HomeMy WebLinkAbout08-26-14 J F FE Pennsylvania 1505613110
OEPM1MENi OVENVE
EX(06-13)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 1 qq
Harrisburg,PA 17128-0601 RESIDENT DECEDENT ` 1 `o�-q
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
11302013 08261920
Decedent's Last Name Suffix Decedent's First Name MI
BECK CLYDE H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH
THE
FILL IN APPROPRIATE BOXES BELOW REGISTER OF WILLS
Q 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(dale of death
Prior to 12-13-82)
Q 4. Agriculture Exemption Q 5. Future Interest Compromise(date of Q 6. Federal Estate Tax Return Required
date of death on or after 7-1-2012) death after 12-12-82)
0 7. Decedent Died Testate Q B. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
Q 10. Litigation Proceeds Received Q 11. No Taxable Asset Return 0 12. Election to Tax under Sec.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
L . TODD BECK 717-861-1035
First Line of Address
780 LONGS GAP ROAD
Second Line of Address
City or Post Office State ZIP Code
CARLISLE PA 17013 rn
M
REGISTER OF WlEllct&XONLY
REGISTER OF WILLS USE ONLY f— N C+ rTl
DATE FILED '�"�- Z C"
1 17 x o
c> o -v -n
e a a -,t :3 "1 3
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Correspondent's email address: DATE FILED-STAMP
Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,it �1J
is true correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. t
SIGNATJ113lfl(;W; $ S�J Ig1.E FOR FILING RETURN DATE 4
ADDRESS
780 LONGS AP ROAD CARLISLE PA 17013
SIGNATURE''OF PREP ER OTHER THAN'REP ENTATIVE DATE
ADDRESS
524 S TH PITT STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505613110 1505613110 J
GIV
1505613210
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: CLYDE H BECK
RECAPITULATION
1. Real Estate(Schedule A).. . .. . ... .... . .. . . .. . .. . .. . ... .. . . .. ... .. . . 1.
2. Stocks and Bonds(Schedule B).. . ... . ... . .. . ... .. . . .. . .. . .. . .. . . ... 2. 4 9 4 3 6 . 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). . . 3.
4. Mortgages and Notes Receivable(Schedule D). . ... ... . .. . .. . .. . ... .. . . 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . .. . 5. 96197 . 00
6. Jointly Owned Property(Schedule F) =Separate Billing Requested.. . ... . 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) =Separate Billing Requested.. 7. 189028 . 01D
6. Total Gross Assets(total Lines 1 through 7).. ... ... . .. . .. . .. . .. . ... . .. 8. 334661 . 00
9. Funeral Expenses and Administrative Costs(Schedule H) . .. . .. . .. . .. . ... . 9. 1770 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . .. . .. . ... . .10. _ 424 . 00
11. Total Deductions(total Lines 9 and 10). ... . ... . .. . .. . . . . .. . . . ... . .. . 11. 2194 . 00
12. Net Value of Estate(Line B minus Line 11). . .. . .. . .. . .. . . .. . .. . .. . ... . 12. 332467 . 00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J).. ... . . . .. . . . . .. . .. . . . 13.
14. Net Value Subiect to Tax(Line 12 minus Line 13).. . .. . .. . .. . .. . .. . ... . 14. 332467 . 00
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.
16. Amount of Line 14 taxable
atlinealrateX.o 45 332467 . 00 16. 14961 . 02
17. Amount of Line 14
taxable at sibling rate X . 12 17.
18. Amount of Line 14 taxable
at collateral rate X . 15 18.
19. TAX DUE. .. . . . .. ... .. . .. . .. . ... ... . .. . ... ... ... . .. ... . .. ... ... .. 19. 14961 . 02
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ' Q
Side 2
L1505613210 1505613210 J
REV-1500 EX Page 3 File Number 178-14-0388
Decedent's Complete Address: 2113-1293
DECEDENTS NAME
CLYDE H BECK
STREETADDRESS
442 WALNUT BOTTOM RD
l CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 14961.02
2. Credits/Payments
A.Prior Payments 10500.00
B. Discount 552.62
Total Credits(A+B) (2) 11052.62
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in box on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3908.40
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......................................................................................... ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income............................................ ❑ ❑X
c. retain a reversionary interest............................................................................................................................. ❑ X❑
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ X❑
2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................................. ❑ ❑X
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............. ❑
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)(1)].
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[72 P.S.§9116(a)(1.3)].A sibling is
defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1503 EX+(B-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ESTATE OF CLYDE H BECK 2113-1293
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. WELLS FARGO ACCT 1398-9871 100 SH EXXON MOBIL CORP 9,348
2. WELLS FARGOACCT 1398-9871 400 SH DOMINION RES INC 10,520
3. WELLS FARGO ACCT 1398-9871 400 SH HSBC HOLDING PLC 10,376
4. WELLS FARGO ACCT 1398-9871 400 SH ING GROUP 10,080
5. WELLS FARGO ACCT 1398-9871 261 SH IVY FD GLOBAL NAT RES B 4,109
6. WELLS FARGO ACCT 1398-9871 CASH ALTERNATIVE 277
7. 90 SH METLIFE INC 4,726
TOTAL(Also enter on Line 2, Recapitulation) $ 49,436
If more space is needed,insert additional sheets of the same size
REV-1508 EX+(08-12) SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT TA REVENUE PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ESTATE OF CLYDE H BECK 2113-1293
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 THORNWALD HOME-ACCT 1305 57
2 SANTANDER BANK CHECKING-ACCT 1671010116 15,776
3 SANTANDER BANK PREMIER MONEY MARKET-ACCT 7678956053 71,139
4 PERSONAL PROPERTY AUCTIONED 7,107
5 REFUND FROM US TREASURY FOR 2013 FORM 1040 2,118
TOTAL(Also enter on line 5, Recapitulation) $ 96,197
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(09-09) SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE RESID E
RESIDENT DECEDENT TAX RE ED RETURN MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
ESTATE OF CLYDE H BECK 2113-1293
This schedule must be Completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDETC NAME OFTHE TRANSFEREE,THEIR RELATIONSHIPTO DECEDENTAND DATE OF DEATH % DEWS EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH ACCFY OFTHE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (FAPPLCASLE) VALUE
1. AMERICAN GENERAL ANNUITY (CONTRACT XP224927) 175,606 100.00% 175,606
2. US STEEL PENSION 13,422 100.00% 13,422
TOTAL Also enter on Line 7, Race itulation $ 189,028
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT DECEDENT ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ESTATE OF CLYDE H BECK 2113-1293
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1. FRANK F GIGLER FUNERAL HOME-$10064.00-$9925.00 PREPAYMENT 139
2. FUNERAL MEAL SUPPLIES 296
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) L.TODD BECK
Street Address 780 LONGS GAP RD
city CARLISLE State PA zip 17013
Years)Commission Paid:
2. Attorney Fees: 601
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees: 290
7. REGISTER OF WILLS 414
NOTARY FEES 10
BANK FEE 20
TOTAL(Also enter on Line 9, Recapitulation) $ 1,770
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX.(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT,
RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
ESTATE OF CLYDE H BECK 2113-1293
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
MILLENNIUM PHARMACY-FINAL PAYMENT 93
2. PA DEPT OF REV FINAL PA 402013 TAX 293
3. VOHRA-FINAL PAYMENT FOR PRESCRIPTION DRUGS 23
4. DR GEORGE BRANSCUM-FINAL DOCTOR BILL 15
TOTAL(Also enter on Line 10, Recapitulation) $ 424
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ESTATE OF CLYDE H BECK 2113-1293
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1 L.Todd Beck SON 50%RESIDUE
780 LONGS GAP RD., CARLISLE, PA. 17013
2. C. Diane DeRoche DAUGHTER 50%RESIDUE
715 A NORTH MEADOW ST, RICHMOND, VA. 23220
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TOTAX IS NOTTAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128 0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 018780
BECK L TODD
780 LONGS GAP RD
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 $10,500.00
ESTATE INFORMATION: SSN: 178-14-0388
FILE NUMBER: 2113- 1293
DECEDENT NAME: BECK CLYDE H
DATE OF PAYMENT: 02/19/2014
POSTMARK DATE: 02/19/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 11/30/2013
TOTAL AMOUNT PAID: $10,500.00
REMARKS: L TODD BECK
CHECK# 1012
INITIALS: WZ
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
0�ie� on
f Va`Ue o M 1ono,00
® - - Wells Fargo Advisors,LLC
301 Grant Street
_ One Oxford Centre,Suite,3600
Pittsburgh,PA 15219
Tel:412-394-3100
Fax:412-394-3166
December 11, 2013
L Todd Beck
780 Longs Gap Road
Carlisle, PA 17013
Dear Todd,
As requested enclosed are the date of death statements for Clyde Beck. The statements dated
December 2, 2013 are the close prices as of November 29th and the statements dated
December 3, 2013 are the close prices for Monday, December 2th. I have also enclosed the
November statement.
If you have any questions please feel free to give me a call at 412-394-3193.
Sincerely, q
C C�L� Ov 2/V a-kA
Carole A Ward
Senior Client Associate
Together we'll go far
Member FINRA/SIPC
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WALNUTBOTTOM ROAD
Holder Account Number
PA 17013 3742 1 C0003278034 i N D
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Record Date - 06 Fab 2013
Check Number 0000189795
001CSM05DamMETL_P I. .,rL.140209.51607/U159A0101$9R0PI�
g MetLife Policyholder Trust-Dividend Distribution
Enroll Now for Direct Depositl
Effective In 2013,McWfe wt9 now pay common stock dividends quarterly rather than annually.In addition,you can now receive your funds
immediately and conveniently by having your dividends directly deposited into your bank account.Just complete the enrollment form on the
back of this statement and return it in the envelope enclosed.You can also enroll by logging Into www.computershare.com or by calling toll-free
at 600.649.3593.
Dividend Summary ( Holder Account Number C0003278034 Price
Data
Record Payable Date Description I Total irderests( Dividend
Rate{ Distribution I Amdunf on I Dividend($} Market value StocReco d Date
06 Feb 2013 13 Mar 2013 TRUST INTERESTS 90 $0.1850D 16.65 0.00 16.65 3,381.30 37.57000
Year-To-Date Paid 18.65 OX
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STATEMENT
Thornwald Home Statement Date: 12
442 Walnut Bottom Road /01/2013
Carlisle, PA 17013
Telephone: (717) 249-4118
Amount Enclosed $
Amount Due: $ -57.31
Account #: 1305
_._ RE: Clyde H Beck
Diane Deroche
715A N. Meadow Street
Richmond, VA 23221
at ` -bescri tion ua nt Rate ,Cha' yes`
Payments ,Balances
Balance B/F 9,428.65 . 9,428.65
11/22/13 DEROCHE, DIANE 9,428.65 .00
11/04/13 Personal Supplies 5 10.71 '15.69 15.69
11/15/13 Medical Supplies 30 12.16 103.56 119.25
11/18/13 Incontinence Supplies 7 10.92 76.44 195.69
11/29/13 Medical Equipment Rental 1 24.50 24.50 220.19
11/01/13 - 11/30/13 Room&Board- Private 30 305.00 -9,150.00 -8,929.81
11/01/13 - 11/29/13 Room&Board -Private 29 305.00 8,845.00 -84.81
11/30/13 Personal Laundry Services 1 27.50 27.50 - -57.31
Current 31=60 Days 61-90 Days Over 90 Days Amount Due
-57.31 .00 .00 .00 57.31
Payments MUST be received BY the 25th of each month.
Reminder!! If you have not returned the 2014 signed rate letter Statement Date: 12/01/2013
acknowledgement,please return immediately. ALL residents must return
a signed copy. - --
Wishing you a Merry and Blessed Christmas and joyous New Year!
Clyde H Beck - Account #: 1305
Thornwald Home
442 Walnut Bottom Road
Carlisle, PA 17013
Telephone: (717) 249-4118
4o Santander
Court Order Processing\Decedents- MA1-MB3-02-10 - P.O. Box 841005 - Boston,MA 02284
January 15, 2014
Z � �
L. Todd Beck
780 Longs Gap Rd
Carlisle, PA 17013
9
RE: Estate of Clyde H. Beck
Date of Death: 11/30/2013
a
z Dear Mr. Beck:
g
n
Per your request, enclosed please find the account information as of the date of death
4 for the above-named decedent. For your information, accrued interest is not included in
I the date of death balance.
Please feel free to contact me if I can be of any further assistance.
e
s
Very truly yours,
;a
�b
Helen Alboth
Lead Specialist
s 617-514-5189
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Santander
ESTATE OF Clyde H. Beck
SOCIAL SECURITY#: 178-14-0388
DATE OF DEATH: November 30, 2013
Account#: 1671010116 Type: Checking Open date: 3/9/1998
In the name of. Clyde H Beck- (L Todd Beck-POA- Carole D Deroche-POA) 2
Date of Death Balance: $15,776.12
Int.(YTD) from 1/1/2013 to 11/14/2013 $0.91
Accrued interest to date of death: $0.09
Other Info: Carole D Deroche added as POA 07/12/2013
Account#: 1674061927 Type: Money Market Open date: 12/26/2006
In the name of. Clyde H Beck- (L Todd Beck-POA)
Date of Death Balance: $0.00
Int.(YTD) from 1/1/2013 to 3/25/2013 $1.47
Accrued interest to date of death: $0.00
Other Info: Account closed 3/25/2013 - $ 1,545.45
Account#: 7678956053 Type: Money Market Open date: 11/19/2013
In the name of: Clyde H Beck- (L Todd Beck-POA)
Date of Death Balance: $71,139.16
Int.(YTD) from 11/19/2013 to 12/10/2013 $0.00
Accrued interest to date of death: $0.00
Other Info: Account closed 12/10/2013 - $71,139.16
Page 1 of 1
ROWE'S AUCTION SERVICE (RH 79L)
2505 Ritner Highway e. Carlisle,PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 574.1008 Dave Rowe (AU 2295L)
Auction Is Action Call `Rowe" For Satisfaction
SELLERS NAME !d' r ' DATE `�', l
ADDRESS G PHONE
OTHER l AUCTIONEER %
AUCTION DATE/LOCATION G CLERK %
/ � ` DESCRIPTIO OF MF,.RC NDISE.
� ,.
Oily
SV�
t'j �•wi`S , — r s
G� 1
/ —
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner.or authorized represen-
tative of the merchandise,goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the pur .ser. I agree t hold harmless the Auctioneers against any claims of the nature referred to in
t ' agreement. /]
u fiu^ �JY C:►Li
AUC ION SIGN TURE SELLERS SIGNATURE
Total Sales (Clerking Tickets Attached) $ f �°
Less Sale Expense:
25 %Commission Auctioneer $
%Commission Clerks $ -
OTHER:
TOTAL SALE EXPENSE DEDUCTED $ _ �t
SELLERS NET $ (D fO '�
Page 1 of 2
Taxpayer Lookup ID Number: Name: BECK, CLYDE H DECD
178140388 Address: % LEWIS TODD BECK
EFIN: 235700 780 LONGS GAP RD
CARLISLE, PA 17013
Accepted Returns
!Federal 1040 Submission Id: 23570020140974dwwfkb DCN: 00235700003074
Transmitted: Acknowledgement: Refund: L�S
+' 4/712014 20:35 EST A- 4/7/2014 $2,118.00 ,SG�
i
Get 9325 DOR-issued Check
Filing Status: 1 Preparer: GROUP AGI: $15,447.00
Tax Year: 2013 Bill Amt: 140.00
PA40 Submission Id: 2357002014097v050eeu DCN: 00235700003074
Transmitted: Acknowledgement: Balance Due:
1 4/7/2014 20:35 EST A- 4/712014 $293.00
Filing Status: 1 Preparer: GROUP AGI: $9,547.00 �G r G—
Tax Year 2013 Bill Amt: 140.00 - -
https:H onlineefdb.drakesoftware.com/OLDB/Overview.aspx 08/25/14
08/20/2014 17:05 . 8063426966 WNL VALIC PAGE 02/02
American General Life Insurance Company
/ The United States Life Insurance Company in the City of New York
SC V l
August 1.9,2014
DEBRA STEWART
FAX# 717-243-5907
Re: Annuity Contract XP224927
Deceased Clyde H Beck
Dear Ms Stewart:
Thank you for your recent inquiry regarding the above referenced annuity contract. We would
like to take this opportunity to respond to your request.
The accumulated value of this contract as of November 30, 2013,the date of death,is
$175,606.08.
Ms Stewart, we appreciate the opportunity to assist you. Should you have any questions, please
contact our Client Care Center at 1-800-424-4990.
Sincerely, .
Linda Perez
Annuity Claims Department
Annuity Service Center• P.O. Box 871 Amarillo,TX 79105-0871
Administrator for Renaissance Life&Health Insurance Company of America • Administrator for John Alden Life Insurance Company
United States Steel Corporation Plan for Employee Pension Benefits 3801749
600 Grant Street,Pittsburgh,PA 15219-2800
Telephone(412)433-5780 000033
Use social security number in any correspondence regarding this benefit. Paynant fnr
Changes to home address,direct deposit.life insurance beneficiary or Boc. Sec. No. the..nth of Pavnent Oete
health coverage must be made by writing to the above address. ...-..-4122 FEB, 2014 02-28-14
TRUST PAYMENT t 11715.35
661 RETRO PAYMT 1706.88
GROSS BENEFIT 13422.23
770 FEDERAL TAX 2343.07-
790 STATE TAX 368.33-
940 FEDERAL TAX 170.69-
R-167418-01 A NET PAYMENT 6 10540.14
C DIANE DEROCHE
715 A NORTH MEADOW ST
RICHMOND VA 23220
YEAR TO STATE TAX FEDERAL TAX GROSS PAYMENT
DATE 368.33 2513.76 13422.23
M .
FOR TAX PURPOSES, TOTAL EMPLOYEE CONTRIBUTIONS TO THE CONTRIBUTORY PENSION PLAN WERE
62498.69 AT THE EMPLOYEE'S RETIREMENT.
THE PLAN, AS REQUIRED'BY LAW, HAS WITHHELD 20% OF YOUR TAXABLE ELIGIBLE ROLLOVER ,
DISTRIBUTION AS FEDERAL INCOME TAX WITHHOLDING. YOU MAY, WITHIN 60 DAYS OF THIS
DISTRIBUTION, ROLLOVER ALL OR PART OF YOUR ELIGIBLE ROLLOVER DISTRIBUTION. WHEN YOU FILE
YOUR INCOME TAX RETURN, YOU MAY GET A REFUND OF THE TAX WITHHELD ON THE PORTION YOU DECIDE
TO ROLLOVER. ,
THIS IS A QUALIFIED TOTAL DISTRIBUTION. REFER TO YOUR TAX CONSULTANT FOR FURTHER
INFORMATION.
-frank igler_f' O 2877LEECHBURGROAD
y li lt7 1 LOWER BURRELL,PENNSYLVANIA 15068
,funeral 30ome PH(724)335-6500 FAx 335-8922
Todd and family,
We appreciate the confidence you have placed in us by engaging our services and
sincerely trust that they were comforting and conducted in a manner entirely satisfactory
to you.
This statement is being sent at this time in order that you may easily verify the details.
Funeral home charges did not change from the original reserve amount. However,third
party charges, which we do not control and cannot guarantee increased by$139.00 due to
the actual obituary cost, and ordering additional death certificates,plus adding the flower
cost to the bill.
If there is anything not fully understood,please call it to our attention at an early date. A
copy of this bill has been to Diane.
Again,thanking you, we are
�o o Sincerely yours,
o Frank F. Gigler Funeral Home
In Celebration of Life
r Tl�i �i rer 2877LEECHBURGRoAD
LOWER BURRELL,PENNSYLVANIA 15068
�IIITE7 �rOITIP PH(724)335-6500 FAx 335-8922
FUNERAL SERVICE FOR Clyde Beck dod 11-30-2013
Estimate Actual Difference
PROFESSIONAL SERVICES $2,500.00 $2,500.00 $0.00
CASKET Estimate $1,611.00 $1,611.00 $0.00
VAULT $1,295.00 $1,295.00 $0.00
EMBALMING $895.00 $895.00 $0.00
COSMETOLOGY $250.00 $250.00 $0.00
REMOVAL From Carlisle Pa $588.00 $588.00 $0.00
VISITATION $520.00 $520.00 $0.00
FUNERAL SERVICE $250.00 $250.00 $0.00
HEARSE $185.00 $185.00 $0.00
LEAD CAR $90.00 $90.00 $0.00
REGISTER BOOK, CARDS, FLAG CASE $115.00 $115.00 $0.00,
TOTAL FUNERAL HOME CHARGES $8,299.00 $8,299.00 $0.00
CASH ADVANCES PAID BY FUNERAL HOME TO THIRD PARTIES
CEMETERY GRAVE OPENING-Greenwood $1,340.00 $1,340.00 $0.00
OBITUARY (Estimate of$150) $150.00 $194.00 -$44.00
DEATH CERTIFICATES 20 @$6 each (6 certs in estimate) $36.00 $120.00 -$84.00
FLOWERS (Not in estimate) $0.00 $111.00 -$111.00
CLERGY $100.00 $0.00 $100.00
TOTAL CASH ADVANCES $1,626.00 $1,765.00 -$139.00
TOTAL FUNERAL CHARGES $9,925.00 $10,064.00 " -$139.00
PLEASE MAKE PAYMENT OF $139.00 TO FRANK F. GIGLER FUNERAL HOME
In Celebration of Life
H105.805 REV(9 1II)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00 pf`yy= This is to certify that the information here given is
"'rp�TH OF
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 20214498
o�Ag9lMENT OED``"°�1`e 4 r , DEC Q 4/In13/
Certification Number rrr=/^j0r
Local Registrar Date Issued
*rou.the commoxwur orrcxxsrzv.xln•DepurrmsxrarxutTx•vrruneconDs
eonim TM CERTIFICATE OF DEATH
.ma lFirs[,mlaak,l„a 1.f, z e Xannth—e<rMte tie
1,Q.YDE X[aH. BECK X .Xe=; wm.meam tm.ra.mn,Xenm.l
MOLE- 2178-14-0388 [ aNOVDIBER 3C 2013
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AUGUST 26 1920 n.eet,pk elw.ttn AR
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`0 780 LONGS GAP ROAD GARLIBLE PA. 17013
t ______ ___1z=_ aaa Deg gnna Gone
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a THORNWALD HOME 442rY PA ue
meln.a.r
E r z z o Dol�.p�mitw l. r a ry s wo a ,nn rs lN. ..aee,v,[
mmr t DEC.4,2013 GREENWOOD 0amm Lll PARK
z twn.1 own,m.e.a zel t,t cn,�x,mIte.m D[-e x.mxt
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REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
No. 2013- 01293 PA No. 21- 13- 1293
Estate Of: CLYDEHBECK
JRIr t,Middle,Las)
a/k/a: CLYDE-HENRY-JAMES BECK CLYDE HENRY BECK
Late Of: CARLISLE BOROUGH
CUMBERLAND COUNTY .,
0 Deceased
Social Security No: 178-14-0388
WHEREAS, on the 9th day of December 2013 an instrument dated
April 10th 2001 was admitted to probate as the last will of
CLYDE H BECK
(First,Middle,Last)
a/k/a CLYDE-HENRY-JAMES BECK CLYDE HENRY BECK
late of CARLISLE BOROUGH, CUMBERLAND County,
who died on the 30th day of November 2013 and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBA UGH Register of wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARYto:
L TODD BECK
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 9th day of December 2013.
Register o i s
m.
Depu
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
zcn � o �
LAST WILL AND TESTAMENT
o ca r m
OF cn
CLYDE H. BECK
I, CLYDE H. BECK, of the Township of Washington, County of Westmoreland
and Commonwealth of Pennsylvania, being of sound mind and memory, do hereby make
publish and declare this to be my Last Will and Testament, in manner and form
following, hereby revoking any will or wills heretofore made by me.
r
FIRST: I direct that all my just debts and funeral expenses be fully paid an
x satisfied, as soon as conveniently may be, after my decease.
SECOND: I direct that all taxes that may be assessed in consequence of my dea
e
of whatever nature and by whatever,jurisdiction imposed shall be paid from my residuary
estate as part of the expense of the administration of my estate.
THIRD: I give, devise, and bequeath all of my estate of whatsoever nature an
wheresoever situate to my son, LEWIS TODD BECK, and my daughter, CAROL
DIANE DeROCHE, equally, share and share alike.
FOURTH: I do hereby name, constitute and appoint my son, LEWIS TODD
BECK, and my ,daughter, CAROL DIANE DeROCHE, to be my Co-Executors of this
my Last Will and Testament, to serve without posting any bond.
Clyde ly. Beck
Page 1
IN WITNESS WHEREOF, I, CLYDE H. BECK, the Testator above-named, have
hereunto subscribed my name and affixed my seal the 10th day of April, in the year o
our Lord Two Thousand One (2001).
(SEAL)
Clyde H./Beck
Signed, sealed, published and declared by the above-named, CLYDE H. BECK, a
and for his Last Will and Testament in the presence of us, who have hereunto subscribe
our names at his request as witnesses thereunto, in the presence of said Testator, and of
each other.
I
it
Charles F.1?ox"lTr-
I�Iny M. cMullen
s .
Page 2
COMMONWEALTH OF PENNSYLVANA )
) ss:
1
COUNTY OF WESTMORELAND )
F We, CLYDE H. BECK, CHARLES F. FOX III, and JOANY M. McMULLEN
i .
t the Testator and witnesses, respectively, whose names are signed to the attached or
t
foregoing instrument, being first duly sworn, do hereby declare to the undersign
authority that the Testator signed and executed the instrument as his Last Will and that he
' had signed willingly, and at he executed it as his free and voluntary act for the purpose
therein expressed, and that each of the witnesses, in the presence and hearing of the
Testator, signed the Will as witnesses and that to the best of his knowledge the Testator
I
was at that time eighteen years of age or older, of sound mind and under no constraint or
undue influence.
ClydjBec -
Charles F. Fox IIf'—"
J,'—),,ZG -&'a,
JyXny M. IcMullen
Subscribed,:sworri to and acknowledged before me by CLYDE H. BECK, the
Testator, and subscribed and sworn to before me by CHARLES F. FOX III, and JOAN
M. McMULLEN, witnesses, on April 10, 2001.
Notary Pub is
My commission expires:
- - NOTARIALSEAL - -
CATHRYN L.HENRY.Notary Publie
- - Vandwgrift Boro.Westmoreland Co.,PA
- - Page 3 Mycommissic expires March 10,2008
COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE
COUNTY OF CUMBERLAND
I, GLENDA FARNER STRA SBA UGH
Register for the Probate of 'Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 9th day of December, Two Thousand and
0 Thirteen,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of CLYDEHBECK late of CARLISLEBOROUGH
(First Middle,Las)
a/k/a CLYDE HENRY JAMES BECK CLYDE HENRY BECK
in said county, deceased, to L TODD BECK
!Firs(,Middle,Lest/
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 9th day of December
Two Thousand and Thirteen.
File No. 2013- 01293
PA File No. 21- 13- 1293
Date of Death 1113012013
S. S. # 178-14-0388
f^
eg e,0 f W177S
1
I Aamll
a e t
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL