HomeMy WebLinkAbout01-21-091505607121
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
Po Box 2aosol 2 1 0 8 0 9 4 4
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
0 8 1 6 2 0 0 8 0 5 2 5 1 9 2 2
Decedent's Last Name Suffix Decedent's First Name M!
B I S T L I N E D O R O T H Y J
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
B I S T L I N E J O S E P H W
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 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. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
S T E P H E N L B L O O M 7 1 7 2 4 9 2 3 5 3
Firm Name (If Aoolicable)
I R W I N & M c K N I G H T
First line of address
6 0 W E S T P O M F R E T S T R E E T
Second line of address
City or Post Office
C A R L I S L E
Correspondent's a-mail address:
State ZIP Code
REGISTER OF WILLS USAF ONLY
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Under penalties of perjury, I declare that I have examined this return, 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 repre
LE R FILING RETURN DATE
82re~( K• HANOVER ST ET, APT 106 CARLISLE PA 17013
SIG AT OF THE ,tiAN REPRESENTATIVE DATE
_ -~>i-6s
D S
60 WEST POMFRET STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 15D56D7121
~~
1505607221
REV-1500 EX
RECAPITULATION
1. Real estate (Schedule A) ........................................ 1
2. Stocks and Bonds (Schedule B) .................................. 2•
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D) ........................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 1 8 1 9 3 . 9 4
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property
(Schedule G) ~ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7)
...........................
8. 1 8 1 9 3. 9 4
9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9•
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10.
11. Total Deductions (total Lines 9 8 10) ........................... 11.
12. Net Value of Estate (Line 8 minus Line 11) ..................
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...........
14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ....
....
.... ... 12.
... 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.o _ 1~ 3 8 1 9. 9 4 15.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 0 0 0 16.
17. Amount of Line 14 taxable Q Q 0
at sibling rate X .12 17.
18. Amount of Line 14 taxable
0 0
0
at collateral rate X .15 18.
19. Tax Due ................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
4 3 7 4. 0 0
4 3 7 4. 0 0
1 3 8 1 9. 9 4
1 3 8 1 9. 9 4
0. 0 0
o. 0 0
0. 0 0
0. 0 0
0. 0 0
Side 2
1505607221 15
REV-1500 ESC Page 3
Cecedent's Complete Address:
File Number
21 08 0944
DECEDENT'S NAME
DOROTHY J. BISTLINE
STREET ADDRESS
825 N. HANOVER STREET
APT 106
PATE -T-- --___
CARLISLE I 'I 117013
Tax Payments and Credits:
1 ~ Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E )
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.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1) 0.00
Total Credits (A + B + C) (2) 0.00
(3)
(4)
0.00
A. Enter the interest on the tax due.
(5) 0.00
(5A)
B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56) 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 : ................................................
. ^ 0
.
....................
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ X^
c. retain a reversionary interest; or ...........:....................................................................................
d. receive the promise for life of either payments, benefits or care? ....................................................... ^
^ ^X
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ Q
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ ^X
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. §9116 (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. §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 arid 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)]. Asibling isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
0.00
REV-1508 cX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
IN R SIDENTEDECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
DOROTHY J. BISTLINE 21 08 0944
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. THE BANK OF LANDISBURG -CHECKING ACCOUNT #733598 18,193.94
TOTAL (Also enter on line 5, Recapitulation) I $ 18,193.94
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
DOROTHY J. BISTLINE 21 08 0944
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A• FUNERAL EXPENSES:
1.
B.
State Zip
2. AttomeyFees IRWIN & McKNIGHT 750.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3.500.00
Claimant JOSEPH W. BISTLINE
Street Address 825 N. HANOVER STREET
City CARLISLE State PA Zip 17013
Relationship of Claimant to Decedent SPOUSE
4. Probate Fees REGISTER OF WILLS 94.00
5 Accountant's Fees
6. ~ Tax Return Preparers Fees
7. I REGISTER OF WILLS -FILING FEE I 30.00
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City
Year(s) Commission Paid:
AMOUNT
TOTAL (Also enter on line 9, Recapitulation) I $ 4 374 00
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (g-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
DOROTHY J. BISTLINE ~, ,.o ,,,,~ .
~. ~ VV V.7'TY
RELATIONSHIP TO DECEDENT
AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
1. JOSEPH W. BISTLINE Spousal 13,819.94
825 N. HANOVER STREET, APT 106 REMAINDER
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 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.
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(It more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
I, DOROTHY J. BISTLINE, of North Middleton Township, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me
made. Knowing I have been saved by grace through faith in my blessed Lord Jesus Christ, I no~v
have peace with God and will stand before Him. to give an account of my stewardship on earth. I
wish to express my love and affection for my precious and faithful husband, Joseph, and for the
many years God has given us together, and for our loving children, their spouses and our
grandchildren, and for their faith in Christ and desire to live for Him.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all
inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property) shall be paid from my residuary estate as soon as practicable after my decease and as part
of the administration of my estate. My personal representative shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other
properly not passing under this Will.
2.
If he shall survive me by thirty (30) days, then I give, devise and bequeath all of my estate,
whether real, personal or mixed property, whether tangible or intangible, and wherever situated, unto
my beloved husband, JOSEPH W'. BISTLINE, absolutely.
,,
Page I of S Pages '~~ ~; !~~
,~-
D.J.B.
In the event my said husband shall predecease or fail to survive me by thirty (30) days, then I
give such items of tangible personal property as are itemized in a certain list or memorandum, if any,
attached hereto or kept herewith to the persons named thereon, which list or memorandum is signed
and dated by me at the end thereof.
4.
In the event my said husband shall predecease or fail to survive me by thirty (30) days, then I
give, devise and bequeath my real property located on Bells Hill Road, Tyrone Township, Perry
County, Pennsylvania, being known as the eighty-acre woodlot, unto my children, JEAN
ELIZABETH REAM and LARRY DAVID BISTLINE, as equal tenants in common, subject,
however, to the condition that if any interest in such real property is proposed to be conveyed to any
person not related by blood or marriage to one of my said c~~ildren, then said interest shall first be
offered, on the same terms and conditions as the proposed conveyance, to EUGENE M. MOLT and
ELIZABETH S. NOLT of Perry County, Pennsylvania, who shall then have a period of thirty (30)
days from the receipt of such offer in which to either accept or decline same (this first right of refusal
shall be personal to the said Eugene M. Nolt and Elizabeth S. Nolt, and shall not extend to their
heirs, successors or assigns).
5
In the event my said husband shall predecease or fail to survive me by thirty (30) days, then I
give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or
mixed property, whether tangible or intangible, and wherever situated, in the following manner:
(A) Forty Percent (40%) thereof unto my daughter, JEAN ELIZABETH REAM, with
substitution of issue, per stirpe.s;
(B) Forty Percent (40%) thereof unto my son, LARRY DAVID BISTLIIv'E, with
substitution of issue, per' stirpes;
(C) Ten Percent (10%) thereof unto the general fiend of WINEBRENNER
THEOLOGICAL SEMINARY of Findlay, Ohio; and
Page 2 of 5 Pages -~~` ~`
b b ~i,,~ 7t ~1
i .J.I3.
(D) Ten Percent (10%) thereof unto the general operating fund of THE CHURCH OF
GOD HOME of Carlisle, Pennsylvania.
6.
I nominate, constitute and appoint my husband, JOSEPH W. BISTLNE, as Executor of my
estate. In the event he shall be unable or unwilling to serve in such capacity, then I appoint my
children, JEAN ELIZABETH REAM and LARRY DAVID BISTLINE, as Co-Executors of my
estate.
7.
I direct that my personal representatives. shall not be required to file a bond to secure the
faithful performance of their duties in any jurisdiction.
8.
I authorize and empower my personal representatives, in their sole and absolute discretion, to
purchase or otherwise acquire and retain any investments or any property of any nature which I own
at my death (and I call to the attention of my personal representatives my interest in a certain
obligation from Eugene M. Nolt and Elizabeth S. Nolt of Perry County, Pennsylvania, arising from
the sale of my farm during my lifetime, which interest comprises a significant portion of my estate as
of the date of this Last Will and Testament, and which obligation shall remain enforceable after my
death); to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to
any or all property of any kind forming a part of my estate for such terms and such prices as they may
deem advisable; to borrow money for any purposes connected with the protection and preservation of
my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join
in or secure the partition of same; to compromise any claims or demands of my estate against others
or of others against my estate; to make distribution in kind and to cause any share to be composed of
cash, property or undivided fractional shares in property different in kind from any other share; to
employ agents, attorneys and proxies and to delegate to them such power as my personal
representatives consider desirable and to pay reasonable compensation for such services as may be
rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may
be necessary to carry out any of these powers. In addition, I direct that my personal representatives
Page 3 of 5 Pages ~~. ; '
D.J.B.
shall have the power to conduct an inventory of any safe deposit box necessary to the administration
of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this 21 S` day of February,
2003.
~~ ~ ~.~~~~`'' (SEAL)
Dorothy J. istline
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other:
/i /~
-t
Page 4 of ~ Pages
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND
I, DOROTI-IY J. BISTLINE, Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
~ ~ ;
;~~vz.~ t~ ~ ~~~-~l~.r.
Dorothy J. is ine
Sworn or affirmed to and acknowledged before me by DOROTHY J. BISTLINE, the
Testatrix, this 21st day of February, 2003.
~I ~ ~' ~ -
Not Public Notarial seal
Lori A. Sullivan, Notary Public
Carlisle 6oro, ~utnberland County
COMMONWEALTH OF PENNSYLVANIA ) { r~ny Coruzussron ~k~r~s Feb. 16, 2004
SS, tvlember,Rf,~°-,r;:;n,-,?!; ,~~^,~~,t,~tior.,~!tJotari2s
COUNTY OF CUMBERLAND )
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We, ~ '~~tXr ~ .C . --XGGr"t'~ and L /~Crl7n ~, i6~C o ~~ ~ ~
the witnesses who e names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw DOROTHY J. BISTLINF,, the
Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and
that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that
each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best
of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence. ~,__~
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Address ;~~C ~ ~~,~~, ~~- / _
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Sworn or affirmed to and subscribed before; me this 21't day of February, 2003.
Notary Public ~ --------
Notarial Seai
i_cri A. Sullivan, Notary Public
C:1SLB\Office -Estate Planning\10399.Iw-will.doc ' Cari~~i~ t3oro, Cumb@rland C:oUnty
` "~'•~' ~:: rmmission Expires Feb. 18, QQQ~
Page 5 of 5 Pales ._. __ ~-~.~-`a.:.:r~r:,rerncate~~;p,;
The (~an~oF Landisbtir~~
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DOROTHY J BISTLINE
825 N HANOVER ST APT 106
CARLISLE PA 17013
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LA~dGISBURG BL.AIN ShERMANS DALE
TELEPHONE ('li) 7&9-32'?
733598
~-rr_rt~~i~,~~.zrt
Aug 31, 2008
Pg 1 of 1
3
08/07/2008 Beginning Balance Regular DDA .00
2 Deposits and Other Additions + 18,193.94
2 Checks and Other Deductions - 14,319.05
08/31/2008 Ending Balance 25 Days in Statement Period 3,874.89
08/07/2008 Beginning Balance .00
08/07/2008 Opening Deposit 3,000.00 3,000.00
08/12/2008 Deposit 15,193.94 .:_18,193.94.
08/20/2008 Check 93 14,307.75- 3,886.19
08/20/2008 ACH Payment 11.30- 3,874.89
;~."-,P.i~~~Pv'D CLAi~i~E C:ii'r: vFcDER i