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Home My WebLink About01-08-07 \ Pa. o.e. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~i..1 ,N\ ~l vL LA tV l'> COUNTY, PENNSYLVANIA Name of Decedent: I IV Ii L I-< 1'<' v HIJ Date of Death: ').I ~ NOS File Number: ;) vo 5" - 00 () ;l 'f Pursuant to Pa. O.C Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. ~Yes D No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. ~ Yes D No :t.: u tV D U <) Tel (.' D rtt CL:t .#) e-. . Ii tT"-u-vCj I 10 ~ I 'Gv L L ,.,\It; t: "L c(:- cl . b. }he separate Orphans' Court No. (if any) for the personal representative's account is: Al/A c. Did the personal representative state an account . fi 11 h ...? ~Y In orma y to t e partIes In Interest. ............................... "" es DNo d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date 11'-/107 ~a-- Signature of Person Filing this Form ....;...\._.!i Capacity: 0 Personal Representative 0 Counsel DQ.-r"\.-<- t H. kut-/w Name of Person Filing this Form . q ;) ~ '-I f> D c::; S u 1"1 1-1 (l LLch...J :7< ,.,,( Address S I-J ; PP ENS' ~ \h'C.v- . P t\ (7.J..) 7 , [7: .~ ~,IJ ,r'"\ (., t.... I i', ~J _, '7 I 7 ~ 0 f.?7 ~ q egos Telephone ,"t l ... ForinRW-lO. rev. 10.13.06 1..__,_.,. ~ R.EV.1500 EX + 16-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT CG (QT~W/ I FILE NUMBER [lilA"i:::. r l~",Lj f; n 2 1 -0 5 0 0 2 4 ""'WJNTYc:55E --Y"S\r- - - ~R-- '* COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF REVENUE DEPT,280601 HARRISBURG, PA 17128-0601 SOCIAL SECURITY NUMBER 2 0 8 - 2 8 - 6 448 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER L1J f- ~~en (,)o::~ L1J g; (,) :I:o::g (,) a.. CJ a.. <l: DECEDENT'S NAME (LAST F1RST ANC MiDDLE INITiAL) to- Z W C W U W C Kuhn, Inez K, a/k/a Kuhn, A nes Inez DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 01/05/2005 01/06/1913 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) o 3, Remainder Return (date of death priorto 12-13.82) o 5, Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) [X] 1, Original Return o 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy of Will) o 9, Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12.12.82) o 7, Decedent Maintained a Living Trust (Attach copy oITrust) o 10. Spousal Poverty Credit (date or death between 12-31-91 and 1-1-95) THIS SECTION 'MUSTBECOMPLETED.ALLCORRESPONDENCEAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Joel R. Zullin er Es uire 14 North Main Street, Suite 200 FIRM NAME (If ApDlicable) Zullin er Davis P.C. TELEPHONE NUMBER 717 264-6029 Chambersbur PA 17201 I- Z L1J o Z o a.. en L1J 0:: 0:: o (,) z o i= <C ..J => t:: a. <C U W 0:: z o i= <C to- => a. :!: o u >< <C to- 1, Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5, Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6, Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8, Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 160,292.80 OFFICIAL USIEONl Y 21,266.30 181.559.10 (8) 29,948.60 325.31 14. Net Value Subject to Tax (Line 12 minus Line 13) 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) 19. Tax Due 0.00 X _ (15) 151,285.19 X .045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) (11) (12) (13) 30,273.91 151,285.19 0.00 16, Amount of Line 14 taxable at lineal rate (14) 151,28519 17. Amount of Line 14 taxable at sibling rate 0.00 6,807.83 0.00 0.00 6,807.83 18. Amount of Line 14 taxable at collateral rate 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ...... QC CHIDI::: "Tr'\AMC::WI=R.b.11 OIII=C::TIt"\tJc::,t"\MDI:::\II:::DC::I:::~lnl:^",n,t:>I:""ul:::""lol" ftIlATU...;., Decedent's Complete Address: STREET ADDR"SS 307 Walnut Street CITY I STATE I ZIP Shippensburg PA 17257 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 6,80783 Total Credits (A. + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 4. Total Interest/Penalty ( 0 + E) (3) 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 (4) 0.00 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. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check (5) (SA) (58) to: REGISTER OF WILLS, AGENT 0.00 6,807.83 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; ............. ......................... ......................... ............ 0 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 c. retain a reversionary interest; or ...................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... [j 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which . b f" d . t' ? 0 contains a ene IClary eSlgna Ion. ...... ...... ........ ................. ..... ...... ......... ...................................... ........ 6,807.83 No 00 00 00 00 00 00 [K] 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS Daniel Harry Kuhn, 9284 Possum Hollow Road, Shippensburg, PA 17257; Nanci Kuhn Atkeson, 104 Two Does Lane Clayton, N.C. 27520; Marie Kuhn DUQQan, 514 Crest Drive, Jefferson City, MO 65109 ' SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 14 North Main Street, Suite 200 Chambersburq, PA 17201 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 PS. 99116 (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. 99116 (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 0% [72 PS. 99116(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. 99116(1.2) [72 PS s9116(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. s9116(a)(1.3)]. A sibling is defined, under Section 9102. as an inrlillirl, ,,,I ",h,., h,,~ "I Ip,,~1 nnp n"rpnt in I"nmmnn wilh Ihp. decedp.nt whp.thAr hv hlnnrl or ;:lrlnntinn REV-1502 EX + (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kuhn Inez K.. a/k/a Kuhn. Agnes Inez 21 05 0024 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 oroiJertv which is iointly-owned with riQht of survivorshio must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Gross proceeds from sale of real estate situate at 307 Walnut St., Shippensburg, PA, to Deborah Francis, copy of HUD attached Received on proration of real estate taxes for above sale of real estate 2. VALUE AT DATE OF DEATH 159.900.00 392.80 TOTAL (Also enter on line 1, Recapitulation) $ 160,292.80 flf mnrp ~n~rp. i~ nAPnprl inc.o.r+ o:lrlrlitinn~1 r;:hootc: nf thoO c::~mQ ci"7o\ REV-15G8 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Kuhn. Inez K.. a/k/a Kuhn. Agnes Inez 21 05 0024 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 1. 2. 3. 4. 5. 6. 7. DESCRIPTION Gross proceeds from sale of personal property by Dan Hershey Auctioneering Services Checking Account #97352098, M& T Bank, including interest accrued to date of death Refund, homeowner's insurance, Nationwide Insurance Refund, Combined Insurance Company Refund, Menno-Haven, Inc., nursing home care Refund, nursing home insurance payment Refund, homeowner's insurance VALUE AT DATE OF DEATH 3,609.50 10,82396 48.00 17.55 83654 5,760.75 170.00 TOTAL (Also enter on line 5, Recapitulation) $ (If mnrp ~n~f"P ic: nj:lorlorl incart ':l."{"{itit"ln~1 ch.ooh:: nf tho. c-:::r.rnn (CO;"'7n\ 21,26630 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kuhn Inez K. a/k/a Kuhn. Agnes Inez SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 05 0024 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger-Bricker Funeral Home, funeral services 7,75550 2. Food and preparation for meal after funeral services 221 .81 3. Spring Hill Cemetery, grave opening 425.00 B. ADMINISTRA TIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Joel R. Zullinger 1,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees JCP fee 10.00; letters 260.00; short certificates 16.00; automation fee 5.00; 334.00 will 15.00; filing return and inventory 28.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Charge for estate checks 862 8. Cumberland Law Journal, advertise letters 7500 9. Borough of Shippensburg, water, sewer and refuse 125.11 10. Edward Straley & Associates, prepare final personal income tax returns 225.00 11. Lisa L. Helm, Tax Collector, county & borough real estate taxes 631.75 12. News-Chronicle, advertise letters 92.75 13. Appraisal of decedent's real estate 200.00 14. Daniel Kuhn, work in preparation for public sale and postage reimbursement 1,339.97 15. Nanci Atkeson, work in preparation for public sale and reimbursement for postage 1,035.54 16. Marie Duggan, work in preparation for public sale 350.00 17. Julie Kuhn, work in preparation for public sale 900.00 18. Kristine Butz, work in preparation for public sale 290.00 TOTAL (Also enter on line 9, Recapitulation) $ 29,948.60 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Kuhn, Inez K., a/k/a Kuhn, Agnes Inez Decedent's Name Page 1 21 05 0024 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER AMOUNT 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29, 30. 31. 32. 33. 34. DESCRIPTION Laurie Kuhn, work in preparation for public sale Adam Kuhn, work in preparation for public sale Jim Karper, moving items to location for public sale Tim Butz, use of truck for removal of items from decedent's residence PPL Gas Utilities, gas service Penelec, electric service Borough of Shippensburg, water, sewer, and refuse PPL Gas Utilities, gas service Penelec, electric service PPL Gas Utilities, gas service Penelec, electric service Dan Hershey Auctioneering Service, commission and expenses of public sale Realtors' commission on sale of decedent's real estate 1 % realty transfer tax on sale of decedent's real estate AON Home Warranty, sale of decedent's real estate Overnight mailing fee for delivery of deed for sale of decedent's real estate 450.00 120.00 80.00 200.00 27822 25.68 125.11 223.33 19.73 183.77 36.14 1,076.50 9,594.00 1,599.00 409.00 18.07 SUBTOTAL SCHEDULE H.B? 14,43855 REV-1512 EX + (6-98) If. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kuhn. Inez K. a/k/a Kuhn. Agnes Inez FILE NUMBER 21 05 0024 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Penelec, utilities due at death VALUE AT DATE OF DEATH 34.08 2. Borough of Shippensburg, water, sewer and refuse due at death 122.53 3. PPL Gas Utilities Corp., gas service due at death 160.43 4. Sprint, telephone service due at death 8.27 TOTAL (Also enter on line 10, Recapitulation) $ 325.31 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (s.nn, SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANiA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kuhn Inez K. a/k/a Kuhn Annes nez NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under See, 9116 (a) (1.2)] FILE NUMBER 21 05 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 0024 AMOUNT OR SHARE OF ESTATE 1, Daniel H, Kuhn 9284 Possum Hollow Road Shippensburg, PA 17257 Nanci L. Atkeson 104 Two Does Lane Clayton, N,C, 27520 Marie K. Duggan 514 Crest Drive Jefferson City, MO 65109 Lineal one-third of residue 2, Lineal one-third of residue 3, Lineal one-third of residue 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 1, 0.00 B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space IS needed, Insert additional sheets of the same size) $ 0.00 Page 1 of3 A. S~ttl9rnent Statt1ment U.S. Department of Housing and Urban Development OMS Approval No. 2502-0265 e, Type of Loan 1 I FHf,2. [ ] FrnflA3 [X) ConV.UnIlIS ,":","1 6 File Number' r:::l . ,. Loan Number. [::;",1 : 8. Morlgage Insurance Case Number: 4. [ I VA 5. [ ! Conv.lns b w w .100500930-C8 005409299~ C NOTE' THIS NOTE IS fURNISHED TO GIVE YOU A STATEMENT OF ACTUAL SETTLEMENT COSTS. AMOUNTS PAID TO AND BY THE SETTl.EMENT AGENT ARE SHOWN ITEMS MARKED "(P.OC.)" WERE PAID OUTSIDE THE CLOSING: THEY ARE SHOWN HERE FOR INFORMATIONAL PURPOSES AND NOT INCLUDED IN THE TOTALS. D. Name and Address of Borrower '-~x-l E. Name and Addre.s of SeUer 'i, F. Name ami Address of Lender DEBORAH FRANCIS CJ MARIE K. DUGAN. CO-EXECUTRIX. 0 ; FIRST HORIZON HOME LOAN CORPORATION NANCI L ATKESON, CO.EXECUTRIX ' 681 ANDERSON DRIVE.. SUITE 42(), 200 11TH ST AND DANIEL HARRY KUHN, PITTSBURGH" PA 15220 JACKSONVILLE. AL 3G265 CO-EXECUTOR OF EST ATE OF AGNES INEZ KUHN AfK/A INEZ K. KUHN ,PA G. PROPERTY lOCATION 301 WALNUT STREET, SHIPPENSSLJRG. PA H. Settlement Agent SECURED lAND TRANSFERS - MECHANICSBURG COUN1Y:GUMRERLAND PARCEL 10: 32.34-2'113-113 TOWNSHIP: SHIPPENSElURG BOROUGH o i Place of Settlement ~1068 HARRISBURG PIKE 'CARLlSLE, PA i 0 I. Settlement Date / Disbursement Date J. SUMMARY OF BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 10 i. Purchase Price $159,900.00 401 Purchase Price $159,900.00 102 Personal Property ~02. Personal Property 103. Settlement Charges to Borrower $4,446.30 403. 104. ~04 105 405. - AdJustmen Is For Items Paid By Seller III Advance Adjustments For Items Paid By Seller In Advance Ins. Ci\yrfown Texes 406. CityTlown Taxes 1117. County Taxes G44.65/yr 6117/2005 to 1/1/2006 $34739 407. County Taxes 64'1 651yr EV1712()Q5 10 1/1/2006 $347.39 lOB Assessments 408. Assessments 109 SchoolTaxes 1.167 651yr 6/1712005 to $45.41 409. School faxes 1, 167.651yr 6/1712005 to $45.41 7/112005 71112005 110 410. III ~1'. -----~ 412 112 6/171200511:00:00 AM/6117/2005 120. Gross Amount OliO From Borrower I $164,739.10 420. Gross Amount Due To Seller I $160,292.80 ~~~!,mounts ~aid By Or In Bohalf Of Borrower 500. Reductions In Amount Due To Seller 2UI EDrnesl Money $1,500.00 501. Exces. deposH 202 Pdnl".lD31 hom First Hnr1zol1 Home loan $127,920.00 502. Settlement Charge. To Seller (line 1400) $11,783.18 CorporRtion 503 Existing Loan(.) taken Subject To 203 EXlstrng ioan(s) laken subject to 504. Payoff of First Mortgage Loan -- 204 505. Payoff of Second Mortgage Loan 205 506. 206 507. 207 508 20B 509. 209 Adjustments For Item. Unp"ld By Seller Adjustments For Itenls Unp"ld By Seller 510. CityfTawn Taxes ---_.".._~..~. 210 City'-rowl1 T?xf's 511 County Taxes 211 County 1 ax"s 512. Assessments 2' 2. Assessments 513. -------~-- 213 514. 2-14 515. --- 215. 516. . - 216 517 217 518 ._- -- 218 519. _.~---'--- 219. ---- 2?0. j otal "'<lId AyrFor Borrower 300. Cash At Set!lernent FromTl 0 Borrower 301 G,'lSS Amount Oue From Borrower (line 120) i 302~~ ^m-~unts Pnid By/r~H Borrower (tine 220) I $129,42000 520. Tot~l RedHCHo!\ ^mount OUP. S'!lhH \ $11.783.18 600. Cash At Settlement lolFrom Selle, $16'1,739. \0 601. Gross Al110unl Due To Seller (line 420) I $129,-120.00 602 Less Deductions In AmI. Due To Seller (line I 520) $160,292.80 $11.18318 303. Ca..h [X] From [ J To Borrower $:~c;.]10.10 1\03. Ca.h [ X J To [ ] From Seller $148,509.62 Page2of3 400500930 - CB L Settlement Statement Page 2 700. Total Sales Commission 159900.00 @ 6 %" 9594.00 DIvIsion of Commission (hne 700) As Follows: Paid From Paid From Seller's Borrower's Funds At 701 $4797.00 to Remax Realty Agency, Ine Settlemenl Funds ."<1 Settlement 702. $4797.00 to ERA-NRT, Inc. 703. Commission paid al selllemenl $9,594 00 707. Transaction Fee to ERA-NRT, tnc. $125.00 800. Items Payable In Connection With Loan 801. Loan Origination Fee 802. Loan Discount 803. Appraisat Fee to First Horizon Home Loan Corporation (pOC 275.00 by Buyer) 804. Credit Report 805 l.ender's Inspection Fee 808 Underwriting Fee to First Horizon Horne l.oan Corporation $25000 810. Tax Service to TMS $90 00 811 Flood Cerl Fee 10 FED Flood $24.00 812 Commilment Fee 10 First Horizon Home Loan Corporation $150.00 813 Processing Fee 10 Turnstone Mortgage Company $137.00 814 Mongage Broker Fee to Turnstone Mongage Company $200.00 815. Wire Fee to First Horizon Home Loan Corporation $45.00 816. MERS Fee to Mers $395 819 Yield Spread Premium to Turnslone Mongage Company (POC $2,078.70 by First Horizon Home l.oan Corporation) 900. Items Required By Lender To Be Paid In Advance 901. Interest from 6117/2005107/1/2005 @195430/day 902. Mongage Insurance Premium for 903 Hazard Insurance Premium for 1000. Reserves Deposited With Lender I I I $273.60 1001. Hazard Insurance 1002. Mortgage Insurance 1003. City Property Taxes 1004. County Property Taxes 1100. Title Charges 1101 Settlement or Cia slOg Fee 1102 Abstract or Tille Search 1103 Title Examination 1106 Notary Fees to Cash $12.00 $1000 1107 Attorney's Fees 1108 Title insuranc.e to Secured Land Transfers ~ Mechanicsburg $1,158.75 1109 l.ender's Coverage $127920.00 ($) 1110 Owner's coverage $159900.00 ($1158.75) 1111 Endorsement 100/300/900 to Secured l.and Transfers - Mechanicsburg $150.00 1113 Insured Closing Protection l.etter 10 First American Title Insurance Company $35.00 1114 Overnight DelivelY & Processing Fee to Secured l.and Transfers - Mechanlcsburg $20.00 1116 Wire Fee to Secured Land Transfers - Mechanicsburg $20.00 1120. Doc Prlnllo Secured l.and Transfers - Mechanicsburg $50.00 1200. Government Recording And Transfer Charges 1201 Recording Fees: Deed $ 38.50; Mongage $ 64.50 $103.00 1202. Cily/Couilty TaxlStamps 1599.00 $1,599.00 1203 State Deed Tax $ 1599.00 $1.599.00 1205 1300. Additional Settlement Charges 1302. Pest Inspeclion to South Cenlral PA Home Inspection Co , Inc. (POC 0 00) 1303. Home Warranty to AON I tome Warranty $409.00 1304. Final Sewer to Shippensburg Borough Office $153.11 1305. Horne Inspection 10 South Central PA Home Inspection Co., Inc. (POC 000) 1306 Overnight Fee to Joel R Zullinger, Esq. $18.07 1400. Total Settlement Charges (Enter On Lines 103, Section J And 502, Section K) $4,446.30 $11,78318 I have carefully reviewed the I tUD-1 Settlement Stalernenl and to the best 01 my knowledge and belief it 15 Irue and accurate stalement of all receipts and dlsblJrseme~ts made ~~: my aCC~tJnl or by rne in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. BU~~S .//. /'/ /- < SELLERS i/;C,f Li/ // ~ ,/" ~ ( \..,/J...{/ t'~. j"-----;; //"'(j;d(,/l -~- Deb078"hFrancis Estale SlfAgnes Inez Kuhn alk/? Inez K "unn '~/ ~:.r,,~~. /:}~~~{.. By: Marie K. Dugan,_90-Execulnx /;~ #,,*,,/:,-~ ? ,,_4---~-<--r...</_.~____ By: Nanci L Atkeson, Co-Executrix '-:~-;;:~.... '-~~.....,).('._.. ....,'~.::-.......- By: Daniel Harry Kuhn, Co-Executor The I-IUO~1 Settlement Statement which I h<:lve prepared [$ a true and accurclte account of this transacUon. f have caused or will cause the funds lu be disbursed in accordance wllh this staternent <; . (T}.J I J. f.,.I / 1 ~/'-8~;.l. //J) /lii~" ,,/...... ,.., ~'%1.-.:../ f t-lNAL -- Vj":! j':v I'if .-,;. /V ;,""} ..) /J ';.:.1 /'/t i ' , ;3' ,'J" ' ~ l~' ~/ "" ! ,) . f?~y / .., ,1~" / .....~'t ~/ / /r.> / SETTLEMENT ELLER NAME (1~~.-'~/.L "T "",,' ~-'--" ""...., ~ .J C- I Lt.;;'..;;:) L 11--/ i,r( " - ~. . ! ' ./ I ii"''''.,' '7' ./'.. :"{ . <'""-:"' .-- /-~'.JP-l- "...-" I DATE OF SALE DDRESS ~7 ~-...) i PHONE ~f--.~- ~<:-; ,7 ../' o-l c- ......... / ~-' )CA TION OF SALE , ("; t ,.", /. , i-fC t" \-' f ' ; , i ./ /... , " .-.' ~ "1 iA 7' c,"'" '1 .)1--:~, .:-r ZIP ~".f/,7 ~)...,_f '-f~' ""'l ....) 'f 'lI./'(',4j ~ /1 /~; /\;> I ,-. / t.J { ,... ~'it .:'.:.( ''-II- .....J ,-"" .UCTIONEER /)" ) 1/ 11 "L i i ,10' to' ~i .." .i.' r'." /'''' J "';1 ....". V ,-,. ri I . i:...;t.,i ... f I S "j .,t.) r~ fr" ,,;...... I-? ' PHONE ...),,1 ~i. - ///L-'~ 7 (.,;;.~ if ,/ GSEllER'SExaENc5ES ,0 / I) &;; PROFESSIONAL FEES & III AUCTIONEER $ c , RECEIP.TS ) J /'l'J , CJ{) CASH $ CLERK $ CHECKS $ CASHIER $ OTHER RECEIPTS OTHER EXPENSES <l' <'-J L-j I Ii C r . j--- Y.-f- "'/- -, --, , ,. ... "", frl/V,'f\! $ I 1 ,', ,.,. C. ".; i.-' r) '.\,,"~ $ .....'""'/1.. --" ',...1 /_- ". I ~ z-j . !}[ '1 (.' !:. / I ;:. f.) I "- t" ,i... '<+1'/ /' ;,) $ ~/"-.?"" ?t" J.J,OC $ $ $ I ; J --:') _Wb .,A "'--I.J (;) c i,.\.../ $ .' 0') t'" ,.....j I () <" ,. "C/ $ $ $ $ $ $ $ $ $ TOTAL RECEIPTS $ $ J60 r.S C $ /c/7{, ~.5tJ $ LESS TOT At EXPENSES PROCEEDSPAYABLETOSELlER $ !tJ76 ,StJ) C TOTAt EXPE~SES I (or we), the seller, accept this settlement and acknowledge receipt of the above specified net proceeds from the auction of my goods and property sold on the above date. I accept 011 responsibility for providing mercho~able title to ali goods, and property sold, and for delivery of title to the purchaser. ;;{J;~/g~Z/ .~~~'- , -- ,.- jA%eer' or Cashier's Signature ' (Seller's Signature) , :5 7,::;- Dote / / , f _-I,!/., c.- Date-) { {~ I (,....J Date {Seller's Signature) ~M&.rBank 499 Mitchell Street, Millsboro, DE 19966 Februar.y 22, 2005 Law Offices Zullinger- Davis 14 North Main Street Suite 200 Chambersburg, PA 17201 RE: Estate of Inez K. Kuhn Date of Death: January 5,2005 Social Security Number: 208-28-6448 Dear Mr. Zullinger: 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...................... 97352098 Ownership (Names of).............. Inez K. Kuhn Opening Date...........................01/28/80 (account closed 01/11/05) Balance on Date ojDeath..........$1O,823.58 Accrued Interest $ 0.38 Total................................... ....$10,823.96 The above named decedent did not have a safe deposit box with this bank. For any additional information on this account please contact our Walnut Bottom branch at 717-532-2414. Sincerely, Charlene Warrington, Records Management 1-888-502-4349 INVENTORY cg@(f:?)~ Estate of Kuhn, Inez K, a/k/a Kuhn, A~nes Inez NO,21 05 0024 , Deceased Date of Death 1/5/2005 Social Security No, 208286448 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We verify that the statements made in this inventory are true and correct. l!We understand that false statements herein made are subject to the penalties of 18 Pa C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Joel R. Zullin~er, Esquire ID.No.: 17516 Address 14 North Main Street, Suite 200 Chambersburq Telephone (717)264-6029 Dated PA 17201 Description Value Stocks & Bonds Closely-Held Corporation, Partnership or Sole-Proprietorship Mortgages & Notes Receivable Cash, Bank Deposits, & Misc. Personal Property Gross proceeds from sale of personal property by Dan Hershey Auctioneering Services 3,609.50 Checking Account #97352098, M& T Bank, including interest accrued to date of death 10,823.96 Total (Attach Additional Sheets if necessary) 181,559.10 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory Kuhn. l'lez K., a/k/a Kuhn, Agnes Inez 21 05 0024 Paqe 1 Description of Inventory Description Refund, homeowner's insurance, Nationwide Insurance Value 48.00 Refund, Combined Insurance Company 17.55 Refund, Menno-Haven, Inc., nursing home care 836.54 Refund, nursing home insurance payment 5,760.75 Refund, homeowner's insurance 170.00 Real Estate Gross proceeds from sale of real estate situate at 307 Walnut St, Shippensburg, PA, to Deborah Francis, copy of HUD attached Received on proration of real estate taxes for above sale of real estate 159,900.00 392.80 Subtotal $ Grand Total $ 167.12564 181,559.10