HomeMy WebLinkAbout11-14-12ESTATE OF IN THE COURT OF COMMON PLEAS
GLEN A. BANNON :CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ~,~-~a-- I~CS~
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PETITION UNDER SECTION 3102 OF THE PROBATE, '
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ESTATES AND FIDUCIARIES CODE FOR _
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SETTLEMENT OF SMALL ESTATE ~ ~:_> ~ ~_ r=; ';-~
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TO THE HONORABLE JUDGES OF SAID COURT: c.~
Mildred M. Bannon your Petitioner, files this Petition for Settlement of a Small Estate
under the provisions of Section 3102 of the Probate, Estates and Fiduciaries Code and in support
thereof avers that:
(1) Your Petitioner, Mildred M. Bannon is a competent adult residing at 31 Essex
Drive, Carlisle, Pennsylvania 17015, and is the spouse of the above decedent.
(2) Glen A. Bannon, died on October 5, 2012 at the age of 65 years, but prior thereto
lived and was domiciled at 31 Essex Drive, Carlisle, Pennsylvania, Cumberland
County, Pennsylvania. A copy of decedent's Death Certificate is attached hereto
as Exhibit "A."
(3) Glen A. Bannon died with a Will. No Letters have been issued. A copy of
Decedent's Last Will and Testament are attached hereto as Exhibit "B."
(4) Glen A. Bannon had no probate estate when he died other than the following:
Valic Retirement Services with a balance of $984.05, as of September 30, 2012.
A copy of the quarterly statement for the period July 1, 2012 through September
30, 2012 is attached hereto as Exhibit "C."
(5) The sole heirs and relationship to the decedent are as follows:
Mildred M. Bannon, spouse
(6) Your Petitioner avers that there are no creditors of the decedent and no claims
unpaid known to your Petitioner.
WHEREFORE, your Petitioner respectfully requests that an Order be made authorizing
Mildred M. Bannon to act as Fiduciary for the Estate of Glen A. Bannon, and the account with
Valic Retirement Services, with the proceeds made payable to Mildred M. Bannon, pursuant to
Section 3102 of the Probate, Estates and Fiduciaries Code.
By
ougl G. Miller, Esquire
Supreme Court I.D. No. 83776
IRWIN & McKNIGHT, P.C.
60 West Pomfret Street
Carlisle, PA 17013
(717) 249-2353
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Mildred M. Bannon being duly sworn according to law, deposes and says that the facts
contained in the foregoing Petition are true and correct to the best of her knowledge, information
and belief.
~,~1~1D~ ~ ' ~Q/l~,/Y~EAL)
Mildred M. Bannon
Sworn d subscribed before me
this day of Nov be , 2012.
otary Public
coMMOnw~un~ of N
Karen S. Nod, Noe~ry py~
~ a~.~rn~
LAST WILL AND TESTAMENT
I, GLEN A. BANNON, of South Middleton Township, Cumberland County,
Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my
debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore,
I direct that all state, inheritance, succession and other death taxes imposed or payable by reason
of my death and interest and penalties thereon with respect to all property composing of my gross
estate for death tax purposes, whether or not such property passes under this Will, shall be paid
by the Executor or Executrix of my estate.
TWO. My Executor or Executrix may, at his or her discretion, compromise
claims, borrow money, retain property for such length of time as he or she may deem proper;
lease and sell property for such prices, on such terms, at public or private sales, as he or she may
deem proper; and invest estate property and income without restriction to legal investments
unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell
any realty and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and
empowered to engage in any business in which I may be engaged at my death, for such period of
time after my death as seems expedient to said Executor or Executrix.
Initial1~~~~y
THREE. I give, devise and bequeath all of my estate of whatever nature and
wherever situate to my spouse, MILDRED M. BANNON.
FOUR. If my spouse, MILDRED M. BANNON, does not survive me by a period
of at least sixty (60) days, and none of my children are under the age of twenty-five (25) years at
the date of my death, then I give, devise and bequeath all of my estate of whatever nature and
wherever situate in equal shares to my children, LORI L. BANNON and STACIE R. BANNON,
per stirpes, which provides that the child or children of any deceased beneficiary shall take the
share their parent would have taken if living.
FIVE. If my spouse, MILDRED M. BANNON, does not survive me by a period
of at least sixty (60} days, and if any of my children are under the age of twenty-five (25) years at
the date of my death, or in the event that any of my children have predeceased me and their child
or children, if any, are under the age of twenty-five (25), then I give, devise and bequeath all of
my estate to be held in trust by the hereinafter named Trustee according to the following terms
and conditions:
A. Upon the creation of this Trust, the Trustee shall divide this trust principal
into individual shares in the name of each heir or beneficiary in the amount equal to the
amount that said heir or beneficiary inherited hereunder. The Trustee, as well as my
Executor or Executrix, as the case may be, is hereby authorized to retain, unconverted,
any property, real or personal, that I may own at my death and shall be under no duty to
convert it into legal investments. The Trustee shall have the power and authority to sell,
transfer, convey, invest and reinvest and to pay over the net income of the trust property,
to or for the use of said heir or beneficiary, or to accumulate it in the sole discretion of the
Trustee. The Trustee is also authorized and empowered to pay over to, or for the use and
Initial~i!%~~' 2
benefit of my heirs or beneficiaries such portion of or all of the principal of the trust
estate as in the Trustee's sole discretion seems proper for their continued support,
maintenance, education, or medical caze. My primary objective is to insure the support,
maintenance, education and medical caze of my heirs and beneficiaries until they obtain
an undergraduate degree from an accredited college or university, or reach the age of
twenty-five (25) yeazs, whichever occurs first. Notwithstanding the above purpose of this
trust, the Trustee, in the Trustee's sole discretion, may distribute any of the trust principal
or income for the benefit of any of my heirs or beneficiazies for any such purpose as the
Trustee deems reasonable under the circumstances such as but not limited to the purchase
of real property, tuition for further education, or any other purpose which would in the
Trustee's sole discretion advance the best interest of said heir or beneficiary. Any
payments made hereunder may be made by the Trustee directly to my heirs or
beneficiaries, or to such of them as may be, in the sole opinion of the Trustee, of such age
and ability to properly handle the funds so paid to such heir or beneficiary, or may be
made by the Trustee directly to the person having the custody and care of any of my heirs
or beneficiazies, or maybe made by the Trustee directly to any institution entitled to such
payment by reason of services rendered or to be rendered to any of my beneficiaries.
B. When my beneficiaries obtait7 an undergraduate degree from an accredited
college or university, or reach the age of twenty-five (25) years, whichever occurs first,
then whatever remains of income or principal of the said heir's or beneficiary's divided
share under this trust estate shall be distributed to said heir or beneficiary, per stirpes,
which provides that the child or children of any deceased heir or beneficiary shall take the
share their parent would have taken if living. In the event that any said heir or beneficiary
becomes deceased prior to the final distribution hereunder without leaving surviving
Initial ~ %~
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issue, said deceased heir's or beneficiary's share shall be divided equally between all of
the heirs and beneficiaries who are a part of this trust and distributed in accordance with
this Paragraph. For whatever reason, if there are no heirs or beneficiaries remaining as a
part of this trust, then in that event, the rest, residue and remainder hereof shall be
distributed in equal shares to the residual beneficiaries in accordance with Paragraph
Seven hereof.
SIX. I nominate and appoint my daughter, STACIE R. BANNON, or if she is
not able or does not serve for whatever reason, my spouse's niece, CAROLYN PEASE, or if she
is not able or does not serve for whatever reason, my spouse's niece, DONNA BATHMANN, to
serve as Trustee of the Trusts created in Paragraph Five hereof.
SEVEN. In the event of a common disaster causing the death of myself, my spouse
and all of my children, without surviving issue, all within a period of sixty (60) days, then I give,
devise and bequeath the rest, residue and remainder of my estate as follows:
A. 50% to the remaining heirs of my family at the date of my decease, per stitpes;
B. 50% to the remaining heirs of my spouse's family at the date of my decease,
per stirpes;
C. The respective identities of those heirs set forth above are to be determined in
accordance with the intestate law in effect in the Commonwealth of Pennsylvania at the
time of my death.
EIGHT. I nominate and appoint my spouse, MILDRED M. BANNON, to be the
Executrix of this my Last Will and Testament. In the event she has predeceased me, failed to
Initial~i'~ 4
qualify or is not able or does not serve for whatever reason, I then appoint my daughter, LORI L.
BANNON, to be the Substitute Executrix of this my Last Will and Testament. In the event she
has predeceased me, failed to qualify, or is not able or does not serve for whatever reason, I then
appoint my daughter, STACIE R. BANNON, to be the Substitute Executrix of this my Last Will
and Testament, whereby the said substitute personal representatives shall have the same powers
as are given to the original Executrix hereunder.
NINE. No person(s) shall benefit hereunder unless such beneficiary shall survive
me by sixty (60) days.
TEN. No Executrix, Executor, or Trustee acting hereunder shall be required to
post bond or enter security in this or any other jurisdiction.
ELEVEN. No beneficiary may assign, anticipate or pledge his or her interest in any
income o r p rincipal he ld o r dis tributable he reunder, a nd no beneficiary's creditors may levy,
attach or otherwise reach any such interest.
TWELVE. The Trustee, as well as my Executor or Executrix, shall have the following
powers, in addition to those vested in it by law, for my property held for the benefit of my
children or beneficiaries, whether income or principal, exercisable without court approval and
effective until the distribution of all property under the terms of the trusts set forth in Paragraph
Five hereof:
The Trustee, at his, her or its discretion, may compromise claims, borrow money
or retain property for such length of time as he, she or it may deem proper, sell lease,
pledge, mortgage, transfer, exchange, convert or otherwise dispose of or grant option of
all or any portion of trust property for such prices and on such terms in public or private
Initial~~?~~ 5
transactions as he, she or it may deem proper; and invest trust property and income
without restrictions to legal investments. The determination of the Trustee with respect
to the advisability of making payments out of the income or principal to any child or
beneficiary inheriting hereunder shall be conclusive and binding on all persons
howsoever interested in the respective trust. Further, the Trustee shall be authorized to
receive additions to the respective trust of any kind or any property whatsoever from
sources other than my estate and at any time in the sole discretion of the Trustee.
THIRTEEN. The validity and administration of any trust established hereunder and any
questions or disputes relating to the construction or interpretation of a ny s aid t rusts s hall b e
governed and construed in accordance with the laws of the Commonwealth of Pennsylvania.
FOURTEEN. If any person or institution entitled to share in any distribution under the
terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest
the probate of this Last Will and Testament, such person or institution shall forfeit his, her or its
entire interest inherited hereunder and all provisions in favor of such person or institution shall
be declared void and of no effect. The share of such person or institution so forfeited shall be
distributed as part of the residue pursuant to either Paragraph Four or Paragraph Five hereof, as
the case may be, except that if such person or institution is entitled to share in the said residue,
that interest shall be distributed proportionately to the other residuary distributees.
[THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK]
Initia~i!~~ 6
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1~ day of
August, 2003.
.~:~~~ ~ (SEAL)
GLEN A. BANNON
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
tae, ~~iUTlti
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ACKNOWLEDGMENT AND AFFIDAVIT
WE, GLEN A. BANNON, TRACI D. SMITH and CHERYL L. CLELAND, the
testator and witnesses respectively, whose names are signed to the foregoing instrument, being
first dul y s worn, do he reby declare to the undersigned authority that the testator signed and
executed the instrument as his last will and that he had signed willingly, and that he executed it
as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the testator, signed the will as a witness and that to the best of their
knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under
no constraint or undue influence.
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by GLEN A. BANNON, the testator
herein, and subscribed and sworn to before me by TRACI D. S Hand CHERYL L.
CLELAND, witnesses, this ~~ day of Au~st, 2003. ~ /}
Notarial Seal
Jacqueline L. Drawbaugh Notary Public
Carlisle Boro, Cumberland County
My Commission Bxpltns Aug. 14, ?A03
M8f Tlb9f, P91N1NyIvEltllll ANOOIIIIIICfl Ot f V01eli9e
~ A
H 105.805 RFV r91i n
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 18882782
Certification Number
~~ TYPe/Print In
r Permanent
Glen A _ gar~o
`~~I 65
No Q Unknow I Q Divorced
Name (First. Middle_ I ae c..rn..r
This is to certify that the information here given is
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.
~9~~~~~ ri~~ net s/za~2
Local Registrar Date Issued
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
State File Number:
2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo)
n Male 162 38 8393
c. under 1 Da 6. Date of Birth (MO/Day/Year s ~C'CO~.r 5 20l 2
Hours Minutes ) ( Pell Month) 7a. Blrthpla4 (City and State or Foreign Country)
August 16, 19477 Tn7illiams rt, PA
idence (Street and Number -Include Apt No.) Bt. Did Decedent Livebin6a Towlnsh pT unty) Tr ~n
Essex Drive Yet, decedent eyed In Soutl'1 Middleton
twp.
Idence (Zip Code) ~ No, decedent Ilyed within limits of
s at Time of Death Mewled Q Widowed 11. Survlyln 5 city/boro
Ney r Married Q Unkno g Pouse's Name (If wife, give name prior to ftrst marriage)
Mildred M_ Stt,;+-~,
`J 02121 J ~ Bannon ~-•. ..arc sme rrlor [o First Marriage (First, Middle, Last)
1aa. Informant's Name Maude - S2Rea1
14b. Relatlonzhip fo Decedent 14c. Informant's Mailing Address (Street snd Number, CFty
Mildred M_ n Wife a. seep eat
avµ~r 31 Essex Dr. Carlisle PA JPs
170
If Death Occurred in a Hospital: tJ In Hent...........••.....••.. ~•~'~~""'""""'"""""""""""',••• `ec on
Pa -.......): one ..........................
S pif Death Occurred Somewhere Other Than a Hospital: ~•••We """"'•'•"""-"""-•••----• .~
Emer ancy Room/Outpatient Q Dead on Arrival Nunl Home Lon Term Care Facility Other 5 Hospice Facility •
156. Facility Name (If not Instlf u[lon, glue street and number; 15c. City or Town State, and Zip Gode ( Peclfy) r
31 Essex Dr_ Carlisle, PA 17015 15d~COAu nLty_of Death
16a. Method of Disposition Burial yc+t`u-JCrla17
~i' Q Cremation 16b. Defe of DisposlTlon 16c. place of Dls osltion (Name of cemetery, crematory, or other pl
0 Removal from State ~ Donation p
other (speary) Oct _ 9 , 201 2 St . Patrick's New CatYloiic Canet
16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature of FU ral rvlce Licensee or 1
of Interment 17b_ License Numb
Carlisle, PA 17013
17c. Name and Com late Address of Funeral Facill
8 Ewin >3
tY
F
K FD O 1 2633 L
ro
lers
unera
l Hcsxle,
~ ig. Decedent's EducaHOn -Ch
k th
b 2nc_ , 630 S_ Hanover St. Carlisle, PA 1 7013
ec
e
ox that best describes the
r- highest degree or IeyN of school completed at the time of death 19. Decedent of Hispania Origin -Check the
b
O
p
.
Q 8th grade or less ox that best describes whether the decedent
is S
i
h to Indicate what
the decedent considered h m
Self or her
self t
b
~ No diploma, 9th - 12th grade pan
s
/HlspanlULatlno. Check the "NO" e-
o
Q'4Vhite
Q High school graduate or GED completed b if decedent Is no[ 5 anlsh/His
~st~ P Panic/Latino.
n
"'o
t S
h Q Korean
~ Black or African American Q Vietna
Q Some college credit, but no degree
,
o
panis
7-J
/Hispanic/Latinq
O Yes
Mexi
M mese
~ American Indian or Alaska Native Q ether Aala
Associate degree (e.g. Aq, q5)
~
'
,
can,
exican American, Chicano
O Yes
Puerto Rican n
dlan 0 Natlye Hawaiia
B
Bachelor
s degree (e.g. BA, AB, 05)
~ Master'
d ,
Yet, Cuban n
Q Chinese
~ Guamanian or Chamorro
s
egree (e.g. MA, M5, MEng, MEd, MSW, MBA)
~ D
t ~ Yes, other Spanish/Hispanic/Latino 0 Filipino
~ Samoan
J
oc
orate (e.g. PhD, EdD) or Professional degree
(S
if ~
apanese ~ Other Paciftc Islander
. MD DDS OVM LLB JD pec
y) Q Other (Specify)
21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or hersNf To b
Q'NhiCe 2
'
Q Japanese
~ Blsck or African American Q Korean
0 Samoan' e. 2a. Decedent
s Usual Occu
Patlon -Indicate type of wort
done during most of workin
Ilf
Q American Indian or Alaska Native 0 Vietnamese ~ Other Pa Gflc Islander
' g
e. 00 NOT USE RETIRED.
Q Asian Indian Q Other Asian Q Don
[ Know/Not Sure Program Analyst
Q Chinese 0 Native Hawaiian O Refused
Q Other (S 1
22b. Kind of Business/Industry
FIIIPIno _ Pec fy)
7 ~ Gu oleo or Chamorro
EMS 29a - 23 MU T BE COMPLETED 23a. Date Pronounce Dea Mo Day r 23 . Signature o Person Pronouncing OeaiFOn~ wte material SLa r-t, p,f f j
CERTIFIES DEATH PRONOUNCES OR October 5 , 201 2 ^ aPP lea a 23c. Cleanse Number
23d. Dace Signed (MO/Day/Yr) 24. Time of Death
6 e 1 O a _m_ zs. wet Medmal Examiner or cprpner Concacted7
O Yes rye
26. Part 1. Enter the chain of eve t --dlteatet, injuries, or c CAUSE OF DEATH
mplicatlons--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Approximate
respiratory arrest, or ventricular flbrlllatlon without showing the eTlology. DO NOT ABBREVIATE. Enter o 1 Interval:
I1~' n y one cause on a line. Add additional Ilnes If necessary j Onset to Death
IMMEDIATE CAUSE ---------------> a-_ r Q y-1 ~• ~.. e C_~t Q f--Cl /~ [l M O~ '
(Final disease or condition p t ( quence on. ~ r1'+ Q
resulting in death)
b. i
Sequentially Ils[ conditions, Due to (or sequence of):
If any, leading to the cause as a con
listed on line a. Enter The
UNDERLYING CAUSE Due to (or sequence of7: )
(disease or InJury that as a con
Initiated The events resulting d.
In death) LAST.
Due to (or sequence of):
26. Psrt 11. Enter other s~niflca nt c dlti ^^t Ib tl t d h but not resulting in the under) In °•
y g cause given in Part I 27. Was an autopsy performed?
m Yes No
$ 28. Were autopsy findings ayallable
ffi to complete the cause of death]
3 29. If Female: 30. Did Tobacco Use Contribute to Death? ~ yO6 No
F ~ Noes Pregnant within past er of Death
v~ 0 Pr gnant at time of deathyear ~ f ~ Probably 31 latural 0 Homicide
~ 0 Not pragna nt, but pregnant within 42 days of death Q'I'1 0 Unknown Q gccident Pendln Invastigstlon
r- Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In Q Suicide O Could not be determined
0 Unknown if pregnanT within The past year Jury (MO/Day/Yr) (Spell Month) ~
33. Time of Injury
34. Place of Injury (e.g. home; co nstrucTlon site; fa rtn; school) 35. Location of In
jury (Street and Number, City, Sate, Zip Code)
2
'~ 36. Injury at Work 37. If Transportation InJury, Specify: 3B. Describe How In
Jury Occurred:
I~ ~ O Passer^Operator O Pedes `rlapeci
Q gar Other 5 fY)
~ 39a. C~rtlfler (Check only one):
Certifying physician - To the best of my knowledge, death occurred tlue to the cause(s) and manner stated
Q Pronouncing 8a Certifying physician - To the best of my knowledge, death occurred at The time, date, and place, and due to the cause(s) and manner stated
Q Medical Examiner/Coroner - On the ba of examination, and/ Inyettlgatlon, In my opinion, death occurred at the time, date, and place, and due to the
Signature of certlfl ~ ~~ (w~ /tom '~ ~tc~a use(s) and manner tatetl
V Title of certlfter: I. 1 1 J License Number.~t~ 03 O S 7 3 1=
39 Adtlress and Zlp Code of Pers Completing Cause of D th (Item 26J
~~r n ~Lf ~ ~ q (~ t 3q~ Z ~~~~ 1 (e n 39c. Date Signed (MO/Oay/Y )
aD. Regitvar•t District Number PTO _~~' ~~ : / f 'r4 / 7 G / / /O - S'- d O /.Z~
41. Registrars 51 ~^ 42. egistrar File Data Mo Dsy
43. Amendments r S
-r
Disposition Permit Np. C J' L `t X~ y ~ H105-143
REV D7/2ptT
VALIC
VALIC Retirement Services Company
P.O. Box 15648
Amarillo, TX 79105
October 19, 2012
GLEN A BANNON ESTATE C/O MILDRED BANNON
31 ESSEX DRIVE
CARLISLE PA 17015
Mutual Fund Account Number: 1569480, 1570633, 1580699
Group/Plan ID: 49111/03 & OS
Dear GLEN A BANNON ESTATE C/O MILDRED BANNON:
Please accept our condolences on the death of Glen A Bannon. Enclosed is the Death Claim Form to be
completed on behalf of GLEN A BANNON ESTATE. A Tax Identification Number (TIN) must be
provided for the ESTATE. Read the Instructions and Legal pages carefully before completing this form.
To ensure accurate and prompt processing of your request, complete the sections noted below:
Client and Beneficiary Information:
Payout Election:
Provide the information identifying the client and
the beneficiary.
Provide the distribution election.
Income Tax Withholding Instructions:
Beneficiary Signature:
Vesting Determination for Employer
Contributions:
Plan Administrator's Approval
Indicate the Federal and State tax withholding
amounts.
In order to process this request, the
EXECUTOR must sign and date this form.
This section is not required to complete your
request.
This section is not applicable
IvIDCR27c
VALIC represents The Variable Annuity Life Insurance Company and its subsidiaries VALIC Financial Advisors, Inc.
and VALIC Retirement Services Company.
VALIC
VALIC Retirement Services Company
P.O. Box 15648
Amarillo, TX 79105
In addition to the Death Claim Form, the following item(s) must also be submitted with the request:
An original or certified copy of the Death Certificate (regular copies are not allowed)
An original or certified copy of the Letters of Testamentary or Letters of Administration for the
Estate
Return the completed form along with the documentation noted above to the address below:
VALIC Retirement
Services Company
P.O. Box 15648
Amarillo, TX 79105
Generally, these types of distributions are completed within 3 weeks. A check will be mailed to the
address listed under the Beneficiary Information, unless you request otherwise. While individual tax
situations can be unique, you may wish to discuss the distribution options and related taxation with your
tax advisor.
We are committed to providing you with quality service and personal attention. Please contact a Client
Service Professional if you have any questions or need further assistance. We are available Monday
through Friday, from 7:00 a.m. to 8:00 p.m. (CT) at 1-800-448-2542 (For hearing and speech impaired
access dial 1-800-248-2542 TDD).
Sincerely,
~~~
Calvin L. King
Vice President, Client Care Center
Enclosure(s)
Return Envelope
~cRn~
VALIC represents The Variable Annuity Life Insurance Company and its subsidiaries VALIC Financial Advisors, Inc.
and VALIC Retirement Services Company.
.' Account Statement
For the Period: 07/01/2012 - 09/30/2012
~~~'
#BWNKDQB
>04486 7802389 002 008120 M
BANNON, GLEN A
31 ESSEX DRIVE
CARLISLE PA 17015.3198
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._ Portfolio Snapshot
Act~yt~ ~Q(~q~ ,
Beginning value 07/~0'I/12 5972.31
v;
Your contributions $9
94
~
r~r; Net change in value
........................................... .
$2.60
.............
Ending value 091r30/12 ....................
~.~
Asse~,Allpc~on.~
0% Large Cap
0% Mid Cap
0% Small Cap
0% Global & Intl Equity
0% Specialty
_ 87.44% Hybrid
[_- ] 12.56% fixed Income
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.................................................................................
Can $3 a day make a difference in your future? Say you make $40,000 a
year and save 2% in your employee retirement plan -about $30 a check.
Increase that to 5% -roughly $3 a day more -and over 30 years at an 8%
average annual return, you could increase your retirement savings by as
much as $140,000. If you get an employer match, the difference is even
bigger.
Illustration only. Assumptions: Bi -weekly pay period, tax -deferred
accuma/ation; fees and charges, if applicable, are not reflected and
would reduce results shown.
Ending value 09/30/12: X984.05
Aot~~l PerfvrmancP
- r:, -,
Portfolio Value
For the period Year to date For 12 months
07/01/12-09/30/12... , . ....01101/12:09/30/12.. , . 09/30/11-09/30/12
2.71
6.41
10.04%
*VALIC is pleased to provide you with your investment's personal
performance. All active accounts at end of the quarter were included in the
calculation, using the actual number of days your funds were invested.
*Past Performance is not a guarantee of future performance.
*Individual fund performance is available online at VALIC.com.
Contions ar+~ Balances.
Contributions for the period Ending value
Plan type.... 07/01/12- 09/30/12 09/30/12
.........................................................................
EMPLOYER
LEHIGH VALLEY HOSPITAL & HEALTH NET
INC
401ik) Plan
Pension Plan $9.14 $828.56
........................................................ $0.00.............. $155.49
Totals 59.14 jgg4,05
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04486 7802369 011285 021373 00001/00003 cM
Account Statement
BANNON, GLEN A
- Investment Summary
Beginning value
funds by asset class 07/01/12
Hybrid >~5.'46
Vanguard Tgt Rtmt Inc $645.45
Fixed Income ~~•~
Wells Fargo Stable Val M $126.86
Totals 5972.31
- Plan Summary
Ending Value
Plan type Account description ....... . ...... . . . . . . . . . ..... . Account number ... _ ..... _ ... , , ...09/30/12
................................................................................
EMPLOYER
LEHIGH VALLEY HOSPITAL & HEALTH NET INC 1569480 $673.26
4011k) Plan ELECTIVE DEFERRAL
MATCHING 1570633 $155.30
Pension Plan DISCRETIONARY 1580699 $155.49
...........................................................................................
LEHIGH VALLEY HOSPITAL & HEALTH NET INC
You can choose to receive a-mail notifications when your account statements, certain regulatory documents and transaction confirmations became
available online with Personal Deliver-e. Save paper, time and energy! Just log on to VALIC Online and click on "My Profile," then select "E-mail
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- Plan Details
EMPLOYER
LEHIGH VALLEY HOSPITAL & HEALTH NET INC
401(k) Plan
a~tiv;ty D~tti~~~ ~ _, ~.
For the period Since
......... 07/01/12 - 09/30/12 ..
............. .....inception
Beginning value 070'1/12 $807.88
Your contributions $9.14 $666.89
Employer contributions $0.00 $315.95
Withdrawals $0.00 -$161.43
Net change in value $11.54
.............
..............
..................................
Ending value 09/30/12 ...............
5828.56 $821.41
2of6
07/01/2012-09/30/2012
Total Investment Total Net change Ending value % of
additions transfers reductions ..... , in value ......09/30/12 ,total
=9.14 50.00 50.00 55.83 5880.42 87.44°k
$9.14 $0.00 $0.00 $5.83 $660.42 87.4496
50.00 50.00 50.00 -53.23 5123.63 1Z.56°k
$0.00 $0.00 $0.00
........ -$3.23
................... $123.63
.................. 12.56°b
....
.................
59.14 ....................
50.00 ...........
50.00 52.60 5984.05 10096
Ending value Vested value
Account 8
. 09/30/12
......................... 09/30/12
.....................................
.....................
1569480 $673.26 $673.26
1570633 $155.30 .......................... $155.30
..............
Totals ........
........
~•~ .
~'~
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