed on Schedule F. FILE NUMBER 21-06-214 ITEM NUMBER 1. DESCRIPTION U. S. Savings Bonds, Series E and Series EE (173) (see inventory attached hereto) VAlUE AT DATE OF DEATH $35,163.94 2. PPG Industries common stock, 210 shares at $60.07 per share 12,614.70 TOTAL (~ enter on tine 2, Recapitulation) $ 47, 778. 64 (If more space is needed, insert additional sheets of the same size) . 1!;;.:,,~J;_,..~.;J.: ' i_... "'t..,. .. ..i,p., REV-'508 EX- (....) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Wendell E. Wingard Include the proceeds of ltigation and the date the proceeds were received by the estate. All property joIntt,-owned with right of .urvlvonhlp must be dIsclosed on Schedult F. FILE NUIISER 21-06-00214 ITEM NUMBER 1. DESCRIPTION Miscellaneous personal property, furniture "and furnishings 2. 2003 Buick La Sabre VALUE AT DATE OF DEATH ~ 3,675.00 10,56.5.00 12,556.18 262.96 15.75 22.24 1,337.00 66.08 3. M&T Bank, checking account No.' 267 6000 348 4. Refund of car insurance premium 5. AAA Membership refund 6. Comcast Cable refund 7. 2006 Federal income tax refund 8. Refund State Farm hazard insurance TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 28,500.21 j, ;dicli(f,ikfiriifj..tH\i$~F' ' _-'509 EX+ I..... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE . JOINTLy-oWNED PROPERTY ESTATE OF FILE NUMBER Wendell E. Wingard 21-06-00214 If an .aset WlS made joInt within on. year of the decedenfs date of death, It must be "'ported on Schedule G, SURVIVING JOINT TENANT(S) NAME A. Terry S. Ocker ADDRESS 124 E. Ridge Street Carlisle, PA 17055 RELATIONSHIP TO DECEDENT Daughter B. c. JOINTLY-owNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INClUDE NAME OF ANANCIAlINSTITUTlON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VAlUE OF NUMBER TENANT JOINT IDENTIFYING NUUBER. ATTACH DEED FOR JOINTlY-HElD REAl ESTATE. VAlUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 10/27/<9 Sovereign Bank Money Market $39,286.39 50% ~19,643.20 Account No. 1671014758 TOTAL (Also enter on line 6, Recapitulation) $19,643.20 (If more space is needed, insert additional sheets of the same size) REV-1510 ex. (..... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERlY ESTATE OF FILE NUMBER Wendell E. Wingard 21-06-00214 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. ITEM NUMBER ,. 2. 3. DESCRIPllON OF PROPERTY 1NCWJE1IENMlEOFnETRMSFEREE. TIBlRElA1lONSHPTOIlECEDENTAII) DAlE OF DEATH "OF DECO'S EXClUSION TAXABLE nEMTEOFTIWISFER. AJW:HACOPI'OFMDES>F<lRREALESl'AlE. VAlUE OF ASSET INTEREST VAlUE Sovereign Bank CD/IRA account No. 167817970 Prime beneficiary Patricia Wingard 25,323.3. 100% N/A $25,323.34 predeceased Decedent on February 15, 2005. Contingent beneficiary is Terry S. Ocker, Decedent's daughter. Date of Transfer: February 17, 2006 PPG Employee Savings Plan, payable upon death on February 17, 2006 to Terry S. Ocker, Decedent's daughter. Date of Transfer: February 17, 2006 ~25,424.9 125,424.99 K/A 100% PPG Industries, Inc. Grol}.p Life Insurance benefit; benefic1ary Terry S. Ocker, Decedent's daughter. Date of Transfer: February 17, 2006 13,600.0 -0- 100% 13,600.01 TOTAL (Also enter on line 7 Recapitulation) $ 150 . 748. 33 (If more space is needed, insert additional sheets of the same size) ,:,~:>L-~~,.1~ i1t;zYlf '/;,1 REV-1511 EX+ (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-06-00214 ESTATE OF Wendell E. Wingard Debts of decedent must be reported on Schedule I, ITEM NUMBER A B. 1. 4. 6. 7. 8_ 9. 10. 11. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: . Hoffman Funeral Home $7,141.30 ADMtNISTRATIVE COSTS: Personal Representative's Commissions Name of Personal RepresentatiYe(s) Social Security Number(s)/EIN Number of Personal Representative(s) Waived Street Address City State _Zip Year(s) Commission Paid: 2. A~yF~ to Snelbaker & Brenneman, P. C. 4,500.00 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent ~ateF~ to Register of Wills, initial fee and additional fee 360.00 5. Accountant's F~ and reserve for final ~i1ing fees, attorney's . fees and miscellaneous expenses Tax Return Preparer's Fees to Group Tax Service 1,000.00 75.00 Auctioneer's fee to Chuck Bricker (personalty) Advertise grant of Letters Testamentary: a. Cumberland Law Journal b. Patriot News 1,057.00 $ 75.00 116.67 191.67 8,874.00 1,479.00 6,500.00 Real Estate Sales Commission to B-H Agency Realty transfer tax payable at sale House foundation engineering and repair costs for sale TOTAL (Also enter on line 9, Recapitulation) $ 31,. 177 . 97 (If more space is needed, insert additional sheets of the same size) RfV-1512 EX+ (12-03) . SCNIDULE I DEBTS Of DECEDENT, MORTGAGE UABIUTIES, & UENS COMMONWEAI..TH OF PEf\t4SVlVANIA NiERlTNlCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wendell E. Wingard 21-06-00214 Report debts Incurred by the decadent prior to death which remained unpaid as of the date of death, IncludIng unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. UGI - payment on account of gas utility expense 38.98 2. Sprint - payment on amount of telephone service 58.07 3. Carlisle Borough - payment on account of water utility bill 16.18 4. PP&L Electric Utilities - payment on account of electrical utility expense 60.78 5. Cumberland County /Borough of Carlisle real estate taxes due to date of death 74.85 6. Lancaster HMA Physicians - payment on account of medical services 5.74 TOTAL (Also enter on line 10, Recapitulation) $ 254. 60 (If more space is needed, insert addIllOnal sheets of the same size) ~~4;~,::,,:~_;~i-~J;&$~tt--ii:~l~:~ji';j~li::ll::~,:;:~i;~" REV-1513 EX+ (9-00) . SCHEDULI J BENEFICIARIES COMMONWEALTH OF PENNSYlVANIA ItftERlTANCE TAX RETURN RESIDENT DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [lncIude outright spousal distributions, and transfers under Sec. 9116 (8) (1.2)) Terry S. Ocker 124 E. Ridge Street Carlisle, PA 17013 FIll NUMBER 21-06-00214 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not Lilt Trustee{I) OF ESTATE ESTATE OF Wendell E. Wingard NUMBER I A. Daughter "1/3 of residue B. Wendell C. Wingard 396 Greason Road Carlisle, PA 17013 Son 1/3 of residue C. Lisa L. Uffelman 11469 Pickle Road Brogue, PA 17309 Daughter 1/9 of residue Kelissa L. Sparks (formerly Kelissa L. Heberlig) 93 E. High Street, Apt. 1 Red Lion, PA 17356 E. Julia A. Uffelman 11469 Pickle Road Brogue, PA 17309 D. Granddaughter 1/9 of residue Granddaughter 1/9 of residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET U 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 $ (If more space Is needed, insert additional sheels of the same size) ~ to.> ~ LAST WILL AND TESTAMENT I, WENDELL E. WINGARD, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease, 2. I authorize and empower my executrix to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3, I devise and bequeath all of my estate of every nature and wherever situate to my wife, Patricia L. Wingard, providing she shall survive me by sixty days. 4. Should the gift in Paragraph No.3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate as follows: (a) 1/3RD to my daughter, Terry S. Ocker, (b) 1/3RD to my son, Wendell t. Wingard, (c) 1/9TH to my daughter, Lisa L. Uffelman, (d) 1/9TH to my granddaughter, Melissa L. Heberlig, and (e) 1I9TH to my granddaughter, Julia A. Uffelman. -1 The child or children of any deceased person taking the share their parent would have taken if living. (f) The shares of Melissa L. Heberlig and Julia A. Uffelman, shall be held in Trust by M&T Bank, Carlisle, Pennsylvania, and all principal and interest in each Trust shall be distributed to Melissa and Julia whep. they reach the age of twenty-five (25) years, 5. I nominate and appoint Patricia L. Wingard to be the executrix of thisi);iy.Last-Win and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint, Terry S. Ocker, as substitute executrix, also to serve as such without bond, with the same powers as are given herein to my executrix, and if she cannot serve for any reason, I nominate and appoint Wendell C. Wingard as executor, 6. I hereby suggest that my personal representative retain the services of IlWin, McKnight & Hughes, as atto~eys in the settlement of my estate, IN WITNESS WHEREOF, I have hereunto set my hand artd--seal-this 22ND day of September, 2000. ~'~~~~"ASEAL) Signed, sealed, published and declared by WENDELL E. WINGARD, the testator above named, as and for his Last Will and Testament, in the presence of us, who at his request, in .. his presence and in the presence of each other have SUbSCribe;;;:;;~~ ~ ~~v;tp/J 2 .;4-h-;;/:"._-- ACKNOWLEDGMENT AND AFFIDAVIT WE, WENDELL E. WINGARD, CHERYL L. CLELAND and MARTHA L. NOEL, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed ~he instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. r COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by, WENDELL E. WINGARD, the testator herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 22ND day of September, 2000. .I?J.~," Notarial Seal R~ger 0. Irwin, Notary Public Carhsle l?or?, Cll.ilberland County My CommIssion Expires Oct. 3, 2000 Member, Pennsylvania Association of f.Jotarles J~;i. HUD - 1 UNIFORM SETTLEMENT STA TEMENT OMB Approval No. 2502-026. A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT B. TYPE Of LOAN 6. File Number: 7. Loan Number: 1. FHA 2. FmHA 3. Cony. Unins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance Case Number C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. NOTE: TIN = Tupaver's IdentificatiOft'1\lumber D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: Robert W. Corrunan Terry S. Ocker, Executrix N/A Martha C. Copnman Wendell E. Wingard Estate 199 Old State Road 124 E. Ridge Road Gardners, PA 17324 Carlisle, PA 17013 G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME, ADDRESS AND TIN 558 F. Street Jacqueline M. Verney, Esquire Carlisle, PA 17013 44 South Hanover Street Carlisle, PA 17013 PLACE OF SETTLEMENT 1. SETTLEMENT DA TE 44 S. Hanover Street 08/01/2006 Carlisle PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. Sl1MMARY OF SELLER'S TRANSACTION 100. GROSS AMOlJNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TOSELLER: I 0 I. Contract sales price 147,900.00 40 I. Contract sales price 147 900.00 102. Personal orooertv 402. Personal orooertv 103. Settlement charl!:es to borrower (Line 1400) 2,303.50 403. 104. 404. 105. .. 405. Adiustments for items oaid bv seller in advance Adiustments for items oaid bv seller in advance 106. City/town taxes 406. City/town taxes 107. County taxes 08/01/2006-12/31/2006 235.01 407. County taxes 08/01/2006-12/31/2006 235.01 108. Assessments 408. Assessments 109. 409. 110. School Tax 08/01/06-06/30/07 1,248.70 410. School Tax 08/01/06-06/30/07 1.248.70 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 151 687.21 420. GROSS AMOUNT DUE TO SELLER 149 383.71 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Denosit or earnest money 1. 000.00 501. Excess denosit 202. Prineinal amount of new loan(s) 502. Settlement chan~es to seller (Line 1400) . 11.744.88 203. Existing loan(s) taken subiect to 503. Existing loan(s) taken subiect to 204. 504. Pavoff of first mortlzage loan 20S. 505. Payoff of second mortgage loan 206. 506. 207. 507. . I 208. 50S. I 209. 509. 1 Adiustments for items uno aid bv seller Adiustments for items unnaid bv seller j 210. City/town taxes 510. City/town taxes i 211. County taxes 51 I. County taxes 212. Assessments 512. Assessments ! 213. 513. 214. 514. ! 215. 515. 216. 516. 217. 517. ; 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 1 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 11.744.88 300. CASH AT SETTLEMENT FROM/TO BORROWER 30l.Gross amount due ITom borrower (Line 12m I 302. Less amount Daid by/for borrower (Line 220) I 303. CASH FROM BORROWER I 151 687.21 L 000.00 150,687.21 600. CASH AT SETTLEMENT FROMrrO SELLER 601. Gross amount due to seller (Line 420) 602. Less reduction in amount due seller (Line 520\- 603. CASH TO SELLER I I I 149,383.71 11 744.88 137 638.83 SELLER'S STATEMENT The information contained in Blocks E, G, H, and r and on line 401 (or, ifline 401 is asterisked, line 403 and 404) is important tax information and is being furnished to the Internal Revenue Service (see Seller Certification). If you are required to file a return, a negligence penalty or other sanction will be imposed on YOll if this item is required to be reported and the IRS determines that it has not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by Jaw. Under penalties of perjury, I certifY that the number shown on this statement is my correct tc1xpayer identification number. (Seller's Signature) Terry S. Ocker, Executrix (Seller's Signature) Wendell E. Wingard Estate ') EASY SOFT, Inc. 200 I Previous editions are obsolete Page 1 form HUD-I (3/86) ref Handbook 4305.2 L SETILEMENT CHARGES 700, TOTAL SALESIBROKER's COMMISSION based on Dnee $ 147.900.00 @ 6.000% PAID FROM PAID FROM Division of Commission (/ine 700) as follows: BORROWER'S SELLER'S 701. S 8 874.00 to B-H Aaencv FUNDS AT FUNDS AT 702.$ SETTLEMENT SETILEMENT 703. Commission mid at Settlement 8,874.00 704. transaction fee to B-H Aaencv 125. 00 800, ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee $ 802. Loan Discount $ 803. Annraisal Fee to 804. Credit reDort to 80S. Lender's Insnection Fee 806. 807. 808. 809. 810. 811. 812. 813. 900. ITEMS REOUIRED BY LENDER TO BE PAID IN ADVANCE 90 1. Interest from 902. Mormalle Insurance Premium for 903. Hazard insurance Premium for 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance 1002. Mortllll2e insurance 1003. Citv Prooertv Taxes 1004. Countv Prooertv Taxes l00S. Annual assessments 1006. 1007. 1008. AIZlm:aate Accountimz Adiustment 1100, TITLE CHARGES 1101. Settlement or closinlZ fee to Jacaueline M. Vernev. Esquire 550.00 1102. Abstract or title search to Karen Coon 111. 00 1103. Title Examination to 1104. title insurance binder to 1105. Document DreDaration to 1106. Notarv fees to Valerie Gsell 7.00 1107. Attornev's fees to Kei th Brenneman Esauire (POC) {includes line numbers: deed DreD 1108. Title Insurance to I I {includes line numbers: 1109. Lender's coveralZe $ 0.00 1110.~er'scov~~e $ 147900.00 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordinlt fees: Deed $ 38.50 M ortl!:al!e $ Release $ 38.50 1202. Citv/cntv taxlstamDs: Deed$ 1.479.00 Morte8lZe $ 1.479.00 1203. State taxlstamos: Deed $ 1 479.00 Mortlt8ee $ 1,479.00 1204. 1205. 1300. ADDmONAL SETTLEMENT CHARGES 1301. Survev to 1302. Pest insoection to 1303. John O'Neill Tax collector 2006-07 school taxes 1,368.70 1304. Carlisle Boro water sewer 16.18 1305. 1306. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103. Section J and 502 Section K) 2 303.50 11 744.88 CERTlFICA TI0N: I have carefully reviewed the HUD-l Settlement Statement and to the best of my knowledge and belief, it is a true and accarate statement of all receipts and disbursements made on my accou or b e in this transaction. I further certifY that I received a coP~jHUD#ettlement Statement. .. I~{u ~~~ Ocker Borrower Robert W. Cornman !1.. evJ:k~ G e~C>>1.- Seller Wendell E. Wingard Estate Borrower Martha C. Cronman The HUD-l Settlement Statement which I have prepared is a true and accurate account of the funds disbursed or to be disbursed by the undersigned as part of the settlement of th. saction. Seller .... 08/01/2006 lem J\gent Jacqueline M. Ve ey, Esquire Date WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar fonn. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. o EASY SOFT, Inc. 2001 Previous editions are obsolete Page 2 form HUD-I (3/86) ref Handbook 4305.2