Form 2-221.1 Complaint for Interpleader [ ^ ] and [ ^ ] Plaintiffs v.

[ ^ ] Serve on [ ^ ]: [ ^ ] and [ ^ ] Serve on [ ^ ]: [ ^ ] * * * * * * * * * * * * * * [CIRCUIT/DISTRICT] COURT FOR [ ^ ] * * *

IN THE

Civil No. [ ^ ]

Defendants * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Complaint for Interpleader [ ^ ], plaintiff, pursuant to Maryland Rule 2-221, files this action for interpleader against the defendant, [ ^ ], and the defendant, [ ^ ], personal representative of the estate of [ ^ ], and says: 1. [ ^ ] is an annuity and insurance corporation organized and doing business in Maryland. 2. [ ^ ], a Maryland resident, is the widow of [ ^ ] who died [ ^ ], 19[ ^ ]. 3. [ ^ ] is the personal representative of the estate of [ ^ ], pursuant to the [ ^ ], 19[ ^ ], order of the Circuit Court for [ ^ ] County, Maryland, sitting as Orphans' Court (Estate No. [ ^ ]). 4. This action involves the respective rights, if any, of [ ^ ] and the Estate to the benefits payable under [ ^ ] Annuity No. [ ^ ] and [ ^ ] Certificate No. [ ^ ], copies of which annuity contracts of [ ^ ] are attached as Exhibits A and B.

5. [ ^ ] completed, signed and returned to [ ^ ] an Application for Retirement Annuity Benefits ("Application") dated [ ^ ], 19[ ^ ] (a copy of which is attached as Exhibit C) with respect to the payout of annuity benefits to begin in [ ^ ], 19[ ^ ], under both of the aforementioned annuity contracts. At the same time, [ ^ ] also forwarded [ ^ ] a Signature Record Card purportedly bearing [ ^ ] signature as "Annuitant", and [ ^ ]'s signature as "Second Annuitant" under a "Joint-Life (Survivor)" option, a copy of which card is attached as Exhibit D. Additionally, [ ^ ] forwarded [ ^ ]'s passport for use as a record of [ ^ ] age, a copy of the identification portion of which passport is attached as Exhibit E. 6. The portion of the Application pertaining to "Choice of Income Option" (Item 8 of the Application) was completed incorrectly, however, in a form not satisfactory to [ ^ ]. Section 19 of each of the attached annuity contracts requires such an election to be completed "in a form satisfactory to" [ ^ ]. Instead of choosing either a "One-Life" type of option or a "Joint Life (Survivor)" type of option, [ ^ ] selected both types of options--which [ ^ ] was not entitled to do. [ ^ ] selections are inconsistent both as to the amounts of the periodic annuity benefits payable an as to beneficiaries. 7. [ ^ ] selected as one income option a "Life Annuity with a Guaranteed Period of Ten Years". Under this option, any annuity benefit payments remaining due after [ ^ ] death for the balance of those ten years would be made to the beneficiary [ ^ ] designated in Item 9 of the Application, namely, [ ^ ] Estate. 8. However, in conflict with the aforesaid option selection, [ ^ ] also selected another income option, the "Full Benefit to Survivor With a Guaranteed Period of Ten Years" option, for which [ ^ ] designated [ ^ ] as the Second Annuitant. Under this option, and upon [ ^ ]'s death, [ ^ ] would receive for the rest of [ ^ ] life the same annuity benefit that [ ^ ] had received; if both Mr. and Mrs. [ ^ ] were to die before the end of the ten-year guaranteed period, the beneficiary designated in Item 9 of the Application, namely, the Estate, would get the balance of any payments remaining due until the end of the guaranteed period. 9. On [ ^ ], 19[ ^ ], [ ^ ] telephoned the [ ^ ]'s residence and was informed by [ ^ ] that [ ^ ] was in the hospital. [ ^ ] explained to [ ^ ] the above- described error in [ ^ ]'s Application. [ ^ ] stated that [ ^ ] believed [ ^ ] desired to designate [ ^ ] as a beneficiary under the "Full Benefit to Survivor With a Guaranteed Period of Ten Years Option". [ ^ ]

explained to [ ^ ], however, that it would be necessary to obtain another written application from [ ^ ] correctly designating a single income option. (See the record of that telephone conversation attached as Exhibit F.) 10. By cover letter dated [ ^ ], 19[ ^ ] (a copy of the [ ^ ] file copy is attached as Exhibit G), [ ^ ] mailed a second application to [ ^ ], however, [ ^ ] died before [ ^ ] could complete and sign it. 11. [ ^ ] mailed back to [ ^ ] the original of the [ ^ ], 19[ ^ ] cover letter with a hand-written note from [ ^ ] on it stating that [ ^ ] died on [ ^ ], 19[ ^ ]. (A copy of that original letter is attached as Exhibit H.) [ ^ ] returned with that letter the second application designating [ ^ ] as the beneficiary under the "Full Benefit to Survivor With Guaranteed Period of Ten Years" option. (A copy of the second application is attached as Exhibit I.) However, that second application was not signed by [ ^ ], rather, it was signed by [ ^ ] and dated [ ^ ], 19[ ^ ], three days after [ ^ ]'s death. That second application was not in a form satisfactory to [ ^ ]. 12. The Annuity Starting Date specified on the face of each of the aforesaid contracts is [ ^ ], 19[ ^ ]. Under the terms of the contracts, the Annuity Starting Date may be changed by election of the Annuitant, for example, by the annuitant's proper completion of an Application For Retirement Annuity Benefits. However, such a change in the Annuity Starting Date is not effective until [ ^ ] receives in a form satisfactory to it a completed Application for Retirement Annuity Benefits. (See Section 19 of each of the attached annuity contracts, which requires such an election to be "in a form satisfactory to" [ ^ ].) 13. Under the aforesaid contracts, death benefits (as contrasted with "annuity benefits") are payable only in the event of death of the Annuitant prior to the Annuity Starting Date. However, once an annuitant elects to receive retirement annuity benefits, and does so in a form satisfactory to [ ^ ], the Annuity starting Date becomes the current date selected by the annuitant for the commencement of retirement annuity benefits and the death benefits are no longer available. 14. Several years before [ ^ ] attempt to apply for retirement annuity benefits, by "Designation of Beneficiary" forms dated [ ^ ], 19[ ^ ], [ ^ ] designated [ ^ ] "executors or

administrators" as beneficiaries of any "death benefits" (as contrasted with " annuity benefits") payable under the aforesaid annuity contracts. Copies of the Designation of Beneficiary form for each annuity contract are attached hereto as Exhibits J and K. If [ ^ ]'s Application for Retirement Annuity Benefits (Exhibit C) is not valid, then the Designation of Beneficiary Forms (Exhibits J and K) would be the current beneficiary designations as they would represent the last beneficiary designations of record made by [ ^ ]. 15. Because [ ^ ] erred in completing [ ^ ] Application for Retirement Annuity Benefits (Exhibit C), [ ^ ] Estate is a potential claimant to the benefits accumulated under the aforesaid contracts. The Estate could argue that, because the Application was not completed in satisfactory form, the original Annuity Starting Date had not been changed effectively before [ ^ ]'s death and therefore the Estate would be entitled to death benefits under the Designation of Beneficiaries forms dated [ ^ ], 19[ ^ ] (Exhibits J and K). Alternatively, if the finder of fact should determine that the Application for Retirement Benefits of [ ^ ] effectively changed the Annuity Starting Date, the Estate could argue that it is entitled to the retirement annuity benefits in lieu of the death benefits. 16. On the other hand, [ ^ ] makes claim to the retirement annuity benefits. [ ^ ] alleges that [ ^ ] effectively designated [ ^ ] as the Second Annuitant entitled to retirement annuity benefits under the aforesaid contracts. 17. Pursuant to the terms of [ ^ ] Annuity No. [ ^ ], [ ^ ] currently is indebted in the amount of $[ ^ ] ($[ ^ ] death benefit plus $[ ^ ] delayed claim interest) to the person or persons entitled to receive payment under that contract. 18. Pursuant to the terms of [ ^ ] Certificate No. [ ^ ], [ ^ ] currently is indebted in the amount of $[ ^ ] (as of [ ^ ], 19[ ^ ]) to the person or persons entitled to receive payment under that contract. 19. By reason of the death of circumstances stated above and the terms contracts, both [ ^ ] and the Estate adverse claimants to the benefits payable [ ^ ], and under the of the aforesaid annuity are actual or potential under the contracts.

20. These actual or potential claims to the benefits are hostile, conflicting and mutually exclusive, and by reason of these claims, [ ^ ] is unable safely to determine for itself and

has great doubts as to which of these actual or potential claimants is entitled to receive the benefits without exposing [ ^ ] to multiple liability therefor. 21. [ ^ ] is an impartial stakeholder having no further interest or concern in the instant controversies, claims or contentions with respect to the benefits. WHEREFORE, [ ^ ] prays: (a) For an order requiring the defendants and any other claimants under the aforesaid annuity contracts to interplead here and settle their respective rights and claims to the benefits payable under the annuity contracts; (b) For the passage of a permanent injunction restraining [ ^ ], the Estate and any other claimant from bringing or prosecuting any other action with respect to pay benefits payable under [ ^ ] Annuity No. [ ^ ] or [ ^ ] Certificate [ ^ ]; (c) For an order discharging [ ^ ] from any further liability upon its deposit with the Court of the amounts payable under the aforesaid Annuity contracts, namely, $[ ^ ] plus delayed claim interest thereon calculated to the date of payment under [ ^ ] Annuity No. [ ^ ] , and the value of the death benefit due under [ ^ ] Certificate No. [ ^ ] at the date of payment (currently $ [ ^ ]). (d) For an order awarding [ ^ ] its costs and reasonable attorney's fees out of the interpleaded fund; and (e) For such other and further relief as the Court may deem proper.

[ ^ ] [Address and Telephone] Attorney for Plaintiff [Insert Demand for Jury Trial, if any: File 2-325-01]