Irrevocable Life Insurance Trust

Document Sample
Irrevocable Life Insurance Trust Powered By Docstoc
					                                      TRUST AGREEMENT


        THIS TRUST AGREEMENT is entered into effective the _____ day of _______, 2010, by
and between _________________________________________, of [address]__________
[city], __________ County, __________ [state] (hereinafter referred to as the "Settlor"), and the
__________ National Bank, [a __________ banking association organized and existing under the
laws of the State of __________, (hereinafter referred to as the "Trustee").

                                              RECITALS

        The Settlor, desiring to create a trust for the benefit of the beneficiaries mentioned below, has
transferred to the Trustee ownership of certain insurance policies on the Settlor's life, which policies
are described in the attached schedule and made a part of this trust agreement. The policies presently
or hereafter will contain a provision making the Trustee the beneficiary of the policies. The proceeds
of the policies, together with any other property that may later become subject to this trust, shall
constitute the trust estate and shall be held, administered, and distributed as provided in this
agreement.

      Now, therefore, in consideration of the mutual covenants and promises contained in this
Agreement, it is hereby agreed as follows:

                                             SECTION I

                        PROVISIONS RELATING TO TRUST ASSETS

        1.1 Provisions Relating to Insurance Policies.

        A. With respect to any insurance policies which are or may become subject to this trust
agreement, the Settlor shall retain no incidents of ownership in them. The Trustee shall have all of
the rights of the owner of such policies and, without the consent or approval of the Settlor or any
other person, may sell, assign or hypothecate those policies and may exercise any option or privilege
granted by the policies, including, without limitation, the right to change the beneficiaries of the
policies, to borrow any sum in accordance with the provision of the policies, to surrender or convert
the policies, to receive all payments, dividends, loan, or surrender values, benefits, or privileges of
any kind which may accrue on account of the policies during the Settlor's lifetime, and generally all
of the incidents of ownership of the policies. The Settlor shall assent to or join in the execution of
any instrument requested by the Trustee to enable it to exercise the rights transferred to it.

        B. Prior to the maturity of any insurance policy, the Trustee shall not be obligated to pay any
premiums, dues, assessments, or other charges which may become due and payable on any policies,
or to see that such payments are made, or to notify the Settlor or any other person that such
payments are or will become due. The Trustee shall not be liable for any failure by the Settlor or any
other person to make such payments and shall be under no responsibility or liability of any kind in
case the premiums are not paid. The Settlor shall not be obligated to maintain any such policy in
force.
        C. No insurance company whose policy or policies shall be deposited under this agreement
and who shall make payment of the proceeds to the Trustee shall be required to inquire into or take
notice of any of the provisions of this instrument or to see to the application or disposition of the
proceeds of the policies. The receipt of the Trustee given to any such insurance company shall be
effectual to release and discharge them from any payment so made and shall be binding on every
beneficiary of the trusts created by this agreement.

         D. On and subsequent to the death of the Settlor, the Trustee shall use its best efforts to
collect the proceeds of the policies that are then payable to the Trustee or may, at its option, exercise
any of the options of settlement that may at that time be available to the Trustee under the terms of
any of the policies. The Trustee may institute any proceedings at law or in equity in order to enforce
the payment thereof, it being distinctly understood, however, that the Trustee shall not, except at its
option, enter into or maintain any litigation to enforce the payment of the policies until it has been
indemnified to its satisfaction against all expenses and liabilities to which it may, in its judgment, be
subjected by any action on its part. The Trustee is authorized to compromise and adjust claims
arising out of insurance policies or any of them, on such terms and conditions as it may deem just.
The decision of the Trustee shall be binding and conclusive on all interested persons and
corporations. The Trustee shall be responsible for the proceeds of the insurance only when, as, and if
collected or paid to it. The Trustee shall not be liable to anyone if for any reason the policies shall
lapse or be otherwise uncollectible in whole or in part.

        1.2 Additions to Trust.

        Additional funds, securities, policies of insurance payable to the Trustee, and other property,
including deferred compensation and interest in pension and profit sharing plans made payable to the
Trustee, may be transferred by the Settlor or any other person, by will or otherwise, from time to
time, to the Trustee as additions to the trust. All such further funds, securities, insurance policies,
and other property shall be dealt with by the Trustee pursuant to the terms of this agreement,
provided that all such additions shall be such as are acceptable to the Trustee. A description of such
additional funds, securities, insurance policies, and other property shall be attached to this agreement
by appropriate schedules.

                                             SECTION II

                    DISTRIBUTION AND ADMINISTRATION OF TRUST

        2.1 During Lifetime of Settlor.

         A. During the lifetime of the Settlor, the Trustee shall collect the annual net income of the
trust estate and shall use such income, or if such income shall be insufficient, to the extent principal
is available, use the principal of the trust estate, to pay any premiums or assessments due on any
insurance on the Settlor's life which constitutes an asset of the trust estate.

        The remaining income, if any, shall be distributed among the beneficiaries, in the same
manner as the income shall be distributed after the Settlor's death provided, however, that no income
shall be used to relieve the Settlor of any support obligations the Settlor may have to any such
beneficiary. Any income not so distributed shall be retained and added to principal.
         B. It is the intent of the Settlor that any insurance premium paid either by the Settlor or by
the Settlor's employer on insurance which is part of the principal of this trust and which premium or
part of it is treated as a gift by the Settlor to the beneficiaries of this trust for federal gift tax
purposes, be a gift of a present interest so as to qualify for the gift tax annual exclusion. Therefore,
during any year in which any payment of an insurance premium by the Settlor or the Settlor's
employer is deemed to be a gift to the beneficiaries or any beneficiary of this trust, each beneficiary
of the trust to whom a part of the gift is attributable shall have the noncumulative right to withdraw
from the trust an amount equal to that portion of the gift attributable to that beneficiary but not more
than the greater of $5,000 or __________ [5%] of the value of the principal of the trust (as
determined by the Trustee) as of the first day of the trust fiscal year in which the gift was deemed to
have occurred. Further, during any year in which a gift of an insurance premium is attributable to
the Settlor, each beneficiary, in order to effect and utilize the right of withdrawal mentioned above,
shall have the right to require the Trustee to convert a sufficient portion of the principal of the trust
to a form of investment which will enable the Trustee to deliver to the beneficiary such amount as he
or she shall be entitled to receive as provided above. In the event such conversion shall be
impracticable, the Trustee may satisfy the exercise of any right of withdrawal by distributing to the
beneficiary making the withdrawal cash or other assets, including insurance policies or interests in
insurance policies.

       The Trustee shall notify beneficiaries of the existence of such withdrawal right and the
property to which it pertains.

        2.2 Following Death of Settlor.

        On and subsequent to the death of the Settlor, the Trustee shall hold, administer, and
distribute the remaining principal and undistributed income and all other funds and properties
coming into its possession under this agreement as follows:

        A. During the lifetime of the Settlor's spouse, the income and the principal of the trust estate
shall be paid from time to time to or for the benefit of the Settlor's spouse, and children and more
remote issue of the Settlor at such times and in such amounts and proportions, equal or unequal, as
the corporate Trustee, in its sole discretion, shall determine to be in their best interest. The Settlor's
spouse shall be the preferred beneficiary of this trust to the extent that other property available shall
not be sufficient for the proper care and support of the spouse.

        B. On the death of the Settlor's spouse, or in the event the Settlor's spouse does not survive
the Settlor, the trust estate shall be held and administered by the Trustee as follows:

         The Trustee shall pay to or for the benefit of each of the Settlor's children then living, and the
issue of any deceased child of the Settlor, so much of the income and principal of the trust estate as
it, in its sole and uncontrolled discretion, shall determine to be in their best interest. The Trustee
shall have the right at any time and from time to time to make payments of different amounts, and to
omit payment to or for the benefit of any or all of the above-named beneficiaries as it shall
determine.

        C. In addition to the foregoing provisions for the Settlor's children, the Trustee may make
additional payments from time to time, in its discretion, in order to provide each of the Settlor's
children with such funds as the Trustee may deem advisable to assist him or her in establishing a
business or profession, purchasing a home, or for any other special purpose that it may determine to
be in his or her best interest. Before mailing each such distribution, the Trustee shall take into
consideration the anticipated financial requirements of the Settlor's other children for maintenance,
support, and education.

         D. At such time as the Settlor's youngest living child shall attain the age of 23 years, or on
the death of the Settlor's last surviving child, whichever first occurs, the Trustee shall divide the trust
estate into as many equal parts or shares as the Settlor shall have then living children and deceased
children with then living issue. In determining the value of each of such shares, there shall be added
to the aggregate value of the trust estate the value of any distribution to any of the Settlor's children,
living or deceased, pursuant to the paragraph next preceding. The shares of any such child or the
issue of any deceased child shall thereafter be reduced by the value of the distribution. In making
this reduction, the value of any part of the trust estate distributed to such child shall be determined as
of the time the distributions were actually made, and Trustee's determination of those values shall be
final and conclusive. The shares divided and determined as described above, shall be held,
administered, and distributed as follows:

        1. The Trustee shall at once deliver one of such shares to each of the Settlor's then living
children who has attained the age of 30 years, and one of those shares to the then living issue of any
deceased child of the Settlor, such issue to take by right of representation.

         2. The Trustee shall hold one of each of the remaining shares as a separate and distinct trust
for the benefit of each child of the Settlor then living who has not attained the age of 30 years (such
child being sometimes referred to as the beneficiary of the trust so held for his or her benefit). Each
such trust shall be held and administered without distinction between principal and income on the
terms and conditions provided below. During the term of each such trust, the Trustee shall pay to or
for the benefit of the beneficiary such amounts from the trust estate, and at such times as the Trustee,
in its sole and uncontrolled discretion, shall determine to be in the best interest of the beneficiary.

         3. As each beneficiary attains the age of 25 years, one-half of the trust held for the benefit of
the beneficiary shall be distributed; when each beneficiary attains the age of 30 years, the trust shall
terminate and all of the assets of the trust shall be distributed. All distributions under this Subsection
3 shall be made to the beneficiary of the trust without reservations of any kind, free and discharged
of all trusts under this agreement.

         4. If any beneficiary shall die before the complete distribution of the trust held for the benefit
of the beneficiary, the trust shall terminate and the assets of the trust shall be paid over and delivered
to the issue of the beneficiary then living, such issue to take by right of representation. In the absence
of such issue, the property shall be delivered over in equal shares to the Settlor's then living children,
and to the issue of any deceased child of the Settlor then living, such issue to take by right of
representation; provided, however, that if there is in existence under this agreement a trust for the
benefit of the distributee, distribution of the property shall be made by adding the same to the trust,
to be held, administered, and distributed as if it had originally formed a part of the trust.

        5. The Trustee shall distribute any share intended for the issue of any deceased child of the
Settlor to such issue without reservations of any kind, free and discharged of all trusts under this
agreement; provided, however, that if any such issue shall be under the age of majority at such time,
the Trustee is authorized in its discretion to hold and administer the share of such issue in trust until
he or she attains the age of majority, and during such period to pay to or for the benefit of such issue
so much of the share held for the benefit of the issue as, in its sole and uncontrolled discretion, the
Trustee shall determine to be necessary or desirable for the care, support, maintenance, and
education of the issue. When the issue attains the age of majority, or on his or her death, whichever
first occurs, the entire share of the issue shall be paid over and delivered over to the issue, or his or
her estate, as stated above.

        2.3 General Provisions.

        A. Distribution in Event of Failure of Named Beneficiaries to Survive.

        If at the time provided in this agreement for the distribution of the principal of any trust
created by or administered under this Section II, there shall be no beneficiaries then living, the trust
shall immediately terminate and the remaining trust estate shall be divided into two equal shares.
One share shall be distributed to the persons who would be entitled to receive the Settlor's personal
property and the other share shall be distributed to the persons who would be entitled to receive the
personal property of the Settlor's spouse, such persons taking in the proportions provided by law as if
the Settlor and the Settlor's spouse both died at that time intestate, each surviving the other and
domiciled in __________ [state].

        B. Early Termination of a Trust.

         Any trust may be terminated earlier than the time provided in this instrument when the
Trustee, in its discretion, determines that such action would be in the best interest of the income
beneficiaries because of circumstances not known or contemplated during Settlor's lifetime,
including, but not limited to, significant depletion of trust assets or changes in laws which may
negate trust purposes. On making a decision for early termination, the Trustee shall distribute all of
the trust estate to the Settlor's spouse. If the Settlor's spouse is not living and the trust estate has not
been divided into equal shares as provided by Section II, 2.2 D, then the Trustee shall distribute all
of the trust estate in equal shares, one for each of the Settlor's then living children and one for the
surviving issue, by right of representation, of each child who shall have died before that time leaving
issue surviving. If the Settlor's spouse is not living and the trust estate has been divided as provided
in Section II, 2.2 D, then the Trustee shall distribute all of the trust estate to the then current income
beneficiary of the trust created for his or her benefit. Persons named to receive the remainder of the
trust principal, whether or not such interest is vested, shall have no claim against early distribution to
other persons and any such remainder interest shall lapse.

        C. Distribution for Benefit of Beneficiary.

         Any distribution of income or principal made by the Trustee during the term of the trust,
whether before or after the beneficiary reaches full age, may, in the Trustee's discretion, be made
directly to the beneficiary, to any person having legal or actual custody of the beneficiary, to any
institution attended by the beneficiary, or in any manner whereby it may reasonably be expected that
the funds will be expended for the benefit of the beneficiary. The Trustee shall be under no duty to
audit the use of those funds.

        D. Spendthrift Clause.

         The right of any beneficiary to receive distributions under this instrument shall not be subject
to any conveyance, transfer, or assignment by any beneficiary, or be pledged as security for the debts
of any beneficiary through legal process or otherwise. It is the Settlor's intention to place the absolute
title to the property held in trust, together with all income, accruals and increases thereof, in the
Trustee with power and authority to pay out the same only as authorized by this agreement. Any
attempted sale, anticipation, assignment, or pledge of any of the funds or property held in trust by the
beneficiaries shall be null and void and shall not be recognized by the Trustee. If, notwithstanding
the foregoing, any beneficiary shall attempt to effect any such sale, anticipation, assignment, or
pledge of the trust property, the Trustee shall withhold from the beneficiary all or part of the benefits
accruing under this agreement for such length of time during the duration of the trusts as the Trustee
may deem to be in the best interest of the beneficiary, during which time the Trustee may, in its
discretion, distribute assets otherwise payable to the beneficiary to or for the benefit of the spouse
and/or children of the beneficiary.

        E. Trust Estate Subject to Federal Estate Tax.

         In the event (a) any part of this trust is taxable in the Settlor's estate for federal estate tax
purposes, and (b) the Settlor shall leave the Settlor's spouse surviving the Settlor, to whom the
Settlor has left property by the Settlor's will or in a trust which qualifies for a marital deduction for
federal estate tax purposes, then the Trustee shall transfer such part of this trust that is taxable in the
Settlor's estate for federal estate tax purposes (together with the income accumulated thereon
subsequent to the Settlor's death) to or for the benefit of the Settlor's spouse (either outright or in a
trust which qualifies for the marital deduction) in such manner and form as may be provided in the
Settlor's will and/or trust which became effective on the Settlor's death. It is intended that any
property passing under this agreement qualify for the marital deduction.

                                             SECTION III

                 ADMINISTRATION POWERS AND DUTIES OF TRUSTEE

        3.1 Allocation and Division of Assets Among Trusts and Beneficiaries.

        Unless otherwise specifically provided in this agreement, in the allocation of assets among
the beneficiaries and trusts created under this agreement, the Trustee may make any division or
allocation in cash or in kind, or partly in cash and partly in kind, and, as to any property incapable of
exact division, it shall not be necessary for the Trustee to divide the same physically into parts to
which each trust shall be entitled but individual parts thereof may, by appropriate book entries, be
allocated among the trusts. In any case where exact division of property or the allocation of
undivided interests in that property between or among the trusts is not practical or expedient, the
Trustee may select assets to be appropriated in whole or in part to any of those trusts.

       The Trustee, in its sole discretion, is authorized to allocate particular assets or parts of assets
or undivided interests therein to any one or more beneficiaries under this agreement and to any trust
hereby created, taking into account the income tax basis of those assets as it shall deem to be for the
best interest of the beneficiary or trust. For the purpose of any such division or distribution, the
Trustee may select such securities or other properties as it may deem suitable and to place such
valuation on the property as it may determine. The decision of the Trustee shall be final and binding
on all parties in interest. The selection shall not be subject to question by any beneficiary and no
adjustments shall be made to compensate for a disproportionate allocation of unrealized gain for
federal income tax purposes.

       3.2 Care and Custody of Assets.

         The Trustee shall have the entire care and custody of all of the assets comprising the trust
estate and shall maintain full and accurate books of account and records of receipts and
disbursements and other financial transactions relative to the trust estate, all of which shall be
available for inspection at any reasonable time by any beneficiary of this trust. The Trustee may
deposit securities held by it with a depository, such as the __________ Depository Trust Company,
or, in the case of government securities, with a United States Federal Reserve Bank.

       The Trustee shall render to each of the presently vested beneficiaries of this agreement an
annual accounting of all receipts and disbursements in relation to the trust account, including an
inventory of the trust estate held in trust for such beneficiary.

       3.3 Rights, Powers, and Duties of Trustee.

         The rights, powers, and duties of the Trustee with respect to the investment and management
of the trust estate of any trust created in this agreement shall be:

        A. To retain any security or other property of the trust estate, so long as such retention
appears advisable, to exchange any such security or property for other securities or properties, and to
retain such items received in exchange without liability for any loss that may be incurred thereby
and without regard to the proportion that any one asset or class of assets may bear to the whole.

        B. To sell, exchange, assign, transfer, and convey any security or property, real or personal,
held in the trust estate, at public or private sale, at such time and price and on such terms and
conditions (including credit) as the Trustee may determine, and to grant options to purchase or
acquire any trust estate property.

         C. To invest and reinvest in such stocks, bonds, and other securities and properties as it may
deem advisable, including stocks and unsecured obligations, undivided interests, interests in
investment funds, mutual funds, legal and discretionary common trust funds, including common and
collective trust funds operated and managed by the corporate Trustee, leases and property which are
outside __________ [state], all without diversification as to kind or amount, without being
restricted in any way by any statute or court decision (now or hereafter existing) regulating or
limiting investments by fiduciaries.

        D. To register and carry any property in its own name or in the name of its nominee or to
hold the property unregistered but without thereby increasing or decreasing the Trustee's liability as
a fiduciary.
       E. To exercise or sell any option, right, or privilege to purchase stocks or securities or
property which might become available during the administration of the trust estates under this
agreement.

       F. To vote in person or by proxy any stock or securities held and to grant such proxies and
powers of attorney to such person or persons as it may deem proper.

        G. To borrow money on terms acceptable to it from any person or corporation, including the
__________ National Bank of __________, to pledge or mortgage any property as security
therefor, and to renew any indebtedness incurred by the Trustee.

         H. To determine the manner of ascertainment of income and principal, and the
apportionment between income and principal of all receipts and disbursements (provided, however,
that all dividends on shares of mutual funds derived from realized capital gains shall be treated as
principal); and to select an annual accounting period. Without limiting the discretion granted in
respect to other administrative powers, the discretion intended by this Paragraph may be exercised
without regard as to whether there is any doubt or uncertainty under general law as to the proper
classification of a particular receipt or disbursement, so long as it is exercised to effectuate the
Settlor's overall intention that due and impartial consideration be given to the interest of those
entitled to income as well as those entitled to principal.

        I. To mortgage, encumber, lease, exchange, pledge, partition, plat, subdivide, dedicate to
public use, grant, and release easements, improve, repair, surrender, abandon, or otherwise deal with
or dispose of my and all property of whatever character and wherever situated forming a part of the
trust estate, at such time or times and in such manner and on such terms as in its absolute and
uncontrolled discretion may be deemed expedient and proper.

        J. To take any action with respect to conserving or realizing on the value of any trust estate
property, and with respect to foreclosures, reorganizations, or other changes affecting the trust estate;
to collect, pay, contest, adjust, arbitrate, compromise, sue on, defend, or abandon demands of or
against the trust estate wherever situated; and to execute contracts, notes, conveyances, and other
instruments containing provisions excluding personal liability.

        K. To consent to and participate in any plan for the liquidation, reorganization,
consolidation, or merger of any corporation, any security of which is held.

       L. To employ accountants, attorneys, and such agents as Trustee may deem advisable, with
or without discretionary power; to pay reasonable compensation for their services and to charge
same to (or apportion same between) income and principal as it may deem proper.

        M. To deposit trust funds in a bank, to hire, rent or lease a safe deposit box or storage facility
for the protection of trust assets and insure the assets of the trust against damage or loss and the
Trustee against liability with respect to third persons.

        N. To exercise all of the powers set forth in __________ [cite applicable statute], which
are hereby incorporated by reference as that statute exists on the date of this agreement, except as
other provisions specifically provide to the contrary.

        O. The powers set forth in __________ [cite applicable statute] are in addition to the
powers and authorities that are granted in other sections of this agreement and that are conferred on
the Trustee by law, and may be exercised without the prior leave or subsequent confirmation of any
court from the date this agreement is executed until the final distribution of the assets of each trust
created by this agreement.

        3.4 Payment of Fees and Expenses.

       The trust estate and the income from it shall be chargeable with the reasonable expenses of
the Trustee in the administration of the trust and with reasonable compensation for the services of
the Trustee. Fees as set forth in periodically published schedules of the corporate Trustee shall be
considered reasonable.

        3.5 Bond.

         No Trustee shall be required to give any bond or other security for the faithful performance
of its duties and powers.

        3.6 Resignation of Trustee.

         The Trustee shall have the right to resign at any time by delivering 30 days' written notice to
that effect to each of the living adult beneficiaries of this agreement then eligible to receive income,
who shall select and appoint a successor Trustee; provided, however, that any such successor
Trustee shall be a corporation authorized to administer trusts under the laws of the United States or
any state. In the event a corporate Trustee has not accepted the appointment as successor Trustee
after a period of 60 days, then the current acting Trustee shall have the power, in its sole discretion,
to appoint a successor Trustee, who may be an individual.

                                            SECTION IV

                                MISCELLANEOUS PROVISIONS

        4.1 Property in Another Jurisdiction.

        If at any time any trust property is situated in a jurisdiction in which the Trustee is unable or
unwilling to act, the Trustee may appoint a person (who may be an officer or employee of the
Trustee or corporation) to act as Trustee with respect to that property and may delegate to that
person or corporation such administrative powers as may be necessary or desirable to deal with the
property and to accomplish the purpose of the trust. The net income from the property and any net
proceeds of its sale shall be paid over to the principal Trustee.

        4.2 Eliminating Distinction Between Genders and Numbers.

        As used in this instrument, the masculine, feminine, or neuter gender and the singular or
plural number shall each be allowed to include the others whenever the context so indicates.
        4.3 Definition of Spouse.

      All reference to the Settlor's spouse in this agreement shall be deemed to mean the
__________ [wife or husband] of the Settlor.

        4.4 Irrevocability.

       The Settlor may neither modify nor alter this agreement in any manner, nor may the Settlor
revoke it, in whole or in part.

        4.5 Definition of Child and Issue.

       Whenever used in this agreement the words "child," "children," and "issue" shall be
construed to include any legally adopted person and that person's descendants, whether natural or
adopted.

        4.6 Provisions Relating to Rule Against Perpetuities.

        If the provisions of any trust created by this for any beneficiary shall be violative of the rule
against perpetuities, then the trust for the beneficiary shall be based on the lives of all beneficiaries
of all other trusts whose lives shall be competent under that rule. Such a trust for the beneficiary
shall continue with all of its other provisions until the expiration of 21 years after the death of the
last survivor of the competent lives unless the provisions of any such trust as continued by this
Section IV, 4.6, shall direct the conveyance of any part or all of the trust to the beneficiary to take
place at a time before the termination of the trust as continued under this Section IV, 4.6, in which
case the conveyance shall be made in accordance with such direction.

        4.7 Registration of Trust Agreement.

       The Trustee shall be exempt from registering this trust agreement and any of the trusts
created under it as may be required by __________ [cite applicable statute], or any other
applicable statute.

        4.8 Applicable Law.

        The validity, construction, and all rights under this agreement shall be governed by the laws
of __________ [state]. If any provision should be invalid or unenforceable, the remaining
provisions shall continue to be effective fully. In any proceedings involving the construction or
operation of this agreement, the then living beneficiaries shall represent all unknown and
undetermined beneficiaries. Any order, judgment, or decree rendered in such proceeding shall be
binding on all unknown and undetermined beneficiaries.

       IN WITNESS WHEREOF, the parties have executed this Agreement effective as of the
day and year first set forth above.

[FIRST PARTY:]
                  IF BUSINESS ENTITY:

                  [Name of Company                            ]



                  By: ___________________________________

                  Name: _________________________________

                  Title: __________________________________


                  IF INDIVIDUAL:


                  Sign: __________________________________

                  Print Name: _____________________________


[SECOND PARTY:]


                  IF BUSINESS ENTITY:

                  [Name of Company                            ]



                  By: ___________________________________

                  Name: _________________________________

                  Title: __________________________________


                  IF INDIVIDUAL:


                  Sign: __________________________________

                  Print Name: _____________________________
                                    [Notary Seals, if needed]

[IF BUSINESS ENTITY]

STATE OF _____________ )

______________ COUNTY )

                I, the undersigned, a Notary Public in and for said County, in said State, hereby
certify that ______________________ [Name], whose name as ________________ [Title] of
_____________________ [Name of Company], a _____________ [Entity Type] formed and
existing under the laws of the State of ___________ [State in which entity was formed], is signed to
the foregoing Agreement, and who is known to me, acknowledged before me on this day that, being
informed of the contents of said Agreement, ______ [he, she or it], as such officer or director and
with full authority, executed the same voluntarily for and as the act of said corporation on the day
the same bears date.

               Subscribed and sworn to before me on this ____ day of _____________, 20__.


                                              _________________________________________
                                              Notary Public
                                              My Commission Expires: ____________________
[IF INDIVIDUAL]

STATE OF _____________ )

______________ COUNTY )

                I, the undersigned, a Notary Public in and for said County, in said State, hereby
certify that ____________________________ is signed to the foregoing Agreement, and who is
known to me, acknowledged before me on this day that, being informed of the contents of said
Agreement, ____ [he or she] executed the same voluntarily on the day the same bears date.


               Subscribed and sworn to before me on this ____ day of _____________, 20__.


                                              _________________________________________
                                              Notary Public
                                              My Commission Expires: ____________________

				
DOCUMENT INFO
Shared By:
Stats:
views:435
posted:2/23/2010
language:English
pages:12
Description: Legal Documents - William M. Keever