INSTRUCTIONS FOR GIFTING STOCK

Size: px
Start display at page:

Download "INSTRUCTIONS FOR GIFTING STOCK"

Transcription

1 INSTRUCTIONS FOR GIFTING STOCK Before gifting your corporate stock, please read the following instructions to understand the procedure and the consequence of gifting your stock: An Aleut Corporation shareholder can gift stock to a child, grandchild, greatgrandchild, a niece, a nephew, a brother, or a sister. Note: This includes children legally adopted into your family, provided the adoption occurred before such children were 18 years of age and you are able to furnish the required substantiating documents. Not included are stepchildren (and the stepchildren of your children or grandchildren), and stepbrothers and stepsisters who have not been legally adopted into your family. By law, the individual receiving the gifted stock must be Native or a descendant of a Native and related to the shareholder giving the gift of stock. Native A citizen of the United States who is a person of one-fourth or more Alaska Indian (including Tsimshian Indians not enrolled in the Metlakatla Indian Community), Eskimo, or Aleut blood, or a combination thereof. Descendant of a Native A lineal descendant of a Native or of an individual who would have been a Native if such individual were alive on December 18, 1971; or an adoptee of a Native or of a descendant of a Native, whose adoption (a) occurred prior to his or her majority, and (b) is recognized at law or in equity. You may gift all your stock or just a portion of your stock to one or more recipients. Gifts must be made in whole shares. Fractional share gifts are not allowed. If you own both village Class A stock and at-large, you must specify which class of stock you wish to gift and to whom. If you gift to a minor (someone under 18 years of age), a custodian must be named to manage the stock until the minor is of legal age. If you do not nominate a custodian, one will be appointed according to the priorities set in state law. The Affidavit For Gifting form must be signed in the presence of a notary. If you are gifting to a minor the Consent To Appointment As Custodian form must be signed in the presence of a notary. The transfer of stock is irrevocable. Once you have gifted stock, you cannot change your mind. You lose all rights to the stock that you gift, and you cannot get the stock back. Once the stock is transferred, dividends and distributions associated with the transferred stock will belong to the person who receives the shares. See back of this page for more instruction

2 INSTRUCTIONS FOR GIFTING ALEUT CORPORATION STOCK In order to document that the persons to whom you wish to gift stock are such relatives, you must provide The Aleut Corporation certified copies of the appropriate birth certificate(s) to establish the relationship between you and the recipient(s) of the gift of stock. If you do not have a copy, contact the Vital Statistics or Social Service department in the state where the recipient was born. EXAMPLES OF TRANSFER SITUATIONS AND REQUIRED BIRTH CERTIFICATES Gift to a Child Your child s birth certificate Gift to a Grandchild Your child s birth certificate (the birth certificate of the parent of your grandchild); and Your grandchild s birth certificate. Gift to a Great Grandchild Your child s birth certificate (the birth certificate of the parent of your grandchild); and Your grandchild s birth certificate (the birth certificate of the parent of your great grandchild); and Your great grandchild s birth certificate. Gift to a Niece or Nephew Your birth certificate; and Your brother s or sister s birth certificate (the parent of your niece or nephew); and Your niece s or nephew s birth certificate. Gift to your Brother or Sister Your birth certificate; and Your brother s or sister s birth certificate. If your name is now different than the name we have on file for you, or if the name of any of the stock recipients differs from the name of his or her birth certificate, you much furnish the legal document or documents to substantiate the name change. This document may be a marriage certification, divorce decree, adoption decree, or other legal document. After completing the required gifting documents, bring them to The Aleut Corporation office or mail the documents to The Aleut Corporation, attention: Shareholder Affairs, 4000 Old Seward Highway, Anchorage, Alaska, It is a good idea to call the corporate office to be sure that your documents were received. If you have questions or need assistance in filling out the forms, call shareholder affairs at , or toll free

3 * If recipient is a minor and you want to designate a custodian, you must list the name and address of the designated custodian. 1 of 2 Affidavit for Gifting Corporate Stock State of: ) County of: ) ss. or Judicial District) I,, being sworn, certify and affirm the following: 1. I am a stockholder of The Aleut Corporation (TAC). My social security number is. My date of birth is. My current address is. My current telephone number is ( ). 2. I own shares of Village Class A stock. I own shares of At-large. 3. I understand that I may only give shares to an Alaska Native, or a descendant of an Alaska Native, who is my child, grandchild, great-grandchild, niece, nephew, brother, or sister who is related to me by blood or adoption (and not simply by marriage); and that it is my responsibility to provide documentation proving Native descent and family relationship. 4. Each of the individuals named below is defined by the Alaska Natives Claims Settlement Act and the 1987 Amendments, thereto, as a Native or descendant of a Native. 5. I authorize The Aleut Corporation to transfer as an irrevocable gift the number of shares listed below to the following recipients:

4 * If recipient is a minor and you want to designate a custodian, you must list the name and address of the designated custodian. 2 of 2 Affidavit for Gifting Corporate Stock Affidavit for Gifting Corporate Stock 6. I affirm that I have not received anything of value nor was I promised anything of value in compensation for the stock I wish to gift and that I execute this instrument as my free and voluntary act for the purposes expressed in it, that I am 18 years of age or older, of sound mind, and under no constraint or undue influence. 7. I affirm that I have read and understand the Instructions for Gifting Aleut Corporation Stock. I affirm that the information that I have provided The Aleut Corporation is true. I agree to defend and hold The Aleut Corporation harmless from any claims, demands, or expenses that result in any way from The Aleut Corporation s reliance upon this affidavit. I understand and agree that The Aleut Corporation may eliminate any fractional shares created by the transfer. I am signing this Affidavit for Gifting Corporate Stock before a Notary Public at: City, State on this day of, 20. Signature: Full legal name SUBSCRIBED AND SWORN to before me on this day of, 20. Notary Public in and for: My Commission Expires:

5

6 Acceptance of Gifted Stock Recipient Not A Minor Name: Full legal name : address: Telephone: Birth Date: Social Security No. Mother s Maiden Name Are you currently an Aleut Corporation Shareholder (circle one): Yes No Are you a Shareholder of any other regional Native corporation (circle one)? Yes No If yes, name(s) of other corporation(s): I, (full legal name) understand that I am to receive shares of Aleut Corporation stock as a gift from (donors full legal name), who is my (state family relationship). I understand that the Alaska Native Claims Settlement Act (ANCSA) defines Native as a citizen of the United States who is a person of one-fourth degree or more of Alaska Indian (including Tsimshian Indians not enrolled in the Metlakatla Indian Community), Eskimo, or Aleut blood, or a combination thereof. I also understand that the ANCSA Amendments of 1987 define descendant of a Native as: 1) a lineal descendent of a Native or of an individual who would have been a Native if such individual were alive on December 18, 1971; or 2) an adoptee of a Native or of a descendant of a Native whose adoption (a) occurred prior to his or her age of majority, and (b) is recognized at law or in equity. I affirm that I am a Native or descendant of a Native, as defined by the ANCSA and the ANCSA Amendments of I also affirm that I have not transferred or promised anything of value to (donor s legal full name) in order to obtain the share(s). If this gift is approved, I understand that I will become the owner of share(s) of Aleut Corporation stock. Signature: Recipient s full legal name Date: SUBSCRIBED AND SWORN to me on this day of, 20 State of: ) ) ss. County of: ) (or Judicial District) Notary Public in and for: My commission expires: SEAL

7 CONSENT TO APPOINTMENT AS CUSTODIAN And Acceptance of Gifted Stock for Minor Minor s Name: Minor s : Social Security No: Telephone No: Mother s Maiden Name: Is Minor currently a TAC Shareholder? (circle one) Yes No Is Minor a shareholder of any other Native regional corporation? (circle one) Yes No If yes, name(s) of other corporation(s): Custodian s Name: Custodian s : Custodian s Telephone No: Is Custodian an Aleut Corporation shareholder? (circle one) Yes No I, (custodian s full legal name), being sworn, certify and affirm that I have been nominated by (donor s full legal name) to act as custodian for a gifting of stock in The Aleut Corporation (TAC) to: (recipient s full legal name), a minor under the age of 18 years. If this gift is approved, I understand that the minor named above will become the owner of (total number of shares) shares of stock in The Aleut Corporation. I understand that the Alaska Native Claims Settlement Act (ANCSA) defines Native as a citizen of the United States who is a person of one-fourth degree or more of Alaska Indian (including Tsimshian Indians not enrolled in the Metlakatla Indian Community), Eskimo, or Aleut blood, or a combination thereof. I also understand that the ANCSA Amendments of 1987 define descendant of a Native as: All further mail from the Shareholder Affairs Department will be sent to the custodian s address as indicated on this affidavit, and can only be changed upon request to Shareholder Affairs. 1 of 2

8 Alaska Statutes Excerpts from the Alaska Uniform Transfers to Minors Act Native corporations; custodians. (a) The stock or membership in a corporation organized under the law of this state under the Alaska Native Claims Settlement Act (43 U.S.C ) that a minor is entitled to receive under that Act shall be held by a custodian. (b) A person making a transfer of stock, whether by gift, devise, or other method, may nominate a custodian. In the absence of a nomination, the custodian shall be determined under the order of priority set out below. The appointment becomes effective upon the corporation's receipt of the custodian's written consent to the appointment. The order of priority is: (1) the legal guardian, if any, of the minor; (2) a parent, if any, of the minor, as selected by the parents; (3) an adult member of the minor's family; in this paragraph, member of the minor's family" has the meaning given in AS , and also includes members of a family with whom the minor has customarily lived. (c) For good cause, a district court or the superior court may vary the order of priority set out in (b) of this section or appoint another suitable person as custodian. (d) The custodianship is governed by this chapter, as modified by the following: (1) [Repealed, 12 ch 60 SLA 1992]. (2) under AS , a third person is responsible for determining whether stock is inalienable under the Act; (3) the custodian shall give an appropriate receipt for property received for the minor; (4) the custodian may not alienate inalienable property except within the limits provided by law; (5) the form of registration or title shall be "as custodian for (name of minor) under the Alaska Native Claims Settlement Act"; (6) a custodian may not receive compensation except, upon application to and approval by the superior court, for unusual and extraordinary services; (7) custodial property includes securities, money, and other real and personal property under supervision as a consequence of the Act. (e) Notwithstanding AS , the stock shall be transferred to the minor when the minor reaches 18 years of age, or to the minor's heirs if the minor dies before reaching 18 years of age. (f) In this section, (1) "Act" means the Alaska Native Claims Settlement Act (43 U.S.C ); (2) "minor" means an individual who is less than 18 years of age; (3) "stock" means the stock or membership in a corporation that is organized under the law of this state under the Act and that a minor is entitled to receive under the Act, whether by gift, devise, or other method; "stock" includes inchoate rights to stock. ( 2 ch 11 SLA 1990; am 8 12 ch 60 SLA 1992) Care of custodial property. (a) A custodian shall (1) take control of custodial property; (2) register or record title to custodial property if appropriate; and (3) collect, hold, manage, invest, and reinvest custodial property. (b) In dealing with custodial property, a custodian shall observe the standard of care that would be observed by a prudent person dealing with property of another and is not limited by any other statute, except AS , restricting investments by fiduciaries. If a custodian has a special skill or expertise or is named custodian on the basis of representations of a special skill or expertise, the custodian shall use that skill or expertise. However, a custodian, in the custodian's discretion and without liability to the minor or the minor's estate, may retain custodial property received from a transferor. (c) A custodian may invest in or pay premiums on life insurance or endowment policies on (1) the life of the minor only if the minor or the minor's estate is the sole beneficiary; or (2) the life of another person in whom the minor has an insurable interest only to the extent that the minor, the minor's estate, or the custodian in the capacity of custodian, is the irrevocable beneficiary. (d) A custodian at all times shall keep custodial property separate and distinct from all other property in a manner sufficient to identify it clearly as custodial property of the minor. Custodial property consisting of an undivided interest is so identified if the minor's interest is held as a tenant in common and is fixed. Custodial property subject to recordation is so identified if it is recorded, and custodial property subject to registration is so identified if it is either registered, or held in an account designated, in the name of the custodian, followed in substance by the words: "as a custodian for (name of minor) under the Alaska Uniform Transfers to Minors Act." (e) A custodian shall keep records of all transactions with respect to custodial property, including information necessary for the preparation of the minor's tax returns and shall make them available for inspection at reasonable intervals by a parent or legal representative of the minor or by the minor if the minor has attained the age of 14 years. ( 2 ch 11 SLA 1990; am 2 ch 10 SLA 1996) Current through st Reg. Sess. and 2nd Sp. Sess. Amended by Laws 1996, c. 10 2, eff. July 3, NOTE: To be sure the statutory information is up-to-date and complete, custodians should consult the entire Alaska Uniform Transfer to Minors Act, AS This page is provided for the custodian's information and convenience. It does not need to be returned.

9 CONSENT TO APPOINTMENT AS CUSTODIAN And Acceptance of Gifted Stock for Minor 1) a lineal descendant of a Native or of an individual who would have been a Native if such individual were alive on December 18, 1971; or 2) an adoptee of a Native or of a descendant of a Native whose adoption (a) occurred prior to his or her age of majority, and (b) is recognized at law or in equity. I hereby affirm my belief that the minor name above is a Native or descendant of a Native, as defined by the ANCSA and the ANCSA Amendments of In accordance with the Alaska Uniform Transfers to Minors Act (AUTMA), I also affirm that I am duly qualified to act as custodian in that I am: The donor of the gift of stock Another adult appointed by the donor If you are not the donor, what is your relationship to the minor? I further affirm that I have not transferred or promised anything of value in order that the minor would obtain the share(s) of stock. I understand that this custodianship will end when the minor reaches the ago of majority. I understand that the stock is currently restricted by provisions contained in ANCSA and cannot be sold or used as collateral for a loan and cannot be otherwise traded except in limited circumstances permitted by ANCSA. I understand that there may be taxes due as a result of receiving or owning the share(s), and I acknowledge that TAC is not responsible for payment of any such taxes. I hereby accept appointment as custodian of the gift of stock in TAC described above on behalf of the minor named above, and I hereby accept the gift of stock on behalf of the minor. I understand that, under AUTMA, I am not entitled to receive compensation for custodian services except, upon application to and approval by the Superior Court, for unusual and extraordinary services. I swear that I will mange the minor s stock and any monies derived from the stock in conformity with the provisions of the Alaska Statutes governing such custodianships, including those provisions related to care of custodial property and record keeping requirements, and in a manner directly contributing to the benefit of the minor. I agree to provide written authorization to TAC of any changes which may affect the minor s TAC stock records, such as address and name changes. I acknowledge I have received, read, and understood Alaska Statutes and , which are sections of AUTMA that address the appointment, powers, and duties of custodians for minors. Signature: Custodian s full legal name Date: Subscribed and sworn to me on this day of, 20 State of: ) ss. County of: ) (or Judicial District) Notary Public in and for: My commission expires: SEAL All further mail from the Shareholder Affairs Department will be sent to the custodian s address as indicated on this affidavit, and can only be changed upon request to Shareholder Affairs. 2 of 2

10 STOCKHOLDER IDENTIFICATION CRITERIA FOR GIFTING SHARES Before shares can be gifted to anyone, the following information is needed about the individual receiving your shares: 1. Full Legal Name of person receiving your shares: FIRST MIDDLE LAST Birth Date: Mother s Maiden Name: Gender: M F Social Security Number: Current Mailing : Telephone number: ( ) 2. What relationship is this individual to you? Child Grandchild Great Grandchild Niece Nephew Other Name Relationship: 3. Is this individual under 18 years of age? Yes No If yes, who may we contact regarding custodianship? : 4. Is this individual one-fourth or more Alaska Native? Yes No 5. If not one-fourth or more Alaskan Native, is this individual a descendant of a Native? A descendant of a Native is defined as a person who is descended from a Native, or adopted by a Native. For example, you are a descendant of a Native even if only one of your great, great grandmothers was one-quarter Native. Yes No If yes, name the Native ancestor: _ Current address: 6. Is this individual enrolled to any other Region under the Alaska Native Claims Settlement Act? Yes No If yes, please name Region: Please complete this form and return to The Aleut Corporation in the prepaid envelope, which has been provided for your convenience. SIGNATURE YOUR CURRENT ADDRESS: DATE TELEPHONE NUMBER: (_) Area Code (If applicable) J:\SHRAFFRS\SHAREHOLDERFORMS\SICFGSHARES

11 SOCIAL SECURITY NUMBER CERTIFICATION INSTRUCTIONS 1. Print and sign your full legal name. 2. If the IRS has notified you that you are subject to backup withholding because of underreporting interest or dividends on your tax return, you must cross out Section (2) below. 3. Do not cross out Section (2) if you were once subject to backup withholding but have been notified by the IRS that you no longer are. I,, under penalties of perjury, certify the following: 1. is: my own my child s or wards correct Social Security number. The name of my child or ward is: 2. I also certify that I am not (or the above-named child or ward is not) subject to backup withholding because: a. I have not been notified that I am (or the above-named child or ward is) subject to backup withholding by the Internal Revenue Service (IRS) as a result of a failure to report all interest or dividend; or b. The IRS has notified me that I am (or the above named child or ward is) no longer subject to backup withholding. (See instruction #2 above) Signature Date For Shareholder Affairs Department Use Only Shareholder ID No: Verified and Entered by: Date:

Gifting of Shares Packet

Gifting of Shares Packet Gifting of Shares Packet Goldbelt, Incorporated, is an Alaska Native Corporation created under the Alaska Native Claims Settlement Act. The gifting of Goldbelt shares may only be transferred to a child,

More information

How to Give Your Kavilco Shares

How to Give Your Kavilco Shares How to Give Your Kavilco Shares The Alaska Native Claims Settlement Act (43 U.S.C. Subsection 1606) permits a shareholder to give a gift of shares to his or her child, grandchild, great grandchild, niece,

More information

Shareholder Form step 1

Shareholder Form step 1 Stock Gifting Packet Shareholder Form step 1 IMPORTANT if you are a Kootznoowoo shareholder and you wish to gift shares to a descendant, niece, nephew or sibling please complete this affidavit and sign

More information

KIKIKTAGRUK INUPIAT CORPORATION

KIKIKTAGRUK INUPIAT CORPORATION KIKIKTAGRUK INUPIAT CORPORATION Dear Shareholder: Under the amendments passed by Congress in early 1988 to the Alaska Native Claims Settlement Act, it is now possible for shareholders to make a gift of

More information

BRISTOL BAY NATIVE CORPORATION Gift of Stock Information

BRISTOL BAY NATIVE CORPORATION Gift of Stock Information BRISTOL BAY NATIVE CORPORATION Gift of Stock Information Who Can Receive Stock? Under the Alaska Native Claims Settlement Act (ANCSA) Amendments of 1987, shareholders may make a gift of ANSCA shares to

More information

INSTRUCTIONS FOR GIFTING STOCK

INSTRUCTIONS FOR GIFTING STOCK INSTRUCTIONS FOR GIFTING STOCK Before gifting your corporate stock, please read the following instructions to understand the procedure and the consequence of gifting your stock: An Aleut Corporation shareholder

More information

TELLER NATIVE CORPORATION Shareholder Instructions for Gift of Stock Who Can Receive Stock?

TELLER NATIVE CORPORATION Shareholder Instructions for Gift of Stock Who Can Receive Stock? Shareholder Instructions for Gift of Stock Who Can Receive Stock? Under the 1991 Amendments to the ANCSA (43 U.S.C. 1601 et seq.), you may only give stock to a person who is your child, grandchild, great-grandchild,

More information

Page/Collins Class Action Settlement Director

Page/Collins Class Action Settlement Director Page/Collins Class Action Settlement Director 1-800-316-8857 RE: Final Benefit Distribution for PARTICIPANT NAME PARTICIPANT ID # Attached are the forms required to re-issue the final distribution check

More information

NOTATIONS FOR FORM 112

NOTATIONS FOR FORM 112 NOTATIONS FOR FORM 112 This form gives testator s residuary estate to the spouse outright. If the spouse predeceases the testator, a child s share can be - Given to the child outright (see right page main

More information

I. All assets of the Decedent s estate and their values are listed here.

I. All assets of the Decedent s estate and their values are listed here. CAUSE NO. P ESTATE OF, DECEASED IN THE COUNTY COURT AT LAW NUMBER 2 MONTGOMERY COUNTY, TEXAS Small Estate Affidavit On the dates indicated below, all of the Distributees of this estate and two disinterested

More information

Dear Shareholder: Please take notice, that ANC discloses to all beneficiaries the final share transfers through inheritance.

Dear Shareholder: Please take notice, that ANC discloses to all beneficiaries the final share transfers through inheritance. Kodiak Office 300 Alimaq Drive Kodiak, AK 99615 (907) 486-6014 800-770-6014 Fax: (907) 486-2514 shareholderservices@afognak.com Dear Shareholder: Afognak Native Corporation ( ANC ) encourages all shareholders

More information

Afognak Native Corporation 3909 Arctic Blvd. Ste. 500 Anchorage, AK 99503

Afognak Native Corporation 3909 Arctic Blvd. Ste. 500 Anchorage, AK 99503 Afognak Native Corporation 3909 Arctic Blvd. Ste. 500 Anchorage, AK 99503 Toll Free: 888-292-9580 / Phone (907) 222-9500 Fax: (907) 222-9501 Dear Shareholder: Afognak Native Corporation ( ANC ) encourages

More information

Small Estate Affidavit

Small Estate Affidavit NO. ESTATE OF, DECEASED IN THE PROBATE COURT NO. BEXAR COUNTY, TEXAS Small Estate Affidavit On the dates indicated below, all of the Distributees of this estate and two disinterested witnesses personally

More information

Small Estate Affidavit

Small Estate Affidavit NO. C-1-PB- - Estate of, Deceased In Probate Court No. of County, Texas Small Estate Affidavit On the dates indicated below, all of the Distributees of this estate and two disinterested witnesses personally

More information

Small Estate Affidavit

Small Estate Affidavit NO. - - Estate of, Deceased of: In the (Court Number) Probate Court County Court/County Court at Law County, Texas Small Estate Affidavit On the dates indicated below, all of the Distributees of this estate

More information

CURRENT. the ALEUTIAN SPECIAL NEWSLETTER. Considering the idea of opening enrollment for descendants of Original TAC shareholders

CURRENT. the ALEUTIAN SPECIAL NEWSLETTER. Considering the idea of opening enrollment for descendants of Original TAC shareholders the ALEUTIAN CURRENT SPECIAL NEWSLETTER Considering the idea of opening enrollment for descendants of Original TAC shareholders May 2011 Dear Shareholders, For some time now, The Aleut Corporation management

More information

Request for Name or Ownership or Beneficiary Change

Request for Name or Ownership or Beneficiary Change The Guardian Life Insurance Company of America ( Guardian ) The Guardian Insurance & Annuity Company, Inc. ( GIAC ) Berkshire Life Insurance Company of America ( Berkshire ) Request for Name or Ownership

More information

U.S. Social Security Number: (SSN) Mother s Maiden Name: Secondary Phone: Country of citizenship:

U.S. Social Security Number: (SSN) Mother s Maiden Name: Secondary Phone: Country of citizenship: Individual Retirement Account (IRA) Application PO Box 2760 Omaha, NE 68103-2760 Fax: 866-468-6268 Questions? Call a New Accounts representative at 800-276-8746. Please visit us at www.tdameritrade.com

More information

Issuing New Stock in ANCSA Corporations By Maude Blair Working Draft

Issuing New Stock in ANCSA Corporations By Maude Blair Working Draft Issuing New Stock in ANCSA Corporations By Maude Blair Working Draft *Maude Blair is Vice President of the Alaska Federation of Natives {AFN}. She previously was an inhouse attorney at NANA Development

More information

MICHIGAN REVOCABLE LIVING TRUST OF

MICHIGAN REVOCABLE LIVING TRUST OF MICHIGAN REVOCABLE LIVING TRUST OF This Revocable Living Trust dated day of, 20, by and between: GRANTOR with a mailing address of (referred to as the Grantor, ) and TRUSTEE with a mailing address of (referred

More information

Resident Relative, Vicarious Liability, etc. Affidavit to Adverse Driver

Resident Relative, Vicarious Liability, etc. Affidavit to Adverse Driver JZ helps an injury law firm 1450 Madruga Ave. Suite 200 Coral Gables, Florida 33146 Tel: 305 661 9977 Fax: 786 472 4179 jz@jzhelps.com Resident Relative, Vicarious Liability, etc. Affidavit to Adverse

More information

SMALL ESTATE AFFIDAVIT CHECKLIST

SMALL ESTATE AFFIDAVIT CHECKLIST SMALL ESTATE AFFIDAVIT CHECKLIST Texas Estates Code Chapter 205 deals with Small Estate Affidavits (SEA). SEA can only be filed in limited circumstances. Before filing an SEA, carefully review this checklist.

More information

Retirement Application

Retirement Application Form # 245 Revised 04/2018 (501) 682-1517 or (800) 666-2877 Fax: (501) 682-1812 Website: www.artrs.gov Retirement Application This application is for retirement from the Arkansas Teacher Retirement System

More information

315 Lincoln Street, Suite 300 Sitka, AK (907) , direct (907) , fax (800) , toll free

315 Lincoln Street, Suite 300 Sitka, AK (907) , direct (907) , fax (800) , toll free 315 Lincoln Street, Suite 300 Sitka, AK 99835 (907) 747-3534, direct (907) 747-5727, fax (800) 478-3534, toll free www.sheeatika.com Dear Shareholder: In order to GIFT SHARES to a Child, Grandchild, Great-Grandchild,

More information

4. Should you wish to transfer your shares to your brokerage account, please have your broker initiate the transfer request.

4. Should you wish to transfer your shares to your brokerage account, please have your broker initiate the transfer request. Brentwood, NY 117170718 Dear Shareholder, Thank you for contacting Broadridge Shareholder Services regarding a transfer. Enclosed is the document you requested. Please read the content carefully and follow

More information

IC Chapter 8.5. Indiana Uniform Transfers to Minors Act

IC Chapter 8.5. Indiana Uniform Transfers to Minors Act IC 30-2-8.5 Chapter 8.5. Indiana Uniform Transfers to Minors Act IC 30-2-8.5-1 "Adult" defined Sec. 1. As used in this chapter, "adult" means an individual who is at least twenty-one (21) years of age.

More information

FORM 6 OPENING DISCOVERY INTERROGATORIES IN THE CIRCUIT COURT OF COLE COUNTY, MISSOURI

FORM 6 OPENING DISCOVERY INTERROGATORIES IN THE CIRCUIT COURT OF COLE COUNTY, MISSOURI FORM 6 OPENING DISCOVERY INTERROGATORIES IN THE CIRCUIT COURT OF COLE COUNTY, MISSOURI In re: the Marriage of ), and ) ) ), ) ) Petitioner, ) Case No. ) v. ) ), ) ) Respondent. ) OPENING INTERROGATORIES

More information

Legal Transfer Form. Online:

Legal Transfer Form. Online: Legal Transfer Form Online: www.disneyshareholder.com E-mail: disneyshareholder@broadridge.com Dear Disney Shareholder, Thank you for contacting Broadridge Corporate Issuer Solutions, Inc., the transfer

More information

APPLICATION FOR SERVICE OR DISABILITY RETIREMENT

APPLICATION FOR SERVICE OR DISABILITY RETIREMENT MARYLAND STATE RETIREMENT AGENCY 120 EAST BALTIMORE STREET BALTIMORE, MARYLAND 21202-6700 APPLICATION FOR SERVICE OR DISABILITY RETIREMENT IMPORTANT: If you are applying for disability, this form must

More information

Summary of Material Modifications and Summary Plan Description for the Retiree Dental Program

Summary of Material Modifications and Summary Plan Description for the Retiree Dental Program Summary of Material Modifications and Summary Plan Description for the Retiree Dental Program This notice serves as a Summary of Material Modifications (SMM) updating information in the 2011 Retiree Dental

More information

EDUCATION IRA/COVERDELL EDUCATION ACCOUNT APPLICATION AND DISCLOSURE STATEMENT Account Number (if known)

EDUCATION IRA/COVERDELL EDUCATION ACCOUNT APPLICATION AND DISCLOSURE STATEMENT Account Number (if known) EDUCATION IRA/COVERDELL EDUCATION ACCOUNT APPLICATION AND DISCLOSURE STATEMENT Account Number (if known) Registered Representative Return your completed application to: William Blair Funds, P.O. Box 8506

More information

Account Application for 403(b) and 457(b) Investors

Account Application for 403(b) and 457(b) Investors Account Application for 403(b) and 457(b) Investors SSBT If you are a non-resident alien, call us before completing this application. Mail this completed application to American Century Investments to

More information

A Savings Plan for Education January 1, 2017

A Savings Plan for Education January 1, 2017 A Savings Plan for Education January 1, 2017 COVERDELL EDUCATION SAVINGS ACCOUNT This page intentionally left blank. Coverdell ESA NEW ACCOUNT APPLICATION A 1 Account Registration Designated Beneficiary

More information

Online: HealthCare.gov. Phone: Call our Health Insurance Marketplace Call Center at

Online: HealthCare.gov. Phone: Call our Health Insurance Marketplace Call Center at Form Approved OMB No. 0938-1190 Application for Exemption for American Indians and Alaska Natives and Other Individuals who are Eligible to Receive Services from an Indian Health Care Provider Use this

More information

COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT

COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION TO ESTABLISH POOLED MEDICAID PAYBACK TRUST SUB-ACCOUNT

More information

City/State/Zip Relationship to Child Account Number Amount of Deposit

City/State/Zip Relationship to Child Account Number Amount of Deposit ESA APPLICATION Child/Student (Designated Beneficiary) Contributor (Depositor) - - - - Social Security Number Social Security Number - - Address Date of Birth Address Phone Number - - City/State/Zip Phone

More information

4. Should you wish to transfer your shares to your brokerage account, please have your broker initiate the transfer request. Our DRS number is 7824.

4. Should you wish to transfer your shares to your brokerage account, please have your broker initiate the transfer request. Our DRS number is 7824. Dear Shareholder, Thank you for contacting Broadridge Shareholder Services regarding a transfer. Enclosed is the document you requested. Please read the content carefully and follow all of the instructions

More information

FAQs. General Questions on Domestic Partnership. 1. What is a domestic partnership?

FAQs. General Questions on Domestic Partnership. 1. What is a domestic partnership? FAQs General Questions on Domestic Partnership 1. What is a domestic partnership? As defined by the CHEIBA Trust, a domestic partnership is one that meets the criteria outlined in the "Affidavit of Domestic

More information

][Form 23 ][SUN FDEATH ][01/24/06 ][Page 1 of 12 ][000: ][TT33][/ Frequency: Monthly Quarterly Semi-Annually Annually

][Form 23 ][SUN FDEATH ][01/24/06 ][Page 1 of 12 ][000: ][TT33][/ Frequency: Monthly Quarterly Semi-Annually Annually Death Benefit Claim Request 401(a) Plan Refer to the Death Benefit Claim Guide while completing this form. Use blue or black ink only. If you have questions regarding the completion of this form, please

More information

County of Ocean, New Jersey. Jeffrey W. Moran, Surrogate 118 Washington Street, P. O. Box 2191 Toms River, NJ Phone:

County of Ocean, New Jersey. Jeffrey W. Moran, Surrogate 118 Washington Street, P. O. Box 2191 Toms River, NJ Phone: County of Ocean, New Jersey Jeffrey W. Moran, Surrogate 118 Washington Street, P. O. Box 2191 Toms River, NJ 08753-2191 - Phone: 732-929-2011 A PLANNING GUIDE TO THE PROBATE PROCESS The Probate Process

More information

NOTATIONS FOR FORM 410

NOTATIONS FOR FORM 410 NOTATIONS FOR FORM 410 This form is designed to obtain the federal gift tax annual exclusion for the settlor even though the property may remain in the trust after the beneficiary attains 21 years of age.

More information

Application Instructions

Application Instructions Colorado CLT Application Instructions You must submit a completed application with all the required documentation prior to signing a contract for purchase. To ensure your application is complete, please

More information

THE ARC OF OHIO INC. ACCOUNT OF THE COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT

THE ARC OF OHIO INC. ACCOUNT OF THE COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT THE ARC OF OHIO INC. ACCOUNT OF THE COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION TO ESTABLISH POOLED

More information

Domestic Partner Forms

Domestic Partner Forms Domestic Partner Forms Version: 2.2 Suffolk County Municipal Employee Benefit Fund 30 Orville Dr. Suite D Bohemia, NY 11716-2513 Eligibility Division wendyz@scmebf.org 631-319-4099 ext. 321 631-218-7970

More information

THINKING OF RETIRING?

THINKING OF RETIRING? 33 Plaza La Prensa, Santa Fe, New Mexico 87507 (505) 476-9401 fax (505) 476-9300 voice (800) 342-3422 Toll-Free www.nmpera.org PERA INFORMATION SHEET THINKING OF RETIRING? If you are considering retiring,

More information

1 Account Holder Information

1 Account Holder Information Transfer on Death (TOD) Application and Agreement 1 Account Holder Information Account Holder(s) Name Social Security Number(s) Account Holder(s) Address City, State Zip You are applying for registration

More information

Coverdell Education Savings Account Application

Coverdell Education Savings Account Application Coverdell Education Savings Account Application SSBT Use this application to open a Coverdell Education Savings Account (CESA). Accounts are available only to U.S. citizens and U.S. resident aliens. Please

More information

Bastrop County Court Guardian of the Person and Estate: Court-Ordered Instructions. Cause No. G - Guardianship of:

Bastrop County Court Guardian of the Person and Estate: Court-Ordered Instructions. Cause No. G - Guardianship of: Cause No. G - Guardianship of: Thank you for considering appointment as the Guardian of the Person and Estate of a minor or incapacitated individual (the Ward). As such a Guardian, the State of Texas,

More information

Elevator Constructors Union Local No. 1 Annuity & 401(k) Fund 140 Sylvan Avenue, Suite 303, Englewood Cliffs, NJ (201) (855)

Elevator Constructors Union Local No. 1 Annuity & 401(k) Fund 140 Sylvan Avenue, Suite 303, Englewood Cliffs, NJ (201) (855) Elevator Constructors Union Local No. 1 Annuity & 401(k) Fund 140 Sylvan Avenue, Suite 303, Englewood Cliffs, NJ 07632 (201) 592 6800 (855) 521 6111 FEE NOTICE APPLICATION FOR ANNUITY ACCOUNT LOAN (OTHER

More information

POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM

POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM (a) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the principal, you give the person whom you choose (your agent ) authority

More information

Dear Shareholder: The Shee Atiká Board of Directors and Staff would like to express our sincerest condolences for the loss of your loved one.

Dear Shareholder: The Shee Atiká Board of Directors and Staff would like to express our sincerest condolences for the loss of your loved one. 315 Lincoln Street, Suite 300 Sitka, Alaska 99835 Tel (907) 747-3534 Fax (907) 747-5727 Toll free (800) 478-3534 www.sheeatika.com Dear Shareholder: The Shee Atiká Board of Directors and Staff would like

More information

General Instructions For Completing This Joinder Agreement

General Instructions For Completing This Joinder Agreement General Instructions For Completing This Joinder Agreement An Important Note to Grantors: Please read the entire Joinder Agreement carefully, including all of the exhibits. Some of the exhibits require

More information

DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION (FLA. STAT )

DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION (FLA. STAT ) DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION (FLA. STAT. 735.301) This probate proceeding is used to request release of assets of a decedent leaving only personal property as described in Fla.

More information

SAFE HARBOR TITLE AGENCY, LTD.

SAFE HARBOR TITLE AGENCY, LTD. SAFE HARBOR TITLE AGENCY, LTD. POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM (a) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the principal, you give the person whom

More information

CITY OF ACWORTH 4415 Senator Russell Avenue Acworth, GA Fax Alcoholic Beverage License Renewal Application

CITY OF ACWORTH 4415 Senator Russell Avenue Acworth, GA Fax Alcoholic Beverage License Renewal Application INSTRUCTIONS: PLEASE PRINT OR TYPE Type of License: (Check all that apply) LIQUOR: BEER: WINE: NEW NEW NEW RENEWAL RENEWAL RENEWAL TRANSFER TRANSFER TRANSFER NAME CHANGE NAME CHANGE NAME CHANGE MANUFACTURER

More information

Change of Registration- Individual Account Checklist

Change of Registration- Individual Account Checklist Change of Registration- Individual Account Checklist 800-240-4313 Use these forms to add a new owner(s) to an individual account or transfer an individual account to a new owner(s). Questions? call us

More information

LIVING TRUST IRREVOCABLE TRUST

LIVING TRUST IRREVOCABLE TRUST LIVING TRUST IRREVOCABLE TRUST Trust Agreement made between I, Peter Miller Residing at : 1287 Pine Avenue Dallas, County of, Las Collinas State of Texas Herein referred to as Grantor and, George Summerlin.

More information

PREPARING GIFT TAX RETURNS

PREPARING GIFT TAX RETURNS PREPARING GIFT TAX RETURNS I. Overview A sample 2014 gift tax return illustrating several different types of gifts is attached at Tab A. The instructions for the 2014 gift tax return can be found at Tab

More information

Summary of Material Modifications for the Vision Program

Summary of Material Modifications for the Vision Program Summary of Material Modifications for the Vision Program This notice serves as a Summary of Material Modifications (SMM) updating information in the 2009 Vision Program Summary Plan Description (SPD) booklet

More information

CREDIT SUISSE PARK VIEW BDC, INC. at $8.79 Per Share in Cash Pursuant to the Offer to Purchase dated September 1, 2016 by

CREDIT SUISSE PARK VIEW BDC, INC. at $8.79 Per Share in Cash Pursuant to the Offer to Purchase dated September 1, 2016 by Letter of Transmittal To Tender Shares of Common Stock of CREDIT SUISSE PARK VIEW BDC, INC. at $8.79 Per Share in Cash Pursuant to the Offer to Purchase dated September 1, 2016 by Credit Suisse Park View

More information

National Electrical Annuity Plan Disability Benefit Application

National Electrical Annuity Plan Disability Benefit Application National Electrical Annuity Plan Disability Benefit Application To avoid delays in the processing and payment of your benefit, please follow these instructions carefully and completely. 1. Print all information

More information

OREGON TRAIL ELECTRIC COOPERATIVE

OREGON TRAIL ELECTRIC COOPERATIVE OREGON TRAIL ELECTRIC COOPERATIVE Corporate Headquarters: 4005 23 rd Street PO Box 226 Baker City, Oregon 97814 Phone (541) 523-3616 Fax (541) 524-2865 www.otecc.com Dear Applicant: Re: Deceased Members

More information

DECLARATION OF THIRD PARTY SUPPLEMENTAL NEEDS TRUST THIS IS A BINDING LEGAL DOCUMENT. YOU ARE ADVISED TO OBTAIN PROFESSIONAL ADVICE BEFORE SIGNING.

DECLARATION OF THIRD PARTY SUPPLEMENTAL NEEDS TRUST THIS IS A BINDING LEGAL DOCUMENT. YOU ARE ADVISED TO OBTAIN PROFESSIONAL ADVICE BEFORE SIGNING. DECLARATION OF THIRD PARTY SUPPLEMENTAL NEEDS TRUST THIS IS A BINDING LEGAL DOCUMENT. YOU ARE ADVISED TO OBTAIN PROFESSIONAL ADVICE BEFORE SIGNING. This Declaration of Third Party Supplemental Needs Trust

More information

Popular, Inc. is pleased to offer POPULAR DIRECT. This plan allows investors to purchase the company s stock, BPOP, which currently trades in NASDAQ.

Popular, Inc. is pleased to offer POPULAR DIRECT. This plan allows investors to purchase the company s stock, BPOP, which currently trades in NASDAQ. 1 Popular, Inc. is pleased to offer POPULAR DIRECT. This plan allows investors to purchase the company s stock, BPOP, which currently trades in NASDAQ. Direct Stock Purchases The POPULAR DIRECT stock purchase

More information

CERF Savings Plan - 401(a) Plan

CERF Savings Plan - 401(a) Plan Death Benefit Claim Request 401(a) Plan CERF Savings Plan - 401(a) Plan 98993-02 When would this form be used? When the Claimant is making a claim on this account due to the death of the Participant (Decedent).

More information

Important Beneficiary Information

Important Beneficiary Information Important Beneficiary Information When you complete your Designation of Beneficiary Form ( Beneficiary Form ), you are naming a person or persons who will receive, upon your death, any remaining account

More information

Attachment D SAMPLE FULL FORM QPRT TRUST AGREEMENT CREATING THE SMITH 2010 RESIDENCE TRUST. 1 Article 2 RECITALS

Attachment D SAMPLE FULL FORM QPRT TRUST AGREEMENT CREATING THE SMITH 2010 RESIDENCE TRUST. 1 Article 2 RECITALS Attachment D SAMPLE FULL FORM QPRT TRUST AGREEMENT CREATING THE SMITH 2010 RESIDENCE TRUST I, MARY SMITH, as Settlor, hereby declare that I have transferred to myself, as Trustee, all of my interests in

More information

APPLICATION FOR ANNUITY

APPLICATION FOR ANNUITY APPLICATION FOR ANNUITY The First Catholic Slovak Union of the United States of America & Canada A Fraternal Benefit Society 6611 Rockside Road Lodge # Suite 300 Independence, OH 44131 Annuity # PLEASE

More information

Kentucky Inheritance and Estate Tax Forms and Instructions

Kentucky Inheritance and Estate Tax Forms and Instructions Kentucky Inheritance and Estate Tax Forms and Instructions COMMONWEALTH OF KENTUCKY DEPARTMENT OF REVENUE For Dates of Death on or After January 1, 2005 (Revised for Web Site November, 2016) Kentucky Department

More information

COMMUNITY FUND MANAGEMENT FOUNDATION MASTER TRUST MASTER TRUST SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION AS GRANTOR

COMMUNITY FUND MANAGEMENT FOUNDATION MASTER TRUST MASTER TRUST SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION AS GRANTOR COMMUNITY FUND MANAGEMENT FOUNDATION MASTER TRUST MASTER TRUST SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION AS GRANTOR TO BE ADMINISTERED IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE

More information

CHANGE OF OWNERSHIP. Kansas City, MO Kansas City, MO Name of Owner/Entity: Tax ID/SS #: Date of Birth:

CHANGE OF OWNERSHIP. Kansas City, MO Kansas City, MO Name of Owner/Entity: Tax ID/SS #: Date of Birth: CHANGE OF OWNERSHIP This form must be used by any current owner (the Current Owner ) in (the Program ) to transfer ownership of shares of common stock (the Shares ) to a new owner (the New Owner ). For

More information

TRUST AND ESTATE PLANNING GLOSSARY

TRUST AND ESTATE PLANNING GLOSSARY TRUST AND ESTATE PLANNING GLOSSARY What is estate planning? Estate planning is the process by which one protects and disposes of his or her wealth, sometimes during life and more often at death, in accordance

More information

Life insurance beneficiary designations

Life insurance beneficiary designations ADVANCED MARKETS Life insurance beneficiary designations BECAUSE YOU ASKED When designating a beneficiary of a life insurance policy, the policy owner should consider a multitude of factors, such as the

More information

LIVING TRUST CHARITABLE REMAINDER UNITRUST

LIVING TRUST CHARITABLE REMAINDER UNITRUST LIVING TRUST CHARITABLE REMAINDER UNITRUST I, Peter Miller Residing at : 1287 Pine Avenue Dallas, County of, Las Collinas State of Texas Herein referred to as Grantor hereby transfer to George Summerlin.

More information

LETTER OF TRANSMITTAL AND PAYMENT INSTRUCTIONS TO SURRENDER SHARES OF CAPITAL STOCK OF ONCURE MEDICAL CORP.

LETTER OF TRANSMITTAL AND PAYMENT INSTRUCTIONS TO SURRENDER SHARES OF CAPITAL STOCK OF ONCURE MEDICAL CORP. 13451/13448 LETTER OF TRANSMITTAL AND PAYMENT INSTRUCTIONS TO SURRENDER SHARES OF CAPITAL STOCK OF ONCURE MEDICAL CORP. Mail or deliver this Letter of Transmittal, together with the certificate(s) representing

More information

ARTICLE I ARTICLE II ARTICLE III ARTICLE IV ARTICLE V

ARTICLE I ARTICLE II ARTICLE III ARTICLE IV ARTICLE V Coverdell Education Savings Custodial Account (Under section 530 of the Internal Revenue Code) Form 5305-EA (Rev. October 2010) Department of the Treasury, Internal Revenue Service. Do not file with the

More information

Owner s Name (or Trustee Name)* (First, M.I., Last) Date of Birth* Social Security Number*

Owner s Name (or Trustee Name)* (First, M.I., Last) Date of Birth* Social Security Number* GIFT TRANSFER FORM IMPORTANT: In compliance with the USA PATRIOT Act, Federal law requires all financial institutions (including mutual funds) to obtain, verify, and record information that identifies

More information

IBEW9-MSECA FRINGE BENEFITS TRUST FUNDS

IBEW9-MSECA FRINGE BENEFITS TRUST FUNDS IBEW9-MSECA FRINGE BENEFITS TRUST FUNDS Your Funds. Your Foundation. Your Future. Contractors Health and Welfare Fund Contractors Pension Fund Contractors Defined Contribution Pension Fund Contractors

More information

APPLICATION SIMPLE IRA

APPLICATION SIMPLE IRA CROSSMARKGLOBAL.COM APPLICATION SIMPLE IRA Crossmark Steward Funds P.O. BOX 183004 Columbus, OH 43218-3004 SIMPLE IRA Application Instructions: Step 1: Complete your SIMPLE IRA Application To complete

More information

8. Checklist for a Discretionary Testamentary Trust and Other Estate Planning Documents

8. Checklist for a Discretionary Testamentary Trust and Other Estate Planning Documents 8. Checklist for a Discretionary Testamentary Trust and Other Estate Planning Documents This form will be used in conjunction with a personal discussion with TressCox to draw up a Testamentary Trust Will

More information

THE PETER JONES IRREVOCABLE TRUST

THE PETER JONES IRREVOCABLE TRUST THE PETER JONES IRREVOCABLE TRUST This trust agreement is effective as of June 1, 2009, by PETER JONES, currently residing at 789 Main St., Anywhere, UT (the "Grantor"), and the Grantor s wife, LAURA JONES,

More information

Subscription Agreement CLASS T SHARES, CLASS W SHARES AND CLASS I SHARES

Subscription Agreement CLASS T SHARES, CLASS W SHARES AND CLASS I SHARES 1. Investment See payment instructions on next page. Please check the appropriate box: o Initial Investment This is my initial investment: $2,000 minimum for Class T shares and Class W shares; $1,000,000

More information

ESTATE PLANNING INFORMATION SHEET I. PERSONAL AND FAMILY INFORMATION

ESTATE PLANNING INFORMATION SHEET I. PERSONAL AND FAMILY INFORMATION Date: ESTATE PLANNING INFORMATION SHEET I. PERSONAL AND FAMILY INFORMATION Husband s Name: Home Address: (Include County) (First) (Middle) (Last) Telephone: Home Business Occupation: Business Address:

More information

New York Life Insurance Company

New York Life Insurance Company New York Life Insurance Company PO Box 30713 Tampa FL 33630-3713 Dear Beneficiary: Please accept our condolences on your recent loss. We understand this is a difficult time, and we hope that we can alleviate

More information

MFS Investment Management MFS 529 SAVINGS PLAN

MFS Investment Management MFS 529 SAVINGS PLAN MFS Investment Management MFS 529 SAVINGS PLAN Participant Agreement and Disclosure Statement NOT FDIC INSURED MAY LOSE VALUE NO BANK GUARANTEE MFS 529 SAVINGS PLAN January 8, 2015 Questions and Answers...

More information

THE JEWISH LOS ANGELES THIRD PARTY POOLED SPECIAL NEEDS TRUST. Dated February 1, 2017

THE JEWISH LOS ANGELES THIRD PARTY POOLED SPECIAL NEEDS TRUST. Dated February 1, 2017 THE JEWISH LOS ANGELES THIRD PARTY POOLED SPECIAL NEEDS TRUST Dated February 1, 2017 A Pooled Master Trust Serving the Needs of Persons with Disabilities in the Greater Los Angeles Area Jewish Los Angeles

More information

PLEASE READ BEFORE COMPLETING THE JOINDER AGREEMENT

PLEASE READ BEFORE COMPLETING THE JOINDER AGREEMENT JOINDER PLEASE READ BEFORE COMPLETING THE JOINDER AGREEMENT The following is information to consider when completing a Trust Joinder Agreement for Trust Sub- Accounts funded with the Beneficiary s own

More information

DBPR ABT Division of Alcoholic Beverages and Tobacco Application for Caterer s License

DBPR ABT Division of Alcoholic Beverages and Tobacco Application for Caterer s License DBPR ABT -6011 Division of Alcoholic Beverages and Tobacco Application for Caterer s License STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION NOTE This form must be submitted as part

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6011 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE CATERER S LICENSE

INSTRUCTIONS FOR COMPLETING DBPR ABT 6011 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE CATERER S LICENSE INSTRUCTIONS FOR COMPLETING DBPR ABT 6011 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE CATERER S LICENSE If you have any questions or need assistance in completing this

More information

FOND DULAC BAND OF LAKE SUPERIOR CHIPPEWA TRIBAL COURT PROBATE PACKET (NO WILL)

FOND DULAC BAND OF LAKE SUPERIOR CHIPPEWA TRIBAL COURT PROBATE PACKET (NO WILL) FOND DULAC BAND OF LAKE SUPERIOR CHIPPEWA TRIBAL COURT PROBATE PACKET (NO WILL) Enclosed are all the information and the necessary forms to probate an intestate estate in Tribal Court. This packet should

More information

If you should have any questions about the process for obtaining your 2016 Occupational License please contact the City Hall:

If you should have any questions about the process for obtaining your 2016 Occupational License please contact the City Hall: Dear Home Occupation Owner: Attached is the application for a Home Occupation Tax Certificate. All Home Occupation Tax Certificates must be approved by City Council. Please note that the application must

More information

SCHOOL EMPLOYEES RETIREMENT SYSTEM OF OHIO 300 E. BROAD ST., SUITE 100 COLUMBUS, OHIO Toll-Free

SCHOOL EMPLOYEES RETIREMENT SYSTEM OF OHIO 300 E. BROAD ST., SUITE 100 COLUMBUS, OHIO Toll-Free SCHOOL EMPLOYEES RETIREMENT SYSTEM OF OHIO 300 E. BROAD ST., SUITE 100 COLUMBUS, OHIO 43215-3746 614-222-5853 Toll-Free 800-878-5853 www.ohsers.org APPLICATION FOR A REFUND OF A MEMBER S ACCOUNT After

More information

Your guide to Coverdell Education Savings Accounts. Coverdell Education Savings Account Disclosure Statement and Custodial Agreement

Your guide to Coverdell Education Savings Accounts. Coverdell Education Savings Account Disclosure Statement and Custodial Agreement Your guide to Coverdell Education Savings Accounts Coverdell Education Savings Account Disclosure Statement and Custodial Agreement Your guide to Coverdell Education Savings Accounts This section of the

More information

Koppel Kessler Julie LLP ESTATE PLANNING QUESTIONNAIRE

Koppel Kessler Julie LLP ESTATE PLANNING QUESTIONNAIRE ESTATE PLANNING QUESTIONNAIRE I. GENERAL INFORMATION DATE: YOUR FULL NAME: FULL NAME OF YOUR SPOUSE: BIRTH DATE: BIRTH DATE: HOME ADDRESS: TELEPHONE: ( ) E-MAIL YOUR CELL SPOUSE S CELL YOUR BUSINESS ADDRESS:

More information

NOTATIONS FOR FORM 201

NOTATIONS FOR FORM 201 NOTATIONS FOR FORM 201 For a discussion of the advantages and disadvantages of the fractional share marital trust, see the INTRODUCTION. This form is designed for a settlor who will execute a will patterned

More information

Individual Retirement Account (IRA) Application Type of IRA

Individual Retirement Account (IRA) Application Type of IRA 1 3 PO Box 2237 Omaha, NE 68103-2237 Fax: 816-243-3765 Individual Retirement Account (IRA) Application Type of IRA Please select only one. I want to establish a: ACCOUNT NUMBER A Traditional (Individual

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION

INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION Application begins on page 3 If you have any questions or need assistance

More information

Mississippi Affordable College Savings (MACS) Program

Mississippi Affordable College Savings (MACS) Program PROGRAM DISCLOSURE BOOKLET AND PARTICIPATION AGREEMENTS Mississippi Affordable College Savings (MACS) Program IMPLEMENTED BY: BOARD OF DIRECTORS OF THE COLLEGE SAVINGS PLANS OF MISSISSIPPI PROGRAM MANAGER:

More information

Group Health Plan For Insured Medical Programs

Group Health Plan For Insured Medical Programs S U M M A R Y P L A N D E S C R I P T I O N L-3 Communications Corporation Group Health Plan For Insured Medical Programs Effective January 1, 2016 Table of Contents The L-3 Communications Group Health

More information

NOTATIONS FOR FORM 101

NOTATIONS FOR FORM 101 NOTATIONS FOR FORM 101 For a discussion of the advantages and disadvantages of the fractional share marital trust, see the INTRODUCTION. Certain provisions of this form assume that there is a disinterested

More information