Sample Living Trust Application And Agreement Form Page 3

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11.
The Trustee(s) certify that they are duly appointed under the Trust Instrument and that by the authority vested in them under the Trust Instrument, they, acting alone or in concert,
are authorized and empowered to transact business of any kind in connection with the Trust’s accounts at the Credit Union. It is agreed that any transaction by the above named
Trustee(s) acting alone or in concert, shall be valid and discharge the Credit Union from any liability. Trustee(s) agree that any account opened at the Credit Union on behalf of
the Trust shall be governed by the terms of this Agreement, as well as the Credit Union’s Bylaws, additional Account Agreements and Truth-in-Savings Disclosures, which are
incorporated herein by reference.
12.
Trustee(s) may authorize the transaction of any business on accounts held at the Credit Union in the name of the Trust by their oral or written instruction to the Credit Union.
Trustee(s) may obtain funds from the Trust’s accounts in their names or the names of third parties upon trustee(s) written or oral instruction.
13.
The Trustee(s) may receive, take possession of, release, assign, mortgage, pledge, hypothecate or otherwise use assets of the trust as security for a loan from the Credit Union
or any other purpose except as specifically set forth below:
___________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
14.
If the Trustee(s) named on this Application and Agreement borrow from the Credit Union and the Trust Instrument must be examined by a third party (for example, a title company),
the Credit Union agrees to forward a copy of the Trust Instrument from the Trustee(s) to a third party only if Trustee(s) present a sealed envelope, containing the Trust Instrument to
the Credit Union. The Credit Union will not accept copies of the Trust Instrument which are not in a sealed envelope. Further, the Credit Union will not keep any Trust Instruments
in its files or be liable for the contents of a Trust Instrument. The Trustee(s) shall sign on a form designated by the Credit Union that the Credit Union has received the Trust
Instruments in a sealed envelope when the Trustee(s) present(s) the Trust Instruments to the Credit Union.
15.
Trustee(s) agree that if they borrow from the Credit Union and use Trust assets as collateral, then the Trustor(s) or the Trustee(s), as members of the Credit Union, will, by
signing all documents relating to the loan, obligate themselves as individuals in addition to the signatures of the Trustee(s) on behalf of the trust.
16.
Trustee(s) agree to promptly notify the Credit Union if any of the Trustor(s)/Trustee(s) die or become incapacitated. Prior to any Successor Trustee(s) transacting business on
accounts held at the Credit Union in the name of the Trust (including any withdrawal pursuant to Section 17 below), the successor Trustee(s) must provide the Credit Union
with either a letter of registration signed by the existing Trustee(s) or a certified copy of the death certificate for the Trustee(s). The Successor Trustee(s) must complete a
new Application and Agreement as well as a Certification of Trust. Death, resignation or incapacitation of any Trustor(s)/Trustee(s) shall not revoke the authority of the Credit
Union to act under this Application and Agreement until written notice of death, resignation or incapacitation has been presented to the Credit Union and the Credit Union has
reasonable opportunity to act on it. However, upon presentation of a certified copy of Trustee(s) death certificate(s), resignation or judicial declaration(s) of incapacity, the
Credit Union is authorized to act upon designated Successor Trustee(s) instructions in accordance with the terms of this Application and Agreement.
17.
Successor Trustee(s) shall close all accounts opened under this Application and Agreement within 90 days after receiving notification of death, resignation or incapacity of the
Trustee(s). Credit Union is authorized, but not required, to close any accounts opened under this Application and Agreement upon the 91st day after receiving notice of the Trustee(s)
death(s), and mail a check to the designated Successor Trustee(s), for the balance of the account and made payable to the designated successor Trustor(s)/Trustee(s) or the
above-named trust. The parties may be able to maintain the Trust accounts at the Credit Union under a new Application and Agreement. See a Credit Union account representative
for eligibility.
18.
Trustor(s) and Trustee(s) acknowledge and agree that the Credit Union’s sole obligation to the Trustor(s)/Trustee(s) is as a depository institution and is a debtor/creditor
relationship and nothing in this Application and Agreement or in the Trust Instrument shall be construed to impose any duties or obligations whatsoever upon the Credit
Union as a trustee or other fiduciary under the Trust Instrument or otherwise.
19.
All Trustor(s) and Trustee(s) hereby agree for the Trust, themselves and all Trust Beneficiaries for the life of the Trust and the statutory life of any cause of action involving any
account of the Trust to indemnify and hold harmless the Credit Union from any and all claims, suits, actions, damages, judgements, costs, charges and expenses, including,
but not limited to, court costs and attorney’s fees, resulting from any and all liability, loss and damage of any nature whatsoever that the Credit Union shall or may sustain
resulting from the establishment, maintenance and transaction of any business on any Trust account at this Credit Union. The Trustor(s) and Trustee(s) on behalf of the Trust
agree to pay any necessary expenses, attorney’s fees or costs incurred in the enforcement of this Application and Agreement.
20.
Trustor(s) and Trustee(s) acknowledge and agree that the Credit Union is relying upon the statements, representations and warranties made by the Trustor(s) and Trustee(s)
contained in this Application and Agreement, and that the Credit Union shall not be responsible in any way for verifying either the existence, validity or legality of the Trust
itself, or the authority or powers of the Trustee(s) under the governing Trust Instrument to establish, maintain or transact any business on the Trust accounts. The Credit
Union reserves the right at any time to require the Trustee(s) to execute and provide a Certification of Trust pursuant to California Probate Code Section 18100.5, in form
and substance acceptable to the Credit Union, affirming the existence of the Trust and the authority and powers of the Trustee(s) thereunder.
21.
This Application and Agreement incorporates the full and complete understanding concerning accounts, and transaction of business thereon at the Credit Union for the above
named Trust.
Part I. Taxpayer Identification Number (TIN)
Part II. For U.S. Payees Exempt From
Backup Withholding
Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded
entity, see Part I of “Specific Instructions” to Payer’s Request for Taxpayer Identification Number and Certification in the Account Agreement and
(see “Specific Instructions”)
Truth-In-Savings Disclosure. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN in “Specific
Instructions” Part I.
Social Security Number
Employer Identification Number
OR
____ ____ ____ -- ____ ____ ____ ____ -- ____ ____ ____
____ ____ -- ____ ____ ____ ____ ____ ____ ____
Note: If the account is in more than one name, see the chart for guidelines on “What Name and Number To Give the Requester.”
Part III. Certification
Under the penalties of perjury, I certify that:
1.
The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2.
I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholdings
as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholdings, and
3.
I am a U.S. person (including a U.S. resident alien).
Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest or dividends
on your tax return. For real estate transactions, item 2 does not apply. Cross out item 3 and complete a W-8 BEN if you are not a U.S. person. For mortgage interest paid, acquisition or abandonment of secured
property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See “Specific Instructions”).
Note: The Internal Revenue Service does not require your consent to any provision of this document other than the certification required to avoid backup withholding.
X
Signature of U.S. Person
_______________________________________________________________________________________________________________ Date ___________________________
Recommendation to Seek Professional Advice: THIS AGREEMENT AFFECTS YOUR LEGAL RIGHTS. IN PROVIDING THIS AGREEMENT FOR THE ESTABLISHMENT OF THIS
ACCOUNT, THE CREDIT UNION MAKES NO REPRESENTATION AS TO ANY TAX, PROBATE AVOIDANCE, OR FINANCIAL OR ESTATE PLANNING ADVANTAGE, BENEFIT OR
RESULT OF ANY KIND WHATSOEVER. IF YOU DESIRE ASSISTANCE CONCERNING THE INTERPRETATION, MEANING OR EFFECT OF ANY OF THE PROVISIONS OF THIS
AGREEMENT, YOU SHOULD SEEK THE ADVICE OF AN ATTORNEY OR OTHER COMPETENT PROFESSIONAL.
Under penalties of perjury, the Trustor(s)/Trustee(s) certify that the information on this form above is true and correct and agree to its terms and conditions. The Trustee(s) also
certify that the signature appearing below are genuine signatures of said authorized persons.
IF THE TRUSTOR(S) IS/ARE ALSO TRUSTEE(S) UNDER THE TRUST INSTRUMENT, AND HAVE CHECKED THE BOX IN SECTION 5 ON THE REVERSE, THE
TRUSTEE(S)/TRUSTOR(S) MAY SIGN ONCE AND CHECK BOTH BOXES UNDER THEIR SIGNATURE.
_____________________________________________________________________
_____________________________________________________________________
I I
I I
I I
I I
Signature
As
Trustor
Trustee
Signature
As
Trustor
Trustee
_____________________________________________________________________
_____________________________________________________________________
I I
I I
I I
I I
Signature
As
Trustor
Trustee
Signature
As
Trustor
Trustee
_____________________________________________________________________
_____________________________________________________________________
Signature
As
I I
Trustor
I I
Trustee
Signature
As
I I
Trustor
I I
Trustee
FOR CREDIT UNION USE ONLY
Prepared By:__________________________________________________Date________________
The Application for membership on the reverse hereof approved by the following CREDIT UNION officer:
Signature/Title:___________________________________________________________________________________________________ Date_______________________
ORIGINAL - TO CREDIT UNION
COPY - RETAIN
FORM 216B REV. 2/09
00522190

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