U-4/67 STATE TEACHERS' RETIREMENT BOARD KEEP THIS RECORD PERMANENTLY Hartford, Connecticut 06115 FOR INCOME TAX PURPOSES! Doris P. McSorley 9320 name July 1, 1973 retirement number retirement date Your retirement allowance will be paid to you monthly according to the payment plan checked below: PLAN A - provides maximum monthly annuity and pension during your lifetime; there is no other settlement at the time of death. PLAN B - provides reduced monthly annuity during your lifetime. However, at the time of your death, any balance remaining of from which such annuity is drawn, will be paid in a lump sum to your designated beneficiary or legal representative. your funds PLAN C - provides reduced monthly annuity and pension guaranteed for years ; such payments are made to you during your lifetime. Should your death occur before the end of the guaranteed payment period, the same annuity and pension will be continued to your beneficiary, if living, for the balance of the period. In case you and your recognized beneficiary do not live for - years, the commuted value of the remaining payments will be paid to the Estate of the survivor. PLAN D - provides reduced monthly annuity and pension during your lifetime, and upon your death, provides your co-participant, if living, with a monthly benefit for life equal to of your allowance. 5% Regular 1% Supplemental Additional Deductions Deductions Deductions As of July 1, 1973 , your total accumulations amounted to $16,608.65 - $ - (The difference between the above and the cost of annuity Indext out of check listed below equals the interest credited to your account during your membership.) Actually taken for comption ANIC. For INCOME TAX PURPOSES, you will need to know the "COST OF ANNUITY" or "INVESTMENT IN CONTRACT" which is - - $ 10,320.27 $ $ Retirement Supplemental Additional Allowance Annuity Annuity Retirement Income payment from July 1, - - to Dec. 31, 1973 $ 4,641.54 $ $ ANNUAL Retirement Income thereafter My yearly encome $ 9,283.08 - $ $ - 773,54812 Further information and instruction on computing !your income tax must be obtained from the District Director of Internal Revenue Service. Figurent JMM on With yearly 9283 the 10,32