TRUSTEE OR CUSTODIAN. OPTION A: [ ] Financial Organization as Trustee or Custodian CHECK ONE: [ ] Custodian. [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ Signature ______________________________________________________________________ Type Name ______________________________________________________________________ COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ ________________________________________________________________________________ OPTION B [X] Individual Trustee(s) Signature /s/ Brucx X. Xxxxxxxx Signature ______________________________ --------------------- Type Name Brucx X. Xxxxxxxx Type Name ______________________________ --------------------- Signature _____________________ Signature ______________________________ Type Name _____________________ Type Name ______________________________
Appears in 1 contract
Samples: Compdent Corp
TRUSTEE OR CUSTODIAN. OPTION A: [ [X] Financial Organization as Trustee or Custodian CHECK ONE: [ [X] Custodian. , [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ SMITX XXXXXX --------------------------------------------------------- Signature ______________________________________________________________________ ---------------------------------------------------------------------- Type Name ______________________________________________________________________ ---------------------------------------------------------------------- COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ ________________________________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- OPTION B B: [X] Individual Trustee(s) Signature /s/ Brucx Elma X. Xxxxxxxx Xxxxxxx Signature ______________________________ --------------------- ----------------------- ---------------------------- Type Name Brucx /s/ Elma X. Xxxxxxxx Xxxxxxx Type Name ______________________________ --------------------- ----------------------- ---------------------------- Signature _____________________ Signature ______________________________ ----------------------- ---------------------------- Type Name _____________________ Type Name ______________________________----------------------- ----------------------------
Appears in 1 contract
Samples: Antigenics Inc /De/
TRUSTEE OR CUSTODIAN. OPTION A: A. [ ] Financial Organization as Trustee or Custodian CHECK ONE: [ ] Custodian. , [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ ------------------------------------- Signature ______________________________________________________________________ --------------------------------------------------- Type Name ______________________________________________________________________ --------------------------------------------------- COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ ________________________________________________________________________________ ------------------------------------------------------------- ------------------------------------------------------------- OPTION B B. [X] Individual Trustee(s) Signature /s/ Brucx Barbxxx X. Xxxxxxxxxxx Signature /s/ Don Xxxxxxxx Signature ______________________________ --------------------- --------------------------- -------------------------- Type Name Brucx Barbxxx X. Xxxxxxxx Xxxxxxxxxxx Type Name ______________________________ --------------------- Don Xxxxxxxx --------------------------- ------------------------- Signature _____________________ /s/ Doug Xxxxx Signature ______________________________ --------------------------- -------------------------- Type Name _____________________ Doug Xxxxx Type Name ______________________________--------------------------- --------------------------
Appears in 1 contract
Samples: Adoption Agreement (Edutrek Int Inc)
TRUSTEE OR CUSTODIAN. OPTION A: [ [X] Financial Organization as Trustee or Custodian CHECK ONE: [ ] Custodian. [ , [X] Trustee without full trust powerspowers or, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ SEE ATTACHED ADDENDUM ----------------------------------------------------------------------------------------------------------- Signature ______________________________________________________________________ ------------------------------------------------------------------------------------------------------------------------- Type Name ______________________________________________________________________ ------------------------------------------------------------------------------------------------------------------------- COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ ________________________________________________________________________________ COLLECTIVE TRUST FUNDS OF SALOMON SMITH BARNEY AND/OR THE TRAVELERS --------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ OPTION B [XB: [ ] Individual Trustee(s) Signature /s/ Brucx X. Xxxxxxxx Signature ______________________________ --------------------- ------------------------------------------------------- ----------------------------------------------------- Type Name Brucx X. Xxxxxxxx Type Name ______________________________ --------------------- ------------------------------------------------------- ----------------------------------------------------- Signature _____________________ Signature ______________________________ ------------------------------------------------------- ----------------------------------------------------- Type Name _____________________ name Type Name ______________________________name ------------------------------------------------------- -----------------------------------------------------
Appears in 1 contract
Samples: Qualified Retirement Plan and Trust (Camco Financial Corp)
TRUSTEE OR CUSTODIAN. OPTION A: [ ] Financial Organization as Trustee or Custodian CHECK ONE: [ ] Custodian. , [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ Signature ______________________________________________________________________ Type Name ______________________________________________________________________ COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicableCOMPLETE IF APPLICABLE). _________________________________________________________-------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Option B: [X] Individual Trustee(s) Signature /s/ STEVEN W. LOGAN Signature _______________________ ________________________________________________________________________________ OPTION B [X] Individual Trustee(s) Signature /s/ Brucx X. Xxxxxxxx Signature ______________________________ --------------------- Type Name Brucx X. Xxxxxxxx Nxxx XXXXXX W. LOGAN Type Name ______________________________ --------------------- Signature _Signatxxx ____________________ Signature ______________________________ Type Name _____________________ Type Name ______________________________
Appears in 1 contract
Samples: Qualified Retirement Plan and Trust (Cornell Corrections Inc)
TRUSTEE OR CUSTODIAN. OPTION Option A: [ ] Financial Organization as Trustee or Custodian CHECK ONECheck One: [ ] Custodian. , [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ Signature ______________________________________________________________________ Type Name ______________________________________________________________________ COLLECTIVE OR COMMINGLED FUNDS Collective or Commingled Funds List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ ________________________________________________________________________________ OPTION B [XOption B: [ ] Individual Trustee(s) Signature /s/ Brucx X. Xxxxxxxx Signature ______________________________ --------------------- Type Name Brucx X. Xxxxxxxx Type Name ______________________________ --------------------- Signature _____________________ Signature ______________________________ Type Name ___________________________ Type Name _____________________________ Signature ___________________________ Signature _____________________________ Type Name ___________________________ Type Name _____________________________ 'c' 1996 Universal Pensions, Inc., Brainerd, MN 56401
Appears in 1 contract
Samples: Tri Continental Corp
TRUSTEE OR CUSTODIAN. OPTION A: [ ] Financial Organization as Trustee or Custodian CHECK ONE: [ ] Custodian. Custodian [ ] Trustee without full trust powers, or [ ] Trustee with full trust powers Financial Organization _________________________________________________________ -------------------------------------------- Signature ______________________________________________________________________ ---------------------------------------------------------- Type Name ______________________________________________________________________ COLLECTIVE OR COMMINGLED FUNDS List any collective or commingled funds maintained by the financial organization Trustee in which assets of the Plan may be invested (Complete if applicable). ________________________________________________________________________________ _____________________________________.___________________________________________ OPTION B [X] B: X Individual Trustee(s) --- Signature /s/ Brucx Willxxx X. Xxxxxxxx Signature ______________________________ --------------------- /s/ Jamex X. Xxxxxxxx --------------------------- --------------------------- Type Name Brucx Willxxx X. Xxxxxxxx Type Name ______________________________ --------------------- Jamex X. Xxxxxxxx --------------------------- --------------------------- Signature _____________________ /s/ Chrixxxxxxx X. Xxxxxx Signature ______________________________ /s/ Robexx X. Xxxxxxxx, Xx. --------------------------- --------------------------- Type Name _____________________ Chrixxxxxxx X. Xxxxxx Type Name ______________________________Robexx X. Xxxxxxxx, Xx. --------------------------- ---------------------------
Appears in 1 contract
Samples: Qualified Retirement Plan And (Meritage Hospitality Group Inc /Mi/)