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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Dece~'~nt: _/~ a (if u r e. + 'Ee Ll r
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Date of Death:
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Will No.
Admin.No.PA # ~/- tJS -0359
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on
Name
Address
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:'-lntice has now been given to all persons entitled thereto under Rule 5.6(a) except__
Date:
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Signature
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Capacity: _ Personal Representative
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__Counsel for personal representative
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MetLifet
July 11 , 2005
Ms. Gloria Roush
557 Gospel Center Road
Reynoldsville, PA 15851
RE:
Pulicy Number:
Owner/Annuitant:
Beneficiary(ies ):
Metlife Investors Usa Insurance Company
A2056738
Margaret L. Bear
Zachary S. Roush
Emily D. Roush
Dear Ms. Roush:
We are sorry to learn of the death of Margaret L. Bear. The following information will be
helpful in settling the claim on this annuity policy.
In accordance with the policy's death benefits, the beneficiary(ies) may choose one of
the following options to settle the funds still accumulating:
1. Request that income begin immediately from any of the annuity income
options described on the enclosed list. This choice maximizes the
benefits of the policy since 100% of the annuity value is applied to
produce periodic annuity income. The guaranteed period of any option
selected cannot exceed the beneficiary's anticipated life expectancy.
Proof of birth is required if a life option is chosen. Benefit payments must
start within one year from the date of death.
2. Request a lump sum payment of the cash surrender value. This value is
paid in one lump sum; it would include all applicable surrender fees. This
payout must be made within 5 years from the date of the participant's
death.
Since this account was purchased with qualified (before tax) funds, we would suggest
that the beneficiary take an annuity payout in order to spread the tax liability over the
payout period.
Because the policy is a legal document, certain forms need to be completed and
returned before settlement of the claim can be processed. Listed below are the
requirements to settle this claim.
1 . A certified copy of the death certificate.
Address replies to: P.O. Box 14593
Des Moines. lA 50306-3593
DC35BM