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Home My WebLink About80-00598 ,\,':. " ~ ~ 0 ti . i .' B " '. tIl ~ ~ ~ If ~ ~ tIl en I ~ . .~ Il<t ~ ~ m p; . ~ . !i! 0 0 CO \??0o . 0 - N . .! 0 J9 Z 1ft ~ LLI \' . ,;", ::y;,; ,"'.-/ ',:.~j :i~ ;.,,1. ::.l "'~ . ,:i;~7 :;~l '....~ :~ ,:~ ~:~ :& ;:;:~, ..,\ 'f~:~ ',7:;t; . .,,~N~ ""~ . i .:r:.~1r ',-r~ . ~.,~:~ ;.\,~. '.,j,lt -:'!:ti !~t~,~~ ,.' NO. 21-80 598 IN :::~~~~~ ~~.~..,~~),t'}~kt~~Dt~~~~.~.~.~~~~~~~ED. To ...........................~gX..~.~...)d;;~;J:.~................................................................. ~::i~:;it~:n ~~I~...~~~k~Z?;t~ia~:;.r:..i.~..~~~..~~:.~~.:::::~.':.I.~~..~~..~~~.n~~~.~~~~::~.~.................. e'-:>~ I- bt. . .......................................................... respectfully showeth that ......../-.7....I.\~:......u..................... ................... was a resident of .J!1;1...IfIf.~..~Pt~..............~':on::;~p ,Cumberland County, Stat~ of :ennsyl. vania, and a Citizen of United States, and departed.-~is life intes.tate in the County of ...~~~:!{ .............;:.:>>>................ ..... and State of ............~...........r!..t?,.C:r.:~.'f.r.~~.................................................................. on ......i~~~............. the ...............!.:?..:.::............. day of ...........(1,;.':::;1~................. A. D., 19...t1!.., - '7 (/ at the age of .....,~.,"',.. ~'ears. If? &4 . That the said ........,!.!.;,..CS.or.?...,...f:....................d..................... deccased, left surviving the following named widow or husband, heirs and next to kin, to wit: Name ..........~.~.....~d........,.......... .........~~..~................ .........1I.!.14d.~.JI............ Relationship Residence ;!! ....I.P./"...4M07.!J:.t!K4;..~); -- ..,JJ.(,.!.?:...~.JZ;..~^.~ ./.~..i.,.0.~'/..~(/A.(4r.~, " .. .............~.~r-............. ....,.... ........!.~f.7f~.............. ...... ....*.r.>-.. ......... ...... ....... .,.............................................................. ..............,............................. ................................................................ ............................................ ................................................................ ................................................................ ................................................................ ............................................ ................................................................ ................................................................ That those above named include all of the next of kin, so far as known. The said decedent was possessed of personal propcrty to the estimated value of $..../..i:I1....q,~........... and of Real Estate, less incumbrance, to the estimated value of $.........,.......:::............. as near as can be ascertained. That the said Real Estate in so far as is known is located in ....~/I.!................................................... ........................................................................................................................................................................................ Therefore, your petitioner (s) respectfully apply(ies) named estate. Dated .................5;y?4;h.....~.~.... A. D., 19.r'?.... Signature and Addrcss for Letters of Administration in the above of Petitioner(s) ....:.6.~c:,Qo.I.......~....J.F............. ...../Q.?".........WC.;c.:IQ.......~f.:;.............................. ....r.!J-J.........H~.....~......fi.,..../..7..O'b S- ........................................................................................ :::':~~~~::'~~~;et~m....m...m.......m....m..........m.... "~~ in the abovc application being duly ...........~.~;!>........................ according to law, sa~' that the facts set / ' . forth ino the above application arc true to the best of ..,/:::'!...... knowledge a~ belirf/;' ..........,b?~............~.................... and SUbscribed] .......~..<.,'.,;.c:.cl.....~~12...;:zz:::......... before me, ... ........ ........ ...... ......... ...... ... ................ ....... ......... ..... ........ ..G f. 1'- Iv .......................g.1....................~..... A: Dj' 19.......... ........................................................................................ m_0:;~(!.,;~R;~;;;;m ..............................-;;..:.;;i-...m;m...... Filed: ..........~~[~./...I.1..~.......................... (over) Attorney: ?~:r.'r.I......I,...!~>7/b./I......jjJfiJ //./2.3-- .J_ /.; t; 0 ~1.80 598 No................................. Renunciation and Request In the Matter of the Estate of ..............,./)...t.&:::t.P~::t;;4~................................................................. To .............i1.f.J./i..j.......(:........!.,f:."'-f,.:>..L........................................................., Esq.. Register for the Probate of Wills and granting Lelters 01 Administration for the County of Cumberland, in the Commonwealth 01 Pennsylvania. .,Jf...., the undersigned, being the .....A&:.iid:~:.::........~.............................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. ...... ............-............................................................................................................................................................................. .................................................................................................................................................................................................. do hereby renounce ................,(J.~..................................right to have Letters ....".i.....t..~ll:t<~uJ:i:r.;....... .......................................................................... on said Estate issued to .................-:Jr.!!::................................................. ................................................................................................. .................................., and do hereby request you to grant the same to ...........................~t....iJ.6.~tt,.~..JJ:....................................................................................... '/JI Wi tness...,~~.....hand.......... .... ..and seal.............. ..this.......... ........ ..1;,............................................................... day of ............~f--tJ.~L.....................A. D. 19...f.P.. . Sealed and- delh.ere,&' presence of ,~)',f1bfQmmmm" ':..u.'<O:G......t:.L....~,;..-,.&.........(L. S.) ................................................................................ ................................................................(L.S.) ............................................................................... ................................................................(L.S.) .................-.............................................................. ................................................................ (L. S.) ........................................................-....................... ................................................................(L.S.) .................-.....................................-........................ ................................................................ (L. S.) ................................................................................ ................................................................(L.S.) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I. J 55: Gerald Bistline, II ..----~_.__.__._.__. -_._--_._---- boing duly SW'QJ:;.lL_ eccording to lew, deposos end says thet he ___~i.~i.s.trator __ ____._,_ _____ of the Esteto 01 .-G...~istline late of "'",-"ugh "of Mt:. Holly Sprinqs. , Cumberlend County, Pe., decaesed and thet the within is an inventory medo by .______ '3eraULJ3.i.st).in~L.It.._,_, tho seid Adm. of the entire esteto of seid decedent. consisting of all the porsonal prap..ty end roel esteto, except reel ostete outside tha Commonweelth of Pennsylvania, and that the figures opposite each item of the Inventory reprosent it's feir velue as of the date of decedent's death. and subscribed before me. \ ,? .'c\ ~ \:SdLc- ~ ~J ~;lIi> . Adminblrd.' j 102 Watt, St., :::, Holly Sprino"'"' S..~grR to December 7, a~~~, 19 81 Notary ~,j,i: f.f. :::,I~. t::-.L':: ; (;:JrJi~li! CU:iI!.l, f: : u':,._ ./ My Commi55icfl r.':~.i ;.,'; Jl,;lj .H, If?:J Deto of Death 12 August Month 1980 Doy Yeer INSTRUCTIONS I. An inventory must bo filed within three months after appointment of personal roprosentetive. 2. A supplement inventory must be 1iI0d within thirty days of discovery of additionel eSlots. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ),., QJ vii G'- s:: ~ ..-\ t!\ .-l .,; >- .IJ " ( t- W lJl ~ ~ '" t- ..-\ .-l .. w ~ " '0 I>. III .-l " 0 '" 0 .. " 0 w '" w .IJ :I: C '" ... J: .. " l- I>. U. l-l . I>. III c Z t- ..J QJI iJ .. III ~ ..J <( 0 I>. 0 W u. <( w .01 r-l ~ > 0 Z '" gl ,;. 0 - ::s I Z 0 c C l-l " 0 ci r '" z 0 0 Cl '" " U Z w <( t!JI III ... I>. -0 " ! c I. ~~ .. - -.: 0 I,; .. ' " < :-r, -'. .Q .... .. E -0 '"- c- "" ~ :", - .oS! 0 .. " 0 IJ_. I ...":.. ..J U u: '" c' , 6," ~ ~~ .::-: ~ -, W' 014. "- ~;:;: 0:(,,') W 0- 0 , l.w c.><:J ....t'.{) LuLu 2~'-:: ace:: ~ ~.::l fO -it.:> U COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' DATE /../ {-'/j ,. .......' / - ' .' . J.!. ~,' ..... i- COUNTY FILE NO: ,'! - ESTATE TO: ,,'-' . I ,- ,/ FILE NO. r/:, _.' ',/ (/ " ,', I , ,/ (/ " / -.' . ,. ... ,)." , .' , COUNTY - , C. I -? , /', /d(-t} ,.' I -.-~ DATE OF DEATH ! C"/" .. ~ : -- '~ ,. Appraised Valuo of Estate: Real Estate $ :.. .... ~; 1 . /. + Personal Property -..----- + Jointly Held Properly/Transfers $ 'i:J ~~, ,. I Total Gross Estate 1/. J Total Approved Deductions I.', /.- : j $ Clear Value of Estate ---..--- Less: Approved Charitable Exemptions $ ~:/ ':},-/ / //' Clear Value of Estate Subject to Tax I.,L/ 'IL/ / " ..<,J Amount Taxable @ 6% Rate $ ,/.J/- $ // tax due tax due Amount Taxable @ 15% Rate TOTAL PENNSYLVANIA INHERITANCE TAX DUE $ /..<,/~'i.rj / ';(\ - - '* * ... ... ... ... A five percent discount totaling $ will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT TAX CREDIT AMOUNT PAID DISCOUNT INTEREST . '-:;' _.' i.. ,-;:"'; . $ /...~I II ,......, + $ = $ ,,,) '~'I $ + = + = Interest accrues at the rate of six (6l percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid by is $ .-" / . " BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE I .-' :l;,~,;r.:..r-t.<-....C- / .' Assessed by: . ,..-.' / ; . /,. . . Agen1 for the cominwulth See Information on Roverse SIde ~_./ ,/) ~~ . ~', /' "- /'0 -. ) GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible ogainst his/her taxoble estote. In oddition to debts incurred by the decedent or estote, other items ore claimable including the cost of administration, ottarney lees, liduciary lees, funeral and buriol expenses including the cost of a buriollot, tombstone or grave marker ond other related burial expenses. All debts being claimed ogainst on estate are subject to the approvol of the Register of Wills with whom the Inheritance Tax Retum is filed. Evidence ,to support the decedent's or the estate's liability far the debts being claimed shauld be attached to this schedule. A family exemption may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has larfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the examptian can be c10imed by a parent or parents who are members of the same household as the decedent, The family exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. NOTE: Compensation paid to an estote representati ve; namely, an executor or administrator, for services performed in administering an estote is reportable lor Pennsylvania Income Tax purposes. This taxable income item should be reported an farm PA.40.lndividuallncome Tax Return. t"' '" 0 n >- t'1 E; ~ - >- 0 0 0 Vl Z Cl n c: 0 ;;! z ::: z t"' ~. ; t'1 9 9 t"' :",'.J t'1 :;.: Z " - Z Z t%l --l t'1 --l Z '"', 9 9 -; -< Vl t'1 - Vl a Z 0 Vl 0 .., . .. 9 '"rj '"rj " 1;- ~ ;'. '. ~ ,_I,; - .....-. t::: :~~~ 0 ::'" c Z JO UJ 6:;5 a: ~ jr-, ~ L' -< -< t'1 t'1 >- >- " " INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the fomily exemption is being claimed, indicate the c1oimant's name, oddress and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date an which each debt was incurred and/or paid. 4. Enter the names of each payee. S. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The farm must be signed by the person who has assumed the responsibility far paying the debts. IF ADDITIONAL SPACE IS NECESSARY USE Sy," x 11" SHEETS. Rt;:\I~4~i ~...+ l~.~tl) CDMMONWEAL TH DF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTV '$,. ~~~,,"I~ I~\ ,.,~~ . ":'i:~~'. (Instructions on Reverse Side) Estate of G. ROBERT BISTLINE, ITEM NO. DESCRIPTION UNIT VALUE ESTIMATED MARKET VALUE DEPARTMENT VALUATION (OFFICIAL USE ONL Yl Lump sum distribution on decedent's retirement from Kimberly-Clark corp. $31,315.70 TOTAL $31,315.7 .$1,d/.f':7tJ If additional spoce is necessary, use 8\," x 11" sheets. t, QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable c;nd adequate consideration? (Answer "Yes" or "No".) 2. Did decedent, within two years of death, transfer property from himself/ herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Yes" or "No".) - 3. If the answer to one or two above is "Yes" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy of death certi ficate. c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer. d. All other information supporting nontaxabiIi ty of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or aller his/her death? (Answer "Yes" or "No".) a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Yes" or "No".) b. What was the transferee's age at time of decedent's death? 5. Did decedent in his/her lifelime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "Nu".) - b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) 6. If the answer to five b. above is "Yes," was lhe right reserved in decedent alone ( ) or decedent and others ( ). 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) 8. Did decedent, at any time, transfer property, the bmeficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) 9. If the answer to eight above is "Yes," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone ( ) or decedent and others ( ). RE\"-453 (x.. (10.80) COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES ~.~. , ,~, , " .~ ~~ ~:::i(~_ '. r.:~~ry.~t. "'-'.' (Instructions on Reverse Side) Estate of G. ROBERT BISTLINE BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED DATE OF INTEREST OF BENEFICIARY DECEDENT BIRTH __no M_ BISTLINE WIFE YES ALL BY FAMILY Watts st. AGREEMENT Mt. Holl" Snas. ,Pa. ~___,.. D'_",;n".TT 102 Watts st. Mt. Holly spgs. ,Pa. son yes Linda Fenton 331 North College E t. carlisle, Pa. dau. yes -- -----.-- The above beneficiaries were living at the time of the decedent's death except for the following: NAME DATE OF DEATH If additional space is necessary. use 8%" x ".. sheets. REV-4S,4' Cl.80)' COMMONWEAL TH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT OECEDENT Estate of G, ROBERT BISTLINE DESCRIPTION NONE SCHEDULE "E" JOINTL Y OWNED PROPERTY (l1I.'itnJcrions on RCllcrsc S/dc) TOTAL MARKET VALUE P it VALUE OF <j, DECEDENT'S N INTEREST T TOTAL THIS PAGE '* DEPARTMENT VALUATION (Official Use Only) ~ ~ . . INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another perty or parties as joint tenants with right of survivorship. Soth tangible and intangible property are to be included, List real estate first. 1. Describe all real property as indicated in the instructions for Schedule" A", Describe all personal property as indicated in the instructions for Schedule "S", Include the name, address and relationship to the decedent of the co-owner (s) and the date the joint ownership was established, 2. Indicate the total market value of the jointly owned property. 3, Indicate the percentage of the decedent's interest, 4. Indicate the market value of the decedent's interest. t: "" 0 n ;0- r-1 > :g Z > 0 0 u Vl 0 ~ n c:: u ....; z ~ z r- t'1 t'1 ;<; Z > 0 0 t"' ;:0 Z Z t'1 o-J r-1 ..., ~ p o-J -< tTl P Vl Vl Z 0 Vl 0 ..., p ~ '"l1 ;:0 ~ I > 0 o-J '" 0 '" I z B ! > r- '. i c:: I '" ~' I t'1 a '" 0 Z ~ ;~ --. r- ~ ~ .~ I -< -< ::$ t...: C~I. w:, c~:;:;:: t'1 t'1 0.:;(/ = (:'l...;...; > > 0-' ::-.:...;:.: :;0 :;0 ,-,'" 1LI1L1 ~ ('~5 0:'" ~ ~~ '-' REV.4114 EX+ tHO) INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) File Number 21-80-0598 Estate Name G, Robert Bistline Date of Death August 12, 1980 Social Securi ty Number 172-26-9728 REPORT OF INHERITANCE TAX APPRAISER o Original o Supplemental o Romaindor I, th. undorllgn.d duly appolnt.d Inheritanco Tax Appraiser in ond lor the County of Cumberland Pennlylvanla. do rOlpectlully report that I 110'" appraised the roal and personal praporty os reported In the farogolng return at tho volues lit forth oppollt. each item In the last column to the right In Sc les "A", "S", "C", and "E" c;;;;:-- ~ .. INHE ANeE TAX APP Dot.d: January 13. 1982 IIIVEHTORY VALUE AS APPRAISED I I ADJUSTMENTS I CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE Roal Property (Schodulo A) $ NONE Po..anol Proporty (Schodulo Bl 31 31 Jolnt.Hold Proporty (Schodulo E) NONE Tranllo.. (Schodulo C) NONE TOTAL GROSS ASSETS .-31. 1 00+ 10+ 2llH 30+ L... D.bu and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE o Llf. Estote o Annuity 40. ~ FACTOR PRIIICI PLE FOR USE DF REGISTER ONLY Tax on $ CODE 6% 15% T ax on $ Tox on $ Tax on $ Tax on $ Exemptions Totol Estate TOTAl.. TAX IIITEREST FROM BALAIICE TO Len Credits DATE OF PAYMEIIT IIITEREST AMOUIIT PAID DISCOUIIT S + $ S + ; BALAIICE S TO 9Z+ 93- VALUE CODE - \ \ COMPUTATIOII OF TAX $ $ $ $- $ $ $ $ = TAX CREDIT $ REV-51. FO.(HOI . .,'" - ',., _ (;,0 NOTICE OF FILING OF APPRAISEMENT COMMONWEALTH OF PENNSVL.VANIA DEPARTMENT OF REVENUE BUREAU OF FIELO OPERATIONS Mr. Gerald Bistline, II 102 Watts Street Mount Holly Springs, PA 17065 RE: Estate of County of File No. O. Robert Bistline Cumberland 21-80-0598 Dear Mr. Bistline: You ore hereby notified that the originals appraisement in the estato of O. Robert Bistline has been filed in the office of the Register of Wills of Cumberland County on January 13 ,19 82. Said appraisement reflects the following valuations: Reol Estate Personal Property Jointly Owned Transfers Total NONE $31.315.70 NONE NONE $31.315.70 As to such tax that is paid within three months from dote of death, 0 five (5%) percent discaunt is allowable. As to ony tax that remains unpaid ofter nine (9) months (fifteen months when death occurrod from December 22, 1965 to June 16, 1971, inclusive; and twelve months when doath occurred prior to Docember 22, 1965) from dote of doath, interest at the rote of six (6%) percent per annum is charged. Any party in interest who is aggrioved by this notice may object thereto within sixty doys ofter receipt of said notice os provided by Section 1001 of the Inheritonce and Estate Tax Act of 1961,72 P.S. 2485-1001, P.L. 373. Dote January 13, 1982 Signed c;:~:~fi'iLv~~ , f7 Title Chief Appraiser NOTE: This is not 0 bill. DEPARTMENT'S APPRAISED VALUE S NONE $ 31,315.70 $ NONE $ NONE $ 31,315.70 REY-41l7 EX+ 17-eOl INHERITANCE TAX APPRAISEMENT COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX o T o SUPPLEMENT AL @ORIGINAL Estate of G. Robert Bistline File No. 21-80-0598 County Cumberland Date of Deoth August 12, 1980 In tho o.ont "'at any futuro Inter..t In this ostat. Is transferrod In passo..lan or enjaymonlla callaloral heirs 01 tho docodonl aher "'0 expiration at any o.tote 'or lIlo or lor yoa... 'h. Cammanwoal'" heroby exprossly r....... the right to appral" and assoss tranol.. Inheritance tOXeI at the lawful collateral rat. on an such future (nhnesf. PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH ASSET SUMMARY NONE Un,eportod $ Unreported $ Unreported $ Unreported $ 1. Total Real Proporty - 5CH. "A" . . . . ., $ 2. Total Personal Property _ 5CH. "B". .. : $ 31.315.70 3. Total Jointly Owned Property - 5CH. "E" $ NONE 4. Totol Transfers _ SCH. "C". . .,. . . .. $ NONE TOTAL GROSS ASSETS OREMAINDER, DLlFE ESTATE DANNUITY TOTAL VALUE $ I do hereby certify that the obove appraisement is made in conformity with Pennsylvania law and has been filed this day with the Register of Wills. ~~ ~ L:?' y . ~l..".....,/~;f:::'l..~ Januarv 13. 1q82 . APP SER DATE \0 ~ ~ ~ Q) ~ <: .... Z ~ ~ .... .. 0 " 101 ..... .. III Q) "tl '" Q) .... <: ;:l .. s.. .... I1l .... M C\I ..:l s.. .. 0 .... .... (\J .2l tIl ::c s.. .... ...: Q) - 0 " .. .c U Z IX: .. <: 3 - 0 .. ::l l<o - . ~ 0 t.> l<o ~ " ::;: 0 c:i ~ l<o l<o fo< 0 '" 0 z c:i <Il 101 '" >- fo< c:i - z Z fo< gj fo< 101 Z :::l c:i - ci ~ ?i ::.: 101 Jol Z ~ Z 0 U " Z - ~ '" ~ 8 0 g; :l ~ Jol 0 .. 'X.' IN THE COURT OF CO~mON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS I COURT DIVISION IN RE: ESTATE OF G. ROBERT BISTLINE, LATE OF THE BOROUGH OF MT. HOLLY SPRINGS, CUMBERLAND COUNTY, PENNA. DECEASED STATEMENT OF PROPOSED DISTRIBUTION The Accountant herein proposes to distribute the said Estate in accordance with the Intestate Act of the Commonwealth of Pennsylvania: Edna Bistline, ~1ido"', All by Family Agreement $23,405.10 ), /' / .n _ J"<ZAMO/, I)(&[i("...( JZ ~rald Bistline, II COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Gerald Bistline, II, being duly sworn according to law, deposes and says that: he is the Administrator of the Estate of G. Robert Bistline, and that the averments of the within Statement of Proposed Distribution are true and correct to the best of signer's personal knowledge, information and belief. d' I R. C7~d! 0,-- S(" Gera d Bistl~ne, II ....; 1YI ,:'. . ,/~\,'i.-~Woi:~~'tti.,and subscribed /~...;~~8"t~.~a}~~his 7th day ; %<;:C1.'~n~9~mhe'f, :).98l. .' :<., ,"'or (,. 'Gi"l" ( /' .:~ "', ,,;~. .':' ~: .' .!.. '. ...... '-..t. (~ ______ .', ,. .......' "'~....'?-&! . .. .- ,.... I ,'IN.\-, ,-.." ~:.:. '4'.0' ... ..' ~ ;','-."r .... f'" .. .. f..'. "('y \'"...... "'_,' 1 ..~,.' ..' . . ";~;..:~:~;~;~':~,.--/!i' [.d' ::-~~_'! L'~r( : " ~~r ,/' ,. {'lfJ lIBtP. 100 rAGE 489 - .. .~,: Ul Ul c- . " ~ .' m III .w ~' f. ... Q) t:: ~ M 0: Ci ..... ;:: - . .- 0: P- QJ .a ~ III :, -. ., P- O P, c ~ 0: ~ ~) C -' 0 - 0) Ql "' ~ '~ Z '-' -. :: <( ~ .~. ..<: >1P, OJ .~ -' .o. :; t!; .u M U) -, . .- .~ -l <: ti 0 "C--? M - U ., , \.~C) .J .. ;;; >- U :3 .... q....; 4-1 0 >. p, V :J ~ 0: III v. l- N 81{) 0 0 0 .- .w 0 'f, " Z ~, - C " .. ~ 0 " z !! ll-! C :.. - .' .. ..' D >- J: 0 0 .1' OJ Q) . ::l ... - ... .- - w !1 m W 0 'd \~ .u ,L.l .L.l 0 .:: " - , ,. ~ ~ Z J: .. ~ - ,. , ci .u " 0:3 i1l i1l .- U II-' 0: ~ '!.: " I~ u.: a: :i W ~ .;: ~ 1ll~0 .u .-'1 0 0 .- .- . " 0 0: .J ~ r ::l 'i:lIU Ul 4~ 'tl 'M ~ ..- -f w I: ... III 0 .. o.. .. '" N J QJ - 0 C .L.l .w -. ~,"\"Cl <: u (l)-.. 0 i1l i:: :3 - .-. o. .. , a: ., .. .. " 0: .ar( Ul 0: .<: M " .a .- .." .. . ~ 0 <( QJ ~ ~ ...r-! t;\ ~ P- ..... .. ./ U ~, u. ~ w .<: OJ M ::l Q. QJ ~ : ... .w u .c IY. .w 0 ,Q .W .w o' .. , '",' (j . p, Ul ~ @ i1l Ul .. o:ll-! 0 ~ C ..... 0 .iJ ..... ~ H OZ 0 H 1'1 P4 U UJ n , .. . " , , If' IN TIlE COURT OF CO~IMON PLEAS OF CUHBERLAND COUNTY, PENNSYLVANIA ORPIIANS I CQUR'r DIVISION IN RE: ESTATE OF G. ROBERT BISTLINE, LATE OF THE BOROUGH OF ltT. HOLLY SPRIllGS, CUMBERLAND COUNTY, PENllA., DECEASED FIRST AND FINAL ACCOUN':' OF GERALD BISTLINE, II, AmUNISTRATOR OF TilE ESTATE OF G. ROBERT BISTLINE, LATE OF PENN TOWNSIIIP, CUHBERLAND COUNTY, PENNSYLVANIA. Date of Death: August 12, 1980 Dates of Letters Advertised: Cumberland Law Journal: Evening Sentinel: May 22, 29, June 5, 1981 May 18, 25, June 1, 1981 DEBITS The accountant herein charges himself with the following: Principal - Real Estate Principal - Personalty Lump Sum distribution of decedent's retirement account - Kimberland Clark NONE $31,315. 70 Total principal Personalty $31,315. 70 Income - Real Estate NONE Income - personalty NONE TOTAL INCm'IE 1l0NE TOTAL PRINCIPAL $31,315. 70 CREDITS The accountant herein credits himself with the following: Register of wills, letters Cumberland Law Journal Evening Sentinel Hoffman Funeral I1ome, funeral George F. Douglas, Jr., attorney's fee Matthews Mem. Div. Register of Wills, filing inventory, etc. Register of Wills, filing first and final account USER 100 rm 48} 11. 00 18.00 18.00 3,103.60 500.00 680.00 15.00 60.00 o KIMBERLY.CLARK CORPORATION EMPLOYEES' INCENTIVE INVESTMENT PLAN STATEMENt OF ACCOUNT ACTIVITY DISTRIDUTICN STATEMENT EDNA 11 e 15 rUNE W,\TTS STREeT MT HOLLY SPRINGS PA 17065 PAYMENT OPTION LU,1P SUM CASH SOCIAL SECURITY NU. 172-26-9726 STATIMENT DATil UNIT NAME EM....OYIEE NUM_Eft ....AN 08-31-80 74 G ROIlERT IlISTLINE 06216 SALARIED PARTICIPATION IN PLAN BEFORE JANUARY 1, 1974 TOTAL PARTICIPATION IN PLAN - - - - - - - 6 YEARS, - - - 13 YEARS, 5 110NTHS 1 MONTH ACCOUNTI P"AN YEAR EMPLOYItE DEPOSITS AND EMPLOYER CONTRIBUTIONS DIVIDENDI AND INTEREIT GAIN OR "055 (-I IN MARKET VA..UEe ACCOUNT VA..UE AT STATEMENT DATE ACCOUNT VALUE AT STATEMENT D"TE INCLUDEI lAND CONr1S!rB~l+ON SHARES of INVEITEO K.C STOcK _ _ _ _ _ -ACCO NT STATUS EFORE DIST IBUTION- - - - - - ,KC STOCK FUNfJ ,,"'...."',,'" HATCHED EMPLOYER 12,100.86 4,915.57 4 , 348 . 0 1 1,657.73 5,903.56 2,389.97 22,352.43 8,963.27 79.65 39.83 ACCOUNT ST AlUS 17,OU,.43 6,005.74 8,293.53 31,315.70 119.48 _ _ _ _ - - - -lISTRIBUTIO - - - - - - - - - - - - - - - - .ASH DISBUR ED $31,315..(0 $31,315.70 STOCK FUND ------ OTAL OISTR 8UTION - - - $31,315.70 FORFEITURES- - - - - - $.00 TOTAL ilSTRH\UTIO AND FORFE TURES - S31,315.70 KC 1862 A 'In the cose of the Government end Diversified Funds, this includes gains or losses on soles of securities as well es the chango In market velue of securities held in the fund. ------.------- - ~.... -.--.. "'-"'-- --... ~,. ""'...... --. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX TAX AT 6% TAX AT 15% Gerald Billtline RECEIVED FROM TAXAT_"" ESTATE TAX ADDRESS TOTAL TAX CREDIT $1.500 _ 00 --------- .-- -- - ------ - ESTATE INFORMATION: DATE OF DEATH LESS DISCOUNT FILE NUMBER % INTEREST TO_I DATE OF PAYMENT PLUS {FROM ill m NAME OF DECEDENT 1" 'i00 no TOTAL AMOUNT PAID COUNTY ------- ------ -------------- POSTMARK DATE REMARKS / -I (, /1./ /./ v//.-J /SIGNATURE v / ,/' " '. ~ ~ ~ I . , I / / I / "PAID ON ACCOUNT.' RECEIVED BY SEAL REGI~;";"[n nr:: \\.'ILLS ..- ~- -- -- -- -- .- - -- - - - -- - - - '--- - - -- ""- - - - - -- -- --- -- ---- -~.- ...... _,~ -- _,,~... tIliI6