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Home My WebLink About06-26-15 (2) REV-1500 Ex(02-I1)(FI) 1505610105 OFFICIAL USE ONLY PA Department of Revenue pennsytvania Bureau of Individual.Taxes v 1 County Code Year File Number PO BOX 28o6o1 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 15 0302 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 03/16/2015 07/10/1936 Decedent's Last Name Suffix Decedent's First Name MI REICHARD JOAN E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 1 n/a Spouse's Social Security Number —.- _._---..._-..._.__—.. - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW CMD 1.Original Return C=) 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) Q 4.Limited Estate C=:) 4a.Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required death after 12-12-82) (ID 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust U B. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received C=) 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Marc Roberts, Esquire (717) 843-1639 REGISTER OF WILLS USt�*LY 'CXI 7, G First Line of Address � � 149 East Market Street "'I- 17,77 Q:7 Second Line of Address r 3 `.l ca < :� : ` 1 City or Post Office State ZIP Code DA, ILRR York PA 17401 > -i U) CD c::) Correspondent's e-mail address:marC@marcrobertslaw.com Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,o rrect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. M-NA E OF PERSON RE NSIBLE F (LING RETURN DATE a---� SS 14 PI invie Road, Camp Hill, PA 17011 S URE REP ER OTHER THAN REPRESENTATIVE DATE " ADDRES 149 East Market Street,York, PA 17401 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 1505610205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: JOAN E. REICHARD 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. 29,503.78 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 154,413.24 8. Total Gross Asses total Lines 1 through 7 8. 183,917.02 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 11,770.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 1,131.93 11. Total Deductions(total Lines 9 and 10)................................. 11. 12,901.93 12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 171,015.09 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 Tax Line 12 minus Line 13 14. 171,015.09 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Seb.9116 (a)(1.2)X.0_ 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 171,015.09 16. 7,695.67 17. Amount of Line 14•.axable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE......................................................... 19. 7,695.67 20. FILL IN THE OVA!. IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT < 1 Side 2 1505610205 1505610205 REV-1500 EX(FI) Page 3 File Number 21-15-0302 Decedent's Complete Address: DECEDENTS NAME Joan E. Reichard STREETADDRESS 14 Plainview Road CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 7,695.67 2. Credits/Payments A.Prior Payments 7,862.45 B.Discount 384.78 Total Credits(A+B) (2) 8,247.23 3. Interest (3) 4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 551.56 5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 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.......................................................................................... [-10 b. retain the right to designate who shall use the property transferred or its income ............................................ El ■ c. retain a reversionary interest.............................................................................................................................. ElN d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ E 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 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 containsa beneficiary designation? ........................................................................................................................ ❑ 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[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-15o8 EX+(o8-12) pennsylvania SCHEDULE E �f7 DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SUSAN E. REICHARD 21-15-0302 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. ,Santander,Checking Account#2761022343 I 948.354' 2,! ;Santander,Money Market Account#2731701307 i 28,355.43-- - 3.1 Cash ! 200.00 _ I i*see attached documentation I I � I TOTAL(Also enter on Line 5, Recapitulation) $ 29,503.78 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER SUSAN E. REICHARD 21-15-0302 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. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (1F APPLICABLE) VALUE 1. Prudential Annuity,Contract#E1642428 154,413.24 , 100•. 0.001 154,413.24 beneficiaries,Susan E.Danyo and John F.Reichard III,children 1 'see attached documentation I Ij 11 11 i� I I f` , I 1 I 14 I �e I ii I I TOTAL(Also enter on Line 7,Recapitulation) $ 154,413.24 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) 12 pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER SUSAN E. REICHARD 21-15-0302 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' John F.Reichard III,reimbursement for funeral expenses and wake 7,160.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) _- Street Address City -- — — _— -— - _. - _. .__. State_.._. ._ZIP — -- — Year(s)Commission Paid: 850.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00 Claimant Susan E. Danyo Street Address 14 Plainview Road City Camp Hill State PA zip 17011 Relationship of Claimant to Decedent daughter 4. Probate Fees: 185.00 5. Accountant Fees: 60.00 6. Tax Return Preparer Fees: 7. Register of Wills,filing Inheritance Tax Return 15.00 TOTAL(Also enter on Line 9, Recapitulation) $ 11,770.00 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) 10 pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER SUSAN E. REICHARD 21-15-0302 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. HSEMS,ambulance 131.47 2. Phy of Rehab Ind&Spine,medical 67.34 3. East Pennsboro,ambulance 859.00 4. Lower Allen Township,ambulance 74.12 TOTAL(Also enter on Line 10, Recapitulation) $ 1,131.93 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE ] Q' DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SUSAN E. REICHARD 21-15-0302 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] _ 1. Susan E.Danyo, 14 Plainview Road,Camp Hill,PA 17011_ Fdaughter �50% , t2.1 [John F.Reichard III,6610 Deiters Mill Road,Dover,PA 17315 son 50% Ll E _ - _ _ I j �� 1:1 . Lm 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 TO TAX IS NOT TAKEN: �� -.._�__..-.�--.wr.-M.-�.. , _._...... -• ......_._... r..._.. .T.-+mow_--^.-.+�+_+w-_.-. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: Ej TOTAL OF PART 11- 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. Financial Summary Statement • • 03/08/15 - 04/07/15 JOAN E RE/CHARD SUSAN E DANYO ATTY/FF Deposit Accounts Account Number Average Daily Balance Current Balance Afd At b l It RMCIt KfNi 1*I tl 23d3 i„7{l 3 :.: get 3 W PREMIER MONEY MARKET-STANDARD 2731701307 $21,345.45 $18,742.68 Total Deposits $19,691.04 PeriodSANTANDER INTEREST CHECKING Statement 0• 04/07/15 JOAN E RE/CHARD Account#2761022343 SUSAN E DANYO ATTY/FF Balances e mnriga9ar8 + ..:.;. tarl�ftt;f3alarice; # . De osits/Credits +$10,000.02 Average Daily Balance $1,270.93 W-ft adravvafslDc�bats $ fl,OtSp t3>] Interest ::::Pard th>s f5 +r�ei* .._... . t2_ 1Xrtnal Petcin# .e l"teldarflez... ... 0. 1 %.: Earned this Period $0.01 Paid Last Year $0.05 td Yer 3 c3 Date $fl 03 *The interest earned and the interest paid may differ depending on when interest is credited to your account. Checks Posted Check# Date Paid Amount Reference tt $iQfaf�r 1 Check(s)Posted=$10,000.00 Account Activity Date Description Additions . Subtractions Balance 03-08 Be innin Balance $948.34 Ili c�C..::t T .:-.-.ftE3Nl.*2/06T2$#1.5.TC):D3/ 5/ f 1 ... . .: Sfk t?1 S9d8 5 03-17 TRANSFER FROM ACCT*1307-SUSAN E DANYO PREMIER $10,000.00 $10,948.35 MONEY MARKET-STANDARD 113 16l0f {7CkU0tl0fltlpb:3t,t1Q03f ...-...... . S41$35. 04-07 INTEREST CREDIT FROM 03/06/2015 TO 04/05/2015 $0.01 $948.36 fl4 0ndulga1 . ....: 9/lE3 36 PREMIER MONEY MARKET-STANDARD Statement Period 03/08/15-04/07/15 JOAN E RE/CHARD Account#2731701307 SUSAN E DANYO ATTY IFF Balances Deposits/Credits +$390.44 Average Daily Balance $21,345.45 r;-Afltfl drv�1 kSIC)e)i rt5 $1�10t50 flf1 SCHEDULE E-1 , 2 d' Interest f#a kd thisi t?e iDO�. :... $5 g9... . �4rrn�al.Aercent�`e'��Id 1 arned..: : Earned this Period $2.72 Paid Last Year $34.87 ....... ... *The interest earned and the interest paid may differ depending on when interest is credited to your account. Account Activity Date Description Additions Subtractions Balance 03-08 Beginning Balance $28,352.24 fl3 fl9 If kTE EST R DIT 1 i Cttv1 61.20:1+570::0.32015 3 9 9 $28 355 A3:!!;:'- 03-17 TRANSFER TO ACCT*2343-Susan E Danyo SANTANDER INTEREST $10,000.00 $18,355.43 CHECKING fl4 01 8E1VE1� P A+It 1�1T DEP05iC,�30Q107d9d I60 .. 38 :;A5 18; 398: 04-07 INTEREST CREDIT FROM 03/06/2015 TO 04/05/2015 $2.80 $18,742.68 a34 0 .:;: .. nd�ttg 8atarce. 3F,72i8 What You Need to Know about Overdrafts and Overdraft Fees Overview An overdraft occurs when you do not have enough money in your account to cover a transaction,but we pay it anyway.We can cover your overdrafts in two different ways: 1. We have standard overdraft practices that come with your account 2. We also offer an overdraft protection plan which allows you to link other accounts such as a savings account or an Easy Access Line of Credit to cover overdrafts in your checking account.This plan may be less expensive than our standard overdraft practices.To learn more,ask us about this plan. This notice explains our standard overdraft practices. What are the standard overdraft practices that come with my account? Santander currently authorizes and pays overdrafts for the following types of transactions: • Checks and other transactions made using your checking account number • Automatic bill payments • Online Banking payments and transfers • Recurring debit card transactions Santander will not authorize and pay overdrafts on the following types of transactions,UNLESS you authorize us to do so: • ATM withdrawals and transfers • One-time debit card transactions We pay overdrafts at our discretion,which means we do not guarantee that we will always authorize and pay any type of transaction. If we do not authorize and pay an overdraft,your transaction will be declined. What fees will I be charged if Santander pays an overdraft caused by my ATM or one-time debit transaction? Under our standard overdraft practices: • We will charge you a fee of up to $35 each time we pay an overdraft.There is a limit of 6 fees per day we can charge you for overdrawing your account. • An additional one-time fee of$35 will be charged on the 6th consecutive business day your account is overdrawn.This charge applies to checking accounts(other than any Premier Checking and Santander Select Checking Accounts),savings and money s market savings accounts(other than any Santander Select Money Market Savings Accounts). �] � What if 1 want Santander to authorize and pay overdrafts on my ATM and one-time debit card transactions? If you want us to authorize and pay overdrafts on ATM and one-time debit card transactions,the easiest way to do so is to enroll online in Santander Account Protector by visiting www.santanderbank.com/accountprotector.You can also call us at 1-877-768-4721,visit your nearest branch or opt-in at any Santander ATM Can I change my mind later? If you tell us that we are permitted to pay any overdrafts caused by ATM or one-time debit transactions,you can always change your mind and tell us you no longer want us to do this.You can visit any branch or call us at 1-877-768-4721 and tell us you no longer want us to pay these types of overdrafts Page 3 of 5 2761022343 E1642428 Apoilb, cc JIF AS&__W.;._d.h-__) Dw of th DA=LR ANNUirY U SEMCE AWARD JP2006 ilifftO 2013 *w Prudential Page 1 of 4 Annuities Service Premier Retirement L Series P.O.Box 13467 Annuity Statement Philadelphia,PA 19176 January 1,2015 through March 31, 2015 >001815 3340682 0001 092001 10Z Financial Professional: JOAN E. REICHARD STEPHEN ROSEWAGMORGAN STANLEY SMITH BARNEY, LLC' 14 PLAINVIEW RD 3RD FLOOR CAMP HILL PA 17011 204 NORTH GEORGE STREET YORK PA 17401 Contract Number: E1642428 Type: Non Qualified Contract Issue Date: 11/18/2013 Owner Name(s): JOAN E. REICHARD Annuity Date: 08/01/2031 Annuitant: JOAN E. REICHARD Please review your statement and contact us within 30 days if you find any information you believe to be inaccurate. The living or death benefit values you have are provided in the"Your Benefits" section of this statement. If you do not see a benefit that you selected,please contact us. Your Portfolio Your Annuity Activity Current Period Year-to-Date "Contract Fees and Charges"reflects certain fees Beginning Account Value $152,386,32 $152,386.32 and charges imposed as of this statement date,including but not limited to Contingent Deferred Sales Purchase Payments $0.00 $0.00 Charge(CDSC),transfer fees,annual maintenance fees,or Withdrawals $0,00 WOO if applicable or imposed during the period covered by this Contract Fees and Charges* ($599,94) ($599.94) statement,other benefit fees or charges.It does not reflect Investment Performance $2,626.86 $2,626.86 contract fees that are included in the daily calculation of the unit price ofthe applicable portfolios.Those are Ending Account Value" $154,41124. $154,413.24 reflected in the values provided under"Portfolio Detail". Please refer to your annuity prospectus for information regarding those fees. **"Ending Account Value"is your value prior to the application of any Surrender Charge(CDSC),Market Value Adjustment(MVA)and any Other Fees and Charges that may be applicable to your annuity contract. Your Benefits ru 0 C3 Highest Daily Lifetime Income v2.1 w/Highest Dail Death Benefit C3 Estimated Protected Withdrawal Value(PWV) $160884-63 Past performance does not guarantee future C3 C3 Estimated Annual Income Amount $8,044.23 results. PWV is separate from your Account C3 ir Value and not available as a lump sum. Ln ru PWV Cumulative Step-ups*** 17 PWV Cumulative Step-ups-The total number of times 0 Date of last Step-up 07/03/2014 the PWV locked in a highest daily value prior to taking the 0first Lifetime Withdrawal under the benefit since the effective M -0 date of your benefit. Step-ups pertain only to your PWV and M C3 not your Account Value,as your Account Value is subject to variation each business day based on the investment performance of your individual fund allocations. rn rn M co SCHEDULE G-1 Annuities Service Center: (888)778-2888 Website: www.prudentialannuities.com Hours: Mon-Thurs 8 AM to 7 PM ET, Fri 8 AM to 6 PM ET Get the paper that you want.Suppress the rest with e-Delivery. Agent ID#B7XXJ4 Office#Z91XA Customize your preference at prudentialannuities.com/edelivery E1642429 Contract Number: E1642428 Page 2 of 4 Your Benefits (continued) You have elected Highest Daily Lifetime Income v2,1 m,/I lighest Daily Death Benefit,a benefit designed to provide you with lifetime income. 11' you had taken a Lifetime Withdrawal on 03/31/2015,your estimated Protected Withdrawal Value would have been$160,884.63 and your estimated Annual Income Amount would have been$8,044,23 for life. Please be aware that the actual amounts will be detennined when you choose to exercise this benefit by taking your first Lifetime Withdrawal. Highest Daily Lifetime Income v2.1 w/Highest Daily Death Benefit uses a predetermined mathematical formula to help us manage your guarantee through all market cycles. Each business day,the formula determines if any portion of your Account Value needs to be transferred into or out of the ASThivestment Grade Bond Portfolio(the"Bond Portfolio"). Amounts transferred by the formula depend on a number of factors unique to your annuity and include:(i)the difference between your Account Value and the Protected Withdrawal Value;(ii)how long you have wvvned Highest Daily Lifetime Income v2.1 w/Highest Daily Death Benefit-,(iii)the amount allocated to,and the performance of,the Permitted Sub-accounts;(iv)the amount allocated to,and the performance of the Bond Portfolio;and(v)the impact of additional purchase payments made to and withdrawals taken from the annuity. Therefore,at any given time,some,none,or most of your Account Value may be allocated to the Bond Portfolio. If you snake additional Purchase Payments to your Annuity,they will be allocated according to your allocation instructions.Once they are allocated to Your Annuity,they will also be subject to the mathematical formula and therefore may be transferred to the Bond Portfolio, ifdictated by the formula. Any Account Value in the Bond Portfolio will not be available to participate in the investment experience of the Pennitled Sub-accounts if there is a subsequent market recovery until it is transferred out of the Bond Portfolio. Please see your contract and prospectus for complete details and/or contact your financial professional. Annuity Death Benefit(Net) $156,293.05 The Annuity Death Benefit amount shown above is the greatest of all applicable death benefits on your contract as of this statement date.This value may fluctuate and may be affected by any owriership or annuitant changes on your contract. The Annuity Death Benefit,shown as a Net amount,does not reflect any Purchase Credits subject to recapture,if applicable,according to state and product limitations. If the Annuity contract is o%&iied by more than one individual,the Annuity Death Benefit shown is based on the oldest designated ONviier. If the Annuity is owned by an entity,the Annuity Death Benefit shown is based on the designated Annuitant. For more information on specific scenarios and how benefit values are calculated,please review the teens and conditions detailed in your contract and/or prospectus. The calculation of the death benefit includes,your election of the Highest Daily Lifetime Income v2.1 w/Highest Daily Death Benefit,designed to enhance the guaranteed minimum value for your beneficiaries if death occurs before annuity payments begin. Portfolio Detail INVESTMENTS VARIABLE TOTAL INVESTMENT VALUE* As of March 31,2015 $154,413.24 $154,413.24 As of December 31,2014 $152,386.32 $152,386.32 * "'total filvestment Value"reflects all charges that have been imposed,as of this statement date,but does not include charges that may he imposed in the future. As of March 31,2015 As of December 31,2014 Variable Investments #of Units Unit Price Portfolio Value #of Units Unit Price Portfolio Value Asset Alloc: AST T, Rowe Price Asset Allocation 10,699.53611 14.43177 $154,413.24 10,740.93167 14.18744 $152,386,32 Total Variable Investments $154,413.24 $152,386.32 Standard Address: Annuities Service, P.O. Box 7960, Philadelphia, PA 19176 Fax: (800)576-1217 Overnight Address: Annuities Service, 2101 Welsh Road, Dresher, PA 19025 LAW OFFICE OF MARC ROBERTS Marc Roberts, Esquire Kelley L. Courchene, Esquire 149 East Market Street Telephone (717) 843-1639 York, Pennsylvania 17401 Facsimile (717) 845-8700 June 23 , 2015 Office of the Register of Wills Cumberland County Courthouse One Courthouse Square Suite 102 Carlisle, PA 17013 Re: Estate of Joan E . Reichard File No. 21-15-0302 Dear Ladies : Please file the enclosed Inheritance Tax Return (in duplicate) and the Rule 6 .12 Status Report in the above captioned estate. Also enclosed is a check in the amount of $15 for the filing fee . A self-addressed, stamped envelope is enclosed for your convenience. Thank you. Sincerely, Mar oberts dasl Encls . M ;7) ca =3 C' r- Cn C) C:) "ri �,.. All >tcn� , a USA'1 �M US i" '� Cpil CLw. tl3 cum—:i. " A t , ,A CLAW OFFICE OF MARC ROBERTS 149 EAST MARKET STREET YORK, PENNSYLVANIA 17,401 TO: OFFICE OF THE REGISTER OF WILLS CUMBERLAND COUNTY COUR'T'HOUSE ONE .COURTHOUSE SQUARE SUITE 102 CARLISLE, PA 37013 I �ii�l��r�j��II��il}r�1��£r►ll��j��ttF�li��r�1'I'£