HomeMy WebLinkAbout11-19-12Lsos61a14o
REV-1500 Ex (°'_'°,
PA Depac Went Of Revenue OFFICIAL USE ONLY
Bureau cf Intllvldual Taxes County Coda Year File Numner
PO Box zaosot INHERITANCE TAX RETURN 2 1 y 2 8 4 3 0
_ Harrisbuw PA 17728-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Saclal Securl[y Number Date of Oeath MMDDVYYV Oate of Birth MIdDDVYYY
2 0 5 0 9 8 9 5 4 0 4 0 4 2 0 1 2 0 2 1 6 1 9 1 9
Decedent's Last Name Suffix Decedent's First Na'~me MI
K E N E E V E R A B E T T Y
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL INAPPROPRIATE OVAL8 BELOW
THtS RETURN MUST BE FILED tN DUPLICATE WITH THE
REGISTER OF WILLS
t. Original Return ~ 2. Supplemental Return
4. Limited Estate ~ ba. Future Interest Compromise (date of
^X
6. Decedent Died Testate
~ death after 12-12-82)
7. Decedent Maintained a Living Trust
~
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ t 0. Spousal Poverty Credit (dale of death
between 12-37-9i and 1-1-95)
il. Remainder Return (date of death
prior to 12-13.82)
5. Federal Estate Tax Return Required
Ei. Total Number of Safe Deposit Bozes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
..vrtrx~arunutrv I - I ma StG NON MUST BE COMPLETED. ALL CORRESPONDENCE AHD CONFIDENTIAL TAR INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
D A V I D H S T O N E E S Q U I R E 7 1 7 7~ 4 7 4 r,''~ 5
~~
•,
REGISTER OF~tlt,~3 USE ONLYC r„ri C J
First line of address L ~' ` ~ [ tj
~n ~ '. i C
4 1 4 B R I D G E S T R E E T c~ ~ t~ c-:;
Second line of address ~ C7 e -~ ' n
_i: 1'1
~l C.. .
l: J
= _+~ _ i.._. _r,~
.. r_-
City Or Post Office ' DATE FILED O ` ~
I
State ZIP Code _.._ Cy
N E W C U M B E R L A N D P A 1 7 0 7 0
Correspondent'se-mail address: DSTONEaSTONELAW•NET
Under penakies o/ perjury, 1 declare that I have examined tins return, mduding accompanying schedules and statements, and to the best of my knowktlge and belief.
it is True, correct and complete. Declaration pf preparer other than the Dersonat representative is based on al! inronnation o(which preparer has any knowledge.
SIGNATU F PE IB FOR FILING RETURN DATE
ADDRESS 1 1 ~~' $.-~~~~
34
Of PR~PA~EJf~fF~R THAN REPRESENTATIVE
T
Side 1
1505610140
E IL 68521
ATE
~~- ZdrZ
BERLAND PA 17878
1505610148
1/
1505610240
REV-1500 EX
Dtecedent's Social Security Number
Decedent's Nama: VERA BETTY KENEE 2 0 5 0 9 8 9 5 4
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 and Notes Receivable (Schedule D) ....................... ... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers -i Miscellaneous N n-Probate Property
(Schedule G) ~ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines 1 through 7) ........................ ... 8.
9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9.
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10.
11. Total Deductions (total Lines 9 and 10) ............................... 11.
12. Net Value of Estate (Line 8 minus Line 11) ............................ 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...................... 13.
14. Net Value Subject to lax (Line 12 minus Line 13) ...................... 14.
1 4 4 5 5 5, 3 2
2 3 9 2 1 1, 7 9
3 8 3 7 6 7, 1 1
2 9 7 5 8. 6 D
3 1 6 8. 8 6
3 2 9 2 7. 4 6
3 5 0 8 3 9. 6 5
3 5 0 8 3 9. 6 5
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 6116
(a)(1.2) X• ~ ~ 0 ~ 15.
i6. Amount of Line 14 taxable
at lineal rate X• 0 p 0 ~ 16.
17. Amount of Line 14 taxable
at sibling rate X .12 ~ ~ 0 17.
18. Amount of Line 14 taxable
at collateral rate X ..5 3 5 0 8 3 9. 6 5 ig,
19. TAX DUE ...................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o. o a
0. 0 0
~. 0 0
5 2 6 2 5. 9 5
5 2 6 2 5. 9 5
^X
Side 2
1505611]240 1505610240 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 12 0430
DECEDENT'S NAME
VERA BETTY KENEE
___ _ _---
STREET ADDRESS -- - -- - ~-
824 LISBURN ROAD AFT ><309
__ - -- -
_-_ - ---
__
CITY ]STATE ZIP
CAMP HILL PA 17011-
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 50, 000 • 00
8. Discount 2 , 6 31 • 3 0
3. Interest
4. Ii 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.
(1) 52,625.95
TotalCredits(A+[j) (2) 52,631.30
(3) 0.0 0
(4) 5.35
5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0 • 0 0
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 u. income of the property lransferred : .............................................. ^ 0
...................
b. retain the right ro designate who shall use the property transferred or its income; .....
^ 0
c. retain a reversionary interest; or ..................................................................... ^
......................
d. receive the pro. ;ise for life of either payments, benefits or care? .................................................. .....
..... ^ Q
2. If death occurred after December 12,1902, did decedent transfer property within one year of death
without receiving adequate consideration? .................................................................................. ..... ^ Q
3. Did decedent own an "intrust for" or payable-upon~eath bank account or security at his or her death? .... ..... ^ Q
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ............................................................................................. ..... Q ^
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
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 ;he child is 0 percent [72 P.S. §9116(a)(1.2)].
• The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefciaries is 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 12 percent [7:! P.S. §9116(a)(1.3)]. Asibling is defined, undo
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood oi' adoption.
REV-1508 EX+ (t ~ _~ 0)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE
CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT oECeoENr PERSONAL PROPERTY
ESTATE OF: - - FILE NUMBER;
VERA BETTY KENEE 21~ 12 0430
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned wkh right of survivorship must 6e disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• Net proceeds of personal property sold at auction 464.55
2 Sovereign Bank-Checking Acct X0461058332 39,405.09
Princ• 53°,405.09, Int• 5.55
3 Sovereign Bank-Checking Acct X0461058332 - Accl^ Int 0.55
4 Sovereign Bank-Checking Acct X1791053475 500.00
5 Sovereign Bank-Money Market #1054168989 104,154.01
Princ• 5104,154.01, Int 531.12
6 Sovereign Bank-Money Market X1054168989 - Accr Int 31.12
TOTAL (Also enter on Line `,i, Recapitulation) I $ 14 4 , 555 • 3 2
If more space is needed, insert additional sheets of paper of the same size
REV-1511 EXt (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
VERA BETTY KENEE 21 12 0430
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 Darrel Zerbe-Reimb for Rolling Green cemetery exp 995.00
Darell Zerbe-Reimb for Auer Cremation Svcs• exp 185.97
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) o! Personal Representative(s) Dare 11 R• Z e r b e
sveet Address 342 Ravine Road
city Hinsdale state IL zIP60521
near(s) Commission Paid: 2 012 / 2 013
2. attorney Fees: David H Stone, Esquire
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: See >< 1 b e l o w
5 • ~ Accountant Fees:
6 • I Tax Retum Preparer Fees:
7• David H Stone-Reimb for probate costs
2 Darell Zerbe-Reimb for trip exp to PA-hotel a gas
3 The Sentinel-advertising grant of letters
4 Cumberland Law Journal-adv grant of letters
5 Register of Wills-filing Inh tax ret 8 Inventory
6 Sovereign Bank-date of death balance fee
7 Reserve for closing expenses
13,207.00
13,207.00
419.50
1,318.97
200.16
75.00
30.00
20.00
100.00
TOTAL (Also enter on Line 9, Recapitulation) ~ $
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT CIECEDENT
SCHEDULE(
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8r LIENS
ESTATE OF FILE NUMBER
VERA BETTY KENEE 2]. 12 0430
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 The Woods W Cedar Run-living expenses 577.42
2 (Masonic Village Elizabethtown-living expenses
3 ~Darell R 2erbe-exp incurred as POA 3-13 to 3-1~i
4 Masonic Villages Elizabethtown-cable services
TOTAL (Also enter on Line 10, Recapitulation) E
If more space is needed, insen additional sheets of the same size.
1,632.12
953.32
6.00
REV-1513 E%i (01-10)
pennsylvania ~ SCHEDULE J
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
VERA BETTY KENEE 27. T.2 nuan
RELATIONSHIP 1'0 DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Includeoutdghtspousaldistributionsandtransfersunder
Sec. 9116 (a)(12).]
1• DARELL R ZERBE Nephew 1/2 value Collateral 132,919.83
342 RAVINE ROAD of Annuities on Sch G
HINSDALE IL 60521- and 1/2 residue
2 BARBARA J KURZENKNABE 1st Cousinrs Collateral 25,000.00
23 CARRIAGE ROAD wife
NEW CUMBERLAND PA 17070-
3 GLENN R KURZENKNABE 1st Cousin Collateral 25,000.00
23 CARRIAGE ROAD
NEW CUMBERLAND PA 17070-
4 KARL E KURZENKNABE 1st Cousin Collateral 25,000.00
2907 WESTBURY COURT, APT 712
CAMP HILL PA 17011-
5 SARA JANE CROGNALE Friend Collateral 5,000.00
213 WEST LOCUST STREET
ENOLA PA 17025-
6 GLADYS SAUNDERS Friend Collateral 5,000.00
824 LISBURN POAD, APT 312
CAMP HILL PA 17011-
7 TODD S KENEE Nephew's son Collateral 6,656.96
1400 SOUTH 5TH AVENUE 1/4 residue
LEBANON PA 17042-
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBU IONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAI(EN:
1•
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 CO\/ER SHEET. b
if more space is needed, use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
VERA BETTY KENEE
Decedent's Name
Schedule J -Beneficiaries - 1
21 12 0430
File Number
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not List Trustee(s) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include ouMghts ousal disNbutions and transfers under
~
Sec. 9116 (a
(1.2).]
8 STEPHANIE L KENEE Nephew's daughter Collateral. 6,656.97
80 KRISTIN DRIVE 1/4 residue
ETTERS PA 17319-
9 STEPHAN KENE~ Nephew (Dec 4-14-12) Collateral 119,605.89
1501 25TH AVENUE 1/2 value of Annuiti s
NORTFI MYRTLE BEACH, SC 29582 on Sch G
F:\[)OCS\EP\Wf LLS\Kena?.Be[Cy.wpd
LAST A1ILL AND TE3TAM;ENT
OS
VERA BETTY RENEE
a/k/a BETTY KENEE
I, VERA BETTY KENEE a/k/a BETTY KENEE, of Lower Allen Township,
Cumberland County, Pennsylvania, declare this t:o be my last will and
revoke any will previously made by me.
ITEM I: I direct that my Executor hereinafter named shall pay all
my dust debts and funeral expenses as soon as conveniently may be done
after my decease from the residue of my estate.
ITEM II: I make the following specific bequests:
A. Twenty-Five Thousand ($25,000.00) dollars to BARBARA J.
KURZENKNABE, of New Cumberland, Pennsylvania, provided she survive my
death by sixty (60) days and, should she not so survive my death, to
such of her issue, per stirpes, as survive my death by sixty (60) days.
B. Twenty-Five Thousand ($25,000.00) dollars to GLENN R.
KURZENKNABE, of New Cumberland, Pennsylvania, provided he survive my
death by sixty (60) days and, should he not so survive my death, to such
of tfis issue, per stirpes, as survive my death by sixty (60) days.
C. Twenty-Five Thousand ($25,000.00) dollars to KARL E.
KURZENKNABE, of Camp Hill, Pennsylvania, provided hie survive my death by
sixty (60) days and, should he not so survive my death, to such of his
issue, per stirpes, as survive my death by sixty (i50) days.
Page 1 of 4
D. Five Thousand (,$5,000.00) dollars to SARA JANE CROGNALE,
of Enola, Pennsylvania, provided she survive my death by sixty (60)
days.
E. Five Thousand ($5,000.00) dollars to GLADYS SAUNDERS,
of Camp Hill, Pennsylvania, provided she survive my death by sixty (60)
days.
ITEM IIT: I devise and bequeath all the rest, residue and remainder
of my estate of every nature and wherever situate as follows:
A. One-half ('~) thereof to STEPHAN KENEE, of Hershey,
Pennsylvania, provided he survive my death by sixty (60) days and,
should he not so survive my death, to such of his issue, per stirpes, as
survive my death by sixty (60) days and, if he leaves no such issue so
surviving my death, to the other person or persons taking under this
Item III of this my last will.
B. One-half (~) thereof to DARELL R. ZERBE, of Hinsdale,
Illinois, provided he survive my death by sixty (60) days and, should he
not so survive my death, to such of his issue, per stirpes, as survive
my death by sixty (60) days and, if he leaves no such issue so surviving
my death, to the other person or persons taking under this Item III of
this my last will.
ITEM IV: I appoint my Executor and his successors guardian of any
property which passes, either under this will or otherwise, to a minor
and with respect to which I am authorized to appoint. a guardian and have
not otherwise specifically done so, provided that this appointment of a
Page 2 of 4
guardian shall not supersede the right of any fiduciary in its
di;>cretion to distribute a share where possit~le to the minor or to
another for the minor's benefit. Such guardian shall have the power to
use principal as well as income from time to time for the minor's
support and education (including college education, both graduate and
undergraduate) without regard to his or her parent's ability to provide
.for such support and education, or to make payment for these purposes,
without further responsibility, to the minor or to the minor's parent or
to einy person taking care of the minor.
ITEM V: I appoint DARELL R. ZERBE, Executor of this my last will.
Should DARELL R. ZERBE, fail to qualify or cease to act as Executor, I
appoint JEANNE H. ZERBE, Executrix of this my last will.
ITEM VI: All of the interests of the beneficiaries hereunder shall
not be subject to anticipation or to voluntary or involuntary alienation
nor shall they be subject to any execution or attachment.
ITEM VII: I direct that all individual retiz-ement accounts, bank
accounts, or other assets I hold with any financial institution which I
hold in trust for another person or on which I may have designated a
beneficiary, will pass in accordance with the provisions of this will.
I also direct that any assets I hold jointly with another person,
whether with the rights of survivorship or otherwise, will pass
according to the provisions of this will. It is my express desire that
the provisions of this will control the passage of ~sny financial assets
Page 3 of 9
I own at the time of my death, whether held in my individual name or in
some other fashion.
ITEM VIII: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of his or her duties
in any jurisdiction.
IN WITtl1ESS WHEREOF, I, VERA BETTY KENEE a/k/a BETTY KENEE, have
hereunto set my hand and seal this
day o:f ___ _~AAiV~GI+e~
2010.
VERA BETT KENEE a/k/a BE TY KENEE
SIGNED, SEALED, PVSLISHED and DECLARED by V'ERA BETTY KENEE a/k/a
BETTY KENEE, the Testatrix above named, as and :Eor her Last Will and
Testasment, and in the presence of us, who at hear request, in her
presence and in the presence of each other, have subscribed our names as
SIP ~,~,r~Prla„~ P
Address ~
tness --
Address
Page 4 of 4
Sovereign
Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box F41005 -Boston, MA 02284
s
B
April 23, 2012
David H. Stone
Stone LaFaver & Shekletski
414 Bridge St
P.O. Box E
New Cumberland, PA 17070
RE: Estate of Vera Betty Kenee
Date of Death: 04/04/2012
Dear Mr. Stone:
Per your request, enclosed please find the account information as of the date of death
for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
Please feel free to contact me if I can be of any further assistance.
Very truly yours,
-~s'G
Ed Stevens
CQP Specialist
61,7-514-5189
Sovereign Bank
ESTATE OF _ Vera Betty Kenee
SOCIAL SECURITY #: 205-09-8954
DATE OF DEATH: Apri14 2012
Account #: 0461058332 Type: Checking Open date: 7/18/1994
In the name of: Betty Kenee (Dazell Zerbe POA)
Date of Death Balance: $39,405.09
Int.(YTD) from 1/1/2012 to 3/6/2012 $p g8
Accrued interest to date of death: $0.55
other Info: Value at close (on 4/11/2012)• $39 461 77
Account #: 10$4168989 Type: _ Money Mazket Open date: 7/18/2007
In the name of: Bed Kenee (Dazell Zerbe ~~ ' '
Date of Death alance:
Int»(YTD) from 1/1/2012 to
Accrued interest to date of death: _
Other Info: Value at close (on 4/11/20:
$1
$1
,154.01
3/6/2012
$31.12
188.55
$99.73
Account #: 1791053475 Type: Checkin
In the name oP B g _ .. g Open date: 3/]4/2012
etty epee (Dazell Zerbe
Date of Death balance:
Int.l(YTD) from 1/1/2012 to
Accrued interest to date of death: _
Other Info: Value at close (on 4/11/201
3/14/2012
$0.00
$500.00
$0.00
Page 1 of 1
financial
Group
06/14/2012
DAVID H. STONE
STONE LAFAVER & SHEKLETSKI
414 BRIDGE STREET
NEW CUMBERLAND PA 17070
To Whom It Nlay Concern:
I Principal Life Insurance Company
Repetitive Payment Services
CONTRACT NO. 9207109
BETTY KENEE
The estimated value from the date of death, 4/4/2012, is $ 179,687.22.
If there are any questions, please call our office Monday through Friday 7:00 a. m. to
5:00 p.m. Cerjtral Time. We will be happy to provide assistance.
Jan Ostwinkle, Manager
Retirement and Investor Services Payout
1-800-247-7011
Repetitive Payment Services
P.O. Box 4926, Grand Island NE 68802-4926
Fax: 515-235-6209 Internet Address: www.principal.corn
CONTRACT N0. 9207109
PAYEE BETTY KENEE
DATE OF ISSUE Sep 26, 2011
AMOUNT APPLIED $190,500.00
BENEFICIARY DARELL RILEY ZERBE, NEPHEW
STEPHAN LAWRENCE KENEE, NEPHEW
CONTINGENT' BENEFICIARY NONE
You may change the beneficiary or contingent beneficiary at any time.
Your request must be in wciting. No change is effective until we approve it.
Death benefits, if any, shall be paid to your beneficiary(s), if living,
or to the survivors in equal shares.
• fi~~is/
Group
,tune 20, 2012
!STONE LAFAVER & SHEKLETSKI
ATTN: DAVID H STONE
PO BOX E
IJEW CUMBERLAND PA 17070
A:e: Betty Kenee
ContractNo. 8635547
Dear David H atone:
Principal Life
Insurance Company
Princor Financial
Services Corporation
Thank you for contacting the Principal Financial Group for further information on the above listed
policy. Per your request I am providing you with the Date of Death value.
The value as of 04/04/2012 was $59,594.64 with a Cost Basis of $59,524.57.
If you have addutional questions concerning this information or need further assistance, a customer
service representative can be reached at 1-800-852-4450, Monday through Friday, 7 a.m, to 6 p,m.,
CST
Sincerely,
The Principal Financial Group®
RIS Annuity Services
(800)852-4450
Corporate Center: Des Moines, Iowa 50392-177018001852-4450
Sacun~n"es offered through Princor Financial Services Corporation, (8ge/ 147-1737, mem~her SIPC.
Princip /Life and Princor®are members o/the Principal Financial Group®, Oes Moines, IA 50392