I,   .-Principal-  , (the "Principal"), an adult person of sound mind and fully understanding the meaning, nature, and effect of this document, hereby freely and voluntarily appoint and designate   .-Agent-  , (the "Agent"), whose address is   .-Agent Address-  , and whose telephone number is   .-Agent Phone #-  , to be my Agent for health and medical care decisions, according to the terms stated in this document.

 

If the person appointed as Agent above is unable, or unwilling, or unduly absent, or not qualified to serve at that time, then I appoint and designate   .-Second Agent-  , whose address is   .-Second Agent Adress-  , and whose telephone number is   .-Second Agent Phone #-   , to be my Agent on the same terms and conditions, which person may be referred to in this document as my "Alternate Agent".

 

I am appointing these people as Agent and Alternate Agent because after fully discussing this document with them, I believe that each of them understands my wishes, attitudes, and values, and that each of them would carry out and put into effect the health care decisions set forth herein and those which I would make if I were able to do so, and that each of them would act in my best interests in all events, including situations where my wishes and desires are not known.

 

This power of attorney is a DURABLE POWER OF ATTORNEY AND ITS VALIDITY SHALL NOT BE AFFECTED BY MY SUBSEQUENT DISABILITY OR INCAPACITY.

 

This Power of Attorney shall become effective only in the event that I am unable to make and communicate decisions about my own health or medical care after I have been certified by my attending physician or other physician who has examined me as not having the mental capacity to make informed health or medical care decisions for myself.

 

Unless revoked by me, this durable Health Care Power of Attorney shall remain in effect until my death or terminated by law.

 

This Health Care Power of Attorney may be revoked by me at any time, so long as I am mentally competent to do so. I understand that it may be revoked by my spoken word, or by other communication if I am unable to speak, by tearing up or destroying the signed original and signed copies delivered to those appointed as Agent and Alternate Agent, but that the best, clearest, and only sure way to revoke this document is by signing a written revocation which is executed in the same manner as this document, and recorded in the county of my residence or the county where I am residing in a health care facility, in the same office where deeds and real estate records are recorded or filed. Further, any person who has not received formal notice of any revocation, or who does not have actual personal knowledge of such revocation, shall have no liability for continuing to act on and accept this document until they have notice of any revocation.

 

If the situation as spelled out herein activates the authority granted to my representative Agent and Alternate Agent, then my acting Agent shall make a bona fide and good faith effort to communicate with me, and in the event I cannot speak or write, to use methods of communication including, but not limited to such things as writing me notes and/or asking me questions to which I could respond by nodding my head; or blinking my eyes in response, such as 1 blink for "yes" and 2 blinks for "no", or other such methods; or squeezing my Agent's hand, indicating such things as 1 squeeze for "yes" and 2 squeezes for "no".

 

Unless invalid under applicable law or specifically restricted herein, or in conflict with any Living Will I have executed either on, before, or after this date, I hereby grant the authority to my Agent specifically to do and perform all the acts set forth on the following terms and conditions just as I could do for myself.

 

1.       To consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure being performed in order to maintain, diagnose, or treat a physical or mental condition of mine; and

 

2.       To make all necessary arrangements at any hospital, psychiatric hospital or psychiatric treatment facility, hospice, nursing home or similar institution; to employ, or either discharge, replace or obtain reassignment of health care personnel to include physicians, psychiatrists, psychologists, dentists, nurses, therapists, or any other person who is licensed, certified, or otherwise authorized or permitted by applicable laws to administer health care, all as my Agent shall deem necessary for my physical, mental, and emotional well being; and

 

3.       To request, receive and review any information, either verbal, written, or otherwise regarding my personal affairs, or my physical or mental health, including medical and hospital records, and to execute any release that may be requested in order to obtain such information; and

 

4.       To move or transport me to any state or country having applicable laws which permit my desires expressed herein, or which I have expressed in a living will, or other such advance health care directive, to be carried out; and

 

5.       To visit me or at least observe me, in any health care facility.

 

6.       To execute on my behalf a waiver or release from liability, or other documents required by a hospital or physician, or other health care facilities or health care personnel, and to execute and deliver any other documents which either carry out the terms of this document or which my Agent reasonably believes to be in my best interest if this document is silent in that regard, or to pursue any reasonable legal enforcement of provisions herein which are valid under applicable law, or other health care treatment which my acting Agent believes that I would do if I were making my own decisions, subject to not unduly expending or draining the available resources of my family and me.

 

7.       To contact members of my immediate family, and business partners, co-workers, and colleagues, and if my Agent deems it appropriate to also contact any other family or friends in order to advise them of my condition.

 

Limitations on Agent's Authority

In addition to limitations on my Agent's authority imposed by applicable law, the authority of my Agent shall also be limited, or my Agent shall also be prohibited from authorizing, consenting to, or performing the following: _______________

 

Any power of attorney for health care decisions which I have previously made is hereby revoked and canceled.

In the event that any terms or provisions of my Health Care Power of Attorney are not enforceable or valid under the laws of the state of my residence, of if applicable, under the laws of the state where I may be located at the time my Health Care Power of Attorney comes into use, then all other provisions herein which are enforceable or valid shall remain in full force and effect, and all terms and provisions herein are severable.

 

IN WITNESS WHEREOF, fully understanding the terms and effect of this Health Care Power of Attorney, I hereby freely, voluntarily, and intentionally sign and execute same on this _______________ in the presence of two (2) witnesses and a Notary Public.

 

Signature of Principal: ______________________________

 

STATEMENT OF WITNESSES

Under penalty of perjury, each of us hereby swears and certifies by our signatures below as follows: I know the Principal personally and I believe him or her to be of sound mind and at least 18 years of age. I believe that his or her execution of this Health Care Power of Attorney is voluntary and with full understanding.

 

I did not sign the Principal's signature above. I am at least eighteen (18) years of age and am not related to the Principal by blood, marriage, or adoption. I am not entitled to any portion of the estate of the Principal according to the laws of intestate succession of the state of the Principal's residence or domicile, or to the best of my knowledge under any Will of the Principal or any codicil to said Will, or under any trust of the Principal, or under any beneficiary designation, nor am I legally responsible for the costs of the Principal’s health, medical, or other care.

 

I am not the Agent or successor Agent appointed by the Principal in this Health Care Power of Attorney. I am not the Principal's attending physician, nor a health care provider who is serving the Principal at this time, nor am I an owner or employee of any person, organization, or institution which is serving or providing health care to the Principal at this time.

 

___________________________          ___________________________

Witness                                                    Witness

___________________________          ___________________________

Address                                                   Address

___________________________          ___________________________

Date                                                         Date

 

Notary Form

State of __________    County of __________

 

BEFORE ME, the undersigned authority, on this day personally appeared _______________, the Principal herein, and ____________________, a Witness, and ____________________, a Witness, whose names are subscribed to this foregoing durable Health Care Power of Attorney in their respective capacities, and all three of said persons, being by me first duly sworn, said ____________________, the Principal, declared to me and to said witnesses in my presence that this is the Principal's Health Care Power of Attorney, and that the Principal had willingly made and executed it as a free and voluntary act and deed for the purposes therein expressed; and the two witnesses each on their oath stated to me in the presence and hearing of the Principal herein, and in the presence and hearing of each other, that said document and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that they did sign the same as witnesses in the presence of each other and in the presence of the Principal and at the request of the Principal, and that the Principal was at that time at least 18 years old, was of sound mind, and under no restraint.

 

Subscribed, acknowledged, and sworn to before me by the above named Principal, and ____________________ and ____________________, witnesses, on this ____________________.

______________________________ Notary Public

 

My commission or appointment expires: ____________________

 

STATEMENT AND ACCEPTANCE OF AGENT

I understand that _______________, who is the Principal, has designated me to be his or her Health Care Agent if he or she is ever found to be incapacitated and unable to make health care decisions himself or herself. The above named Principal has discussed his or her desires regarding health care decisions with me; I have read the Principal's Health Power of Attorney, but did not serve as a witness to it, and I hereby accept such designation and appointment as Agent.

 

Signed: __________________________________

 

_________________________

_________________________

_________________________

_________________________

 

STATEMENT AND ACCEPTANCE OF ALTERNATE AGENT

I understand that _______________, who is the Principal, has designated me to be his or her health care Alternate Agent if he or she is ever found to be incapacitated and unable to make health care decisions himself or herself. The above named Principal has discussed his or her desires regarding health care decisions with me; I have read the Principal's Health Care Power of Attorney, but I did not serve as a witness to it, and I hereby accept such designation and appointment as Alternate Agent.

 

Signed: __________________________________

_________________________

_________________________

 

 

I

The name of this Corporation is .-Name of Corporation-.

 

II

A.         This corporation is non-profit and is not organized for the private gain of any person. It is organized under the Nonprofit Corporation Law exclusively for non-profit purposes.

 

B.         The specific purpose of the corporation is to provide homeless shelter, services, and training in the following areas: job training and placement, transitional housing, permanent housing, health care services, life skills training, and spiritual enrichment. As a non-profit corporation, we will have an educational and counseling center in conjunction with local, state, and federal platforms in health care for mental illness children.

 

III

The name and address in the State of California of this corporation’s initial agent for service of process is:

Name:         .-Corporation Agent-
Address:      .-Corporation Address-
City:             .-Corporation City, State Zip-

 

IV

A.         This corporation is organized and operated exclusively for non-profit purposes within the meaning of section 501 (C) (3), Internal Revenue Code.

 

B.         No substantial part of the activities of this corporation shall consist of carrying on propaganda, or otherwise attempting to influence legislation, and the corporation shall not participate or intervene in any political campaign (including the publishing or distribution of statements) on behalf of any candidate for public office.

 

V

Any and all property of this corporation is irrevocably dedicated to non-profit purposes and no part of the net income or assets of this corporation shall ever inure to the benefit of any director, officer, or member thereof or to the benefit of any private person. Upon the dissolution or winding up of the corporation, its assets remaining after payment, or provision for payment, of debts and liabilities of this corporation which is organized and operated exclusively for Christian religious purposes and which has established its tax exempt status under Section 501© (3), Internal Revenue Code.

 .-Corporation Agent-
 .-Corporation Address-
 .-Corporation City, State Zip-

 

BY-LAWS

OF

.-Name of Corporation-

A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION

 

ARTICLE 1. OFFICES

SECTION 1. PRINCIPAL OFFICE

The principal office of the corporation for the transaction of its business is located at .-Corporation Address- .-Corporation City, State Zip-.

 

SECTION 2. CHANGE OF ADDRESS

The County of the corporation’s principal office can be changed only by amendment of these Bylaws and not otherwise. The Board of Directors may, however, change the principal office from one location to another within the named county by noting the changed address and effective date below, and such changes of address shall not be deemed an amendment of these Bylaws:

_______________________________Dated:____________________20__

_______________________________Dated:____________________20__

 

SECTION 3. OTHER OFFICES

The corporation may also have offices at such other places, within or without of the State, where it is qualified to do business, as its business may require and as the Board of Directors may from time to time designate.

 

ARTICLE 2. PURPOSES

SECTION1. PURPOSE

This corporation is organized exclusively for religious purposes as per section 501 © (3) of the Internal Revenue Code, or the corresponding section of any future federal tax code.

 

The primary objective of this corporation is to provide financial help, educational, and counseling centers in conjunction the laws of the State.

 

No substantial part of the activities of the corporation shall be the carrying on of propaganda, or otherwise attempting to influence legislation, and the corporation shall not participate in, or intervene in (including the publishing or distribution of statements) any political campaign on behalf of or in opposition to any candidate for public office. Not withstanding any other provision of these articles, the corporation shall not carry on any other activities not permitted to be carried on (a) by a corporation exempt from federal income tax under section 501(C) (3) of the Internal Revenue Code, or the corresponding section of any future federal tax code, or (b) by a corporation, contributions to which are deductible under section 170 (C) (2) of the Internal Revenue Code, or the corresponding section of any future federal tax code.

 

ARTICLE 3. DIRECTORS

SECTION 1. NUMBER

The corporation shall have seven (7) directors and collectively they shall be known as the Board of Directors. The number may be changed by amendment of this Bylaw, or by repeal of this Bylaw and adoption of a new Bylaw, as provided in these Bylaws.

 

SECTION 2. POWERS

Subject to the provisions of the California Nonprofit Public Benefit Corporation Law and any limitations in the Articles of Incorporation and these Bylaws’ relation to the action required or permitted to be taken or approved by the members, if any, of this corporation, the activities, and affairs of this corporation shall be conducted and all corporate powers shall be exercised by or under the direction of the Board of Directors.

 

SECTION 3. DUTIES

It shall be the duty of the Directors of this Corporation to:

 

a]         Perform any and all duties imposed on them collectively or individually by law, by the Articles of Incorporation of this corporation, or these Bylaws.

 

b]         Appoint and remove, employ and discharge, and except as otherwise provided in these Bylaws, prescribe the duties and fix the compensation, if any, of all officers, agents, and employees of the corporation.

 

c]         Supervise all officers, agents, and employees of the corporation to assure that their duties are performed properly.

 

d]         Meet at such times and places as required by these Bylaws.

 

e]         Register their addresses with the Secretary of the corporation and notices of meeting mailed to them at such addresses shall be valid notices thereof.

 

SECTION 4. TERMS OF OFFICE

Each Director of the Corporation shall hold office for the period of one year, and until his or her successor is elected and qualifies.

 

SECTION 5. COMPENSATION

Directors shall serve without compensation. They shall be allowed reasonable advancement or reimbursement of expenses incurred in performance of their regular duties as specified in Section 3 of the Article. Directors may not be compensated for rendering services to the corporation in any capacity other than director unless such other compensation is reasonable and is allowable under the provisions of Section 6 of the Article.

 

SECTION 6. RESTRICTION REGARDING INTERESTED DIRECTORS

Not withstanding any other provision of these Bylaws, not more than forty-nine percent (49%) of the persons serving on the board may be interested persons. For purposes of the Section, “interested persons,” means either:

 

a]         Any person currently being compensated by the corporation for services rendered it within the previous twelve (12) months, whether as a full- or part-time officer or other employee, independent contractor, or otherwise, excluding any reasonable compensation paid to a director as director.

 

b]         Any brother, sister, ancestor, descendant, spouse, brother-in-law, sister-in-law, son-in-law, daughter-in-law, mother-in-law, father-in-law of any such person.

 

SECTION 7. PLACE OF MEETING

Meetings shall be held at the principal office of the corporation unless otherwise provided by the board or at such place within or without the State which has been designated from time to time by resolution of Board of Directors. In the absence of such designation, any meeting not held at the principal office of the corporation shall be valid only if held on the written consent of all directors. Written consent is given either before or after the meeting and filed with the Secretary of the corporation or after all board members have been given written notice of the meeting as hereinafter provided for special meeting of the board. Any meeting, regular or special, may be held by conference telephone or similar communications equipment, so as long as all directors participating in such meeting can hear one another.

 

SECTION 8. REGULAR AND ANNUAL MEETINGS

Regular meeting of Directors shall be held on the last Saturday of each calendar quarter at 2:00 PM, unless such days fall on a legal holiday, in which event the regular meeting shall be held at the same hour and place the following Saturday.

 

If this corporation makes no provision for members, then, at the annual meeting of directors held on the last Saturday in June, directors shall be elected by the Board of Directors in accordance with this section. Cumulative voting by directors for the election of directors shall not be permitted. The candidates receiving the highest number of votes up to the number of directors to be elected shall be elected. Each director shall cast one vote, voting by ballot only.

 

SECTION 9. SPECIAL MEETINGS

Special meetings of the Board of Directors may be called by the Chairperson of the board, the President, the Vice President, the Secretary, or by any two directors, and such meeting shall be held at the place, within the State of California, designated by the person or persons calling the meeting, and in the absence of such designation, at the principal office of the corporation.

 

SECTION 10. NOTICE OF MEETINGS

Regular meetings of the Board may be held without notice to Directors; Special meetings of the Board shall be upon four (4) days notice by first-class mail, or forty-eight (48) hours notice delivered personally or by telephone. If sent by mail, the notice shall be deemed to be delivered upon deposit in the mail. Such notices shall be addresses to each director at his or her address as shown on the books of the corporation. Notice of the time and place of holding an adjourned meeting need not be given to absent directors as the time and place of the adjourned meeting are fixed at the meeting adjourned and if such adjourned meeting is held no more than twenty-four (24) hours form the time of the original meeting. Notice shall be given of any adjourned regular or special meeting to directors absent from the original meeting if the adjourned meeting is held more than twenty-four (24) hours from the time of the original meeting.

 

SECTION 11. CONTENTS OF NOTICE

Notice of meeting not herein dispensed with shall specify by place, day, and hour of the meeting. The purpose of any “Board meeting” need not be specified in the notice.

 

SECTION 12. WAIVER OF NOTICE AND CONSENT TO HOLD MEETINGS

The transactions of any meeting of the Board, however called and noticed or wherever held, are as valid as though the meeting had been duly held after proper call and notice, provided a quorum, as hereinafter defined, is present and provided that either before or after the meeting each Director not present signs a waiver of notice, a consent to holding the meeting, or an approval of the minutes thereof. All such waivers, contents, or approvals shall be filed with the corporate records or made a part of the minutes of the meeting…

 

SECTION 13. QUORUM FOR MEETINGS

A quorum shall consist of fifty-one percent (51%) of the filled number of Directors.

 

Except as otherwise provided in these Bylaws or by law, no business shall be considered by the Board at which the Chair shall entertain at such meeting its motion to adjourn. However, a majority of the director’s present at such meetings may adjourn from time to time until the time fixed for the next regular meeting of the board.

 

When a meeting is adjourned for lack of a quorum, it shall not be necessary to give any notice of the time and place of the adjournment at the meeting or of the business to be transacted at such meeting, other than by announcement at the meeting at which the adjournment is taken, except as provided in Section 10 of this Article.

 

The directors present at a duly called and held meeting, provided that any action thereafter taken must be at least a majority of the required quorum for such greater percentage as may be required by law, or the Article of Incorporation or Bylaws of this corporation.

 

SECTION 14. MAJORITY ACTION AS BOARD

Every act decision done or made by a majority of the quorum present at a Board of Directors meeting, duly held, is the act of the board of Directors, unless the Articles of Incorporation, Bylaws of this corporation, or provisions of the California Nonprofit Public Benefit Corporation Law, particularly those provisions relating to appointment of committees (Section 5112), approval of contracts, or transactions in which a Director has a material financial interest (Section 5233) and indemnification of Directors (Section 5238e), require a greater percentage or different voting rules for approval of a matter by the Board.

 

SECTION 15. CONDUCT OF MEETINGS

Meetings of the Board of Directors shall be presided over by the Chairperson of the Board, or, if no such person has been so designated or, in his or her absence, the President of the corporation or, in his or her absence, by the Executive Vice President of the corporation or, in the absence of each of these persons, by a Chairperson chosen by a majority of the directors present at the meeting. The Secretary of the corporation shall act as secretary of all meetings of the board, provided that in his or her absence, the presiding officer shall appoint another person to act as Secretary of the Meeting.

 

Roberts Rules of order shall govern meetings; as such rules may be revised from time to time, insofar as such rules are not inconsistent with or in conflict with these Bylaws, with the Articles of Incorporation of this corporation, or with provisions of law.

 

SECTION 16. ACTION BY WRITTEN UNANIMOUS CONSENT WITHOUT A MEETING

Any action required or permitted to be taken by the Board of Directors under any provision of law may be taken without a meeting, if all members of the Board shall individually or collectively consent in writing to such action. For the purposes of this section only, “all members of the Board” shall not include any “interested Director” as defined in Section (5233) of the California Nonprofit Public Benefit Corporation Law. Such written consent or consents shall be filed with the minutes of the proceedings of the Board. Such action by written consent shall have the same force and effect as the unanimous vote of the Directors. Any certificate or other document filed under any provision of law which relates to action so taken shall state that the action was taken by unanimous written consent of the Board of Directors without a meeting and that the Bylaws of the corporation authorize the Directors to so act. Such statement shall be prima facie evidence of such authority.

 

SECTION 17. VACANCIES

Vacancies on the Board of Directors shall exist [1] on the death, resignation, or removal of any Director, and [2] whenever the number of authorized Directors is increased.

 

The Board of Directors may declare vacant the office of a director who has been declared of unsound mind by a final order of court, or convicted of a felony, or been found by a final order or judgment of any court to have breached any duty under Section 5230 and following of the California Nonprofit Public Benefit Corporation Law.

 

If this corporation has any members, then, if the corporation has less than fifty (50) members, directors may be removed without cause by a majority of all members, or, if the corporation has fifty (50) or more members, by vote of a majority of the votes represented at a membership meeting at which a quorum is present.

 

If this corporation has no members, directors may be removed without cause by a majority of the directors then in office.

 

Any director may resign effective upon giving written notice to the Chairperson of the Board, the President, the Secretary, or the Board of Directors, unless the notice specifies a later time for the effectiveness of such resignation. No director may resign if the corporation would then be left without a duly elected director or directors in charge of its affairs, except upon notice to the Attorney General.

 

Vacancies on the board may be filled by approval of the board or, if the number of directors then in office is less than a quorum, by (1) the unanimous written consent of the directors then in office, (2) the affirmative vote of a majority of the directors then in office at a meeting held pursuant to notice or waivers of notice complying with this Article of these Bylaws, or (3) a sole remaining director. If this corporation has members, however, vacancies created by the removal of a director may be filled only by the approval of the members. The members, if any, of this corporation may elect a director at any time to fill any vacancy not filled by the directors.

 

A person elected to fill a vacancy as provided by this Section shall hold office until the next election of the Board of Directors or until his or her death, resignation, or removal from office.

 

SECTION 18. NON-LIABILITY OF DIRECTORS

The Directors shall not be personally liable for the debts, liabilities, or other obligations of the corporation. The liability of the directors of the corporation for monetary damages shall be eliminated to the fullest extent permissible under California law.

 

SECTION 19. INDEMNIFICATION BY CORPORATION OF DIRECTORS, OFFICERS, EMPLOYEES AND OTHER AGENTS

To the extent that a person, who is, or was, a Director, Officer, employee, or other agent of this corporation, has been successful on the merits in defense of any civil, criminal, administrative, or investigative proceedings brought to procure a judgment against such person by reason of the fact that he or she is, or was, an agent of this corporation, or has been successful in defense of any claim, issue or matter, therein, such person shall be indemnified against expenses actually and reasonably incurred by the person in connection with such proceedings.

 

If such person either settles any such claim or sustains a judgment against him or her, then indemnification of such expenses, judgments, fines, settlements, and other amounts reasonably incurred in connection with such proceedings, shall be provided by this corporation, but only to the extent allowed by, and in accordance with, the requirements of, Section (5238) of the California Nonprofit Public Benefit Corporation Law.

 

SECTION 20. INSURANCE FOR CORPORATE AGENTS

The Board of Directors may adopt a resolution authorizing the purchase and maintenance of insurance on behalf of any agent of the corporation (including a Director, officer, employee, or other agent of the corporation) against any liability other than for violating provisions of law relating to self-dealing (Section 5233 of the California Nonprofit Benefit Corporation Law) asserted against or incurred by the agent in such capacity or arising out of the agents’ status as such, whether or not the corporation would have the power to indemnify the agent against such liability under the provisions of Section 5238 of the California Nonprofit Public Benefit Corporation Law.

 

ARTICLE 4. OFFICERS

SECTION 1. NUMBER OF OFFICERS

The officers of the corporation shall be President, Executive Vice-President, Vice- President, Secretary, and a Chief Financial Officer who shall be designated the Treasurer. The corporation may also have, as determined by the Board of Directors, a Chairperson of the Board, one or more Vice-Presidents, Assistant Secretaries, Assistant Treasures, or other officers. The same person may hold any number of offices except that neither the Secretary nor the Treasurer may serve as the President or Chairperson of the Board.

 

SECTION 2. QUALIFICATION, ELECTION AND TERM OF OFFICE

Officers shall be elected by the Board of Directors, at any time, and each officer shall hold office until he or she resigns, is removed, or is otherwise disqualified to serve, or until his or her successor shall be elected and qualified, whichever occurs first.

 

SECTION 3. SUBORDINATE OFFICERS

The Board of Directors may appoint such other officers or agents as it may deem desirable, and such officers shall serve such terms, have such authority, and perform such duties as may be prescribed from time to time by the Board of Directors.

 

SECTION 4. REMOVAL AND RESIGNATION

The Board of Directors may remove any officer, either with or without cause, at any time. Any officer may resign at any time by giving written notice to the Board of Directors or to the President or Secretary of the corporation. Any such resignation shall take effect at the date of receipt of such notice or at any later date specified therein, and, unless otherwise specified therein, the acceptance of such resignation shall not be necessary to make it effective. The above provisions of this Section shall be superseded by any conflicting terms of a contract, which has been approved or ratified by the Board of Directors relating to the employment of any officer of the corporation.

 

SECTION 5. VACANCIES

Any vacancy caused by the death, resignation, removal, disqualification, or otherwise of any officer, shall be filled by the Board of Directors. In the event of a vacancy in any office other than that of President, such vacancy may be filled temporarily by appointment by the President until the Board shall fill the vacancy. Vacancies occurring in offices of the officers appointed at the discretion of the board may or may not be filled, as the board shall determine.

 

SECTION 7. DUTIES OF THE PRESIDENT

The president shall be the chief executive officer of the corporation and shall, subject to the control of the Board of Directors, supervise and control the affairs of the corporation and the activities of the officers. He or she shall perform all the duties incidental to his or her office and such other duties as may be required by law, and by the Articles of Incorporation, or by these Bylaws, or which may be prescribed from time to time by the Board of Directors. If applicable, the President shall preside at all meetings of the members. Except as otherwise provided by law, by the Articles of Incorporation, or by these Bylaws, he or she shall, in the name of the corporation, execute such deeds, mortgages, bonds, contracts, checks, or other instruments which may from time to time be authorized by the Board of Directors.

 

SECTION 9. DUTIES OF THE VICE-PRESIDENT

In the absence of the President and the Executive Vice-President, the Vice-President shall perform all the duties of the President, and when so acting shall have all the powers of, and be subject to, all the restrictions on the President. The Vice-President shall have other powers and perform such other duties as may be prescribed by law, by the Articles of Incorporation, or by these Bylaws, or as may be prescribed by the Board of Directors.

 

SECTION 10. DUTIES OF THE SECRETARY

The Secretary shall:

 

[a]        Certify and keep at the principal office of the corporation the original, or a copy, of these Bylaws as amended or otherwise altered to date.

 

[b]        Keep at the principal office of the corporation or at such other place as the Board may determine, a book of minutes of all meetings of the directors and if applicable, meetings of committees of Directors and members, recording therein the time and place of holding, whether regular or special, how called, how notice thereof was given, the names of those present or represented at the meeting, and the detail of proceedings thereof.

 

[c]        See that all notices are duly given in accordance with the provisions of these Bylaws or as required by law.

 

[d]        Be custodian of the records and of the seal of the corporation and see that the seal is affixed to all duly executed documents, the execution of which on behalf of the corporation under seal is authorized by law and these Bylaws.

 

[e]        Keep at the principal office of the corporation a membership book containing the name and address of each and any member. In the case where any membership has been terminated, he or she shall record such fact in the membership book together with the date on which such membership ceased.

 

[f]         Exhibit at all reasonable times to any Director of the corporation or to his or her agent or attorney, on request therefore, the Bylaws, the membership record, and the minutes of the proceedings of the Directors of the corporation.

 

[g]        In general, perform all duties incidental to the office of Secretary and such other duties as may be required by law, by the Articles of Incorporation, or by these Bylaws, or which may be assigned to him or her from time to time by the Board of Directors.

 

SECTION 11. DUTIES OF THE TREASURER

Subject to the provisions of these Bylaws relating to the “Execution of Instrument, Deposit of Funds”, the Treasurer shall:

 

[a]        Have charge and custody of, and be responsible for all funds and securities of the corporation, and deposit all such funds in the name of the corporation in such banks, trust companies, or other depositories as shall be selected by the Board of Directors.

 

[b]        Receive and give receipt for monies due and payable to the corporation from any source whatsoever.

 

[c]        Disburse, or cause to be disbursed, the funds of the corporation as may be directed by the Board of Directors, taking vouchers in a proper manner for such disbursements.

 

[d]        Keep and maintain adequate and correct accounts of the corporation’s properties and business transactions, including accounts of its assets, liabilities, receipts, disbursements, gains and losses.

 

[e]        Exhibit at all reasonable times the books of accounting and financial records to any Director of the corporation, or to his or her agent or attorney, on request therefore.

 

[f]         Render to the President and Directors, whenever requested, an account of any or all of his or her transactions as Treasurer and of the financial condition of the corporation.

 

[g]        Prepare or cause to be prepared, and certify or cause to be certified, the financial statements to be included in any required reports.

 

[h]        In general, perform all duties incidental to the office of Treasurer and such other duties as may be required by law, by the Articles of Incorporation of the corporation, or by these Bylaws, or which may be assigned to him or her from time to time by the Board of Directors.

 

SECTION 12. COMPENSATION

The salaries of the officers, if any, shall be fixed from time to time by resolution of the Board of Directors. No officer shall be prevented from receiving such salary by reason of the fact that he or she is also a director of the corporation, provided, however, that such compensation paid a director for serving as an officer of this corporation shall only be allowed if permitted under the provisions of Article 3, Section 6 of these Bylaws. In all cases, any salaries received by officers of this corporation shall be reasonable and given in return for services actually rendered for the corporation which relate to the performance of the charitable or public purposes of the corporation.

 

ARTICLE 5. COMMITTEES

SECTION 1. EXECUTIVE COMMITTEE

The Board of Directors may, by a majority vote of directors, designate two (2) or more of its members (who may also be serving as officers of this corporation) to constitute an Executive Committee and delegate to such Committee any of the powers and authority of the board in the management of the business and affairs of the corporation, except with respect to:

 

[a]        The approval of any action, which under law or the provisions of these Bylaws, requires the approval of the members or of a majority of all the members.

 

[b]        The filling of vacancies on the board or on any committee, which has the authority of the board.

 

[c]        The fixing of compensation of the directors for serving on the board or on any committee.

 

[d]        The amendment or repeal of Bylaws or the adoption of new Bylaws.

 

[e]        The appointment of committees of the board or the members thereof.

 

[f]         The expenditure of corporate funds to support a nominee for director after there are more people nominated for director than can be elected.

 

[g]        The approval of any transaction to which this corporation is a party and in which one or more of the directors has a material financial interest, except as expressly provided in Section 5233(d)(3) of the California Nonprofit Public Benefit Corporation Law.

 

By a majority vote of its members then in office, the board may at any time revoke or modify any or all of the authority so delegated, increase or decrease, but not below two (2) the number of its members, and fill vacancies therein from the members of the board. The Committee shall keep regular minutes of its proceedings, cause them to be filed with the corporate records, and report the same to the board from time to time as the board may require.

 

SECTION 2. OTHER COMMITTEES

The corporation shall have such other committees as may from time to time be designated by the resolution of the Board of Directors. Such other committees may consist of persons who are not also members of the board. These additional committees shall act in an advisory capacity only to the board and shall be clearly titled as “advisory” committees.

 

SECTION 3. MEETINGS AND ACTION OF COMMITTEES

Meetings and action of committees shall be governed by, noticed, held, and taken in accordance with the provisions of these Bylaws concerning meetings of the Board of Directors, with such changes in the context of such Bylaw provisions as are necessary to substitute the committee and its members for the Board of Directors and its members, except that the time for regular meetings of committees may be fixed by resolution of the Board of Directors or by the committee. The Board of Directors may also fix the time for special meetings of committees. The Board of Directors may also adopt rules and regulations pertaining to the conduct of meeting of committees to the extent that such rules and regulations are not inconsistent with the provisions of these Bylaws.

 

ARTICLES 6. EXECUTION OF INSTRUMENTS, DEPOSITS AND FUNDS

SECTION 1. EXECUTION OF INSTRUMENTS

The Board of Directors, except as otherwise provided in these Bylaws, may by resolution authorize any officer or agent of the corporation to enter into any contract or execute and deliver any instrument in the name of and on behalf of the corporation, and such authority may be general or confined to specific instances. Unless so authorized, no officer, agent, or employee shall have any power or authority to bind the corporation by any contract or engagement, to pledge its credit, or to render it liable monetarily for any purpose or in any amount.

 

SECTION 2. CHECKS AND NOTES

Except as otherwise specifically determined by resolution of the Board of Directors, or as otherwise required by law, checks, drafts, promissory noted, orders for the payment of money, and other evidence of indebtedness of the corporation shall be signed by the Executive Vice-President and countersigned by the President of the corporation.

 

SECTION 3. DEPOSITS

All funds of the corporation shall be deposited to the credit of the corporation in such banks, trust companies, or other depositories as the Board of Directors may select. All deposits will be placed in those institutions covered by deposit guarantees under government secured FDIC or FSLIC programs.

 

SECTION 4. GIFTS

The Board of Directors may accept on behalf of the corporation any contribution, gift, bequest, or devise for the charitable or public purpose of this corporation. Any member of the Board of Directors may accept on behalf of the corporation any cash gift for the charitable or public purpose of this corporation.

 

ARTICLE 7. CORPORATE RECORDS REPORTS AND SEAL

SECTION 1. MAINTENANCE OF CORPORATE RECORDS

The corporation shall keep at its principal office in the State of California:

 

[a]        Minutes of all meetings of directors, committees of the board, and if this corporation has members, of all meetings of members, indicating the time and place of holding such meetings, whether regular or special, how called, the notice given, and the names of those present and the proceedings thereof.

 

[b]        Adequate and correct books and records of account, including accounts of its properties and business transactions and accounts of its assets, liabilities, receipts, disbursements, gains and losses.

 

[c]        A record of its members, if any, indicating their names and addresses, and if applicable, the class of membership held by each member and the initial and termination date of any membership.

 

[d]        A copy of the corporation’s Articles of Incorporation and Bylaws as amended to date, which shall be open to inspection by the members, if any, of the corporation at all reasonable times during office hours.

 

SECTION 2. CORPORATE SEAL

The Board of Directors may adopt, use, and at will alter a corporate seal. Such seal shall be kept at the principle office of the corporation. Failure to affix the seal to corporate instruments, however, shall not affect the validity of such instrument.

 

SECTION 3. DIRECTOR’S INSPECTION RIGHTS

Every Director shall have the absolute right at any reasonable time to inspect and copy all books, records, and documents of every kind and to inspect the physical properties of the corporation.

 

SECTION 4. RIGHT TO COPY AND MAKE EXTRACTS

Agent, or attorney may make any inspection under the provisions of the Article in person, and the right to inspection includes the right to copy and make extracts.

 

SECTION 5. ANNUAL REPORT

The Board shall cause an annual report to be furnished not later than one hundred and twenty (120) days after the close of the corporation’s fiscal year to all Directors of the Corporation and, if this corporation has members, to any member who requests it in writing, which report shall contain the following information inappropriate detail:

 

[a]        The assets and liabilities, including trust funds, of the corporation as of the end of the fiscal year

 

[b]        The principal changes in assets and liabilities, including trust funds, during the fiscal year

 

[c]        The revenue or receipts of the corporation both unrestricted and restricted to particular purposes, for the fiscal year.

 

[d]        The expenses or disbursements of the corporation, for both general and restricted purposes, during the fiscal year.

 

[e]        Any information required by Section 7 of this Article.

 

The annual report shall be accompanied by any report thereon of independent accountants, or, if there is no such report, the certificate of an authorized officer of the corporation that such statements were prepared without audit from the books and records of the corporation.

 

If this corporation has members, if this corporation receives TWENTY-FIVE THOUSAND DOLLARS ($25,000), or more, in gross revenues or receipts during the fiscal year, this corporation shall automatically send the above annual report to all members, in such a manner, at such time, and with such contents, including an accompanying report from independent accountants or certification of a corporate officer, as specified by the above provisions of this Section relating to the annual report

 

SECTION 7. ANNUAL STATEMENT OF SPECIFIC TRANSACTIONS TO MEMBERS

This corporation shall deliver to all directors and all members a statement within one hundred and twenty (120) days after the close of the fiscal year, which briefly describes the amount and circumstances of any transaction of the following kind:

 

[a]        Any transaction in which the corporation, or its parent or its subsidiary, was a party and in which either of the following had direct or indirect material financial interest

 

[b]        Any director or officer of the corporation, or its parent or its subsidiary, was a party, and in which either of the following had a direct or indirect material financial interest

 

[c]        Any holder of more than ten percent (10%) of the voting power of the corporation, its parent or its subsidiary.

 

Similarly, the statement need only be provided with respect to indemnifications or advances aggregating more than TEN THOUSAND DOLLARS ($10,000) paid during the previous fiscal year to any director or officer, except that no such statement need be made if such indemnification was approved by the members pursuant to Section 5238(e)(2) of the California Nonprofit Public Benefit Corporation Law.

 

Any statement required by this Section shall briefly describe the names of the interested persons involved in such transactions, stating each persons relationship to the corporation, the nature of such person’s interest in the transaction and, where practical, the amount of such interest, provided that, in the case of a transaction with a partnership of which such person is a partner, only the interest of the partnership need be stated.

 

If this corporation has any members and provides all members with an annual report according to the provisions of Section 6 of this Article, then such annual report shall include the information required by this Section.

 

ARTICLE 8. FISCAL YEAR

The fiscal year of this corporation shall begin on the first day of January and end on the last day of December in each year.

 

ARTICLE 9. AMENDMENT OF BYLAWS

SECTION 1. AMENDMENT

Subject to any provision of law applicable to the amendment of Bylaws of public benefit nonprofit corporations, these Bylaws, or any of them, may be altered, amended, or repealed and new Bylaws adopted as follows:

 

[a]        Subject to the power of members, if any, to change or repeal these Bylaws under Section 5150 of the Corporations Code, by approval of the Board of Directors, unless the Bylaw amendment would materially and adversely affect the rights of members, if any, as to voting or transfer, provided, however, if this corporation has admitted any members, then a Bylaw specifying or changing the fixed number of directors of the corporation, the maximum or minimum number of directors, or changing from a fixed to a variable board or vice versa, may not be adopted, amended, or repealed except as provided in sub paragraph (b) of the Section or

 

[b]        By approval of the members, if any, of this corporation.

 

ARTICLE 10. AMENDMENT OF ARTICLES

SECTION 1. AMENDMENT OF ARTICLES BEFORE ADMISSION OF MEMBERS

Before any members have been admitted to the corporation, any amendment of the Articles of Incorporation may be adopted by approval of the Board of Directors.

 

SECTION 2. AMENDMENT OF ARTICLES AFTER ADMISSION OF MEMBERS

After members, if any, have been admitted to the corporation, amendment of the Articles of Incorporation may be adopted by the approval of the Board of Directors and by the approval of the members of this corporation.

 

CERTAIN AMENDMENTS

Notwithstanding the above Sections of this Article, this corporation shall not amend its Articles of Incorporation to alter any statement which appears in the original Articles of Incorporation of the names and addresses of the first directors of the corporation, or the name and address of its initial agent, except to correct an error in such statement to delete such statement after the corporation has filed a “Statement by a Domestic Non-Profit Corporation” pursuant to Section 6210 of the California Nonprofit Corporation Law.

 

ARTICLE 11. PROHIBITION AGAINST SHARING CORPORATE ASSETS AND PROFITS

No Director, Officer, employee, or other person connected with this corporation or any private individual, shall receive at any time any of the net earnings or pecuniary profit from the operations of the corporation, provided, however, that these provisions shall not prevent payment to any such person of reasonable compensation for services performed for the corporation in effecting any of its public or charitable purposes, provided that such compensation is otherwise permitted by these Bylaws and is fixed by resolution of the Board of Directors; and no such person or persons shall be entitled to share in the distribution of, and shall not receive, any of the corporate assets on dissolution of the corporation.

 

All Directors, Officers, employees, members, if any, of the corporation, or other person connected with this corporation or any private individual, shall be deemed to have expressly consented and agreed that on such dissolution or winding up of the affairs of the corporation, whether voluntarily or involuntarily, the assets of the corporation, after all debts have been satisfied, shall be distributed to a nonprofit fund, foundation, or corporation which is organized and operated exclusively for Christian religious purposes and which has established its tax exempt status under Section 501(c)(3), Internal Revenue Code, or the corresponding section of any future tax code, or shall be distributed to the federal government, or to a state or local government for a public purpose. Any such assets not so disposed of shall be disposed of by a court of Competent Jurisdiction of the country in which the principal office of the corporation is then located, exclusively for such purposes or to such organization or organizations, as the said Court shall determine, which are organized and operated exclusively for such purposes.

 

ARTICLE 12. MISCELLANEOUS

SECTION 1. CONSTRUCTION AND DEFINITIONS

Unless the context otherwise requires, the general provisions, rules of construction, and definitions contained in the Nonprofit Corporation Law of the State of California shall govern the construction of these Bylaws. If any section, subsection, sentence, clause, or phrase of these Bylaws, or the application thereof is contrary to the Nonprofit Corporation Law of the State of California, the provisions of that law shall prevail. Without limiting the generality of the foregoing, the masculine gender includes the feminine and neuter, the singular number includes the plural and the plural number includes the singular, and the term “person” includes a Corporation as well as a natural person.

 

SECTION 2. DISSOLUTION

This Corporation may elect voluntarily to wind-up and dissolve by approval of majority of the Board of Directors of this Corporation. In the event of the dissolution of this Corporation in any manner and for any cause, the assets of the corporation, after all debts have been satisfied, shall be distributed as required by the Articles of Incorporation of the corporation and not otherwise.

 

CERTIFICATION

This is to certify that the foregoing is a true and correct copy of the Bylaws of the corporation named in the title thereto and that such Bylaws were duly adopted by the Board of Directors of this corporation on _______________________(Date)

 

Dated:________________          ________________________________
                                                     PRESIDENT

 

 

This Property Settlement Agreement (“Agreement”) is made and effective .-Effective Date- , by and between .-Wife's Name- (“Wife”) and .-Husband's Name- (“Husband”).

 

The parties were married on .-Marriage Date- in .-Marriage City- , and have since that time been and are now by law Husband and Wife.

 

The parties do / do not (circle one) have minor children. .-Children's Names-

 

It is the desire of the parties by execution of this Agreement, to fully and for all-time settle and determine all property rights of the parties, all rights of support and maintenance (including support and custody of minor children, as applicable), all rights and claims arising out of the marriage relationship including dower, curtsey, maintenance, inheritance and homestead, together with any and all other rights existing between the parties or claims one against the other, arising out of the marriage relationship of the termination of said relationship, or otherwise, independent and regardless of the disposition, judicially or otherwise, of the marriage relationship.

 

NOW, THEREFORE, each of the parties hereto, in consideration of the mutual promises, covenants and agreements made herein, agree as follows

 

MINOR CHILDREN OF THE PARTIES

The parties desire to determine in this Agreement all matters pertaining to the care, custody and control of any minor children and to provide for their support.

 

Custody and Visitation.

A. The parties shall have the joint care, custody and control of their minor children with primary residence with ____________________ (the “Custodial Parent”) except for _____________________. During any period and child resides with one party, the other party shall have reasonable visitation rights and opportunities. The following shall be considered the minimum visitation to which the non-custodial parent shall be entitled ___________________. In addition, Husband and Wife agree to the following visitation schedule _________________________.

 

B. It shall be the mutual responsibility of Husband and Wife to arrange for the transportation of a child at the times specified and to return the child at the times specified. It shall also be the mutual responsibility of Husband and Wife to have the child ready for visitation at the time the child is to be picked up and to be present at the home to receive the child at the time the child is returned.

 

C. Each party shall give the other at least 48 hours notice if he or she does not intend to exercise his or her visitation, unless an emergency situation exists, in which case he or she will give notice as soon as possible under circumstances.

 

D. Each of the parties shall supply the other with his or her current address and telephone number and shall advise the other of any changes which may occur and shall keep the other advised as to the whereabouts of their minor children.

 

E. Under the above-described residential custodial arrangement, the Custodial Parent shall have the primary daily responsibility for the guidance and upbringing of each minor child while the minor child is in the Custodial Parent's residence. Both parties have the right to participate with the other in decisions affecting a child including, but no limited to, authorization for major medical, mental, institutional, psychiatric, or other cares, schooling and educational placement, to inspect and receive records, and to inspect and receive medical records. Such decisions shall be make only after prior consultation with the other parent except in the event of an emergency. The parent having the residential care of a minor child shall at the time of that residence take responsibility for meeting medical and dental emergencies and in an emergency the permissions of both parents shall not be necessary.

 

Child Support.

A. During the period in which a minor child resides with ______________________, the other parent (the “Support Payer”) shall pay the monthly sum of _______________________ not later than the 10th day of each month of which support is due. Such obligations with respect to a minor child shall cease as to that child upon such child experiencing any of the following events

 

1. Death

2. Marriage

3. Becoming self-supporting

4. Ceasing any; residence with the primary custodial parent

5. Dropping out of school; or

6. The end of the month of the year the child normally would have graduated from school.

 

B. During any period of _______________________ consecutive days or more that primary residence is with the Support Payer, child support as set out below shall be reduced ______________________.

 

Life Insurance.

The Support Payer shall maintain insurance providing for benefits upon death in the amount of _____________________. The insurance shall name each minor child as a principal beneficiary. During such time as the Support Payer is obligated to provide child support for the benefit of a minor child, the Support Payer shall continue to pay, or cause to be paid, all of the premiums on any policy maintained as required hereby, and shall not allow the lapse of the insurance evidenced thereby. The Support Payer shall not borrow against any policy obtained as required by this Agreement or otherwise cause any encumbrance against the proceeds such as to cause death benefits to be less than herein above required. The Support Payer shall furnish proof of said insurance at such time or times as the other party may reasonably request. After the duty to provide child support hereunder has ceased, the Support Payer shall become the sole owner of any policy of insurance maintained hereunder and shall have the exclusive right to name a successor beneficiary or beneficiaries of the Support Payer's choice or to terminate the policy all together. In the event the Support Payer should die and for any reason whatsoever the full amount of insurance required hereby shall not be available, the beneficiary shall have a claim against the estate of the Support Payer for any deficiency.

 

Tax Exemptions.

A. The right to claim dependent exemptions on federal and state income tax returns shall be allocated as follows _______________________.

 

B. Each party agrees to provide a release to his or her claim to any such exemption pursuant to Section 152(e)(2) of the Internal Revenue Code of 1986, as amended, as reasonably requested by the party entitled to such exemption, to be provided by January 31 of each year.

 

Higher Education.

_____________________ shall pay the reasonable and ordinary expenses of a child of the parties in attaining an undergraduate college degree as a resident at a state college or university, or a degree equivalent, or attendance at a trade, vocational or business school.

 

Change of Residence.

The residence of a minor child subject to this Agreement shall not be changed without the written agreement of the other parent or by Court order.

 

Consultation.

Each of the parties shall keep the other informed on all matters relating to the health, education and welfare of each child and the parties agree to consult with each other regarding decisions concerning such matters. The following nonexclusive list includes examples of the kinds of matters that shall be the subject of consultation between the parties' school, work, activities, schedules, transportation arrangements, and recreation.

 

Medical and Dental Expenses.

 

A. ______________________ shall maintain, for the benefit of each minor child, medical insurance benefits. The parent providing medical insurance coverage shall provide the other party with an identification card or other evidence of insurance coverage necessary to permit prompt admission of a covered minor child to hospitals, clinics and/or other institutions and shall provide all necessary claim forms and other documents and will cooperate fully in submitting claims hereunder as quickly as possible.

 

B. All medical and dental expenses and costs not covered by the above described insurance for the benefit of a minor child shall be borne by the parties as follows ______________________.

This provision shall include, but be limited to, all medical and dental costs and expenses not covered under said insurance coverage, all medical and dental costs which are applied to insurance deductibles and all medical and dental costs remaining after insurance has paid the covered portion of each claim.

 

C. The obligations to provide medical insurance for the benefit of a minor child shall be null and void as to such minor child as such time as the child is no longer in insured party under the medical insurance policy by reason of a change in the subject child's age, residency, student or marital status.

 

Modification.

The parties recognized and agree that any provisions for the care, custody and support of the minor children are subject to further order of the Court and may be altered by any court of competent jurisdiction.

 

 

Maintenance

 

Periodic Payments.

A. _____________________ (the “Maintenance Payer”) shall pay to the other party, and the other party agrees to accept, in complete satisfaction of any claim, which may now or hereafter be made for alimony, support or maintenance, the sum of ____________________ per month. The foregoing maintenance payments shall cease upon the first happening of one of the following events

1. Death of the party entitled to receive the maintenance payments;

2. Remarriage or cohabitation (as below defined) of the party entitled to receive the Maintenance payments; or

3. ______________________________________

 

B. For purposes of this Agreement, cohabitation means living in a residential, conjugal relationship with another person for a substantially consecutive period in excess of 30 days.

 

Maintenance Modification.

The parties further agree that the obligation to pay maintenance shall be subject to modification according to state law.

 

Division of Property

A. Wife shall have as her sole and separate personal property, free and clear of all right, title, claim or interest of Husband, all of the following household goods, personal property, furnishings and household appliances _____________________________.

 

B. Husband shall have as his sole and separate property, free and clear of all right, title, claim or interest of life, all of the following household goods, personal property, furnishings and household appliances _______________________________________.

 

C. All of the personal property and effects transferred to a party hereunder and presently in the possession of the other party shall be removed within thirty (30) days of the execution of this agreement.

 

Automobiles.

A. Wife shall have as her sole and separate property the following vehicle(s)________________________, free and clear of all right, title, claim or interest of Husband, subject to any encumbrance thereon.

 

B. Husband shall have as his sole and separate property the following vehicle(s)_________________________, free and clear of all right, title, claim or interest of Wife, subject to any encumbrance thereon.

 

Real Estate.

A. The following described real estate shall be transferred to Wife free and clear of all right, title, claim or interest of Husband, subject only to any lien or encumbrances of others___________________________________ shall be responsible for paying the mortgage or any other outstanding borrowing secured by this property.

 

B. The following described real estate shall be transferred to Husband free and clear of all right, title, claim or interest of Wife, subject only to any lien or encumbrances of others _______________________________________ shall be responsible for paying the mortgage or any other outstanding borrowing secured by this property.

 

Money Accounts, Profit-Sharing Plans and Retirement Benefits.

A. Wife shall be entitled to all of the funds in the following checking, savings, money market and similar accounts _____________________. Husband shall be entitled to all of the funds in the following checking, savings, money market and similar accounts ____________________.

 

B. The Court retains jurisdiction herein to effect the intent of the parties to transfer interests as described in the event any issue remains as to the various profit sharing or retirement plans.

 

C. The pension and profit sharing transfers referenced above, if any, are directed by the parties to be accomplished through instructions to plan administrators to be completed by the party in whose interest the benefit, plan, pension, or account is now listed.

 

Securities Ownership.

A. The following described securities shall be transferred to, or remain the property of, each party, as appropriate _________________________________.

 

Encumbrances against Property.

A. Except as specifically provided herein, any property set aside to a party hereunder, whether real or personal, is accepted subject to existing encumbrances which that party assumes and agree to pay.

 

B. Both Husband and Wife herein state and contract their agreement, each to the other, whereby the party receiving property subject to encumbrance hereby indemnifies the transferring party from any and all liability which such transferring party may suffer as a result of any default upon the encumbrance obligation.

 

Miscellaneous Provisions

 

Debts.

_______________________ shall be responsible to pay in a timely fashion all bills and amounts now owed and arising from the marriage. Husband and Wife shall be individually responsible for any debts or bills incurred by either of them individually after the date of this Agreement. Each party specifically agrees to indemnify and hold harmless the other party from any loss, claim, and suit of law and/or judgment, which the other party might suffer by reason of the responsible party failing to meet his or her obligations as stated herein.

 

Federal and State Income Tax Returns.

A. Unless otherwise agreed, the parties shall file joint federal and state income tax returns until the year a divorce decree is entered by a competent court.

 

B. The parties agree that each shall be individually responsible for the intangible, personal and real property taxes due subsequent to the execution of this Agreement with reference to the items of property satisfied to each of them under the provisions of this Agreement.

 

Submission to Court.

In the event a petition for divorce, separate maintenance or annulment comes before a court of appropriate jurisdiction for trial or other disposition, this Agreement may be submitted to the Court for such actions the Court may determine proper.

 

Payment of Maintenance.

In the event that this Agreement is submitted to a court as aforesaid and is by such court accepted and incorporated into a decree of divorce, separate maintenance or annulment, all sums to be paid as support of maintenance hereunder shall be made in cash or by check or money order payable to ________________________________.

 

Execution of Instruments.

Each of the parties agrees that at any time reasonable requested, he or she shall make, execute and deliver to the other any and all deeds of conveyance, bills of sale, titles, tax exemption declarations or any other instrument which may be necessary to carry out the terms of this Agreement or to reflect the agreement of the parties.

 

Agreement Absolute.

This Agreement is absolute and irrevocable and, therefore, is not conditioned upon the parties hereto being divorced or upon court approval. This Agreement shall be considered to be contractual between Husband and Wife and binding as such upon them, their executors, administrators, heirs, devisees, beneficiaries, assigns and other legal representatives.

 

Free Will Exercised.

Each of the parties acknowledges that this Agreement, as to each of its provisions, has been made of his or her free will and volition and further acknowledges that no coercion, force, pressure or undue influence has been used or exerted by or against the other party.

 

Independent Counsel and Full Disclosure.

The parties declare that each has had the independent advice of his or her own counsel, or has rejected such counsel and that each disclosed t such counsel and/or to the other party the full extent and nature of his or her assets, liabilities, income and expenses.

 

Applicable Law.

The parties agree that this Agreement shall be construed enforced according to the laws of the State of _____________________________.

 

Court Costs.

_________________________ shall be responsible for the court costs herein.

 

Attorney's Fees.

_________________________ shall be responsible for the other party's reasonable attorney's fees. Except as otherwise expressly agreed or ordered by the Court, each party shall be responsible for all other of his or her individual attorney's fees, incurred on the negotiation of this Agreement or any enforcement or modification of this Agreement in the future.

 

Waver of Appeal.

Each of the parties waives the right of appeal of a judgment of divorce, which may be granted in any action in which this Agreement is submitted to the Court and approved in its entirety.

 

Credit Cards.

The parties specifically agree that upon the execution of this Agreement, all credit cards and charge cards in the possession or control of one party for which the other party is primarily liable shall be returned to the party with primary liability. In the event the parties have any credit cards or charge cards for which they are jointly liable, such cards will be promptly canceled. Nothing in this Agreement shall prevent either party from keeping or using credit cards or charge cards for which he or she is solely liable.

 

Mutual Release of Marital Rights.

In consideration of the mutual release contained in this Section, each of the parties hereby releases the other party and his or her respective legal representatives, successors and assigns, from any claim of any kind, and specifically relinquishes any right, title or interest in or to any of the earnings, accumulations, future investments, money or property of the other, any rights of inheritance in the estate of the other, which either may have heretofore, may now or may hereafter have except as otherwise provided in this Agreement, any rights to elect to take against the will of the other, any rights to act as executor or administrator of the will or estate of the other, any rights to receive any allowance from the estate of the other, any additional rights which either party has or may have by reason of their marriage, including dower or curtsy, whether by statute, agreement or common law, and any right to receive insurance proceeds as beneficiary on life insurance on the life of the other (unless after the date of this Agreement the insured takes affirmative action to make or retain him or her as beneficiary, except those exceptions and provisions herein above contained). It is specifically understood and agreed that nothing herein contained in this Section shall be construed as limiting the rights of enforcement of the terms and provisions of this Agreement by either party.

 

IN WITNESS WHEREOF, the parties hereto have signed this Agreement upon the date first above written.

 

 

Wife Husband

.-Wife's Name- .-Husband's Name-

 

_____________________ _______________________

 

 

I, .-Declarant- ("Declarant" herein), being of sound mind, and after careful consideration and thought, freely and intentionally make this revocable declaration to state that if I should become unable to make and communicate my own decisions on life sustaining or life support procedures, then my dying shall not be delayed, prolonged or extended artificially by medical science or life sustaining medical procedures, all according to the choices and decisions I have made and which are stated here in my Living Will.

 

It is my intent, hope and request that my instructions be honored and carried out by my physicians, family and friends, as my legal right.

 

If I am unable to make and communicate my own decisions regarding the use of medical life sustaining or life support systems and/or procedures, and if I have a sickness, illness, disease, injury or condition which has been diagnosed by two (2) licensed medical doctors or physicians who have personally examined me, (or more than two (2) if required by applicable law), one of whom shall be my attending physician, as being either (1) terminal or incurable certified to be terminal, or (2) a condition from which there is no reasonable hope of my recovery to a meaningful quality of life, which may reasonably be referred to as hopeless, although not necessarily "terminal" in the medical sense, or (3) has rendered me in a persistent vegetative state, or (4) a condition of extreme mental deterioration, or (5) permanently unconscious, then in the absence of my revoking this Living Will, all medical life sustaining or life support systems and procedures shall be withdrawn, unless I state otherwise in the following provisions.

 

Unless otherwise provided in this Living Will, nothing herein shall prohibit the administering of pain relieving drugs to me, or any other types of care purely for my comfort, even though such drugs or treatment may shorten my life, or be habit forming, or have other adverse side effects.

 

____________________

 

I am also stating the following additional instructions so that my Living Will is as clear as possible:

 

 

 

 

 

 

501-3-C California Non-Profit Funding Sources

Arata Bros. Trust

4061 Marsalla Court,

Sacramento, CA 95820

Estimated balance in fund $8,000,000

Attn: Mark Sewell

916-443-1955

High - $50,000, Low - $700

Human Services 20%--Education 18%--Arts

16%--Health 10%--Youth 10%--Disease 4%.

 

Arques Charitable Education Trust170 Columbus Ave. # 500,

San Francisco, CA 94113

Estimated balance fund $3,400,000

Attn: William Ziegler

415-788-8180

High - $25,000, Low - $1,500

Education 75% - Recreation 18% - Sports 13%--Art 5%.

 

Anna & Harry Borun FoundationP.O. Box 63954

San Francisco, CA 94163

Attn: Hydar Bessoloss

213-253-3155

High - $175,000, Low - $300

Disease 4% - Human Services 8%--Arts 5%--Education 60%--Religion 15%--Other 2%.

 

Atkinson Foundation1100 Grundy Lane #140

San Bruno, CA 94066

Estimated balance in fund $15,000.000

Attn: Elizabeth Curtis

650-876-0222

High - $25,000, Low - $1,000

Human 20%--Religion 13%--Health 3%--Education 12%-- Community 8%--Youth 5%.

 

AirTouch Communications Foundation One California Street, 17^th Floor

San Francisco, CA 94111

Estimated balance in fund $18,000,000

Attn: Sue Diekman

415-658-2208

High - $100,000, Low - $450.

Community 40%--Education 8%--Arts 20%--Youth 4%--Human Services 11%--Other 15%.

 

Arron and Marie Blackman Foundation, Inc.100 Spear Street # 1800

San Francisco, CA 94105

Estimated balance in fund $8,900,000

Attn: Milton Jacobs

415-777-3001

High - $300,000, Low - $450.

Community 6%--Health 8%--Education 40%--Human Services 40% Other 6%.

 

Anne and Jason Farber Foundation, Inc.1676 N California Blvd 3rd Floor

Walnut Creek, CA 94596

Estimated balance in fund $2,800,000

Attn: James Farber

High - $45,000, Low - $200, Avg - $19,000

Medical Research 8%--Education 70%-- Disease 10%.

Arsey And Olga Kovshar Private Charitable693 Sutter Street, 6^th Floor

San Francisco, CA 94102

Estimated balance in fund $3,900,000

Attn: Alexander Anolik

High - $45,000, Low - $200

Health 18%--Religion 60%--Human Services 7%.

Alletta Morris McBean Charitable Trust400 S. El Camino Real, #777

San Mateo, CA 94402

Estimated balance in fund $4,900,900

Attn: Charlene Kleiner

650-555-8480

High - $870,000, Low -$4,900

Education 18%--Environmental 45%--Religion 7%--Arts 5%--Community 3%.

Arthur P. Pratt & Jeanette Gladys Pratt Memorial9266 Towne Centre Dr. # 820

San Diego, CA 92122

Estimated balance in fund $4.8 million

858-552-2066

High - $17,000, Low - $950

Youth 15%--Human Services 30%--Disease 10%--Health 5%--Arts 19%.

Annunziata Sanguinetti FoundationP.O. Box 63954

San Francisco, CA. 94163

Estimated balance in fund $4.9 million

Attn: Eugene Ranghiasci

415-396-3215

High - $15,000, Low - $5,000

Health 25%--Human Services 65%--Recreation 5%--Youth 3%.

Bechtel Foundation50 Beale Street

San Francisco, CA 94105

Estimated balance in fund $20 million

Attn: Lee Anne Lang

415-768-7158

High - $498,000.00, Low - $30,000.00

Community 10%--Education 60%--Arts 5%--Human Services 3%.

Bellini Foundation400 Estudillo Ave Suite # 200

San Leandro, CA 94577

Estimated balance in fund 5.9 million

510-895-9932

High - $24.900.00, Low - $490.00

Youth 18%--Education 21%--Health 15%--Disease 8%--Medical 9%.

Broderbund Foundation P.O. Box 6121

Novato, CA 94948

Estimated balance in fund 3.5 million

Attn: Christopher Disalvo

415-444-5170

High - $15,500, Low - $26.00

Education 5%--Human Services 45%--Disease 7%--Arts 4%--Food 3%

Bruce & Anne Bundy Foundation18300 Von Karman, # 340

Irvine, CA 92612

Estimated balance in fund 9.7 million

Attn: Joanna Pfeld

High - $95,000, Low - $65,000

Medical 22%--Human Services 61%--Health 17%--Disease 3%.

Barbara Gauntlett Foundation Inc. 901 Market Street. Ste, # 400

San Francisco, CA 94103

Estimated balance in fund $39.9 million

Attn: Suwanna Gauntlett

High - $195,000, Low - $995

Animal Services 21%--Environmental 35%--Science--Food-Nutrition 15%.

Bertha Russ Lytel Foundation P.O. Box 893

Ferndael, CA 95536

Estimated balance in fund 14.9 million

Attn: Charles Lawrence

High - $59,000, Low - $95

Human Services 18%--Health 19%--Religion 11%--Community 12%--Environmental 8%.

Bernard G. Sarnat & Rhoda G. Sarnat Family 150 Post Street. Ste, # 350

San Francisco, CA 94108

Estimated balance in fund 2.9 million

650-854-6805

Attn: Bernard Sarnat

High - $119,900, Low - $495

Art 3%--Philanthropy 62%--Human Services 25%--Disaster, Public Safety 3%.

Bechtel Foundation50 Beale Street

San Francisco, CA 94105

Estimated balance in fund 21 million

Year-end 12/31

Attn: Lee Ann Lang

415-768-7158

High - $500,000, Low - $28,000

Education 70%--Community 8%--Human Services 6%--Arts 3%--Public Safety 5%.

Bank of America Giannini Foundation799 Market St #10067-5

San Francisco, CA 94103

Estimated balance in fund $19 million

Attn: Caroline Boitano

High - $60,000, Low - $5,000

Education 63 %--Human Services 10%--Health 5%--Food 3%--Youth 2%--Disease 1%.

Lowell Berry Foundation4 Orinda Way #140-B

Orinda, CA 94563

Estimated balance in fund $32 million

Attn: Debbie Coombe

925-254-1944

High - $500,000, Low - $400

Youth 3%--Religion 63%--Unknown 10%--Human 5%--Education 3%--Science 5%.

The Arron and Marie Blackman Foundation, Inc.100 Spears Street #1800

San Francisco, CA 94105

Estimated balance in fund $10 million

Attn: Paul Mahan

High - $299,000, Low - $495

Human 52%--Education 38%--Health 4%--Community 8%--Youth 3%

The Jennifer Altman FoundationP.O. Box 1080

Bolinas, CA 94924

Estimated balance in fund $15 million

Attn: Michael Lerner

High - $400,00, Low - $1,000

Health 40%--Unknown 20%--Human 10%--Environmental 7%--Arts 5%--Education 3%.

Brayton Wilburn Foundation320 California Street

San Francisco, CA 94104

Estimated balance in fund $5.1 million

Attn: Brayton Wilburn, Jr.

415-772-4006

High - $145,000, Low - $995

Recreation 5%--Arts 70%--Community Improvement 3%--Health 4%--Animal Related 2%.

Byron Williford TrustP. O. Box 63954

San Francisco, CA 94163

Estimated balance in fund $5.1 million

High - $174,000, Low - $50,000

Health 90%.

Compton Foundation 545 Middlefield Road,

Menlo Park, CA 94025

Estimated balance in fund $103.9 million

Attn: Edith Eddy

High - $949,000, Low - $99

Social Sciences 18%--Environmental 22%--International 19%--Education 15%.

Callison Foundation969 G Edgewater Blvd, #148

Foster City, CA 94404

Estimated balance in fund $8.5 million

Attn: Ward Ingersoll

650-340-1800

High - $24,000, Low - $4,900

Human services 26%--Education 40%--Health 15%--Arts 5%--Youth 8%.

Chan Foundation 1388 Sutter Street.

San Francisco, CA 94109

Estimate balance in fund $4.7 million

Attn: Gordon Choy

High - $1,000, Low -$100

Arts 100%.

Clorox Company Foundation1221 Broadway, 13^th Floor,

Oakland, CA 94612

Estimated balance in fund $7.9 million

Attn: Craig Sullivan

510-271-2199

High - $698,000, Low - $99

Education 18%--Community 8%--Youth 28%--Arts 12%--Human Services 7%.

Columbia Foundation One Lombard Street # 305

San Francisco, CA 94111

Estimated balance in fund $85.9 million

Attn: Susan Clark

High - $198,000, Low - $1,000

Arts 18%--Environmental 28%--Education 13%--Civil Right 7%--Community 12%.

 

 

Arts & Cultural Funding Sources

E. D. Foundation P. O. Box 628

Woodmere, NY 11598

Estimated balance in fund $1 million

Attn: Carol Puchyr

High - $7,000, Low - $3,500

Grants awarded to experienced full time painters and sculptors.

Dedalus Foundation, Inc. C/o Hecht & Co., P.C.

111 W. 40^th Street.

New York, NY 10018

Estimated balance in fund $47.8 million

212-220-4220

High - $16,000, Low - $7,250

Grants awarded to art historian, critic that is studying modern art.

Larchmont Chamber Music Circle, Inc. C/o Goldstein, Golub, Kessler & Co., PC

1185 Ave of the Americas

New York, NY 10036

Estimated balance in fund $9.8 million

High - $3,450, Low - $700

Grants awarded to talented musicians, individuals who display unusual potential and talents.

Broadcasters Foundation, Inc 296 Old Church Rd.

Greenwich, CT 06830

Grants awarded to needy members of the broadcast industry.

Leni Fe Bland Foundation 2059 Boundary Dr.

Santa Barbara, CA 93108

Estimated balance in fund $10,500

High - $2,300, Low - $325

Grants for U.S citizens to encourage use of instrumentalists and vocalists to further their careers.

Frank Huntington Beebe Fund for Musicians. C/o Welch & Forbes

45 School Street

Boston, MA 02108

Estimated balance in fund $998,900

Attn: Carol Woodworth

617-585-1267

High - $ 8,900, Low - $ 1,700

 

 

Research Funding Sources

Whitehall Foundation, Inc.251 Royal Palm Way, Ste. 211

Palm Beach, Fl 33480

Estimated balance in fund $89.9 million

Attn: Laurel Baker

561-655-4474

High - $23,000, Low - $1,450

Grants for Ph.D.s who are affiliated with accredited universities and research institution grants for invertebrate and vertebrate for the field of neurobiology.

Wacker Foundation 10848 Strait Lane

Dallas, TX 75229

Estimated balance in fund $898.8 million

Attn: John Wacker

214-373-3308

High - $25,000, Low - $10,000

Grants awarded for neurophysiological learning behavior and disorders.

Society of Economic Geologists Foundation, Inc.8811 Shaffer Pkwy

Littleton, CO 80127

Florence Gay Smith Foundation2191 E. Iverson Woods Pl.

Salt lake City, UT 84117

Estimated balance in fund $595 million

801-272-0111

High - $3,750, Low $145

Grants for child abuse prevention and projects for community education.

Do Something, Inc.423 W. 55^th Street.

New York, New York 10019

Estimated balance in fund $2.6 million

Attn: Michale Sanchez

High - $10,000, Low - $3,000

Grants to implement creativity for individuals.

The Dow Jones News Paper Fund, Inc.P. O. Box 300

Princeton, NJ 08543

Estimated balance in fund $449,000

Attn: Richard Holden

609-452-2820

High - $900, Low - $500

Grants for journalism work.

Awarded to individuals for lectureships, travel, and graduate students, for the science of economic geology.

 

 

International Needs Funding Sources

The Commonwealth Fund1 E. 75^th Street.

New York, New York 10021

Estimated balance in fund $586.8 million

Attn: Robin Osborn

212-606-3809

High - $74,000, Low - $50,000

Grants for New Zealand, United Kingdom, and Australian citizens in health care research for master’s/doctors.

Agape FoundationP. O. Box 1226

Donna, TX 78537

Estimated balance in fund $645.9 million

Attn: James Fitzerald

High - $3,000, Low - $1,000

Grants for individuals in Mexico for Christian missionary work that is economically disadvantaged.

The Ford Foundation320 E. 43^rd Street.

New York, NY 10017

Estimated balance in fund $11.8 billion

Attn: Barron Tenny

212-573-5000

High - $ 200,000, Low - $100,000

Grants to individuals from Africa, Latin America, Asia, Russia, and the Middle East 3 yr help.

Karyae Benevolent Foundationc/o Selection Committee

P. O. Box 37169

Charlotte, NC 28237

Estimated balance in fund $381,000

High - $535. Low - $275

Grants for support to Greece, and Karyae for education to colleges or trade school.

Kasser Family Foundation26 Park Street.

Montclair, NJ 07042

Estimated balance in fund $2.4 million

Attn: Mary Mochary

973-783-7722

High - $3,000, Low - $700

Grants for public school students from Israel.

The Trustees of Ivan V. Koulaieff Education FundC/o Stadtler, Rosenblum, and Saris

451 Montgomery Street, 3^rd Floor.

San Francisco, CA 94104

Estimated balance in fund $8.1 million

415-472-3516

High - $7,000, Low - $ 1,800

Grants for Russian immigrants and their descendants.

Indonesian Cultural Foundation, Inc.605 3^rd Ave., Street, # 1501

New York, NY 10158

Estimated balance in fund $2.0 million

Attn: Carl Morelli

212-972-1100

High - $5,375, Low - $ 800

Grants to financial needy Indonesians.

The Thomas Cholnoky Foundation, Inc.100 Old Church Rd.

Greenwich, CT 06830

Estimated balance in fund $359,000

Attn: Thomas Cholnoky

High - $4,000, Low - $500

Grants for Hungarians travel, research, and other expenses.

Taraknath Das FoundationC/o Southern Asian Institute, Colombia University.

420 W. 118^th Street. , Ste. # 113

New York, NY 10027

Estimated balance in fund $674.9 million

Attn: Leonard Gordon

High - $3,450, Low - $1,900

Grants for Indian graduate students who are scholars, researchers, & writers that are studying in the U.S.

Fine Arts Work Center in Provincetown, Inc.24 Pearl Street.

Hamilton, NY 13346

Attn: Thomas Brackett

315-824-3435

High - $795, Low - $95

Grants to refugees for educational support

that has been displaced.

Grants for Company Employees and Their ChildrenEducationAmerican General Finance Foundation601 North West 2^nd Street.

Evansville, IN 47701

Estimated balance in fund $316,000

High - $20, 000, Low - $5,000

Four years of study with a minimum of “B” average maintained.

Alcoa Foundation201 Isabella Street

Pittsburgh, PA 15212

Attn: Kathleen Buechel

412-553-2348

Estimated balance in fund $400,000,000.00

High - $7,500.00

Low - $1,000.00

High school seniors with a minimum C+ average or upper 50% of their class.

American Electric Power System Educational Trust Fund1 Riverside Plaza

Columbus, OH 43215

614-233-1000

Estimated balance in fund $2,500,000.00

High - $2,500.00

Low - $1,500.00

Undergraduate scholarships to children of employees of American Electric Power Co.

Armco Foundation1 Oxford Center

301 Grant Street

Pittsburgh, PA 15219

Attn: Kathy Zurku

412-255-9882

Estimated balance in fund $13,000.00.

High - $5,500.00

Low - $1,000.00

Scholarships to dependents of employees of Armco Inc. only.

Arnold Industries Scholarship FoundationP.O. Box 7558

Philadelphia, PA 19101

Attn: Kenneth Leedy

215-987-7917

Estimated balance in fund $400,000.00

High school senior enrolled as full-time college student.

Associated Banc-Corp Founders Scholarship, Inc.P.O. Box 19006

Green Bay, WI 54307

Attn: Mary Magyar

Estimated balance in fund $700,000.00.

High - $1,250.00

Low - $500.00

Must have maintained a “B” average throughout high school and plan to attend college full-time.

The Barden Foundation, Inc.1146 Barnum Ave.

Bridgeport, CT 06610

Attn: Scholarship Committee

203-744-2211

Estimated balance in fund $7,000,000.00

High - $2,000.00

Low - $500.00

Bestfoods Educational Foundation700 Sylvan Ave.

International Plaza

Englewood Cliffs, NJ 07632

Attn: Kathy Schaefer

201-894-2377

Estimated balance in fund $10,000,000.00

High - $20,000, Low - $200

Awarded on basis of prior academic performance.

The Borax Education Foundation26877 Tourney Road

Valencia, CA 91355

661-287-5400

Estimated balance in fund $3,000.00

High - $3,000, Low - $200

For dependents of U.S. Borax, Inc. employees.

CHEMCENTRAL Charitable TrustP.O. Box 730

Bedford Park, IL 60499

Attn: William Mulliken

708-594-7000

Estimated balance in fund $25,000.00

High - $1,500.00

Low - $500.00

Children of employees of CHEMCENTRAL Corporation.

Circuit City Foundation9950 Mayland Drive

Richmond, VA 23233

Attn: Jan Gurganus

804-527-4000

Estimated balance in fund $190,000.00

Children and spouses of Circuit City Stores, Inc.

The CIT Group Foundation, Inc.650 CIT Drive

Livingston, NJ 07039

Attn: Corinne Taylor

973-740-5638

Estimated balance in fund $10,000.00

High - $8,000.00

Low - $200.00

Unsolicited applications not considered. Recipients are nominated by their schools.

The Walt Disney Company Foundationc/o Scholarship Administration Committee

500 S. Buena Vista Street

Burbank, CA 91521

Estimated balance in fund $3,000,000.00

High - $15,000, Low - $200.

Undergraduate scholarships to children of full-time, regular employees of The Walt Disney Company.

Dixie Foundation, Inc.P.O. Box 1008

Lexington, NC 27293

Attn: Personnel Office

Estimated balance in fund $15,000

High - $3,000, Low -$500

Undergraduate scholarships to children of Lexington Furniture Industries employees.

Dunkin’ Donuts Charitable TrustP.O. Box 317, Pacella Park Drive

Randolph, MA 02368

Attn: Scholarship Committee

781-961-4000

Estimated balance in fund $170,000.00

High - $1,000.00

Low - $500.00

Dependent children of employees or franchise owners of Dunkin’ Donuts, Baskin-Robbins, or Togo’s eateries.

GEICO Philanthropic Foundation1 GEICO Plaza

Washington, DC 20076

Attn: Michael Campbell

301-986-2185

Estimated balance in fund $25,000,000.00

High - $2,500.00

Low -$1,000.00

Scholarships to military personnel, active and retired federal employees, and their dependent children.

Georgia-Pacific Foundation, Inc.133 Peachtree Street NE

Atlanta, GA 30303

Attn: Curley Dossman Jr.

404-652-4182

Estimated balance in fund $900,000.00

Scholarships to high school juniors whose parents are employees of Georgia-Pacific Corp.

The Gerber Foundation4747 W. 48^th Street, Ste 153

Fremont, MI 94912

Attn: Catherine Obits

231-924-3175

Estimated balance in fund $85,000,000.00

High - $3,000, Low - $750

Scholarships to children of regular, full-time associates of Gerber Products Co.

GTE Foundation1255 Corporate Drive

Irving, TX 75038

Attn: Maureen Gorman

972-507-5433

Estimated balance in fund $50,000,000.00

High school seniors who are dependents of GTE Corporation employees.

Hall Family FoundationP.O. Box 419580

Kansas City, MO 64141

Attn: Jeanne Bates

816-274-8516

Estimated balance in fund $ 900,000,000

High - $2,250, Low - $750

Children of employees of Hallmark Cards, Inc. only.

Halton FoundationP.O. Box 3377

Portland, OR 97208

Attn: Susan Findlay

503-288-6411

Estimated balance in fund $1,100,000.00

High - $4,000, Low - $600

Children of employees of The Halton Company.

Lockheed Martin Corporation Foundation6801 Rockledge Drive

Bethesda, MD 20817

Attn: Donna Price

301-897-6292

Estimated balance in fund $2,500,000.00

High - $500,000, Low - $600

High school graduates who are children of Lockheed Martin Corporation employees.

Manpower Foundation, Inc.5301 N. Ironwood Road

P.O. Box 2053

Milwaukee, WI 53217

Attn: Scholarship Program Coordinator

414-961-1000

Estimated balance in fund $800,000.00

High - $6,000, Low - $2,000

Children of Manpower, Inc., and its subsidiaries, or affiliated franchise corporations.

MBNA Scholars Foundation, Inc.M.S. 2811

Wilmington, DE 19884

Attn: Benjamin Cabell

302-543-9930

Estimated balance in fund $1,500,000.00

To dependent children of full-time MBNA employees.

Benjamin Moore Educational Foundation, Inc.51 Chestnut Ridge Road

Montvale, NJ 07645

Estimated balance of fund $600,000.00

High - $4,000, Low - $2,000

Undergraduate scholarships to children of Benjamin Moore, Inc. employees.

National Machinery Foundation, Inc.161 Greenfield Street

P.O. Box 747

Tiffin, OH 44883

Attn: Don Bero

419-447-5211

Estimated balance in fund $16,000,000.00

Children of employees of National Machinery Company.

NCR Scholarship Foundation1700 S. Patterson Blvd.

Dayton, OH 45479

Attn: Kim Dinsmore

973-445-1422

Estimated balance of fund $400,000.00

High - $1,500, Low - $1,000

Scholarships to children of NCR Corporation employees.

Pennsylvania Automotive Recycling Trade Society (PARTS) Scholarship Foundation1106 Carlisle Road

Camp Hill, PA 17011

717-780-2330

Estimated balance of fund $65,000.00

High - $3,000, Low - $1,000

To members, employees, and dependents of PARTS for undergraduate or technical school education.

Pennsylvania Steel Foundry Foundationc/o First Union National Bank

Broad & Walnut Streets

Philadelphia, PA 19109

215-985-7597

Estimated balance in fund $20,000.00

High - $8,000 Low - $1,000

Employees and dependents of Pennsylvania Steel Foundry and Machine Company.

The Quaker Chemical FoundationElm & Lee Streets

Conshohocken, PA 19428

Attn: Kathleen Lasota

610-828-4313

Estimated balance of fund $500,000.00

Employees of Quaker Chemical Corporation only.

Reader’s Digest FoundationReader’s Digest Road

Pleasantville, NY 10570

Attn: Claudia Edwards

845-244-5370

Estimated balance of fund $28,000,000.00

Undergraduate scholarships to children of Reader’s Digest Association, Inc. employees.

Temple-Inland Foundation303 S. Temple Drive

P.O. Drawer 338

Diboll, TX 75941

Attn: Doyle Simons

936-829-1721

Estimated balance of fund $88,000.00

High - $1,000, Low - $500

Scholarships to children of employees of Temple-Inland, Inc.

Texas Industries Foundation1341 W. Mockingbird Lane, Ste 700

Dallas, TX 75247

Attn: Scholarship Coordinator

972-947-6700

Estimated balance of fund $1,900.00

Dependents of employees of Texas Industries, Inc.

Wal-Mart Foundation702 S.W. 8^th Street

Bentonville, AR 72716

Attn: Scott Jackson

501-273-6878

Estimated balance in fund $10,000,000

High - $6,000, Low - $1,000

Children of employees of Wal-Mart and high school employees of Wal-Mart Stores.

Walton Family Foundation, Inc.P.O. Box 2030

Bentonville, AR 72712

Attn: Brenda Dean

501-277-1905

Estimated balance in fund $500,000,000

Children of Wal-Mart employees who are high school seniors who demonstrate high academic achievement.

Weiss Education Foundation14380 M.W. Science Park Drive

Portland, OR 97229

Attn: Admissions Committee

503-650-5600

Estimated balance in fund $280,000.00

High - $11.000, Low - $1,500

Children of Weiss Scientific Glass Blowing Company.

The H.O. West Foundation101 Gordon Drive

Exton, PA 19341

Attn: George Bennyhoff

610-594-2900

Estimated balance of fund $300,000

High - $2,000, Low - $300

Only for dependents of employees of The West Company, Inc.

Whirlpool Foundation2000 N. M-63

Benton Harbor, MI 49022

Attn: Jay Van Den Berg

616-923-5580

Estimated balance in fund $ 21,000,000.00

Scholarships to children of employees of the Whirlpool Corporation.

General WelfareThe Clara Abbott Foundation

200 Abbott Park Road, D579, Bldg J37

Abbott Park, IL 60064

Attn: Barry Wojtak

Estimated balance in fund $300,000,000.00

Relief grants, loans, and aid for the aged and economically disadvantaged of children of employees and retirees who have worked at Abbott Laboratories for at least one year.

Burlington Industries Foundation3330 W. Friendly Ave.

P.O. Box 21207

Greensboro, NC 27420

Attn: Park Davidson

336-379-2515

Estimated balance of fund $3,000,000.00

High - $2,000, Low - $300

Emergency aid for disaster relief to employees of Burlington Industries and their families

A.P. Giannini Foundation for Employeesc/o Bank of America, Trust Dept.

P.O. Box 513189 GMF

Los Angeles, CA 90051

Attn: Personnel Department

Estimated balance of fund $1,000,000.00

High - $3,000, Low - $150

Relief assistance to employees and their families of the Bank of America and its subsidiaries for medical bills or other emergencies.

Hall Family Foundationc/o Charitable & Crown Investment

P.O. Box 419580

Kansas City, MO 64141

Attn: Jeanne Bates

816-274-8516

Estimated balance in fund $950,000,000.00

High - $2,250.00

Low - $750.00

Emergency relief assistance only for employees of Hallmark Cards, Inc.

Walgreen Benefit Fund200 Wilmot Road

Deerfield, IL 60015

Attn: Edward King

Estimated balance in fund $19,000,000.00

High - $16,000.00

Low - $50.00

Welfare assistance to financially needy Walgreen employees and their families.

 

 

Individual & Small Business Grant Funding Sources

CALHOUN COUNTY COMMUNITY FOUNDATIONPO Box 1826

Anniston, AL 36202

STOCKHAM FOUNDATIONPOB 10326

Birmingham AL 35202

COMMUNITY FOUNDATION OF SEALPO Box 1422

Dothan AL 36302

THEIS MEMORIAL TRUST400 Essex Drive

Sierra Vista AZ 85635

THE ARIZONA COMMUNITY FOUNDATION2122 E. Highland Ave Ste 400

Phoenix AZ 85016

COMMUNITY FOUNDATION2250 E Broadway Blvd

Tucson AZ 85719

LYON FOUNDATIONPOB 5308

N. Little Rock AR 72119

ARKANSAS COMMUNITY FOUNDATION700 Rock St

Little Rock AR 72202

REST HAVEN8861-C Balboa Ave.

San Diego CA 92123

SHUNAMMITE FOUNDATION115 Moore Crook Rd

Santa Cruz CA 95060

BARNES FOUNDATION200 Helen Ct.

Santa Cruz CA 95065

NEW HORIZONS FUND600 Flower st.#1222

Los Angeles CA 90017

McMILAN FOUNDATION325 Belleville Ave.

Brewton AL 36426

COMMUNITY FOUNDATION GREATER B2027 1st Ave. N Ste. 401

Birmingham AL 35203

WALKER AREA COMMUNITY FOUNDATIONPOB 581

Jasper AL 35502

PRECIOUS THOUGHTSPOB 11860

Tucson AZ 85734

WOMEN’S FOUNDATION OF SOUTHER3610 N. Prince Village PI unit 100

Tucson AZ 85719

DOUGHERTY FOUNDATION3507 N. Central Ave. #404

Phoenix AZ 85012

ARKANSAS RESETTLEMENTPOB 1437

Little Rock AR 72203

UNION COUNTY COMMUNITY FOUNDATIONPO Box 148

El Dorado AR 71731

ITIALIAN-AMERICAN COMM. SERVICE678 Green St.

San Francisco CA 94133

N. VALLEY COMMUNITY FOUND.389 Connors Ct.#B4

Chico CA 95926

ALL CULTURE5250 Santa Monica Blvd.

Los Angeles CA 90029

MIDDLETON FOUNDATION409 First Atlanta Bank Bldg

Mobile AL 36602

CENTRAL ALABAMA COMMUNITY FOUND.PO Box 11587

Montgomery AL 36111

COMMUNITY FOUNDATION SOUTH PO Box 990

Mobile AL 36601

HAZELTON TRUSTPOB 53436

Phoenix AZ 85072

MULBERGER FOUNDATION702 E. Osborn

Phoenix AZ 85012

NORTHWEST ARKANSAS COMMUNITYPOB 207

Springdale AR 72765

ARKANSAS HUMAN DEVELOPMENT COM.300 Sout psping st. #800

Little Rock AR 72201

KERN COUNTY COMMUNITY FOUND.1626 19th Street, .Ste 18

Bakersfield CA 93301

AUBURN COMMUNITY FOUNDATIONPOB 511

Auburn CA 95604

ANAHEIM COMMUNITY FOUNDATION200 S. Anaheim Blvd. #433

Anaheim CA 92805

THE HUMBOLDT AREA FOUNDATIONPOB 99

Bayside CA 95524

THE CLAREMONT COMMUNITY FOUNDATION205 Yale Ave.

Claremont CA 91711

VENTURA COUNTY COMMUNITY FOUNDATION1317 Del Norte Rd., Ste. 150

Camarillo CA 93010

STREAMS IN THE DESSERT FOUNDATION15030 Genesee Rd.

Apple Valley CA 92307

BERKELEY COMMUNITY FUND2320 Shattuck Ave. #A

Berkeley CA 94704

BURKS CHARITABLE TRUST3444 E. Shields Ave.

Fresno CA 93726

MARIN COMMUNITY FOUNDATION17 E. Sir Francis Drake Blvd. Ste 200

Larkspur CA 94939

HOEFER FOUNDATION30 Aster Ave.

Hillsborough CA 94010

ORANGE COUNTY COMMUNITY FOUNDATION2081 Business Center Dr. Ste 100

Irvine CA 92612

GLENDALE COMMUNITY FOUNDATIONPOB 313

Glendale CA 91209

CROCKETT COMMUNITY FOUNDATION720 2nd Ave.

Crockett CA 94525

CALIFORNIA COMMUNITY FOUNDATION445 S. Figueroa St. Ste. 3400

Los Angeles CA 90071

FRESNO REGIONAL FOUNDATION3425 N. 1st St. Ste. 101

Fresno CA 93726

LOS ALTOS COMMUNITY FOUNDATION183 Hillview Ave.

Los Altos CA 94022

COASTAL COMMUNITY FOUNDATION204 N. El Camino Real # E-127

Encinitas CA 92024

THE SAN DIEGO FOUNDATION1420 Kettner Blvd. Ste. 500

San Diego CA 92101

LADIES OF THE GRAND ARMY1500 Grant Ave.

Novato CA 94945

RANCHO SANTA FE FOUNDATIONPOB 811

Rancho Santa Fe CA 92067

PARADISE COMMUNITY FOUNDATIONPOB 2095

Paradise CA 95967

COMMUNITY FOUNDATION FOR MON99Pacific St. Ste.155A

Monterey CA 93940

PASADENA FOUNDATION16 N. Marengo Ave. Ste. 300

Pasadena CA 91101

COMMUNITY FOUNDATION OF THE N433 Soscol Ave. Ste. B151

Napa CA 94599

EAST BAY COMMUNITY FOUNDATION501 Wickson Ave.

Oakland CA 94610

SHASTA REGIONAL COMMUNITY FOUNDATION2280 Benton Dr. Ste. A

Redding CA 96003

EL DORADO COMMUNITY FOUNDATIONPOB 1388

Placerville CA 95667

AVERY-FULLER-WELCH CHILDRENS FOUNDATION500 Sutter St #400

San Francisco CA 94102

BABCOCK MEMORIAL ENDOWMENT305 Anselmo Ave. #219

San Anselmo CA 94960

THE COMMUNITY FOUNDATION3800 Orange St. Ste.230

Riverside CA 92501

PORENTA FOUNDATION485 Seaport Ct.

Redwood City CA 94063

MARGUERITE HOME ASSOC.555 Capitol Mall #200

Sacramento CA 95814

SACRAMENTO REGIONAL FOUNDATION555 Capitol Mall Ste. 710

Sacramento CA 95814

CURTIS TRUST401 South College

Fort Collins CA 80522

McCLENNAN FUND1750 New York Ave.

Washington DC 20006

EL-MAHDAWY FOUNDATION4421 SW 85th Way

Gainesville FL 32608

COM. FOUND. FOR GREATER ATLANTIC 50 Hurt Plaza #449

Atlanta GA 30303

CENTRAL SAVANNAH AREA RIVER CPOB 31358

Augusta GA 30903

THE SAVANNAH FOUNDATION, INC428 Bull Street

Savannah GA 31401

THE GWINNETT FOUNDATION INC6500 Sugarloaf Parkway #220

Duluth GA 30097

HAWAII COMMUNITY FOUNDATION222 Merchant St.

Honolulu HI 96813

MARGARET W.POB A

Coeur D’ Alene ID 83814

COSSEV FOUNDATIONPOB 2833

Boise ID 83700

THE CHICAGO COMMUNITY TRUST222 N La Salle St Ste 1400

Chicago IL 60601

SHEFTAL & MIRRIAM FOUNDATIONPOB 5850

Denver CO 80217

EAGLES MEMORIAL FOUNDATION4710 14th st W

Bradenton FL 34207

RYAN FOUNDATION207 State 434 # A

Winter Springs FL 32705

BAKER FOUNDATIONPOB 4956 MC-678

Atlanta GA 30302

BURKE FOUNDATION182 Riley Ave. #8

Macon GA 31204

COM. FOUND. OF NORTHWEST GEORGIAPOB 942

Dalton GA 30722

COM. FOUNDATION OF CENTRAL GEORGIA277 MLK JR Blvd., #303

Macon GA 31201

HUGHES TRUSTPOB 3170

Honolulu HI 96802

ROUCH BOYS FOUNDATIONPOB 7

Twin Falls ID 83303

KNUDSEN FOUNDATIONPOB 736

Boise ID 83729

READE FUNDPOB 755

Chicago IL 60690

ROSS FOUNDATION1101 Pennsylvania Ave. #3rd C/S A

Washington DC 20004

DUPONT FOUNDATIONPOB 1380

Jacksonville FL 32201

PINE MOUNTAIN BENEFICIAL FOUND.POB 2301

Columbus GA 31902

SAVANNAH WINDOWS SOCIETYPOB 30156

Savannah GA 31410

NORTH GEORGIA COMMUNITY FOUNDATIONPOB 1583

Gainesville GA 30503

COM. FOUND. OF SOUTHWEST GEORGIAPOB 2654

Thomasville GA 31799

CHATTAHOOCHEE VALLEY COM. FOUNDATIONPOB 1620

Columbus GA 31902

IDAHO COMMUNITY FOUNDATION210 W State St

Boise ID 83702

CALDWELL COMMUNITY FOUNDATIONPOB 1358

Caldwell ID 83606

THE AURORA FOUNDATION111 W Downer Pl Ste 312

Aurora IL 60506

CHARLESTON AREA CHARITABLE FOUNDATIONPOB 677

Charleston IL 61920

CROWN POINT COMMUNITY FOUNDATIONPOB 522

Crown Point IN 46308

SCHENK TRUST111 Monument Circle #1501

Indianapolis IN 46277

LEVIN TRUST515 Franklin Sq c/o First Citizen

Michigan City IN 47250

THE COMMUNITY FOUNDATION OF HOWARD COUN202 N Main St.

Kokomo IN 46901

THE PUTNAM COUNTY FOUNDATIONPOB 514

Greencastle IN 46135

COMMUNITY FOUNDATION OF GRANT COUNTY, IN,505 W. 3rd St.

Marion IN 46952

ELKHART COUNTY COMMUNITY FOUNDATIONPOB 279

Elkhart IN 46515

DUBOIS COUNTY COMMUNITY FOUNDATIONPOB 269

Jasper IN 47547

NORTHERN INDIANA COMMUNITY FOUNDATIONPOB 441

Logansport IN 46947

SMOCK FOUNDATIONPOB 2383

FORT WAYNE IN 46801

SWISS BENEVOLENTPOB 2137

Chicago IL 60690

GREATER LAFAYETTE COMMUNITY FOUNDATIONPOB 225

Lafayette IN 47902

LEGACY FOUNDATION, INC1000 E. 80th Pl #420

Merrillville IN 46410

ADAMS COUNTY COMMUNITY FOUNDATION313 W. Jefferson St. Rm 303

Decatur IN 46733

HERITAGE FUND OF HUNTINGTON POB 5037

Huntington IN 46750

NOBLE COUNTY COMMUNITY FOUNDATION1599 Lincolnway S

Ligonier IN 46767

GREATER JOHNSON COUNTY COMMUNITY FOUNDATIONPOB 217

Franklin IN 46131

CENTRAL INDIANA COMMUNITY FOUNDATION615 N. Alabama St. Ste. 119

Indianapolis In 46204

FORT WAYNE COMMUNITY FOUNDATION701 S. Clinton St. Ste. 324

Fort Wayne IN 46802

HIGGINS TRUST FOR AVELENA FOUNDATION111 Monument Circle #1501

Indianapolis IN 46277

UNION COUNTY FOUNDATION INC404 Eaton St.

Liberty IN 47353

COMMUNITY FOUNDATION OF CHAMPAIGN404 W Church St

Champaign IL 61820

COMMUNITY FOUNDATION ALLIANCE123 NW. 4th St. Ste. 322

Evansville IN 47708

COMMUNITY FOUNDATION MADISON & JEFFERSONPOB 306

Madison IN 47250

HANCOCK COUNTY COMMUNITY FOUNDATION312 E. Main St.

Greenfield IN 46140

CENTRAL INDIANA COMMUNITY FOUNDATION615 N. Alabama St. Ste. 119

Indianapolis IN 46204

DECATUR COUNTY COMMUNITY FOUNDATIONPOB 72

Greensburg IN 47240

DEARBORN COUNTY COMMUNITY FOUNDATIONPOB 292

Lawrenceburg IN 47025

THE HUNTINGBURG FOUNDATION309 N. Geiger St.

Huntingburg IN 47542

AVALINE TRUST FOUNDATION 111 Monument Circle #1501

Indianapolis IN 46277

BLACKFORD COUNTY COMMUNITY FOUNDATIONPOB 711

Hartford City IN 47348

LAGRANGE COUNTY COMMUNITY FOUNDATION109 E. Central Ave. #3

Lagrange IN 46761

THE CLARINDA FOUNDATIONPOB 273

Clarinda IA 51632

WAVERLY COMMUNITY FOUNDATONPOB 58

Waverly IA 50677

THE GREATER JEFFERSON COUNTY FOUNDATIONPOB 1325

Fairfield IA 52556

SOUTH CENTRAL IOWA COMMUNITYPOB 38

Osceola IA 50213

COMMUNITY FOUNDATION111 E. 3rd St. Ste. 710

Davenport IA 52801

HUTCHINSON COMMUNITY FOUNDATIONPOB 298

Hutchinson KS 67504

THE ABILENE COMMUNITY FOUNDATIONPOB 735

Abilene KS 67410

SOUTH CENTRAL COMMUNITY FOUNDATION348 NE State Road 61

Pratt KS 67124

HOMAN MEMORIAL TRUST FUNDPOB 80

Lawrenceburg KY 40342

K.Y. HOUSING CORP.1231 Louisville Road

Frankfort KY 40601

GEOFFREY FOUNDATIONPOB 1112

Kennebunkport ME 04046

COMMUNITY FOUNDATION OF THE EASTERN SHOPOB 152

Salisbury MD 21803

SIOUXLAND COMMUNITY FOUNDATIONPOB 2014

Sioux City IA 51104

GREATER DECORAH AREA COMMUNITY FOUNDATIONPOB 43

Decorah IA 52101

COMMUNITY FOUNDATIONPOB 1176

Waterloo IA 50704

MAGNUS HOME500 Cedar St.

Muscatine IA 52761

HUMAN AID SOCIETY400 First Interstate Blvd.

Des Moines IA 50309

JONES FOUNDATION527 Commercial St. #515

Emporia KS 66801

WESTERN KANSAS COMMUNITY FOUNDATIONPOB 1452

Garden City KS 67846

NEWTON COMMUNITY & HEALTHCAREPOB 548

Newton KS 67114

THE COMMUNITY FOUNDATION OF L325 W. Main St. Ste. 1110

Louisville KY 40202

FOUNDATION FOR THE TRI-STATE COPOB 2096

Ashland KY 41105

WEINGLASS FOUNDATION2 Hopkins Plaza #802

Baltimore MD 21201

EATON FUND766 Old Hammonds Ferry Rd.

Linthicum MD 21090

PELLA COMMUNITY FOUNDATIONPOB 112

Pella IA 50219

MAQUOKETA AREA FOUNDATIONPOB 795

Maquoketa IA 52060

THE GREATER DES MOINES FOUNDATIONPOB 7271

Des Moines IA 50309

GREATER POWESHIEK COMMUNITY FOUNDATION1010 Main St.

Grinnell IA 50112

SIDWELL TRUSTPOB 754

Winfield KS 67114

COMMUNITY FOUDATION OF SW KANSASPOB 1313

Dodge City KS 67801

MALLORY-TAYLOR FOUNDATIONPOB 229

Lagrange KY 40031

THE BLUE GRASS COMMUNITY FOUNDATION200 W. Vine St. #305

Lexington KY 40507

P.H.P. INCPOB 319

Hopkinsville KY 42240

FLEISHER-JACOBSON FOUNDATIONPOB 5658

Baltimore MD 21210

MONTGOMERY COUNTY COMM. FOUNDATIONPOB 5465

Silver Spring MD 20913

PIERCE TRUST225 Franklin St. #M-3

Boston MA 02101

BRIDGEPORT CHARITABLE TRUST4 Dennett Rd.

Marblehead MA 01945

HUNTINGTON FUND25 Research Dr.

Westborough MA 01582

THE KIRKSIDE5 Adams St.

Westboro MA 01581

PILGRIM FOUNDATIONPOB 3400

Brocton MA 02040

CROSSROADS COMMUNITY FOUNDATION20 Main St. #301

Natick MA 01760

HOWARD BENEVOLENT SOCIETY14 Beacon St. #804

Boston MA 02108

PERPETUAL BENEVOLENT FUND39 Main St.

Watertown MA 02172

MASS CHARITABLE FIRE SOCIETY79 Milk St.

Boston MA 02109

OLD COLONY CHARITABLE FOUNDATIONPOB 9477

Boston MA 02108

BROOKLINE COMMUNITY FUND40 Webster Place

Brookline MA 02146

SOUTH SHORE & NEPONSET VALLEY430 Adams St.

Quincy MA 02169

LEND A HAND SOCIETY34 Beecon St.

Boston MA 02108

HOWLAND FUND1061 Pleasant St.

New Bedford MA 01101

QUOGUE COMMUNITY FOUNDATION585 Rutland St. C/O John Post

Carlisle MA 01741

BOSTON FATHERLESS & WIDOWS 2200 Exchange Place

Boston MA 02109

GREATER WORCESTER COMMUNITY FOUNDATION44 Front St. #530

Worcester MA 01608

HOWARD BENEVOLENT SOCIETYPOB 9

Newburyport MA 01950

BOSTON FOUNDATIONOne Boston Place #2400

Boston MA 02108

GREATER LOWELL COMMUNITY FOUNDATION169 Merrimack St. #500

Lowell MA 01852

SALEM CHARITABLE SOCIETY175 Federal St.

Boston MA 02110

MERRIMACK VALLEY COMMUNITY FOUNDATION305 Essex St. #400

Lawrence MA 01840

DEVENS TRUST C/O RICE,HEARD & B50 Congress St. #1025

Boston MA 02109

DAVENPORT CHARITABLE TRUST C/O1Monarch Place MASPM21TRU

Springfield MA 02568

COMMUNITY FOUNDATION OF WESTERN M.A.1500 Main ST.

Springfield MA 01115

BERKSHIRE TACONIC COMMUNITY FOUNDATION271 Main St.

Great Barrington MA 01230

PERMANENT ENDOWMENT FOR MARTPOB 1356

Vineyard Haven MA 02568

CAMBRIDGE COMMUNITY FOUNDATION 99 Bishop Allen Dr.

Cambridge MA 02139

WOODS HOLE FOUNDATONPOB 603

Woods Hole MA 02543

COMMUNITY FOUNDATON OF SOUTHEASTERN227 Union St. #609

New Bedford MA 02740

ESSEX COUNTY COMUNITY FOUNDATON49 Salem Rd.

Topsfield MA 01983

BENNET MEMORIAL CORPORATON100 Bertwell Rd.

Lexington MA 02420

ROBBINS TRUSTPOB 351 M-10

Boston MA 02101

MIDLAND AREA COMMUNITY FOUNDATIONPOB 289

Midland MI 48640

SAGINAW COMMUNITY FOUNDATION100 S Jefferson Ave. FL 501

Saginaw MI 48607

KEWEENAW COMMUNITY FOUNDATIONPOB 101

Houghton MI 49931

DICKINSON AREA COMMUNITY FOUNDATION427 S. Stephenson Ave. #207

Iron Mountain MI 49801

COMMUNITY FOUNDATION OF GREATER RPOB 80431

Rochester MI 48308

MARQUETTE COMMUNITY FOUNDATION129 W. Baraga Ave. Ste. D

Marquette MI 49855

ALGER REGIONAL COMMUNITY FOUNDATIONPOB 39

Munising MI 49862

HILLSDALE COUNTY COMMUNITY FOUNDATIONPOB 276

Hillsdale MI 49242

MANISTEE COUNTY FOUNDATIONPOB 31

Manistee MI 49660

KALAMAZOO COMMUNITY FOUNDATION151 S Rose St. Ste. 332

Kalamazoo MI 49007

FOUR COUNTY COMMUNITY FOUNDATION210 N Rawles St.

Romeo MI 48065

GRATIOT COUNTY COMMUNITY FOUNDATION POB 310

Ithaca MI 48847

ANCHOR BAY COMMUNITY FOUNDATION 51066 Washington St.

New Baltimore MI 49770

LIVONIA COMMUNITY FOUNDATION32900 5 mile Rd.

Livonia MI 48154

JACKSON COUNTY COMMUNITY FOUNDATION230 W Michigan Ave.

Jackson MI 49201

COMMUNITY FOUNDATION OF ST. CLAIR C516 McMorran Blvd.

Port Huron MI 48060

BARAGA COUNTY COMMUNITY FOUNDATIONPOB 352

L’anse MI 49446

NORTHVILLE TOWNSHIP CENTENNIA321 N. Center St.

Northville MI 48167

MACKINAC ISLAND COMMUNITY FOUNDATIONPOB 1933

Mackinac Island MI 49757

MARSHALL COMMUNITY FOUNDATION126 W Michigan Ave. Frnt. 202

Marshall MI 49068

PETOSKEY-HARBOR SPRINGS AREA C616 Petoskey St. Ste. 100

Petoskey MI 49770

M&M AREA COMMUNITY FOUNDATIONPOB 846

Menominee MI 49858

COMMUNITY FOUNDATION MUSKEGON CO425 W Western Ave. Ste. 200

Muskegon MI 49440

CAPITAL REGION COMMUNITY FOUNDATION6035 Executive Dr. Ste. 104

Lansing MI 48911

COMMUNITY FOUNDATION OF MONROEPOB 627

Monroe MI 48161

BARSTOW FOUNDATION333 East Main St.

Midland MI 48640

COMMUNITY FOUNDATION HOLLAND/ZEELAND AR1 W 8th St.

Holland MI 49423

LEELANAU TOWNSHIP FOUNDATIONPOB 818

Northport MI 49670

SCHOOLCRAFT COUNTY COMMUNITY POB 452

Manistique MI 49854

MT. PLEASANT AREA COMMUNITY FOUNDATION1651 S. Bamber Rd.

Mount Pleasant MI 48858

OWEN FOUNDATIONPOB 1366

Columbus MS 39703

GULF COAST COMMUNITY FOUNDATIONPOB 1899

Gulfport MS 39502

COMMUNITY FOUNDATIONPOB 5778

Meridian MS 39302

CHRISTIS EVANGELICAL OUTREASCHRR 1 Box 81

Turney MO 64493

CALKINS BOARD14 West 10th St. C/O First Nation

Kansas City MO 64105

INDEPENDENCE COMMUNITY FOUNDATION300 N. Osage St.

Independence MO 64050

THE COMMUNITY FOUNDATION OF THE LOWER FLPOB 379

Pablo MT 59855

HARTINGTON COMMUNITY FOUNDATION229 N. Broadway Ave.

Hartington NE 68739

PHELPS COUNTY COMMUNITY FOUNDATION701 4th Ave. Apt. 2A

Holdrege NE 68949

MERRICK FOUNDATON, INCPOB 206

Central City NE 68826

NEBRASKA COMMUNITY FOUNDATION 317 S. 12th St. Ste. 200

Lincoln NE 68508

PHILLIPS FOUNDATIONPOB 471

Columbus MS 39703

CREATE FOUNDATIONPOB 1053

Tupelo MS 38802

LAKE FOUNDATIONPOB 1200

Jackson MS 39215

SEDALIA AREA COMMUNITY FOUNDATION113 E. 4th St.

Sedalia MO 64105

ST. LOUIS COMMUNITY FOUNDATION319 N. 4th St. Ste. 501

Saint Louis MO 63102

GODS LOVE INC533 North Main St.

Helena MT 59601

HAMILTON COMMUNITY FOUNDATIONPOB 283

Aurora NE 68818

LINCOLN COMMUNITY FOUNDATON215 Centennial Mall S. Ste. 200

Lincoln NE 68508

LEXINGTON COMMUNITY FOUNDATIONPOB 422

Lexington NE 68850

FREMONT AREA COMMUNITY FOUNDATION605 N. Broad St. #182

Fremont NE 68025

LOWNDES COMMUNITY FOUNDATIONPOB 1016

Columbus MS 39703

GREATER JACKSON FOUNDATION4500 I-55 North #258

Jackson MS 3921

PRESCIOUS MOMENTSPOB 802

Carthage MO 64836

COMMUNITY FOUNDATION OF THE O901 E. Saint Louis St. Ste. 701

Springfield MO 65806

THE GREATER KANSAS CITY COMMUNITY FOUNDATION1055 Broadway St. Ste. 130

Kansas City MO 64105

MONTANA COMMUNITY FOUNDATION101 N. Last Chance Gulch St. Ste. 211

Helena MT 59601

LA VISTA COMMUNITY FOUNDATION8116 Park View Blvd.

La Vista NE 68128

GRAND ISLAND COMMUNITY FOUNDATIONPOB 430

Grand Island NE 68802

HASTINGS COMMUNITY FOUNDATIONPOB 703

Hastings NE 68902

KEARNEY AREA COMMUNITY FOUNDATIONPOB 607

Kearney NE 68848

STEARNS BLODGETT TRUSTPOB 30100

Reno NV 89520

PRO DEO GUILDPOB 304

Hartsdale NY 10530

FARMERS FOUNDATION225 West 106th St.

New York NY 10025

JOSHUA FOUNDATION8 Leesome Lane

Aftamont NY 12009

CHESED FUND1650 56th St.

Brooklyn NY 11204

OSTHERG FOUNDATION225 Park Ave. S

New York NY 10003

NURSES HOME350 Hudson St.

New York NY 11014

ONTARIO CHILDRENS HOME210 W Gibson St.

Canandaigua NY 14424

SOCIETY OF KASTORIANS246 8th Ave.

New York NY 10011

MALLON MEMORIAL FOUNDATIONThe Knoll Gipsey Trail Rd.

Carmel NY 10512

CARNEGIE CORPORATION437 Madison Ave.

New York NY 10022

FOUNDATION OF THE ALUMNAEOne Levy Place

New York NY 10029

PRUDEN FOUNDATION30 Maple St.

Summitt NJ 07901

BAGBY FOUNDATION501 5th Ave.

New York NY 10017

BALDWIN FOUNDATION176 Third St.

Troy NY 12180

WELFARE TRUSTOne Wall St. C/O of Bank of N.Y.

New York NY 10286

FORD FOUNDATION 320 E. 43rd St.

New York NY 10017

NEW YORK SOCIETY521 5th Ave. C/O Davies and Davie

New York NY 10175

GREATER BROOME COMMUNITY FOUNDATION300 Security Mutual Bldg.

Binghampton NY 13901

CHAUTAUQUA REGION COMMUNITY FOUNDATION418 Spring St.

Jamestown NY 14701

N. CHAUTAUQUA COMMUNITY FOUNDATION212 Lake Shore Dr.

Dunkirk NY 14048

BROWN TRUST B1211 Ave of the Americas

#34th F

New York NY 10036

HEBREW BENEVOLENT SOCIETY 787 Delaware Ave.

Buffalo NY 14209

YOUNAN FOUNDATION1145 Bordentown Ave.

Parlin NJ 08859

ROCHESTER CHARITABLE SOCIETYPOB 1412

Rochester NY 14603

ADAMS MEMORIAL FUND603 Third Ave. #23rd Fl

New York NY 10036

COMMUNITY FOUNDATIONOF GREATER BUFFALO712 Main St.

Buffalo NY 14202

PHYSICIANS FUND115 East 61st Street

New York NY 10021

GLEN FALLS FOUNDATIONPOB 318

Glen Falls NY 12801

COOPERSTOWN COMMUNITY FOUNDATION9 Westridge Rd.

Cooperstown NY 13326

ROCHESTER AREA COMMUNITY FOUNDATION500 East Ave.

Rochester NY 14607

NEW YORK COMMUNITY TRUST2 Park Ave. #2400

New York NY 10016

COMMUNITY FOUNDATION OF THE ELMIRA-COR307-B East Water St.

Elmira NY 14901

LONG ISLAND COMMUNITY FOUNDATION 1740 Old Hericho Turnpike

Jericho NY 11753

MOUNT MORIAH BENEVOLENT FUND114 W. James St.

Falconer NY 14733

SCHOELLKOPF FUNDPOB 22900

Rochester NY 14101

DANFORTH MEMORIAL FUND8 Fremont St.

Gloversville NY 12078

BROCKAWAY FOUNDATIONC/O Key Bank

25 South Main St.

Homer NY 13077

MacKINNON FUND245 Main St.

Oneonta NY 13820

GAFFNEY FOUNDATIONPOB 1446

Williston ND 58802

GOSSENS TRUST POB 10032

Toledo OH 43604

MOTRY MEMORIAL FUNDPOB 357

Sandusky OH 44870

TULSA COMMUNITY FOUNDATION7010 S. Yale Ave. Ste. 110

Tulsa OK 74136

BEATTY TRUSTPOB 514

Blackwell OK 74631

JOHNSON EDUCATION AND BEN. TRUST622 NE 19th St.

OKC OK 73105

McCOMAS FOUNDATION POB 3168

Portland OR 97208

COMMUNITY FOUNDATION OF DUTCHESS COUNTY80 Washington St. #201

Pooughkeepsie NY 12601

BROADCASTERS FOUNDATION320 West 57th St.

New York NY 10019

SUSSMAN TRUST POB 1374 Trainsmeadow Station

Flusihg NY 11370

HUTCHINS FOUNDATION45 John St.

NYC NY 10038

ADIRONDACK COMMUNITY TRUSTCrestview Plaza C/O J.S. Lansing

Lake Placid NY 12946

MANSFIELD FUNDC/O Fifth Third Bank Dept. 00858

Cincinnati OH 45263

NICHOLL MEMORIAL FUND235 W. Schrock C/O Bank One

Westerville OH 43081

BROKEN ARROW COMMUNITY FOUNDATIONPOB 2772

Broken Arrow OK 74013

OKLAHOMA CITY COMMUNITY FOUNDATIONPOB 1146

Oklahoma City OK 73101

NEWBURG COMMUNITY FOUNDATION POB 956

Newburg OR 97132

FISCHER FOUNDATION1001 SW 5TH St. #1550

Portland OR 97204

MAINZER MEMORIAL FOUNDATION129 E. 73rd St.

New York NY 10021

BETHESDA FOUNDATION 396 Cleveland Ave.

Hornell NY 14843

HAVENS RELIEF SOCIETY105 East 22nd ST. #908

New York NY 10010

COMMUNITY FOUNDATION OF ORANGE COUNTYPOB 56

Goshen NY 10924

NEEDLES TRUST FUNDFirst Union Bldg. CHG-1161

Charlotte NC 28288

GREAT COMMISSION FUND10454 County Road 128

Findlay OH 45840

FORD FUNDPOB 10099

Toledo OH 43699

CHASE CHISITIAN CHARITY TRUST2312 N. Brookline

OKC OK 73107

THE NORMAN COMMUNITY FOUNDATION210 E. Main St. Ste. 204

Norman OK 73069

SALEM FOUNDATION1099 Commercial St. NE

Salem OR 97301

BENTON COUNTY FOUNDATIONPOB 911

Corvallis OR 97339

PHILOMATH COMMUNITY FOUNDATIONPOB 1000

Philomath OR 97370

WESTERN LANE COMMUNITY FOUNDATIONPOB 1589

Florence OR 97439

CLARKE ENDOWMENT FUNDPOB 3168

Portland OR 97208

BLAISDELL FOUNDATION410 Seneca Bldg.

Bradford PA 16701

BLAIR COUNTY COMMUNITY ENDOWMENT1216 11th Ave. #315

Altoona PA 16601

EMPORIUM FOUNDATION4th & Broad St. C/P Bucktail B

Emporium PA 15834

RHODE ISLAND FOUNDATIONOne Union Station

Providence RI 02903

HILTON HEAD ISLAND FOUNDATION4 Northridge Drive #A

Hilton Head SC 29302

COMMUNITY FOUNDATION COASTAL SOUT.90 Mary St.

Charleston SC 29403

COMMUNITY FOUNDATION OF GREATER G27 Cleveland St. #101

Greenville SC 29601

COMMUNITY FOUNDATION OF MIDDL210 23rd Ave. N

Nashville TN 37203

COMMUNITY FOUNDATION OF GREAT1900 Union Ave.

Memphis TN 38104

THE OREGON COMMUNITY FOUNDATION111 SW 5th Ave. Ste. 3600

Portland OR 97204

FRENCH BENEVOLENT SOCIETYBroad & Walnut STS C/O First

Philadelphia PA 19109

ERIE COMMUNITY FOUNDATION127 W. 6th St.

Erie PA 16501

LEHIGH VALLEY COMMUNITY FOUNDATION961 Marcon Blvd. #300

Allentown PA 18103

EDGEFIELD COUNTY FOUNDATION301 Buncombe St.

Edgefield SC 29824

WACCAMAW COMMUNITY FOUNDATIONPOB 370

Myrtle Beach SC 29578

GRAHAM FUNDPOB 533

Bennettsville SC 29512

QUARTER CENTURY FUND6400 Poplar Ave.

Memphis TN 38197

LAZARUS FOUNDATION501 5th St.

Bristol TN 37620

STOVE FOUNDATION POB 307

Ashland City TN 37015

HURLBUT MEMORIAL FUND701 Market St. C/O First Tennessee

Chattanooga TN 37401

MILTON-FREEWATER AREA FOUNDATIONPOB 50

Milton Freewater OR 97862

BUCKS COUNTY FOUNDATION60 E. Court St. C/O Eastburn

Doylestown PA 18901

BEAVER COUNTY FOUNDATIONPOB 569

Beaver PA 15009

PRESSER FOUNDATIONPresser Place

Bryn Mawr PA 19010

RELIEF SOCIETY 19 Guerard Rd

Charleston SC 28407

THE SPARTANBURG COUNTY FOUNDATION320 E. Main St.

Spartanburg SC 29302

CENTRAL CAROLINA COMMUNITY FOUNDATIONPOB 11222

Columbia SC 29211

EAST TENNESSEE FOUNDATION550 W. Main St. Ste. 550

Knoxville TN 37902

COMMUNITY FOUNDATION OF OBION1104 Sherwood Dr.

Union City TN 38261

COMMUNITY FOUNDATION OF GREATER CHATTANOOGA1270 Market St.

Chattanooga TN 37402

HAMMILL FOUNDATION8700 Shoal Creek Blvd.

Austin TX 78757

MATAGODA COUNTY COMMUNITY FOUNDATIONPOB 2005

Bay City TX 77404

COMMUNITY FOUNDATION OF ABILEPOB 1001

Abilene TX 79604

FERGUSON FOUNDATIONPOB 1839

Arlington TX 76010

FLEETWOOD MEMORIAL POB 429

Arlington TX 76004

COPLEY FUND91 Portland St.

Morrisville VT 05661

VIRGINIA BEACH FOUNDATIONPOB 4629

Virginia Beach VA 23454

G.I.V. POB 9

Bastian VA 24382

GREATER LYNCHBURG COMMUNITYPOB 714

Lynchburg VA 24505

ARLINGTON COMMUNITY FOUNDATION2250 Clarendon Blvd. #J

Arlington VA 22201

TROLINGER TRUSTPOB 27385

Richmond VA 23261

DPC COMMUNITY FOUNDATIONPOB 1039

Danville VA 24543

FANT FOUNDATION 9212 Katy Freeway #161

Houston TX 77024

COMMUNITY FOUNDATIONPOB 2392

Angleton TX 77516

AUSTIN COMMUNITY FOUNDATIONPOB 5159

Austin TX 78763

SPARKS FOUNDATION1303 Booth Lane

Alvin TX 77511

DIALYSIS RESEARCH FOUNDATION5575 S. 500 East

Ogden UT 84405

ROBERTS TRUST828 Main St. C/O Fidelity Bank Trust

Lynchburg VA 23225

HARRISON & CONRAD TRUSTPOB 26903

Richmond VA 23261

COMMUNITY FOUNDATION SERVING7325 Beaufort Springs Dr. #210

Richmond VA 23225

BEDFORD COMMUNITY HEALTH FOUNDATIONPOB 1104

Bedford VA 24523

CHARLOTTESVILLE - ALBERMARLE FOUNDATIONPOB 1767

Charlottsville VA 22902

STAUNTON AUGUSTA WAYNSBORO 1100 W. Broad St.

Waynesboro VA 22980

PEARL VISION2534 Royal Lane

Dallas TX 75229

FERGUSON FOUNDATION601 E. Abram St.

Arlington TX 76010

AMARILLO AREA FOUNDATON, INC801 S. Fillmore St.

Amarillo TX 79101

ARCHER COMMUNITY FOUNDATIONPOB 877

Archer City TX 76351

MORSE FUNDPOB 999

Rutland VT 05702

ST. PAUL HOME1314 Loch Lomond Lane

Richmond VA 23454

PORTSMOUTH COMMUNITY FOUNDATIONPOB 1394

Portsmouth VA 23705

COMMUNITY FOUNDATION OF THE RIPOB 6009

Christiansburg VA 24068

FOUNDATION FOR ROANOKE VALLEYPOB 1159

Roanoke VA 24006

COMMUNITY FOUNDATION OF RAPPAPOB 208

Fredericksburg VA 22404

ST PAULS CHURCH HOME1723 Park Ave.

Richmond VA 23220

JOHNS FOUNDATON1411 Johnson Willis Dr.

Richmond VA 23235

PEGRAM ASSOC.14709 E. 17th Ave. #18

Spokane WA 99037

G.M.I. FOUNDATIONPOB 916

Port Angeles WA 98362

STEVENS POINT AREA FOUNDATIONPOB 968

Stevens Point WI 54481

THE NEW RICHMOND COMMUNITY FOUNDATION1100 Heritage Dr.

New Richmond WI 54017

COMMUNITY FOUNDATION OF SOUTH WOOD POB 444

Wisconsin Rapids WI 54495

WEGAND TRUSTPOB 1308

MILWAUKEE WI 53201

GORGEN FUNDPOB 400

Buffalo WY 82834

THE COMMUNITY FOUNDATION OF JACKSONPOB 574

Jackskon WY 83001

TACOMA FOUNDATIONPOB 1995

Tacoma WA 8401

WHATCOM FOUNDATIONBellingham National Bank #423

Bellingham WA 98225

WATERTOWN AREA COMMUNITY FOUNDATIONPOB 140

Watertown WI 53094

MILWAUKEE COMMUNITY FOUNDATION1020 N. Broadway Ste. 112

Milwaukee WI

WAUSAU AREA COMMUNITY FOUNDATION500 3rd St. Ste. 310

Wausau WI 54403

RACINE COMMUNITY FOUNDATION818 6th #201

Racine WI 53403

CODY MEDICAL FOUNDATION 721 Sheridan Ave.

Cody WY 82414

LAURENDREAU FOUNDATON2700 Iron St.

Bellingham WA 98225

RIDER TRUSTPOB 195

Rosalia WA 99170

COMMUNITY FOUNDATION OF PORTAPOB 968

Stevens Point WI 54481

OSHKOSH COMMUNITY FOUNDATIONPOB 1726

Oshkosh WI 54903

ST. CROIX VALLEY COMMUNITY FOUNDATIONPOB 530

ntsSomerset WI 54025

PERKINS FOUNDATIONPOB 1064

Sheridan WY 82801

 

WYOMING COMMUNITY FOUNDATION221 E. Ivinson Ave. #202

Laramie WY 82070

Copyright YADA Software Corp.1998

YADA is a Trade-Mark Corporation

Grants for General Support.

A.F Williams Fund for Teachers

C/o Citibank, N.A.

1 Court Sq., 22^nd Follr.

Long Island City, NY 11120

Estatement blance in the fund $695,000.00

Hi $10,000,00

Low $5,000.00

Grants for retired teacher emergency support for the state of New York.

Anna Emory Warfield Memorial Fund, Inc.

c/o Anne S. Demuth

P.O. Box 674

Riderwood, Md 21139

410-494-0808

Estatement balance in fund $ 7.3 million

Hi $ 5,500.00

Low $ 395.00

Grants for the elderly and dependent women in Baltimore MD.

Allen B. Puckett, Jr. Family Foundation, Inc.

P.O. Box 7558

Columbus, Ms 39705

Estatement balance in fund $225,000.00

Hi $ 13,000.00

Low $1,000.00

Grants for medical expenses and general support.

Anita Card Montgomery Foundation

20 Mechanic Street.

Camden, ME 04843

Att: Julia Libby.

Estement balance in fund $7,550.00

Hi $ 1,998.00

Low $150.00

Grants for eye care, medical expense, and dental for individuals living in the lRockport, Hope, Lincolnville, and Camden ME, area.

Ambrose Midleton Trust

C/o key Trust Co. of Ohio, N.A.

P.O. Box 94605

Toledo, Oh 43699

614-962-3911

Att: Billy White

Estatement balance in fund $ 15,000.00

Hi $9,985.00

Low $5,000.00

Grants to individuals for clothing, medical, and food. People who live in Morgan County, Oh area.

A.J. Magnus Home

c/o Taylor, Rees & Co.,

500 Cedar Street.

Muscatine, IA 52761

391-263-9466

Estatement balance in fund $1.7 million

Hi $ 40,000.00

Low $10,000.00

Grants for men who live in the county or city of Muscatine IA. That are over 65 years of age and who wish too live in a group home.

 

 

 

To .-Addressee-

.-Address Line 1-

.-Address Line 2-

.-Address Line 3-

 

 

Re: Patient's Name .-Patient's Name-

Patient's Address .-Patient Address Line 1-

.-Patient Address Line 2-

.-Patient Address Line 3-

Date of Birth .-Date of Birth-

 

1. I hereby authorize you to release, disclose and deliver medical information described below regarding the above named patient to .-Release To Name- , .-Release PersonsTitle-.

 

2. You are authorized to release all medical information form your records on the above named patient, .-Patient's Name- .

 

3. This authorization may be revoked by the undersigned at any time by giving written notice to the party authorized herein. Any disclosure made prior to revocation in reliance upon this authorization shall not constitute a breach or rights of confidentiality of the patient. If not earlier revoked, this authorization will automatically expire .-Months to Expire- months from the date of signature.

 

4. The party named above to receive the information is not authorized to make any further release or disclosure of the information received. This authorization does not authorize the release or disclosure or any information except as provided herein. The following notice regarding re-disclosure of substance (drug and alcohol) abuse information must be included with any such information pursuant to this authority, if such disclosure is authorized herein

 

This information has been disclosed to you from records protected by Federal confidentiality rules (42 CFR part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.

 

Medical information may be released as provided in this authorization.

 

 

Date

 

 

 

I,   .-Principal-  , (the "Principal"), an adult person of sound mind and fully understanding the meaning, nature, and effect of this document, hereby freely and voluntarily appoint and designate   .-Agent-  , (the "Agent"), whose address is   .-Agent Address-  , and whose telephone number is   .-Agent Phone #-  , to be my Agent for health and medical care decisions, according to the terms stated in this document.

 

If the person appointed as Agent above is unable, or unwilling, or unduly absent, or not qualified to serve at that time, then I appoint and designate   .-Second Agent-  , whose address is   .-Second Agent Adress-  , and whose telephone number is   .-Second Agent Phone #-   , to be my Agent on the same terms and conditions, which person may be referred to in this document as my "Alternate Agent".

 

I am appointing these people as Agent and Alternate Agent because after fully discussing this document with them, I believe that each of them understands my wishes, attitudes, and values, and that each of them would carry out and put into effect the health care decisions set forth herein and those which I would make if I were able to do so, and that each of them would act in my best interests in all events, including situations where my wishes and desires are not known.

 

This power of attorney is a DURABLE POWER OF ATTORNEY AND ITS VALIDITY SHALL NOT BE AFFECTED BY MY SUBSEQUENT DISABILITY OR INCAPACITY.

 

This Power of Attorney shall become effective only in the event that I am unable to make and communicate decisions about my own health or medical care after I have been certified by my attending physician or other physician who has examined me as not having the mental capacity to make informed health or medical care decisions for myself.

 

Unless revoked by me, this durable Health Care Power of Attorney shall remain in effect until my death or terminated by law.

 

This Health Care Power of Attorney may be revoked by me at any time, so long as I am mentally competent to do so. I understand that it may be revoked by my spoken word, or by other communication if I am unable to speak, by tearing up or destroying the signed original and signed copies delivered to those appointed as Agent and Alternate Agent, but that the best, clearest, and only sure way to revoke this document is by signing a written revocation which is executed in the same manner as this document, and recorded in the county of my residence or the county where I am residing in a health care facility, in the same office where deeds and real estate records are recorded or filed. Further, any person who has not received formal notice of any revocation, or who does not have actual personal knowledge of such revocation, shall have no liability for continuing to act on and accept this document until they have notice of any revocation.

 

If the situation as spelled out herein activates the authority granted to my representative Agent and Alternate Agent, then my acting Agent shall make a bona fide and good faith effort to communicate with me, and in the event I cannot speak or write, to use methods of communication including, but not limited to such things as writing me notes and/or asking me questions to which I could respond by nodding my head; or blinking my eyes in response, such as 1 blink for "yes" and 2 blinks for "no", or other such methods; or squeezing my Agent's hand, indicating such things as 1 squeeze for "yes" and 2 squeezes for "no".

 

Unless invalid under applicable law or specifically restricted herein, or in conflict with any Living Will I have executed either on, before, or after this date, I hereby grant the authority to my Agent specifically to do and perform all the acts set forth on the following terms and conditions just as I could do for myself.

 

1.       To consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure being performed in order to maintain, diagnose, or treat a physical or mental condition of mine; and

 

2.       To make all necessary arrangements at any hospital, psychiatric hospital or psychiatric treatment facility, hospice, nursing home or similar institution; to employ, or either discharge, replace or obtain reassignment of health care personnel to include physicians, psychiatrists, psychologists, dentists, nurses, therapists, or any other person who is licensed, certified, or otherwise authorized or permitted by applicable laws to administer health care, all as my Agent shall deem necessary for my physical, mental, and emotional well being; and

 

3.       To request, receive and review any information, either verbal, written, or otherwise regarding my personal affairs, or my physical or mental health, including medical and hospital records, and to execute any release that may be requested in order to obtain such information; and

 

4.       To move or transport me to any state or country having applicable laws which permit my desires expressed herein, or which I have expressed in a living will, or other such advance health care directive, to be carried out; and

 

5.       To visit me or at least observe me, in any health care facility.

 

6.       To execute on my behalf a waiver or release from liability, or other documents required by a hospital or physician, or other health care facilities or health care personnel, and to execute and deliver any other documents which either carry out the terms of this document or which my Agent reasonably believes to be in my best interest if this document is silent in that regard, or to pursue any reasonable legal enforcement of provisions herein which are valid under applicable law, or other health care treatment which my acting Agent believes that I would do if I were making my own decisions, subject to not unduly expending or draining the available resources of my family and me.

 

7.       To contact members of my immediate family, and business partners, co-workers, and colleagues, and if my Agent deems it appropriate to also contact any other family or friends in order to advise them of my condition.

 

Limitations on Agent's Authority

In addition to limitations on my Agent's authority imposed by applicable law, the authority of my Agent shall also be limited, or my Agent shall also be prohibited from authorizing, consenting to, or performing the following: _______________

 

Any power of attorney for health care decisions which I have previously made is hereby revoked and canceled.

In the event that any terms or provisions of my Health Care Power of Attorney are not enforceable or valid under the laws of the state of my residence, of if applicable, under the laws of the state where I may be located at the time my Health Care Power of Attorney comes into use, then all other provisions herein which are enforceable or valid shall remain in full force and effect, and all terms and provisions herein are severable.

 

IN WITNESS WHEREOF, fully understanding the terms and effect of this Health Care Power of Attorney, I hereby freely, voluntarily, and intentionally sign and execute same on this _______________ in the presence of two (2) witnesses and a Notary Public.

 

Signature of Principal: ______________________________

 

STATEMENT OF WITNESSES

Under penalty of perjury, each of us hereby swears and certifies by our signatures below as follows: I know the Principal personally and I believe him or her to be of sound mind and at least 18 years of age. I believe that his or her execution of this Health Care Power of Attorney is voluntary and with full understanding.

 

I did not sign the Principal's signature above. I am at least eighteen (18) years of age and am not related to the Principal by blood, marriage, or adoption. I am not entitled to any portion of the estate of the Principal according to the laws of intestate succession of the state of the Principal's residence or domicile, or to the best of my knowledge under any Will of the Principal or any codicil to said Will, or under any trust of the Principal, or under any beneficiary designation, nor am I legally responsible for the costs of the Principal’s health, medical, or other care.

 

I am not the Agent or successor Agent appointed by the Principal in this Health Care Power of Attorney. I am not the Principal's attending physician, nor a health care provider who is serving the Principal at this time, nor am I an owner or employee of any person, organization, or institution which is serving or providing health care to the Principal at this time.

 

___________________________          ___________________________

Witness                                                    Witness

___________________________          ___________________________

Address                                                   Address

___________________________          ___________________________

Date                                                         Date

 

Notary Form

State of __________    County of __________

 

BEFORE ME, the undersigned authority, on this day personally appeared _______________, the Principal herein, and ____________________, a Witness, and ____________________, a Witness, whose names are subscribed to this foregoing durable Health Care Power of Attorney in their respective capacities, and all three of said persons, being by me first duly sworn, said ____________________, the Principal, declared to me and to said witnesses in my presence that this is the Principal's Health Care Power of Attorney, and that the Principal had willingly made and executed it as a free and voluntary act and deed for the purposes therein expressed; and the two witnesses each on their oath stated to me in the presence and hearing of the Principal herein, and in the presence and hearing of each other, that said document and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that they did sign the same as witnesses in the presence of each other and in the presence of the Principal and at the request of the Principal, and that the Principal was at that time at least 18 years old, was of sound mind, and under no restraint.

 

Subscribed, acknowledged, and sworn to before me by the above named Principal, and ____________________ and ____________________, witnesses, on this ____________________.

______________________________ Notary Public

 

My commission or appointment expires: ____________________

 

STATEMENT AND ACCEPTANCE OF AGENT

I understand that _______________, who is the Principal, has designated me to be his or her Health Care Agent if he or she is ever found to be incapacitated and unable to make health care decisions himself or herself. The above named Principal has discussed his or her desires regarding health care decisions with me; I have read the Principal's Health Power of Attorney, but did not serve as a witness to it, and I hereby accept such designation and appointment as Agent.

 

Signed: __________________________________

 

_________________________

_________________________

_________________________

_________________________

 

STATEMENT AND ACCEPTANCE OF ALTERNATE AGENT

I understand that _______________, who is the Principal, has designated me to be his or her health care Alternate Agent if he or she is ever found to be incapacitated and unable to make health care decisions himself or herself. The above named Principal has discussed his or her desires regarding health care decisions with me; I have read the Principal's Health Care Power of Attorney, but I did not serve as a witness to it, and I hereby accept such designation and appointment as Alternate Agent.

 

Signed: __________________________________

_________________________

_________________________

 

 

This Living Trust Agreement (the "Trust Agreement" or the "Agreement") is made and entered into .-Date of Agreement- by and between .-Grantor- , .-Grantor Title- ( the "Grantor") and .-Trustee- , .-Trustee Title- (the "Trustee").

 

Grantor desires to establish a revocable trust with respect to certain of the Grantor's property. Grantor hereby assigns transfers and delivers to the Trustee the sum of Ten Dollars ($10.00) and such other property, if any, as described on Schedule A attached to this Trust Agreement. This property shall constitute the initial Trust estate. Additional property may be transferred to the Trust estate at any time, which property shall become part of the Trust estate upon acceptance by the Trustee. All of the property of the Trust shall be held and managed by the Trustee pursuant to the provisions of this Trust Agreement.

 

The Trustee agrees to accept the Trust estate and to hold and administer the Trust estate, in trust, as set forth in this Trust Agreement.

 

I. The Trust Estate and Trustee's Activities.

A. Creation of Trust Estate. Grantor has caused or will cause certain assets identified on Schedule A to be transferred to Trustee. The assets shown on Schedule A, and any other assets which may hereafter become payable or be transferred to Trustee by Grantor, shall constitute the Trust estate, all of which shall be held, administered and disposed of by Trustee in accordance with the provisions set forth in this Agreement.

 

B. Additions. Trustee shall always be authorized and empowered to receive property by gift, by will, by naming Trustee as a beneficiary of a life insurance policy or benefit plan, or otherwise, from Grantor or from any person or persons other than Grantor, as additions to the Trust estate under this Agreement and to hold and administer any such additions to the Trust estate in accordance with the terms and provisions of this Agreement.

 

C. Trustee's General Duties. Trustee shall hold and administer the Trust estate in accordance with the provisions of this Agreement and collect all income and profits, pay the necessary expenses of administering the Trust, and distribute the net income and principle as provided in this Agreement.

 

II. Grantor Trust

A. Distributions Directed by Grantor. During the Grantor's lifetime, the entire net income derived from the Trust estate shall be paid to, or upon the order of, the Grantor, in regular monthly or other convenient installments. In addition, the Trust shall distribute such amounts of the principal of the Trust estate to one or more persons or entries (including Grantor) in such amounts and in such manner as the Grantor may direct from time to time.

 

B. Disability of Grantor. If, at any time, the Grantor, while also serving as Trustee, is unable due to mental incapacity or physical disability to administer the Trust income or principal and/or is unable to direct the distribution of income and principal as provided in Paragraph A of Article II above, then a successor Trustee as provided in Article VII of this Trust Agreement shall serve as Trustee and the following provisions shall apply.

 

(1) Distributions to or for Grantor or Dependents. The Trustee shall not pay income directly to the Grantor, but the Trustee (other than the Grantor) shall use and apply for the benefit of any one or more of a group composed of the Grantor, anyone whom the Grantor has a legal obligation to support and any other person in a manner consistent with the Grantor's pattern of providing support prior to disability, so much of the income and principle of the Trust estate ____________________.

 

(2) Distributions to Relative or Legal Guardian. A distribution which otherwise would be made to or for the benefit of the Grantor may be made, in the Trustee's discretion, to any relative or legal guardian of the Grantor to be used or applied for the Grantor's benefit. The written receipt of such relative or legal guardian for any such distribution shall be all that is required of the Trustee in any accounting made by the Trustee. The Trustee shall not be required to guarantee that any such distribution is used or applied for the Grantor's benefit. However, by written direction filed with the Trustee, the Grantor may at any time prohibit any such distribution from being made to a relative of the Grantor pursuant to this paragraph.

 

C. Payment of Debts, Taxes & Expenses

 

(1) Upon the death of the Grantor, to the extent that the Grantor's probate estate, exclusive of real property and tangible personal property, shall be insufficient to pay the Grantor's legally enforceable debts and last illness and funeral expenses, estate administration expenses, and all pecuniary bequests under the Grantor's Last Will, the Trustee is authorized, in the sole and absolute discretion of the Trustee, to pay such debts, expenses and bequests.

 

(2) Except as otherwise specifically provided below, upon the death of the Grantor, if the assets of the Grantor's taxable estate shall be insufficient to pay or if the Grantor's Will shall not provide for their payment, then the Trustee may in the sole and absolute discretion of the Trustee pay (a) any and all taxes owing by the Grantor at the Grantor's death, including, but not limited to, federal or state income, gift or property taxes (including interest and penalties, if any), and (b) all taxes lawfully imposed by reason of the Grantor's death, including federal estate taxes, state estate or inheritance taxes, federal, state, or foreign country transfer or succession duties (including interest and penalties, if any), other than generation-skipping transfer taxes.

 

(3) The Trustee shall not be required to pay any state inheritance tax which has not been assessed prior to the date of final distribution of this Trust estate, it being the Grantor's intention that the final distribution of the Trust estate not be extended because of any such tax which cannot be determined as of the date of such final distribution.

 

(4) Any taxes payable under this Paragraph shall be paid out of the assets of the Trust estate remaining after payment of all gifts, bequests and devises which are deductible for tax purposes and the payment of all gifts, bequests and devises of a specific sum of money or of specific property. No portion of such taxes shall be charged against, or reduce any gift, bequest or devise which is deductible for tax purposes.

 

(5) The payments authorized by this Paragraph may be made to the Personal Representatives of the Grantor's estate for the purposes intended, or may be made directly to the person, firm, corporation or governmental agency to whom the obligation to the discharged shall be payable.

 

(6) All actions taken by the Trustee in the exercise of the discretion and powers granted in this Paragraph shall be conclusive and binding upon all parties in interest. All other provisions of this Trust Agreement providing for the distribution of trust property after the death of the Grantor shall be subject to the right of the Trustee to withhold any such distribution, in whole or in part, pending a final determination by the Trustee of the action to be taken under the provisions of this Paragraph.

 

D. Disposition on Grantor's Death. Grantor .-Grantor- upon the date of this Trust Agreement. The name of Grantor's spouse is .-Grantor Spouse- . Upon the Grantor's death, the Trust estate (including any accumulated income) and any property passing to this Trust as a result of the Grantor's death, less any amounts disbursed by the Trustee for debts, taxes and expenses pursuant to the above provisions, shall be held, managed and distributed by the Trustee as follows:

 

(1) Specific Distributions. The Trustee shall make the following Specific Distributions from the Trust estate:

 

(2) Distribution of Remainder of Trust estate. _________________________ If the Grantor has no living descendants, the remainder of the Trust estate shall be distributed pursuant to Article IV of this Trust Agreement.

 

(3) Family Trust. ____________________

 

E. Family Trust — Principal. ____________________

 

F. Family Trust — Termination. Each Family Trust shall terminate as follows:

 

III. Contingent Trusts.

If, upon distribution of a Trust estate, any beneficiary would otherwise become entitled to an outright distribution from such Trust estate while such beneficiary is under age ____________________ the Trustee shall hold such distribution as the Trust estate of a separate Contingent Trust for the use and benefit of such beneficiary as provided below:

 

A. Distribution of Income. The Trustee may pay to or use and apply for the benefit of the beneficiary all or any part of the net income of the Trust estate as necessary for the health, education, maintenance and/or support in the accustomed manner of living of such beneficiary. Any income not so used shall be added to the principal of the Trust estate, at least annually.

 

B. Distribution of Principal. If, at any time and from time to time during the continuance of the trust, the Trustee shall determine that (a) the beneficiary is in need of funds in excess of the income which is available for distribution to such beneficiary (taking into consideration all other sources of support which the beneficiary has to the knowledge of the Trustee) and (b) such funds are needed for such beneficiary's health, education, maintenance and/or support in his or her accustomed manner of living, then the Trustee may in Trustee's discretion distribute such amounts of the principal of the Trust estate as necessary to relieve any such need, in whole or in part.

 

C. Termination of Trust. Each Contingent Trust shall terminate as follows:

 

(1) When the beneficiary for whom the trust is created becomes age _______ the Trustee shall distribute all of the remaining principal and accumulated income of the Trust estate to the beneficiary, free from trust.

 

(2) If the beneficiary for whom the trust is created should die before age ____________________, the trust shall terminated upon such beneficiary's death, and the remaining principal and accumulated income of his or her trust estate shall be distributed, subject to the Contingent Trust provisions of this Article, to the beneficiary's descendants, but if the beneficiary has no living descendants, the trust estate shall be distributed in equal shares to the beneficiary's brothers or sisters who are the descendants of the Grantor, with the share for any deceased brother or sister being created only if he or she has living descendants, in which case the share for such deceased brother of sister shall be distributed to his or her descendants. If non of these persons is living, the trust estate shall be distributed to the descendants of the beneficiary's nearest ancestor who are descendants of the Grantor and who have descendants then living, but if none of these persons is living, to the Grantor's descendants, but if the Grantor has no living descendants, then pursuant to the following Article IV of this Trust Agreement.

 

IV. Contingent Distribution to Heirs.

 

V. Miscellaneous Trust Provisions.

The following provisions shall apply to each separate trust established under this Trust Agreement.

 

A. Spendthrift Provision. Neither the principal nor the income of any Trust estate created this Trust Agreement shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in any Trust estate in any manner.

 

B. Income Distributions. All non-discretionary income payments from any Trust estate shall be payable to or accrue for the benefit of the respective beneficiaries from the data of death of the Grantor. Except as may be otherwise specifically provided under another provision of this Trust Agreement, at the death of any income beneficiary of any Trust estate, the right of such beneficiary to receive the income shall terminate, and all accrued and distributed income to which such beneficiary would have been entitled, and all accrued and undistributed income to which such beneficiary would have been entitled shall pass as income to the succeeding income beneficiary, unless the share or Trust estate of such beneficiary terminates on the death of such beneficiary, in which event such income shall be distributed in the same manner as the principal of such share of Trust estate.

 

C. Distributions To or For Beneficiaries.

 

(1) In considering whether or not to make any distribution to a beneficiary under this Trust Agreement, the Trustee shall give primary consideration to the needs of any income beneficiary or beneficiaries, rather than to the conservation of the Trust estate for persons having remainder interests.

 

(2) Any power to make distributions (other than distributions upon the mandatory termination of a trust) to or for the benefit of a person who is serving as Trustee of a trust, or any discretionary power, the exercise of which could result in distribution of principal to or for the benefit of such an individual (including any decision to cause an early termination of the trust), shall not be exercisable by such an individual except to the extent such power is limited, under this Trust Agreement, to an ascertainable standard for such individual's health, education, maintenance and/or support in his or her accustomed manner of living. The provisions of this Paragraph shall not restrict the right of the Grantor, while acting as Trustee, to make distributions to or for the benefit of the Grantor.

 

(3) During the continuance of any Trust estate, or upon the termination of any Trust estate, any distribution to be made to a beneficiary from the Trust estate may be made (a) to the beneficiary, (b) if the beneficiary is under a legal disability or if the Trustee determines that the beneficiary is unable to properly manage his or her affairs, to a person providing for the health, education, maintenance and/or support needs of the beneficiary, or to a person with whom the beneficiary is residing, for expenditure on the beneficiary's behalf, (c) to a custodian for a minor beneficiary, as selected by the Trustee, under the Uniform Transfers to Minors Law (or similar statue) of any state, or (d) directly by the Trustee for the beneficiary's benefit. However, no such distribution shall be made, regardless of who is the Trustee, in a manner which discharges, satisfies or mitigates any legal obligation of any person (other than the beneficiary) to provide any benefit for such beneficiary, including health, education, maintenance and/or support.

 

(4) In making the distributions from a Trust estate to a beneficiary, the Trustee may consider the age of the beneficiary, the costs of the beneficiary's health, education, maintenance and/or support, any income the beneficiary may have from other sources to the knowledge of the Trustee, the effect of any distribution upon the income and transfer tax liability of the beneficiary or of any trust having more than one permissible distributee, unless otherwise required by this Trust Agreement, (a) distributions may be made unequally among the beneficiaries and may be made wholly to one beneficiary, (b) distributions may be made regardless of whether any ancestor of a beneficiary is then living or receiving distributions from the same or another trust, and (c) no deduction shall be made from a beneficiary's share of the trust estate upon the trust's termination on account of any prior distribution made from the trust.

 

D. Distributions to Existing Trusts. Any distribution which otherwise would be made upon termination of a trust to a beneficiary for whom a trust is in existence under this Trust Agreement, instead shall be made to the Trustee of such existing trust, as an addition to the trust estate of such trust.

 

E. Maximum Term of Trusts. Notwithstanding any other provision of this Trust Agreement, unless earlier terminated by the terms of the trust, each trust shall terminate 21 years after the death of the last to survive of the Grantor, the Grantor's spouse named in Article II (if any) and all of the Grantor's descendants who were living on the date of the Grantor's death. The principal and undistributed income of any trust terminates as a result of the provisions of this Paragraph shall be distributed, free from trust, to the beneficiary for whom the trust was created.

 

F. Tangible Personal Property. In the event that any tangible personal property passes to the Trustee as a result of provisions under the Will of the Grantor or the Grantor's spouse named in Article I above (if any) which is to be held for the benefit of any minor beneficiary, such property shall be held by the Trustee for the benefit of such beneficiary. Such property may be placed in safekeeping by the Trustee and delivered by the Trustee, free from trust, to such beneficiary when he or she attains majority. The Trustee, after consultation with the legal guardian of such beneficiary, may sell all or any part of such property, and add the proceeds of any such sale to the Trust estate or share being held for such beneficiary under this Trust Agreement. Furthermore, in the sole and absolute discretion of the Trustee, the Trustee may deliver all or any part of such property to such minor beneficiary for use by such beneficiary, without any liability on the part of such beneficiary or on the part of the Trustee for any waste, loss, damage or destruction to such property.

 

VI. Fiduciaries.

A. Successor Trustees.

 

(1) The Grantor, while acting as a Trustee, may at any time (a) appoint one or more Co-Trustees and/or (b) appoint a successor Trustee to act in place of the Grantor, either immediately or in the future upon any stated contingency, and may thereby supersede or supplement the Trustee succession provisions in the remainder of the Paragraph.

 

(2) In the event the Trustee first named above in this Trust Agreement should fail or cease to act as Trustee for any reason, then ___________________ ("First Successor Trustee"), shall become successor Trustee. In the event the First Successor Trustee should fail or cease to act as Trustee of any trust, for any reason, then the following shall become the successor Trustee in the order named: ___________________ ("Second Successor Trustee") and ____________________ ("Third Successor Trustee").

 

(3) As to each Trust estate, the individual Trustee or Trustees acting at any time may appoint any corporate fiduciary having the qualifications set forth below to serve as Co-Trustee with the individual Trustee or Trustees, or as successor Trustee, and may substitute any other corporate fiduciary having such qualifications for any corporate fiduciary so named.

 

(4) No Trustee acting under this Trust Agreement shall be required to give bond for the faithful performance of such Trustee's duties.

 

(5) The Trustee or Trustees acting at any given time (acting jointly if more than one) may appoint one or more Co-Trustees.

 

(6) If at any time with respect to any trust there is no Trustee acting and no successor has been appointed, the income beneficiary or a majority of the income beneficiaries of such Trust estate, as the case may be (or his, her or their legal disability), shall appoint a successor corporate Trustee of such trust.

 

(7) The term "Trustee" as used in this Trust Agreement, shall include Co-Trustees when more than one Trustee has been appointed and is acting as such, and shall also include any and all successor Trustees. Every title, estate, right and discretion vested in or conferred on the Trustee of any trust shall likewise become and be vested in, and may be exercised by, any successor Trustee and by a Co-Trustee continuing to act as the Trustee of such trust.

 

(8) The appointment of any successor Trustee or Co-Trustee pursuant to this Article shall be in writing and shall become effective upon the filing of such successor's or Co-Trustee's written acceptance of such appointment with (a) the records of the trust, (b) the remaining Trustee, if any, and (c) the income beneficiary or beneficiaries of such trust (or his, her or their legal or natural guardian or guardians, if any such beneficiary is then under a legal disability).

 

(9) Any corporation which by merger, consolidation, purchase or in any other manner succeeds to the fiduciary business of a corporate Trustee or Co-Trustee then acting under this Trust Agreement shall, without further action, become the corporate Trustee or Co-Trustee of such Trust estate.

 

B. Resignation of Trustee. Any Trustee may resign as the Trustee of any trust at any time, upon the giving of thirty (30) days' written notice of such Trustee's intention of resign, duly signed and delivered to the income beneficiary or beneficiaries of such trust and to the Co-Trustee or successor Trustee of such trust. Upon such resignation, the Trustee shall deliver to the Co-Trustee or successor Trustee all of the property and assets of the Trust estate in the possession or under the control of such resigning Trustee. After full settlement of such Trustee's accounts, the resigning Trustee shall stand fully charged and released from any further liability or responsibility under this Trust Agreement.

 

C. Removal of Trustee. At any time, and from time to time, the income beneficiary or a majority of the income beneficiaries, as the case may be (or his, her or their legal or natural guardian or guardians, if any such beneficiary is under a legal disability), of any Trust estate may remove any corporate Trustee of any Trust estate or any individual Trustee appointed by the income beneficiaries pursuant to the above provisions and, if no corporate Trustee would then be acting, shall designate any corporate fiduciary (meeting the requirements provided below) as successor Trustee of such Trust estate, by notice in writing to such Trustee accompanied by the appointment of and acceptance by the successor corporate Trustee. Such removal and appointment shall be without hearing or order by any court.

 

D. Who May Be Appointed. Except as otherwise limited by this Article, a Trustee, Co-Trustee or successor appointed under this Article may be individual, a bank or trust company.

 

E. Appointment of Custodian. The individual Trustee or Trustees may at any time appoint a corporate custodian and delegate to such custodian any or all powers or duties, discretionary or otherwise, exercisable or required of such individual Trustee or Trustees with respect to the bookkeeping and related administrative duties of the Trustee or Trustees. Such appointment or delegation may be revoked at any item by written instrument duly signed, acknowledged and delivered to such custodian. Written notice of any appointment, delegation or revocation shall also be given to the income beneficiary or beneficiaries of any trust affected by the exercise of such power. The individual Trustee or Trustees exercising this power of delegation shall not be liable for the acts, omissions or defaults of the custodian unless such Trustee or Trustees, in selecting such custodian, are guilty of gross negligence, bad faith or fraud. Any custodian appointed under the provisions of this Paragraph shall serve only during the tenure of the individual Trustee or Trustees who appointed the custodian.

 

F. Majority of Trustees May Act. A majority decision of the then acting Co-Trustees of any Trust estate shall be the decision of all of the then acting Co-Trustees, and shall bind such Trust estate as fully as though it had been a unanimous decision of the Co-Trustees. However, any Co-Trustee not consenting to such majority decision shall incur no liability for, nor have any responsibility for, any action taken or omitted to be taken as a result of any such majority decision.

 

G. Trustee's Authority Presumed. No person dealing with the Trustee shall be obligated to see to the application of any money, securities or other property paid or delivered to the Trustee, nor to inquire into the authority of the Trustee to enter into and consummate any transaction or take any other action.

 

H. Trustee's Liability for Own Actions. No Trustee shall be liable for any mistake in judgment in the making or retaining of investments, or any other decision made by the Trustee, so long as any such decision is made in good faith.

 

I. Trustee's Liability as General Partner. The liability of the Trustee as a general partner in any specific partnership shall be limited to the assets which comprise the Trust estate; and (1) the partnership, the other partners, all parties owning an interest in the partnership and all parties dealing with the partnership shall look solely to the Trust estate for the payment of all claims, indebtedness and liability of the partners or the partnership and for the performance of any covenant or obligation, express or implied, of the partners or the partnership, (2) neither the Trustee nor the beneficiaries of the Trust of the Trust estate shall be liable for the debts, claims and liabilities of the partners or partnership or for the performance by the partners or partnership of any covenants or obligations except to the extent of the Trust estate, and (3) the Trustee and such beneficiaries shall have no personal liability of any kind in connection with any such partnership and shall be indemnified by the Trust estate to the extent any such liability is imposed.

 

J. Trustee's Liability for Actions of Predecessor. No Trustee shall have any liability for the acts or omissions to act of any predecessor fiduciary, and in accepting the Trust estate, no Trustee shall have any obligation to audit the accounts of any predecessor fiduciary. No Trustee shall be entitled to any acceptance fee or other additional compensation for auditing or investigating the accounts of such predecessor fiduciary.

 

K. Trustee Indemnified. Any individual acting as Trustee of any trust under this Trust Agreement shall be indemnified and reimbursed from the Trust estate for any loss, damage, liability or expense incurred or sustained by such Trustee, in an individual or fiduciary capacity, by reason of any act or failure to act of such Trustee for or on behalf of and in furtherance of the trust. However, the protection provided by this Paragraph shall not apply to any loss, damage, liability or expense incurred or sustained by reason of gross negligence or willful malfeasance of the Trustee.

 

L. Accountings. If requested by any income beneficiary, but in any event not more often than annually, the Trustee shall render to each income beneficiary (which shall be given to the legal or natural guardian, or other person having custody, of each income beneficiary under a legal disability) of each Trust estate created under this Trust Agreement, annual statements of the transactions of such Trust estate, which requirement may be satisfied by delivering to each such income beneficiary or his or her guardian a copy of the federal income tax return for the trust for such period. Except as provided in this Paragraph, and to the maximum extent permitted by law, the Grantor hereby relieves the Trustee from any obligation, whether pursuant to state statue or otherwise, to render for any trust created under this Trust Agreement.

 

M. Compensation. Each individual Trustee may be entitled to receive reasonable compensation for services as Trustee, and may be reimbursed for the reasonable and necessary expenses incurred in the performance of duties as such. Any corporate Trustee shall be entitled to reimbursement for expenses and to receive compensation for its services as Trustee in accordance with its published schedule of fees in effect at the tine such expenses are incurred or such services are rendered, or a lower amount as otherwise negotiated.

 

N. Custody of Trust Assets. While two or more Trustees are acting, the corporate Co-Trustee, if any, shall have the right to custody of all trust assets and shall keep the records of the trust. If no corporate Co-Trustee is acting, custody of trust assets and the trust records shall be kept by any one or more of the Co-Trustees.

 

VII. Trustee Powers

A. General. Except as otherwise specifically provided in this Trust Agreement, the Trustee of each Trust estate shall have full power and authority to do any and all things necessary or proper to manage, control, invest and reinvest the assets constituting the Trust estate, consistent with the provisions of this Trust Agreement and of applicable law, in the same manner as if the Trustee were the fee simple owner of the Trust estate. The Trustee of any such Trust estate shall have the power to enter into any covenants or agreements binding the Trust estate, regardless of whether said covenants or agreements extend beyond the termination of such Trust estate.

 

B. Fiduciary Nature of Powers. Notwithstanding any other provision of this or any other Article of this Trust Agreement, all discretions, powers and authority shall be exercised by the Trustee in a fiduciary capacity, prudently and exclusively in the interest of the beneficiaries.

 

C. Enumerated Powers. In addition to all powers granted to Trustees under applicable state law, the powers of management, control and investment conferred upon the Trustee of each Trust estate shall include, but shall not be limited to, the following rights, powers, obligations, duties, authorities, privileges and immunities, any or all of which may be exercised by the Trustee at any time, or from time to time:

 

(1) Exercise all powers granted to Trustees by common law or applicable Statutes (as now exist or may exist in the future) to the extent that they increase the powers granted to Trustees. If, however, those powers provided by law are in conflict with the provisions of this Agreement, the terms of this Agreement shall control.

 

(2) Retain and hold in or as a part of the Trust estate any investment or other property acquired from Grantor or Grantor's estate, with full power, nevertheless, to change and vary the form of any investment from time to time as the Trustee shall deem best.

 

(3) Invest the Trust estate in such stocks, bonds, notes, or other securities or personal, including shares or interests in investments in investment trusts and common trust funds, of foreign or domestic issuers, as Trustee may deem advisable, even though such investments (by reason of their character, amount, proportion to the total Trust estate, or otherwise) may not generally be deemed appropriate for investment by fiduciaries. Investments need not be diversified any may be made or retained without a view to possible increase in value. Trustee may at any time hold cash or readily marketable securities of low yield for such period as Trustee may deem available.

 

(4) Purchase any assets from Grantor's estate at fair market value in such quantities as Trustee deems advisable.

 

(5) Loan funds or assets belonging to the Trust estate to the testamentary Estate of Grantor, upon such terms and in such amounts as Trustee deems advisable.

 

(6) Retain, for any length of time during the trust by purchase or otherwise, and manage temporarily or permanently, any kind of realty or personality, whether an original asset of the trust or not, with no obligation to diversity as to kind or amount and without limitation by statute or rule of law without liability for loss or depreciation.

 

(7) Enforce or abstain from the enforcement of any right, obligation or claim, and to abandon, if in Trustee's absolute discretion Trustee shall deem it advisable, any property, real or personal, which may at any time form a part of the Trust estate, and in general, to protect in every way the interests of the Trust estate and of the beneficiaries thereof, either before or after default.

 

(8) Sell, lease for any period, improve or dispose of reality or personal Property, or any interest of any nature in realty or personal property, publicity or privately, wholly or partly on credit and without appraisal.

 

(9) Employ such brokers, bank custodians, investment counsel, attorneys, and other agents or servants and to delegate discretionary or ministerial powers to them, procure necessary advice and services, and pay all expenses and fees so incurred, all regardless of whether such person or entity is (or is affiliated with) a beneficiary or Trustee.

 

(10) Renew, assign, alter, extend, compromise, release, with or without considerations, or submit or arbitration, any obligations or claims, including taxes, held by or asserted against Trustee which affect trust assets.

 

(11) Execute such tax returns and pay such taxes as Trustee shall determine to be necessary, including contributions to any taxes arising as a result of the death of Grantor as provided in this Agreement.

 

(12) Hold property in the name of a nominee or in Trustee's own name without disclosure of Trustee's fiduciary position.

 

(13) Exercise voting rights and all other rights and options concerning securities which Trustee holds, by proxy or otherwise, as freely as an absolute owner of the same might do.

 

(14) Establish, from rents, profits and other income, such reserves for taxes, assessments, insurance, repairs, improvements, depreciation and maintenance of building and other property, as Trustee shall deem appropriate.

 

(15) Determine, in case of doubt, how any money or other property received, or any gain or loss realized or incurred, shall be allocated as between income and principal, and to apportion between income and principal any loss or expenditure in connection with the Trust estate, as Trustee may deem just, except that: (a) in case of securities purchased at a discount, the entire subsequent sale price or maturity value shall be credited to principal; (b) in case of securities purchased at a premium, the premium shall be charged against principal without amortizing the same.

 

(16) Rely on any information, affidavit, certificate, letter, notice, Telegram, or other document, or upon any telephone conservation believed by Trustee to be genuine and sufficient.

 

(17) Serve as Trustee without increased liability or accountability, even if Trustee, or Trustee's directors, officers, or employees, or their interests, has an interest of any nature whatsoever in any instrumentalities in which assets of the trust may be invested.

 

(18) Borrow money and execute promissory notes therefore, and pledge or mortgage any property of the Trust estate to secure any borrowing or for the payment of taxes, expenses, or any purposes which in Trustee's opinion will facilitate the administration of the trust.

 

(19) Make loans, secured or unsecured, in such amounts and upon such terms and rates of interests, and to such persons or entities that Trustee deems appropriate.

 

(20) Divide and distribute the principal of the trust in kind or in money or partly in each, or by way of undivided interests.

 

(21) Be reimbursed for reasonable and necessary expenses from the trust, and receive such compensation for Trustees services as shall be customary in like cases.

 

(22) Release any fiduciary power of administration herein granted in expressed or implied terms.

 

(23) Insure any part of the Trustee property against such risks as Trustee shall deem appropriate; such insurance to be based on market values or costs, and such coverage to be full or partial; pay premiums and collect or adjust the losses; acquire, hold, and pay premiums for insurance upon the life of any person and to exercise the ownership rights in such policies; and purchase other types of insurance or annuities for any beneficiary; provided that all incidents of ownership with respect to any life insurance of any Trustee shall be vested in and exercisable solely by another Trustee.

 

(24) Exercise all powers conferred in this Trust Agreement without authorization or approval of any court, and such powers shall: (a) be exercisable by Trustee and by any successor or substitute in any jurisdiction whatsoever; (b) be exercisable in respect to all assets held by Trustee or under Trustee's control; (c) remain exercisable as fiduciary powers of administration only, and without affecting the vesting of beneficial interests, until actual and final distribution of all of the assets of the trust; (d) be exercisable without any duty on any person dealing with Trustee to inquire into Trustees authority; and (e) be conclusive, when exercised, upon all persons interested in the trust.

 

D. Early Termination of Trust. Subject to any express limitation provided with respect to the Trust estates, or any specific Trust estate, created under this Trust Agreement, the Trustee (other than a Trustee who is an income beneficiary) may terminate any Trust estate or merged Trust estate and distribute the property then constituting such Trust estate, free from trust, to the income beneficiary or beneficiaries of such Trust estate (and in the case of a minor income beneficiary, to a custodian for such beneficiary under the Uniform Transfers to Minors Law or any similar law of any state) if, as and when the fair market value of such property is not sufficient, in the opinion of the Trustee, to make it economical, prudent or wise to continue to administer such Trust estate as a separate Trust estate.

 

E. Satisfaction of Monetary Amounts. Except as otherwise specifically provided in this Trust Agreement.

 

(1) any allocation or distribution of a specific monetary amount which is to be made by the Trustee may be made in one or more allocations or distributions, in cash or in kind (i.e., in the form of a whole or partial undivided interest in one or more specific properties, real, personal, or mixed) or partly in cash and partly in kind and with or without being made subject to liabilities (pre-existing or newly created), all in the respective sole discretion of such Trustee; and

 

(2) any allocation or distribution of a fractional share of the assets of any part of any Trust estate need not be pro rata nor include any particular asset, but rather may be composed of such assets and made subject to such liabilities (pre-existing or newly created), if any, pro rata or not, as the Trustee, in the exercise of the Trustee shall determine.

 

However, as of the effective date (or dates) or any such allocation or distribution, the net fair market value of the assets and liabilities comprising such allocation or distribution shall represent the specific monetary amount or proper fractional share of the then net fair market value of the whole, as the case may be, which such allocation in distribution is to satisfy.

 

E. Division of Trusts Receiving S Corporation Stock. If any S Corporation stock is to be distributed to the Trust estate of any trust which would not otherwise qualify as a permissible S Corporation shareholder under the applicable provisions of the Internal Revenue Code, the Trustee shall have the power to hold such stock in a separate Trust estate for the benefit of the sane beneficiaries, to be known as an "S Corporation Trust". The Income Beneficiary of each S Corporation Trust shall be the person for whom such trust was created. The Provisions of each S Corporation Trust shall be identical to the provisions of the trust to which such stock would otherwise have been distributed, except for the following special provisions:

 

(1) All of the net income of the S Corporation Trust shall be distributed to the Income Beneficiary of such trust, in convenient installments, at least annually.

 

(2) No distributions of principal shall be made from the trust estate to any person other than the Income Beneficiary.

 

(3) If the S Corporation Trust terminates prior to the death of the Income Beneficiary, then upon such termination, the remaining principal and accumulated income of the Trust estate shall be distributed to the Income Beneficiary.

 

It is the Grantor's intent that any S Corporation Trust created pursuant to this Paragraph shall qualify as a trust permitted to hold S Corporation Stock pursuant to the provisions of Sections 1361 of the Internal Revenue Code.

 

VII. Definitions and General Provisions.

A. Survivorship. If the Grantor and the Grantor's spouse above named (if any) die under such circumstances that the order of their deaths cannot be established by proof, or if the Grantor's spouse survives the Grantor by any period of time whatsoever, the Grantor's spouse shall be considered to have survived the Grantor. Any other beneficiary who dies within thirty (30) days after the Grantor's death shall be considered to have died prior to the Grantor's death.

 

B. Trust estate. The terms "Trust estate" or "trust estate" wherever used in this Trust Agreement mean all assets, however and whenever acquired (including income and accumulated income), which may be held in a trust at any given time.

 

C. Children. The terms "child" and "children" as used in this Trust Agreement shall include legitimate, natural children and children who are legally adopted prior to age eighteen (18). A posthumous child shall be considered as living at the death of his or her parent. Any child born to an unwed mother shall be deemed to be the legitimate child of such mother, but shall not be the child of the father unless (1) the father has executed a written declaration acknowledging the child as his own, or (2) a court of competent jurisdiction has entered an order or judgment declaring that a father/child relationship exists. On the date this Trust Agreement is executed, the Grantor has ___________________.

 

D. Descendants. The term "descendants" as used in this Trust Agreement means the children of the person designated and the descendants of such children and shall include any such descendant who is legally adopted prior to age 18, and such person's descendants. Except for distributions which may be made unequally, whenever a distribution is to be made to the descendants of any person (or whenever any Trust estate is to be divided for the benefit of the descendants of any person), the property to be distributed (or Trust estate to be divided) shall be divided into as many equal shares as there are living children of the person and deceased children of the person who have descendants who are then living. Each child shall take one share and the share of each deceased child shall be divided among his or her then living descendants in the same manner.

 

E. Income Beneficiaries. The term "income beneficiaries as used in this Trust Agreement shall mean such one or more beneficiaries of a trust to whom income distributions from such trust are required to be made or to whom income distributions from such trust are allowed to be made. Except for distributions, which may be made unequally, any distribution of income, or principal which is to be made to the income beneficiaries of any trust shall be made to such income beneficiaries in proportion to their respective interests in the income of such trust. For purposes of any notice to be given to the income beneficiaries under this Trust Agreement, and for purposes of any distributions to be made pursuant to an early termination of the trust, a beneficiary's interest in the income of such trust shall be determined as though income distributions were required to be made equally among the income beneficiaries, except that with respect to income beneficiaries in more than one generation, such interests shall be per stirpes.

 

F. Internal Revenue Code. The term "Internal Revenue Code" as used in this Trust Agreement means the Internal Revenue Code of 1986 or corresponding provisions of any subsequent federal tax laws.

 

G. Personal Representative. The term "Personal Representative" as used in this Trust Agreement shall be deemed to include the terms "Executor" and "Administrator" if those terms are used elsewhere in this Trust Agreement or in the statutes of any state having jurisdiction over any property included in this Trust estate or the Grantor's probate estate.

 

H. Determination of Incapacity or Disability. For purposes of this Trust Agreement, the mental incapacity or physical disability of the Grantor or of any Trustee shall be determined by such person's regular attending physician or physicians; or, if none, by any physician who has examined or treated such person for the mental or physical condition causing the incapacity or disability. A written report signed by such physician or physicians shall act as sufficient evidence as to such person's incapacity or disability.

 

I. Other Terms. For the purposes of this Trust Agreement, the use of any gender shall be presumed to include the other gender, and the use of either the singular or the plural shall be presumed to include the other. The use of titles and headings in this Trust Agreement are for convenience only and no such title or heading shall have any legal effect.

 

J. Additions to Trust Estate. The Grantor and any other person or entity, with the consent of the Trustee, may transfer, devise or bequeath additional property to the Trustee of any trust established under this Trust Agreement, by inter vivos or testamentary transfer, or may make the proceeds of any policies of insurance or the death proceeds of employee benefit plans payable to the Trustee of this Trust Agreement. All such property and proceeds shall be added to the Trust estate of the designated trust, to be held by the Trustee for the uses and purposes and subject to the terms and conditions set forth in this Trust Agreement. In the case of the transfer of property by inter vivos gift or under the Last Will of a transferor, such transfer shall be evidenced by the receipt of the then acting Trustee of the affected trust.

 

K. Governing Law. This Trust Agreement and the administration of all trusts created in this Trust Agreement shall be governed by the laws of the State of ____________________.

 

L. Disclaimer. In addition to any disclaimer rights conferred by law, any beneficiary or Trustee, at any time within nine (9) months after the date of the Grantor's death, is hereby given the right to disclaim in whole or in part any interest, benefit, right, privilege or power granted to such beneficiary or Trustee under this Trust Agreement. Any such disclaimer shall be made by duly acknowledged written instrument executed by such beneficiary or Trustee, or his or her legal representative, and delivered to the Trustee under this Trust Agreement, and to the Grantor's Personal Representative, if any, and filed in the court having jurisdiction over the Grantor's estate, if any. In the event of any such disclaimer (including a disclaimer under state law), the disclaimed interest, benefit, right, privilege or power shall pass as though such beneficiary or Trustee had predeceased the Grantor.

 

Specifically, in the case of a beneficiary who disclaims a beneficial interest in trust, as to any interest so disclaimed, the trust will be administered and future distributions made as though such beneficiary had predeceased the Grantor, even though this may cause an acceleration of one or more remainder interests. However, any such disclaimer by a beneficiary shall not affect any other interest, benefit, right, privilege or power of such beneficiary under this Trust Agreement which has not been disclaimed (including the right, if any, of the Grantor's spouse to receive income from property passing to any Trust estate by reason of such disclaimer.

 

M. No-Contest Provision. If any person who has been given an interest in a trust estate under this Trust Agreement institutes or joins in (except as a party defendant) any proceeding to contest the validity of this Trust Agreement or any of its provisions, all benefits provided for that person shall be revoked and those benefits shall pass as though the person did not survive the Grantor. This provision shall apply regardless of whether the proceedings are instituted in good faith or with probable cause.

 

VIII. Rights Reserved by Grantor.

A. Right to Revoke. The Grantor, at any time during the Grantor's lifetime, may revoke this Trust Agreement in it entirety, thereby terminating the trust so created, by notice in writing executed by the Grantor and delivered to the Trustee. Upon receipt of such notice, the Trustee shall transfer and deliver to the Grantor, or the Grantor's nominee, free from trust, all of the property then constituting the Trust estate, and shall take any and all other actions reasonably necessary to the transfer title in such property to the Grantor, or the Grantor's nominee. The receipt of the Grantor, or the Grantor's nominee, for such property shall be a full and complete discharge to the Trustee for any such transfer.

 

B. Right to Withdraw. The Grantor, at any time and from time to time during the Grantor's lifetime, may withdraw all or such part of the assets then constituting the Trust estate as the Grantor may designate in a written request delivered to the Trustee. Upon receipt of such request, the Trustee shall transfer and deliver to the Grantor, or the Grantor's nominee, free from trust, such property of the Trust estate as described in such written request. The receipt of the Grantor, or the Grantor's nominee, for nay such property shall be a full and complete discharge to the Trustee for any such transfer.

 

C. Right to Amend. The Grantor, at any tine and from time to time during the Grantor's lifetime, may amend, alter or modify this Trust Agreement, or may amend, alter, modify or revoke any such amendments, by an instrument in writing executed by the Grantor. Such instrument shall be effective upon its execution by the Grantor, but until a copy has been received by a Trustee, that Trustee shall not incur any liability or responsibility either (1) for failure to act in accordance with such instrument, or (2) for acting in accordance with the provisions of the Trust Agreement without regard to such amendment. Any proposed amendment relating to the compensation, liabilities or immunities of the Trust shall have the approval of the Trustee, in writing, before becoming effective.

 

This Trust Agreement has been executed by the Grantor and the Trustee effective the day and year shown on the first page of this Trust Agreement.

 

Grantor: Trustee:

.-Grantor- .-Trustee-

____________________ ____________________

 

Acknowledgement

State of __________ County of __________

 

On this _____ day of __________, 19 _____, before me personally appeared ____________________, Grantor of the foregoing Living Trust Agreement, known to me to be the person described in and who executed the Living Trust Agreement on behalf of the trust, as Grantor, and acknowledged to me that the Living Trust Agreement was executed by said person as ____________________ free act and deed for the purposes therein stated.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year first above written.

 

______________________________

Notary Public

My Commission Expires: ____________________

 

 

Schedule A

Living Trust Agreement of ____________________

Real Estate: ____________________

Bank Accounts: ____________________

Intangible Property: ____________________

Life Insurance: ____________________

Vehicles: ____________________

Other Property: ____________________

 

Durable Power of Attorney

 

KNOW ALL MEN BY THESE PRESENTS, that I .-Your Name- of .-Your City and State- do hereby make, constitute and appoint .-Your Appointee- of .-Appointee City and State- my true and lawful attorney for me and in my name, place and stead, and in my behalf, and for my use and benefit

 

1. To exercise or perform any act, power, duty, right, or obligation whatsoever that I now have, or may hereafter acquire the legal right, power, or capacity to exercise or perform, in connection with, arising from, or relating to any person, item, transaction, thing, business, property, real or personal, tangible or intangible, or matter whatsoever.

 

2. To request, ask, demand, sue for, recover, collect, receive, and hold, possess and invest all sums of money, debts, commercial paper, checks, drafts, accounts, deposits, bequests, devises, notes, interests, bonds, dividends, certificates or deposit, any and all documents of title, chooses in action, and demands whatsoever, whether agreed to or disputed, as now are, or shall hereafter become, owned by, or due, owing payable, or belonging to, me or in which I have or may hereafter acquire any interest, to have, or use, and take all lawful means and equitable and legal remedies, procedures, and writs in my name for the collection and recovery thereof, and to adjust, sell, compromise, and agree for the same; and to make, execute, and deliver for me, on my behalf, and in my name, all endorsements, releases, receipts, or other proper discharges for the same as if done by me personally.

 

3. To maintain, repair, improve, manage, insure, rent, lease, grant, bargain, sell, exchange, pledge and contract for all of the foregoing, and in any way or manner deal with all or any part of any real or personal property whatsoever, tangible or intangible, or any interest therein, that I now own or may hereafter acquire, in my behalf, and in my name; and to effect any or all of the above-described transactions to any entities on such terms and at prices my attorney-in-fact may deem proper, and in my name to make, execute, acknowledge and deliver any deed of conveyance or other instrument, necessary to effect such transactions; and to ask for, demand, sue for, collect, recover and receive all monies which may become due and owing to me by reason of such transaction.

 

4. To conduct, engage in, and transact any and all lawful business of whatsoever nature or kind for me, on my behalf and in my name.

 

5. To receive, deposit, hold, invest or cash all payments which I receive from Social Security, Medicare or any other government program or agency, annuities, pension and retirement benefits, insurance benefits and proceeds and to request, ask, demand, sue for and recover same.

 

6. To make, receive, sign, endorse, execute, acknowledge, deliver, and possess such applications, contracts, agreements, options, covenants, conveyances, deeds, trust deeds, security agreements, bills of sale, leases, mortgages, assignments, insurance policies, bills of lading, warehouse receipts, documents of title, bonds, debentures, checks, drafts, bills of exchange, letters of credit, notes, stock certificates, proxies, warrants, commercial paper, receipts, withdrawal receipts and deposit instruments relating to accounts or deposits in, certificates of deposit of, or investments with or through bans, savings and loan brokers, mutual fund companies or other institutions or associations, proofs of loss, evidences of debts, releases, and satisfaction of mortgages, lien, judgments, security agreements and other debts and obligations and such other instruments in writing of whatever kind and nature as may be necessary or proper in the exercise of the rights and powers herein granted.

 

7. To enter safe deposit box, vault or other storage area leased by me alone or in conjunction with any other person, to sign such documents as may be necessary to gain access to same, and to examine, remove and keep the contents of same fully as I could if I were present.

 

8. To prepare, or cause to be prepared, federal, state and local tax returns and Internal Revenue Service, state and local powers of attorney; to execute and file federal state and local tax returns on my behalf and in my name; to respond to notices and audit inquires and to settle tax disputes.

 

9. To deal with and elect options under retirement plans including but not limited to annuities, pension plans, profit sharing plans, individual retirement accounts, rollovers, transfer and voluntary contributions of same; to apply for and maintain life insurance; to complete charitable contributions; to make statutory elections and disclaimers; and to settle, pursue, or appeal litigation on my behalf and in my name.

 

10. To make, execute, deliver and complete gifts of my property, whether real or personal, tangible or intangible, and without regard to whether such gifts are a part of estate planning or otherwise, and regardless of whether such gifts are a part of a pattern begun by me.

 

11. I grant to said attorney full power and authority to do, take, and perform, all and every act and thing whatsoever requisite, proper, or necessary to be done, in the exercise of any of the rights and powers herein granted, as fully for all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that said attorney, or his substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.

 

12. No person shall be required to inquire as to the circumstances of the issuance or use of this instrument or as to the disposition of any proceeds paid to my attorney based on this instrument.

 

As used herein, “disability” or “incapacity” shall mean that my ability to receive and evaluate information effectively or to communicate decisions, or both, is impaired to such an extent that I lack the capacity to manage my financial resources as determined by the certification of one licensed physician, and shall include by inability to take actions due to involuntary detention or disappearance, as determined by affidavit of one party with knowledge regarding the same. I hereby waive any physician-client privilege for this limited purpose and authorize the disclosure or such certification by the physician to my agent for use by that person as necessary hereunder.

 

If this Durable Power of Attorney is terminated by operation of law, any person acting in reliance upon it without notice of such termination shall be held harmless. The enumeration of specific terms, rights, acts or powers is not intended to limit the definition or scope of powers granted herein.

 

IN WITNESS WHEREOF, ___________________ has executed this Durable Power of Attorney on ___________________ at _________________.

 

 

 

_____________________________ ___________________

 

 

Notary's Acknowledgement

 

State of ____________________ County of __________________

 

On this __________________, before me personally appeared _________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged to me that ____________________ executed the same as __________________ free act and deed.

 

 

 

____________________________________

Notary Public

 

 

P

CONFIDENTIAL

 

Child Identification Report

Printed [DateLong] at [Time]

 

 

[ChildHealth.Portrait]

 

 

Name: [ChildHealth.Name]

Address: [ChildHealth.Address1]

[ChildHealth.Address2]

[ChildHealth.City] [ChildHealth.State], [ChildHealth.Zip]

 

Date of Birth: [ChildHealth.DOB]

Age: [Age]

Height: [ChildHealth.Height]

Weight: [ChildHealth.Weight]

Eye Color: [ChildHealth.EyeColor]

Hair Color: [ChildHealth.HairColor]

Gender: [ChildHealth.Gender]

Blood Type: [ChildHealth.BloodType]

 

 

[ChildHealth.LThumb]

Left Thumb Print

 

[ChildHealth.RThumb]

Right Thumb Print

 

[ChildHealth.LFingers]

Left Fingers Print

 

[ChildHealth.RFingers]

Right Fingers Print

 

 

 

 

Produced by Yada Software - www.yadasoftware.com - (800) 200-6172

 

 

 

CONFIDENTIAL

 

Child Immunization Form

Printed [DateLong] at [Time]

 

 

 

Name: [ChildImmunization.Name] Date of Birth: [ChildImmunization.DOB]

Address: [ChildImmunization.Address1]

[ChildImmunization.Address2]

[ChildImmunization.City] [ChildImmunization.State], [ChildImmunization.Zip]

 

Gender: [ChildImmunization.Gender]

 

 

 

0 - 2 months [ChildImmunization.Imm01Dte] Hepatits B (HepB) [ChildImmunization.Imm01Loc]

 

1 - 4 months [ChildImmunization.Imm02Dte] HepB (booster #1) [ChildImmunization.Imm02Loc]

 

2 months [ChildImmunization.Imm03Dte] DTaP (Diphtheria, Tetanus & Acellular Pertusis), [ChildImmunization.Imm03Loc]

HIB (Haempphilus Influenzae),

IPV (Inactive Polio)

 

4 months [ChildImmunization.Imm04Dte] DTap (booster #2), IPV (booster #1), [ChildImmunization.Imm04Loc]

HIB (booster #1)

 

6 months [ChildImmunization.Imm05Dte] DTap (booster #2), HIB (booster #2) [ChildImmunization.Imm05Loc]

 

6 - 18 months [ChildImmunization.Imm06Dte] OPV (Oral Polio, booster # 2), [ChildImmunization.Imm06Loc]

HepB (booster # 2)

 

12 - 15 months [ChildImmunization.Imm07Dte] HIB, MMR (Measles, Mumps & Rubella) [ChildImmunization.Imm07Loc]

 

12 - 18 months [ChildImmunization.Imm08Dte] Varicella (Chicken Pox) [ChildImmunization.Imm08Loc]

 

15 - 18 months [ChildImmunization.Imm09Dte] DTap (booster #3) [ChildImmunization.Imm09Loc]

 

4 – 6 years [ChildImmunization.Imm10Dte] DTap (booster #4), OPV (booster #3), [ChildImmunization.Imm10Loc]

MMR (booster #1)

 

11 – 16 years [ChildImmunization.Imm11Dte] TD (Tetanus & Diphtheria) [ChildImmunization.Imm11Loc]

Can also provide catch-up doses of HepB and

MMR as well as the initial Varicella vaccine)

Produced by Yada Software - www.yadasoftware.com - (800) 200-6172

Notice of Revocation of

Power of Attorney

 

I, .-Your Name- , of .-Your City and State- , in the County of .-Your County- , through my .-POA Date- , dated .-Title of Original POA- (the “Power of Attorney”), made and appointed .-Your Appointee- , of .-Appointee City and State- , in the County of .-Appointee County- , my true and lawful attorney in fact for the purposes, and with the powers, set forth therein.

 

I hereby give notice that I have revoked, and hereby do revoke, the Power of Attorney, and all powers and authority given, provided or implied therein to .-Your Appointee- .

 

IN WITNESS WHEREOF, I have signed this Notice of Revocation of Power of Attorney on __________________.

 

____________________________________

____________________________________

 

 

 

Notary Acknowledgment

 

State of ____________________ County of __________________

 

On this __________________, before me personally appeared ___________________, to me known to be the person described in and who executed the foregoing instrument and acknowledgment to me that ___________________ executed the same as __________________ free act and deed.

 

 

 

____________________________________

Notary Public

 

Special Power of Attorney

 

KNOW ALL MEN BY THESE PRESENTS, that I .-Your Name- of .-Your City and State- do hereby make, constitute and appoint .-Your Appointee- , of .-Appointee City and State- my true and lawful attorney for me and in my name, place and stead, and in my behalf, and for my use and benefit to exercise or perform any act, power, duty, right or obligation whatsoever that I now have, or may hereafter acquire the legal right, power, or capacity to exercise or perform, but only to the extent set forth below in this Special Power of Attorney

I grant to said attorney full power and authority to do, take, and perform, all and every act and thing whatsoever requisite, proper, or necessary to be done, in the exercise of any of the rights and powers herein granted, as fully for all intents and purposes as I might or could do if personally present, with full power or substitution or revocation, hereby ratifying and confirming all that said attorney, or his substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.

 

No person shall be required to inquire as to the circumstances of the issuance or use of this instrument or as to the disposition of any proceeds paid to my attorney based on this instrument.

 

If this Special Power of Attorney is terminated by operation of law, any person acting in reliance upon it without notice of such termination shall be held harmless.

 

IN WITNESS WHEREOF, ____________________ has executed this Special Power of Attorney on ____________________ at ________________________.

 

 

 

___________________________ _________________________

 

 

 

Acknowledgement

 

 

State of ___________________ County of ________________

 

On this ___________________, before me personally appeared ___________________, to me known to be the person described in and who executed the foregoing instrument and acknowledged to me that ____________________ executed the same as ___________________ free act and deed.

 

 

 

____________________________________

Notary Public

 

 

Estate Planner

 

Estate: [Estate.Name]

[Estate.Address]

[Estate City]

[Estate Zip]

 

Plans/Notes:

[Estate.Plans] ATTORNEY:

 

 

CPA:

 

 

BOOKKEPER OR TAX Preparer:

 

Clothing:

 

 

_____________________________________________________________________

Shoes:

 

 

Accessories:

 

 

_________________________________________________________________________

 

 

Vehicles:

 

[VehicleList] 1.) Car

 

 

2^nd Car)

 

 

3^rd Car)

Total Value $ [VehicleValue]

 

Estate (HOME)Property or Properties:

 

1.)

 

 

 

 

2.)

 

 

 

 

3.)

 

 

$ [PropertyValue]

 

Boat

 

 

Painting:

 

 

Jewelry:

 

 

Household Goods:

 

 

_________________________________________________________________________

 

Insurance Policys:

 

Whole Life Insurance Company:

 

 

Term Insurance Company:

 

 

Health Insurance Company:

 

 

 

Homeowners Insurance Company:

 

 

Renter Insurance Company:

 

 

Other Insurance Company:

 

 

_________________________________________________________________________

 

 

Medication:

 

 

Lock Box:

Box #

Code; Back up this listing somewhere:

 

 

Pictures Take and Given to Insurance Company:

 

Yes

No

 

 

If, a Fire or Earthquake or Natural Disaster or Burglar/Robbery:

 

The Insurance Company may not pay you for lack of “PROOF” you must take pictures of all items so you can get the full value of your estate. With coverage of loss or stolen.

 

 

_________________________________________________________________________

 

 

 

 

_________________________________________________________________________

TOTAL Estate Value: $ [EstateValue]