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HomeMy WebLinkAbout07-21-14 1505610105 REV-1500 { ,,' `> Pennsylvania OFFICIAL USE ONLY n PA Department of Revenue Pe�Y Bureau of Individual Taxes °INHERITANCE Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN �� Harrisburg,PA 17128-06 I ' o1 RESIDENT DECEDENT a j j 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMODYYYY 0$11512013 021081192$ Decedent's Last Name Suffix D�e'ceedent's First Name MI BENSON [N �� �,_•_.,.� DI ONALD (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name _ Suffix Spouse's First Name MII, BEI NSON (nee: UndseY) . nita FL Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C*1 1.Original Return C? 2.Supplemental Return C=) 3. Remainder Return(Date of Death Prior to 12.13.82) p 4.Limited Estate C) 4e'Future Interest Compromise(date of p S. Federal Estate Tax Return Required death after 12.12.82) {C 6.Decedent Died Testate CI 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) C) 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death C=3 '11. Election to Tax under Sec.9113(A) Between 12-31.91 and 1-1-95) (Attach Schedule 0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD RE DIRECTED TO: Name jj}} _ Daytime Telephone Number C eN y �� ti n e U41l/�)9p (�( S/S f f /},� 717-334-1422 O•T" -6 a r r J 6 CMS u•Y\ REGISTER OF WILLS USE ONLY t t..> C7 c� First Line of AddressG�j v1 c_ n �� -rC_}- 967 Hens Ridge Road yr„ t i 7 �S`econd Line of Address 1 C70! n{-� ' City or Post Office State ZIP Code -'-atTATE-FtLEO - f.;:C-91 Gettysburg PA 117325 Correspondent's e-mail address: ,_R,. rr„� APit 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 prepamr ether than the personal representative;Is based on all infoanation of which preparer has any knowledge. SIGNATURE an eQFe—, 1 N RESPONSIBLE I� Qm,L,i OR FILING RETURN DATE IDRES 4,�o}LYJ nY „R/1S ADDRESS Y7 SS O R THER�yq�At�A AT M_IVE D - I ( I ADDRESS ,,'4S° vb+�@y,••-r PLEASE USE ORIGINAL FORM ONLY NOTARY PUBLIC STATE OFMAARYh NID My Comm*('On E4-ires Fetirwry;74.2018 Side 1 ? � Y 1505610105 15056101!05 writ,--•. ,R 1505610205 REV-1500 EX(Fl) Decedent's Social_Security Number l Decedent's Name: fllp,ld flnte ReAS0f1 RECAPITULATION 1. Real Estate(Schedule A). ....... .......... ..... ...................... 1. I N/A 2. Stocks and Bonds(Schedule B) .... ....................... ........ . N 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .... . 3. N/A 4. Mortgages and Notes Receivable(Schedule D)......... ..I........ ........ 4. ' N/A 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E):...... 5. N/A 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. $5,189.91 7. Inter-Vivos Transfers.&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. ...... 7. N/A 8. Total Gross Assets(total Lines 1 through 7)................... .......... 8. f $5,189.91 9. Funeral Expenses and Administrative Costs(Schedule H)............. ...... 9. $5,500.00' 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. N/A' 11. Total Deductions(total Lines 9 and 10).............................. ... 11. $5,500.0 12. Net Value of Estate(Line 8 minus Line 11) .......... ............. ..... .. 12. -$310.09 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. ..................... . 13. t 14. Net Value Subject to Tax(Line 12 minus Line 13) ........ ..... ........... 14. TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 ;"- (a)(1.2)X.0- 15. 0 16. Amount of Line 14 taxable at lineal rate X.0- 16. 0 17. Amount of Line 14 taxable at sibling rate X.12 17. 0 18. Amount of Line 14 taxable at collateral rate X.15 jg,! 0 19. TAX DUE ...... ........................ ..... .................... L.--- 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610205 1505610205 Decedent's Complete Address: DECEDENTS NAME -Donald-Dale-Benson STREET ADDRESS _Hanover-Hall-Nursinq-&R_ehabilitabonF-acilitVJ Ventillator_Unit CITY STATE 21p Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) $3303 2. Credits/Payments A.Prior Payments A33_03. B.Discount 3. Interest Total Credits(A+B) (2) c 4. It Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) NVA Fill in oval on Page 2,Line 20 to request a refund. (4) c 5. If Line 1 +tine 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) tiro 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 ............................................ ❑ 0 c. retain a reversionary interest .............................................................................................................................. ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ E 3. Did decedent own an'in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ E 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 Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 4.5 percent,except as noted in(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 12 percent 172 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. pennsytvania SCHEDULE F DEPARTMENT TAX 30INTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: IIonnirl Dale Benson 2113-1135 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.Anita L.Benson Hanover Hall Nursing Rehabilitation Facility Surviving Spouse 267 Frederick Street, Hanover, PA 17331 e.Barry D.Benson 46483 Sue Drive Son Lexington Park,MD 20653 C. I i 30INTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % DATE OF DEATH ITEM FOR 301NT MADE INCLUDE NAME OF FINANCIpI INSTnUT1ON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUEOF NUMBER TENANT MINT IDENTItl4NG NUMBER.ATTACH OECD FOR 30INTLY HELD REAL ESTATE. VALUE OF ASSES INTEREST DECEDENTS INTEREST t. A. 7110109 Aprx Free Checking Account-55-6101-1036 $4,404.27 $4,404.27 7101113Aprx Saving Statement-55-5926-6961 $785.64 $785.64 TOTAL(Also enter on Line 6, Recapitulation) $ 5 1RQ Q1 [" pennsylvania a%,,r1CL0WLc n DEPARTMENT'OFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Donald Dale Etenson 9113-1+36 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Monahan Funeral Home,Gettysburg,PA Cremation and grave side services. $2,800.00 2. Codori Memorials,Gettysburg,PA Memorial Stone and cement base installation $2,125.00 3. Mr.Harry Bucher Flohr's Church Lot $275.00 4. Flohes Church Cemetery Assoc. Burial Plot Olgging $300.00 6. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP years)Commission Paid: 2. Attorney Fees: 3. Famity Exemption:(if decedent's address is not the same as daimant's,attach explanation.) Claimant Bauy-Dale-Benson Street Address 46483-Sue.-0 t1u City.Lexington-P-ark State-MD_ZIP 20653 Relationship of Claimant to Decedent 4. Probate Fees: S. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ c grin nn i i Free Cheddng Statement PNC Bank (9 PNCBANX t Primary account number:55.8101-1036 Page 1 of 2 For the period 08/1012013 to 08199!2013 Number of enclosures:0 i NI T M ANN For 24-hour banking,and transaction or AA ! BENSON interest rate information,sign onto DONALD D BENSON DECD PNC BankOniine Banking atpncoom. BARRY D BENSON Forcustomer service call 1-888-PNC-BANK + PO BOX 810 I Monday-Friday:7 AM-10 PM ET CALIFORNIA NO 20629-0810 Saturday&Sunday: 8AM-5PMET i Para servicic en espaticl, 1-866-NOI.A-PNC i t tOor4tyt Please contact us at 1-888-PNC-BANK i ®Write to:Customer Service i PO BOX 609 Pittsburgh PA 15230-9738 s Its Visit us at PNC.com t ® TOD terminal:14)00-531-1648 FM hearing hnpaaed etirnu only OWN sea IMPORTANT ACCOUNT INFORMATION The information below amends the Account Agreement for Personal Checking,Savings and Money Market Accounts.Please read this information and retain it with your records. Disputing Information Reported'to ChexSystems We may report information about you and your accounts}to ChexSystems.If you believe that the information that PNC Bank is furnishing to ChexSystems is inaccurate or incomplete,you have the right to file a dispute with ChexSystems by writing to:Chex Systems,Inc.,7805 Hudson Road,Suite 100,Woodbury,MN 55125,or faxing it to:602-659-2197. Your correspondence should include the following information: >Your name,address and Social Security Number >Your account number >The information being reported that you believe is inaccurate or incomplete ' >Any supporting documentation,such as account statements,letters,etc. >A copy of the ChexSystems report,if available You may also dispute the information that PNC Bank is furnishing to ChexSystems by submitting your dispute with the above information to: PNC Bank,Attn:DRU,P.O.Sax 464,Louisville,KY,40201-0464. --• IC g 6acoc¢ome Summary Anita L Benson Account number:55-6101-1036 Barry D Benson Donald 0 Benson Decd Overdraft Protection Provided By: XXXXXX6961 OrerdiafR Coverage-Your account is currently Opted-Out. You or your joint owner may revoke your opt-in or opt-out choice at anytime. ToteemmoreaboutPNCOvoalmft SaiatartsvisitMoniiMatpm.e rrV*verdraftaoiutiam, Celt 14M-588-3605,visit any branch,or Sign on to PNC Ontins flanking,and setect the'Ovsrdtait Solutions'link under the Account Services sectlon to manage both your Overdraft Coverage and Overd raft Protection settings. wee Summary Beginning Deposits and checks and other Ending balance other additions deductions balance 674.29 .00 .00 674.23 Average monthly Charges balance arid fees 67428 .00 Cry PNr1Ml TA1-hrlhMa1i t.Ndr1_NNNNNN.nn 1.117Ritn FFORM100472-MJW PNCBANK Your account was DEBITED for the following reason: ❑y Check# posted on encoding error posted to incorrect account icy Ctosed account 5561011036 ❑ Branch adjustment(branch name) ❑ Service charge error ❑ Other. ' w...' i Account Number its ID A 5561011038 040 MOUNT $ 674 .23 PNC Bank, National Association D ANITA L BENSON FOR BANK USE ONLY E BARRY D BENSON Branch#!Dept # Date B DONALD D BENSON DECD 0000447 09j21j2013 T I 967 R'ERRS RIDGE RD � GETTYSBURG, PA 17325-8402 Prepared By(PRINT Name) Authorized By BARBARA A SAY]OR Customer's Advice of Charge 3200-0212 - PAPER FOR GL TICKETS AND CONVENIENCE CHECKS y i M O N N 00 � � P 1 � N 0 M � N V z A 69 0 U s. a � X � Z < r hd"M V t zm Y zzo Z O � z w ry w o° Gq � A Q w m oN 0090-9f60Z LWH043 Savings Statement Pl��P1��C PNC Bank ?Wit. Primary account number.55-5926.6961 Page 1 of 3 For the psefad 07149!20113 to 4$13012413 Number of enclosures:0 063140 For 24-hour banking,and transaction or ANITA L BENSON interest rate information,sign onto BARRY D BENSON PNC Bank Online Banking at pnc.com. DONALD D BENSON DECD 'a For customer service call 1-008-PNC-BANK PO BOX 810 Monday-Friday:7 AM-10 PM ET CALIFORNIA NO 2061 9-081 0 Saturday&Sunday: 8AM-5 PM ET Pam servicio on espatiol,1-866-HOLA-PNC l4oeing? Please contact us at 1-688-PNC-BANK CO Write to:Customer Service PO Box 609 Pittsburgh PA 15238-9736 E3 Visit us at PNC.com TDD terminal:1-800-531-1648 For hewing hnp2ired clients only IMPORTANT ACCOUNT INFORMATION The information below amends the Account Agreement for Personal Checking,Savings and Money Market Accounts.Please read this information and retain it with your records. Disputing Information Reported to CheltSystems We may report information about you and your account(s)to ChexSystems.If you believe that the information that PNC Bank is furnishing to ChexSystems is inaccurate or incomplete,you have the right to file a dispute with ChexSystems by writing to:Chex Systems,Inc.,7805 Hudson Road,Suite 100,Woodbury,MN 55125,or faxing it to:602-659-2197. Your correspondence should include the following information: •Your name,address and Social Security Number •Your account number •The information being repotted that you believe is inaccurate or incomplete •Any supporting documentation,such as account statements,letters,etc. •A copy of the ChexSystems report,if available You may also dispute the information that PNC Bank is furnishing to ChexSystems by submitting your dispute with the above information to: PNC Bank Attn:DRU P.Q.Box 464 Louisville.KY 40201-0464. Savings Ae"Mt Summary Anita L Benson Account s u rdsor:55.5928.6961 Barry D Benson Donald D Benson Decd Ballance Summary Beginning deposits and Checks and other Ending balance other additions deductions balance '785.64 .01 785.65 .00 Intereal'Summary As of 09/30,a totalof$AS in interest was Annual Percentage Number of days Average ooliected Interest Paid paid this year, Yield Earned(APYE) in Interest period balancefor APYE this period 0.002 0 .00 AO eecaeilc and Flliaer Addiiiene Therewas 1 DeposhorOtherAddhion Date Amount Description totaling$A1. 06/31 .01 Interest Payment Savings .Statement For the period 07104/2012 to 09/30/2013 For 24-hour Information,sign on to PNC Bank Online Banking ANITA L BENSON on pno.00rn• Primary account number.55-5926-6961 Account ntmtber!555926.6961.contmtrod Page 2 of 3 Other Dedweti®et9 There were 2 Other Deductions totaling Date Amount Description $795.85. 09/23 .00 Outstanding item©ose 09/23 785.65 Debit Memo Reference No. 050862461 Daily Balaaae Detanl Date Balance Date - Balance Date Balance 07/01 185.64 08/31 785.65 09/23 .00 r / 9 « ! ! � 2 q ■ � wtorA ` / }| 0to § § | ! ; ; n0 . * � § n � } } 0 2 / . ) � § g K � q \ . . \ " to a @ 7 2 2 § 3 e n 6 a M o z � k \ z 22 2. n z . 2 �k 0 Fr § / ! � . R i r ` r < § n \ \ r ® , 0 � PNCBANK 040 CALIFORNIA (447) f 22610 THREE NOTCH ROAD i LEXINGTON PARK, MD, 20653 Cashbox O1 I 1 Business Date SEP 23, 2013 1 Calendar Date SEP 21, 2013 Purchase 09:10 Transaction Number 00046 Account Type Official Check Account Number XXXXXX6961 Document Number 00653293 Transaction Amount $ 1,459.88 Funded by Check $ 1,459.88 Payee: CHERYL DUNLAP Remitter: ANITA BENSON This deposit or payment is accepted subiect to verification and to the rules and regulations of this bank. Deposits Bay not be available for immediate withdrawal. Receipt should be held until verified with your statement. B PNCBANK Cashier's Check PNC Bank,National Association No. 12422611 8 ANITA L BENSON Date September 21, 2013 2 BARRY D BENSON Pay to the Omer or DONALD D BENSON DECD $ 785.65 z w Seven Hundred Eighty-five Dollars And Sixty-five Cents Non-Negotiable Customer Copy N59266961 aemhter MONAHAN FUNERAL HOME, INC. Robert J. Monahan Supervisor Robert J. Monahan,Jr. William P. Monahan Thomas M. Monahan Kevin M.Neiderer Itemized Funeral Expenses for Donald Benson - Date of Death June 15, 2013 Cremation with Graveside Services $2800.00 Floral Wreath - 159.00 Other Floral Arrangements 69.00 Gettysburg Times 125.00 Sioux City, SD Newspaper 127.50 Certified copies of Death Certificate 6 copies @ 6.00 36.00 Total Expenses $3316.50 Received check from family July 10, 2013 1000.00 Balance on account $2316.50 received check from Hanover Hall on 8-21-2013 (852.87) Balance as of September 30, 2013 $1463.63 Thank You, Gtr' Thomas M. Monahan ao z��b00 125 Carlisle Street Gettysburg, Pennsylvania 17325 717-334-2414 monahanfimeralliome@conicast.net scan T° ' CudnrieFmurittftt GRANITE - MARBLE - BRONZE 400 W.Middle St. P.G. Box 3055 510 Carlisle St. ^�� �"—"6ettysburg, PA 17325 Hanover, 63 -5009 {717) 334-1413 (717) 633-5009 FAX(717)334-2476 FAX(717)633-9325 www.codorimemorials.com SUBJECT DATE /6 DATE SIGNED Emm TO tttbutt a Pm11Cttt GRANITE - MARBLE - BRONZE 400 W.Middle St. P.G. Box 3055 510 Carlisle St. Gettysburg, PA 17325 Hanover, PA 17331 (717) 334.1413 (717) 633-5009 FAX(717) 334-2476 FAX (717) 633-9325 www.wdorimemorials.com SUBJECT DATE_ �•-� 1 �q � 2 ) n - tom DATE SIGNEDd . 11,.Track TDm FspeflEY>; - 4.28 - f: aWD� o�duaY� oAiaae�uwDro,I a ChanEes I F- hinianl 0TaacI,,.❑ Lubas 13 cow .DEPOW 0 TAX DEDUCHBLE rrEM - - For enharroed 6BCUrdy your eDCmmt number xgl not be printed on this cro - - - . 7.1 PY=;' NOT-NEGOTIABLE - �---.--- ------ - _ � ✓TmeliYourFSpemPS ----- ----- ------ -------4.29 - M" : �AutNnavel ❑Ebaatbn OmckaVDenlaf ❑BLEI 0Enfenainment❑Savhgs -4 Chaftes ❑Food ❑Taxes 4 �r7oaaO ' ❑Home ❑-Lnfts eAL �v� .O DeP"XII Care [Doscrence. DOErer _. .w L . -DE➢Da1T RQTAXBEDuQUCTQ�IB`LE r�fEM� �{ - FORM . ; For enh2nceu security your account number wtll trot be Pdmed on III copy _ �''NAT NEGOTIABLE ff"A CIA VV' SEPTEMBER 6, 2013 ANITA BENSON 267 FREDERICK STREET HANOVER, PA 17331 Dear Mrs. Benson: We recently mailed a package explaining benefits in which you are entitled. At this time, we have not received the required documents in order to process your benefit. If you have not received the package or require assistance, please call and speak with a representative at the telephone number listed below. Thank you for your prompt attention to this matter. The overpayment for July-August 2013 in the amount f$753.96 1 still outstanding. Please submit a check in tt e amount of$753.96 payab oeing Pension Trust. You have the option to have the overpayment deducted from your retroactive benefits. If you choose this option, please submit the request in writing. If you have specific questions, please contact the Boeing Pension Service Center by calling Total Access at 1-866-473-2016. Hearing-impaired callers should use the relay service offered through their telephone service provider. Pension Representatives are available Monday through Friday, 9:00 a.m. -5:00 p.m. Eastern Time, excluding holidays. If you prefer, you may write to the fallowing address. All correspondence should include the participant's name and Social Security number. Boeing Pension Service Center P.O. Box 199404 Dallas, TX 75219-9404 Sincerely, Boeing Pension Service Center j h I✓ .6 1of1 9046 1010212003 D&:itr November 22, 2013 ANITA BENSON HANOVER HALL CIO SARAH LAUGHLIN 267 FREDERICK ST HANOVER, PA 17331 Dear ANITA BENSON: On behalf of The Boeing Company, we extend our sympathy on your loss. As a survivor, you are entitled to a survivor benefit(s)from The Boeing Pension Value Plan. You will receive a monthly benefit of$50.00 beginning 211/2014 and continuing for the remainder of your life. Enclosed is a Surviving Spouse/Domestic Partner Pension Payment Application. Your completed application must be notarized and returned to us, along with a death certificate, in order for your benefits to start. These benefit amounts are estimates only. All benefit amounts are subject to verification and audit to ensure compliance with the terms of the Plan. Pension payments are to be received through direct deposit. The direct deposit process ensures your payments are sent electronically to your financial institution. This service is available for your _ safety and convenience. We have enclosed a Direct Deposit for Pension Payments Form. If the form is received by the fifth of the month, your direct deposit will be made the first of the following month. Review the enclosed Tax Withholding Notice for information about the tax implications of receiving a pension benefit. The enclosed Tax Withholding Election form must be completed and returned or taxes will automatically be withheld from your pension check as if you were a married person claiming three withholding allowances. The total gross benefit paid and total withholdings deducted will be reported annually on an IRS Form 1099-R. IRS Forms 1099-R will be issued for payments made during this calendar year at the beginning of next year. The forms will be mailed to the address on record. If you need tax advice, we urge you to contact your tax advisor. The information and the fors contained in this packet are for your review and completion. Refer to the enclosed document checklist for a list of the required information and fors. Page t 1310 0910512013 DB7:ttr