HomeMy WebLinkAbout08-01-06
Register of Wills of______u _Cumb~rland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of John J. Grenoble
also known as
No. 21-06- (07 ~
, Deceased
Social Security No. 208-24-2308
Isabelle M. Grenoble
Petitioner(s), who is/are 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
[R] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated 05/14/2004 and codicils dated
Executrix
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc_
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
none
o B. Grant of Letters of Administration
(c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
I Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
or principal residence at 270 Frost Road, Gardners
(list street, number, and municipality)
Decedent, then
72
years of age, died
02/25/2006
at Carlisle Regional Medical Center, S. Middleton Township
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
29,000.00
$
$
$
$
"-,
situated as follows: none
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
of letters in the appropnate form to the undersigned:
I Signature Typed or printed name and residence
Isabelle M. Grenoble 270 Frost Road
Gardners, PA 17324
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Prepared by the Pennsylvania Bar ASSOCiation
Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct
to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will
well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
$1
before me this .. 1 day of
CU'1llal . dC.{)L,o
Jjtlt~l~L
-p.5LA '. _ Cl \orthe ~egister \j
No.
,'t..'-G/cLiLP //: / /. ,"-.
Isabelle M. Grenoble
,,/
'[..(..;.!'C.A vL_l c/
21-06- lQ1 L(
Estate of
John J. Grenoble
, Deceased
also known as
Social Security No: 208-24-2308 Date of Death: 02/25/2006
AND NOW, (l~ ",-t J ,dO;Jlo ' ;" ooooide""oo
of the Petition on the revl se side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 00 Testamentary 0 of Administration
(c.I.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Isabelle M. Grenoble, Executrix
in the above estate and that the instrument(s) dated 5/14/2004
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
,
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Short Certificate(s)...................... $
4.00
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~eg;ster of Wiils ~ \ I~~~
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Attorney: George F. Douglas III
FEES
Letters.......................................... $
90.00
Renunciation............................... $
I.D. No: 61886
Said is, Flower & Lindsay
Address: 26 West High Street
Affidavits ( )...........................$
Extra Pages ( ).W~..kh.....$ \S. (2)
Codicil.......... ......... ............... ........ $
Carlisle, PA 17013
Telephone: (717) 243-6222
JCP Fee.......................................$ --.J5.f::J::J ~
Inventory...... ......... .................. ..... $
E-Mail:
Other............................................ $
TOT AL...... ................. ..... $
124.00
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
fhi" ;~ tt) <,,'('nit) that the inforn;ltion here given j, correctly copied from an original certificate of death dul) flle.! \\ ItI1 me ,\>
Lll',d Rq~;qrar TI'L' original c(~nif!cate will be focwarded to the Statc Vital Records Office (or per'nancnt I ding,
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H105.143 Rev.01AJ6
TYPElPRINT IN
PERMANENT
BLACK INK
1 Name ot Decedel1t (First. middle, last)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATEFILE NUMBER
3. Social Secur~y Number 4 Dale of Death (Month, day, year)
John
208 - 24 Feb 25 2006
Sa. Place of Death Check on one
HosP~al:
In alieni 0 EAIOut alient
9
5 Age (lasl birthday)
15. Surviving Spouse (If wife, \live maiden name)
Yrs.
o Residence 0 Other.S i
10, Race:Ameri::anlndian,Black,White,etc
(Specify)
White
Bb. County o! Dealh
~\. Cumberland
Medical
13, Decedent's Educalion eci
ElementarylSecondary(0-12}
hi hes! rade co leled 14, Marital Status: Married. Never married,
College (1-4 or 5+) Widowed, Divorced (Specify)
Marrie
Did Decedent
live in a Hc. M Yes. Decedent Lived in ~
Townsh~?
IV[; nn' pj-nn Twp,
270 Frost Rd.
Gardners, PA 17324
Pennsylvania
Curuberland
Cilyl8oro
1'7d.O No, Deceden1 livectwithin
Actual Umits of
17b. County
18 Father's Name (First,middle,\ast)
John M. Grenoble
19. Mothers Name (First, middle, maiden surname)
Hazel Duck
2Gb. Inlormant's Mailing Mdress (Street, crtyllown, state, zip code)
2Qa, Informant's Name (Type/print)
Isabelle M. Grenoble
270 Frost Rd. Gardners, PA 17324
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21a. Method of Disposition
XI Burial 0 Cremation 0 Rem:lval from State 0 Donation
o Other.S ci
22a. Signatureot Funeral Service Licensee (or person acting as such)
~~.~
COrfl)lete items 23a-c only when certify,' g 23a. To the best of my knowledge, death occurred al the lime, date and place slated. {Signature and title)
physi::ian is not available at time of death 10
certify cause o! dealh
21c. Place of Disposition (Name 01 cemetery. crematory or olher place) 21d. Location (Cifyllown, state, zip code)
Goodyear cemetery Gardners,PA17324
22c. Name and Mdress of Facilify
HollingerFH&Crematory Mt.
23tl. license Nurrber
. Ilems 24-26 must be cOrfl)leled by person
who pronounces death
24. Timeo/Dealh
Approximate interval Part 11: Enter other sianiocant conditions conlributina 10 death, 28 Did Tobacco Use Contribute to Dealh?
onset to death but not resuRlng in the underlying cause given in Part I 0 Yes 0 Probably
.g"No 0 Unknown
d-P'>ol? -!" M
26, Was Case Referred to a Medical ExarrinerfCoronec?
o y" 0"1f0'
CAUSE OF DEATH (See Instructions and examples)
lIem27, Pari t En1erlhe~-diseases, injuries, orcorfl)tications-lhatdirecllycausedlhedealh. DO NOT enler terminal evenls such as cardiac arresl,
respiralory arrest, or venlri:ular fibriHation without showing the etiology. DO NOT abbreviate, Enter only one cause on a line.
IMMEDtATE CAUSE (Final disease or
corxmion resulting in dealh) ---7 a.
1ffl:;"'~1_~.L
29. If Female
o Not pregnan1 within pasl year
o Pragnanlallimeofdealh
o Notpregnanl.butpregnanllltilhin42da}'5
ordealh
o Notpregnanl,bufpregnant 43 days to 1 year
betoredeath
o Unknown if pregnant within the past year
32c, Place ollnjury: Home, Farm, Slreel, Factory, Office
Building. elc. (SpdciM
St':f.J 1..1 '!l(1~ ;\'0>>C-"",,"'...l
Duefo (ora a consequenceoQ:
~...~? F-t'.. L..~
Due lo{orasa consequence oQ"
SeQuentially Iistcondrtions, i!any,
~adiogtolhecalJselistedonLinea
- Enter the UNDERLYING CAUSE
. (diseaseorinjucylhalinitiatedlhe
evenfs resulling indealh) LAST.
Due Io{orasa consequence of)
30a. Was an AlJtopsy
Perlormed?
3Ob. Were Autopsy Findings
Availab~ Prilr 10 Corfllletion
of Cause of Dealh?
DYes 0 No
32d. Timeo/lnjury
32g.Location(Street,cityfloWfl,Slate)
32a.DateOflnJucy(Montf1,day,year)
32b, Describe how tnjury Occurred:
31. Mann,fDeath
nalural 0 Homicide
o Accident 0 Pending Investigation
o Suicide 0 Could Not Be Determined
DYes
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33a. Certifler(checkonlyone)
Certifying physician (Physician certifying cause of death when anothel physician has pronounced death and completed lIem 23)
To the best of my knowledge, dQ3th occurred due to the COIUSe{S) and man~r as stated. .... ...................................................._..
Pronourn:!ng and certtfylng physician (Physician both pronouncing dea!h and certifying to cause of death)
To the best of my knowledge, dealh occurred at the time, date, and place, and due to thecause(s) and manner as stated
Medical examiner/coroner
On the basis 01 examination and/or Investigation, in my opinion, dealh occurred al the time, date, and place, and due to the cause{s) and manner as slaled
33d DateSigned(Month,day,year)
35
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(See instructions and examples on reverse)
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LAST WILL AND TESTAMENT
I, John J. Grenoble, of Gardners, Pennsylvania, being of sound and
disposing mind, memory and understanding, declare the following to be my last
will and testament, hereby revoking any and all wills heretofore made by me.
Item I. I direct my executor hereinafter named to pay all my debts
and funeral expenses.
Item II. I give, devise and bequeath all my property, both real and
personal to my wife, Isabelle M. Grenoble, providing she survives me by thirty
days.
Item III. My wife, Isabelle, and I are the grantors of a joint
revocable trust agreement dated March 19, 2004, with Manufacturers and
Traders Trust Company in Carlisle, Pennsylvania, as the Trustee. The said joint
revocable trust agreement shall be known as the "John and Isabelle Memorial
Trust Fund." In the event my wife does not survive me, or dies in a common
disaster with me, I hereby exercise the power of appointment referred to in
Article I of the aforesaid trust and direct the Trustee to hold the assets of the
aforesaid trust in further trust and continue the trust in perpetuity subject to the
following terms and distribute the income from the aforesaid trust as follows:
A. One -half to Mt. Zion Evangelical Lutheran Church, 4200
Carlisle Rd., Gardners, P A,
B. One-half to Lutheran Theological Seminary, 61 Seminary
Ridge, Gettysburg, P A.
C. If either the Mt. Zion Evangelical Lutheran Church or the
Lutheran Theological Seminary ceases to exist then the
bequest for that organization shall pass to the Synod Church
Council, Harrisburg, Pennsylvania. Upon the death of the
second spouse, the assets of the revocable trust shall go into
trust for the benefit of these two organizations. The trust is
perpetual, and the income only shall be distributed to the
beneficiaries quarterly, and Manufacturers and Traders Trust
Company shall serve as the Trustee.
Said trust shall be subject to the following provisions:
(1). In the event that the foregoing charitable organizations are
not organizations described in Sections 170 ( c ) and 2055 (a) of the
Code of 1986, as amended (hereinafter referred to as the "Code"),
at the time when any principal or income of the trust is to be
distributed to it, then the Trustee shall distribute such principal or
income to such one or more organizations described in Sections
170(c) and 2055(a) as the Trustee shall select in its sole discretion.
(2). The Trustee shall make distributions at such time and in such
manner as not to subject the trust to tax under Section 4942 of the
Code.
(3). The Trustee shall not engage in any act of self-dealing, as
defined in Section 4941(d) of the Code, and shall not make any
taxable expenditures, as defined in Section 4945(d) of the Code.
The Trustee shall not make any investments that jeopardize the
charitable purpose of the trust, within the meaning of Section 4944
of the Code and the regulations there under, or retain any excess
business holdings, within the meaning of Section 4943 ( c ) of the
Code.
(4). The operation of the trust shall be governed by the laws of
the Commonwealth of Pennsylvania. The Trustee, however, is
prohibited from exercising any power or discretion granted under
said laws that would be inconsistent with the qualification of the
trust as an exempt organization described in Section 501 ( c ) (3) of
the Code and the corresponding regulations.
(5). The Trustee, however, shall have the power, acting alone, to
amend the trust in any manner required for the sole purpose of
ensuring that the trust qualifies and continues to qualify as an
exempt organization described in Section 501 ( c ) (3) of the Code
and the corresponding regulations.
(6). Nothing herein shall be construed to restrict the Trustee
from investing the trust assets in a manner that could result in the
annual realization of a reasonable amount of income or gain from
the sale or disposition of the trust assets.
Item IV. In the event that my wife does not so survive me, or dies
in a common disaster with me, I make the following specific bequest:
A. The sum of $2,500.00 to the Kiwanis International
Foundation, 3636 Woodview Trace, Indianapolis, Indiana 46268-
3196.
Item V. In the event that my wife does not so survive me, or dies
in a common disaster with me, I give, devise and bequeath, all the rest, residue
and remainder of my estate as follows:
A. Twenty Five per cent (25%) of my estate to my two
grandchildren: April Marie Broomhead and Steve Broomhead of 21
Columbus Ave., Belle Vernon, P A 15012. If one of them is
deceased, then their share shall go to my remaining living
grandchild.
D. Seventy Five per cent (75%) of my estate to be divided among
my 13 nieces and nephews as follows. If any of my nieces or
nephews shall be deceased, their share shall go to my remaining
living nieces and nephews.
Jacob Charles Sheely, III
818 Merdith Dr.
Media, P A 19063
David William Sheely
411 West Simpson St.
Mechanicsburg, P A 17055
Laura Ellen Sheely
265 Skyline View
Carlisle, P A 17013
Mary Beth Bergey
2840 Louisiana Ave.
Baltimore, Md 21227
Loline Marie Himmelreich
4832 Smith St.
Harrisburg, P A 17109
Charles William Reider
2629 South 3rd Street
Steelton, P A 17113
Pamela Ann Reider
2153 S. 3rd Street
Steelton, P A 17113
Linda Carol Biesecker
691 Winebary Circle
Lewisberry, P A 17339
Loline Elizabeth Saras
312 Trexler Ave.
Kutztown,PA 17530
John William Judge
6205 Patricia Court
Fredericksburg, V A 22407
Elaine Mae Macedonia
314 Loch Lomond
Madison, AL 35758
Ann Louise Masood
13 Georges Place
Fredonia, New York 14063-2122
Marian Leslie Steele
15 Freshfields
Comberbach
Northwich
Cheshire CW96QE
England
Item VI. I nominate, constitute and appoint my wife, Isabelle M.
Grenoble, as my executrix. If she should be unable to serve, I appoint my
attorney, George F. Douglas, III, Esquire, as substitute executor, and I direct that
either of them may serve without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
/116 day of --YVt o.y ,2004.
~~ (SEAL)
(.,/ J onn J. Grenoble
Signed, sealed, published and declared by the above-named testator, as and for
his last will and testament, who at his request, in his presence, in our presence,
and in the presence of each other, have hereunto subscribed our names as
attesting witnesses:
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COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND
I, John J. Grenoble, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my last will, that I
signed it willingly, and that I signed it as my free and voluntary act for the
purposes therein expressed.
~
-~~
Joh. . Gre~
Sworn to and subscribed before me
. "'-~l
this 'l{-- ,( L day of
(f\ OJ,v
I
, 2004.
NOTARtAl SEAL
Kathy L. Mummert, Notary Public
Borough of Carlisle, Cumberland Co., PA .
My Commission Expires Aug. 11 , 2007
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND
)
We, ~~J,~I.1J~j\,17J..<r i;and Arnav1do,. (n,An)/i V\... ' the
v
witnesses whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we were present
and saw testator sign and execute the instrument as his last will, and that he
signed willingly and that he executed it as his free and voluntary act for the
purposes therein contained, that each of us in the hearing and sight of the
testator signed the will as witnesses; and that to the best of our knowledge, the
testator was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
1
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Sworn to and subscribed before me
this (1..f'r1) of
(Y\f)..tj/
, 2004.
NOT ARtAl SEAL
Kathy L. Mummert, Notary Public
Borough of Carlisle, Cumberland Co., PA
My Commission Expires Aug. 11, 2007
Revocable Trust Agreement (Joint)
..
Manufacturers and Traders Trust
Company
. M8U'Investment Grou~
Manufacturers and Traders Trust Company is not representing or advising, directly or indirectly, that this
agreement or the trust created hereunder is suitable or appropriate for your particular situation. You should
consult with your legal advisor regarding the suitability of the Trust and this agreement for your pmiicular
situation.
.
JOINT
REVOCABLE TRUST AGREEMENT
FOR
John J. & Isabelle M. Grenoble ,Husband and Wife
ON THIS DATE,
we,
John J. Grenoble
and
Isabelle M. Grenoble
, husband and wife, of
2~ Frost Rd., Gardners, PA \7324
, and Manufacturers and Traders Trust Company (M&T Bank), the Trustee, hereby
enter into the following agreement.
CREA TION
OF TRUST
WHEREAS, we wish to create a revocable trust primarily for the purpose of being relieved of
investment responsibility and to provide for ourselves or any person dependent on us if for any
reason we are unable to direct in writing the disposition of income and principal of the Dust.
NOW, THEREFORE, in consideration of the Trustee's willingness to serve under this
agreement, we transfer and assign to the Trustee, in tmst, the property described in Article IX.
This property, together with all other additional property hereinafter received by the TlUstee,
shall be held, managed, invested and distributed in accordance with the following terms and
conditions:
ARTICLE I
DISTRIBUTIONS
During the telID of the Trust, the TlUstee shall hold, manage, invest and reinvest the trust
propelty, shall collect the income therefrom and shall distribute the net income and so much of
the principal as either of us may, from time to time, request for whatever purpose or purposes
either of us may designate. Any undistributed income may be added to principal for
reinvestment by the Trustee. We specifically acknowledge and agree that the Trustee shall
have no responsibility to detennine the purpose or purposes for which such income or
principal is used by whoever of us requests any such withdrawal. If, for any reason, we are
unable to direct in writing how to dispose of the income and principal of the Trust, we
authorize and direct the Trustee to apply such of the income and principal for our benefit or
for the benefit of any person dependent upon us as the Trustee deems appropriate in its sole
discretion and to continue our pattem of making gifts to individuals and organizations.
Each of us individually reserves the right to appoint any part or all of the principal of the bust
to anyone or more persons (including ourselves) by delivering to the other of us and to the
Trustee a written instrument executed and acknowledged by the individual exercising this
right or by a duly authorized attomey-in-fact for such individual.
The Trustee shall not be liable for the good faith exercise of its discretion in its determination
that neither of us is capable of managing our affairs. Any payments made under this
paragraph to either or both of us, or on behalf of either or both of us, which are made in good
faith shall be deemed proper and the Trustee shall have no duty to inquire as to the application
of any such payments by the recipient.
Upon the death of the first of us to die, the Trust shall continue for the benefit of the survivor
of us. Upon the death of the survivor, the Trustee shall distribute the principal, together with
any undistributed income, to or in tmst for such one or more persons or organizations as such
survivor may appoint by Will specifically exercising this power of appointment or, to the
extent such power is not exercised, to the personal representative of the Estate of the survivor,
2
TRUSTEE'S
AUTHORITY AND
INVESTMENT OF
TRUST PROPERTY
and this Tmst shalI tenninate. The receipt of the bust property held under this agreement by
such person, organization, or personal representative, shall release the Tmstee from any
further responsibilities with respect to such property. This Agreement does not serve as a
substitute for a Last Will and Testament.
ARTICLE II
In addition to the powers conferred by law, the Trustee shall have the following powers, to be
exercised in its absolute discretion without the order or ratification of any Court: to retain alI
assets received in kind as investments, without any duty of diversification, or to sell the same
upon such terms as it shall deem advisable; to invest in all fOlms of property without regard to
statutory limitations, including in one or more of the collective investment funds maintained
by the Tmstee or any affiliate, or such other assets as are acceptable to the Tmstee; to hold
shares in any registered investment company which may by advised by the Tmstee or any
affiliate and from which the Tmstee or any affiliate may receive compensation as advisor,
sponsor, manager, custodian, transfer agent, registrar, distributor, or service provider; to
exchange or lease for any period of time any real or personal property and to give options for
sales, exchanges and leases; to exercise all rights of security holders including the right to vote
personally or by general or limited proxy, any shares of stock; to register any securities in the
Trustee's name or in the name of a nominee; to pay, compromise, settle or release any claim
or controversy without COUlt approval; to bOlTOW money from any source, including M&T
Bank and to pledge any real or personal property pursuant thereto; to delegate discretionary
powers as permitted by applicable law; to employ agents, brokers, attomeys and accountants
and to treat their compensation as an administration expense; and to make distribution in cash
or in kind at CUlTent values, in undivided interests or non-pro rata shares, and without regard to
income tax basis.
By way of illustration and not limitation, the Trustee may invest in interest-bearing accounts
or in certificates of deposit issued by the banking department of the Trustee, or in securities
undelwritten by syndicates of which the Trustee is a member, but not if purchased from said
Trustee; and may execute purchases and sales through an affiliated discount brokerage service,
paying its regular charges as part of the trust administration expenses, so long as it provides
services of comparable quality and price as are available from altemative brokerage service
firms. The tenD "affiliate" shall include a subsidiaty of the Tmstee or any affiliate of a
subsidiaty.
The Trustee is not authorized to disclose, pursuant to SEC Rule I 4b-l (c), our names,
addressees), or security position(s) of CUlTent and/or future security holdings that the Tmst
may own from time to time.
The Trustee shall not be liable to us or any beneficiaty of this hust for any loss that may result
from retaining or making investments pursuant to our directions.
Any action or distribution made by the Tmstee at our direction or with our consent shall be
considered proper and authorized by this instrument, notwithstanding any provision of this
instrument or rule of law to the contrary and the Trustee shall not be liable to us or any
beneficiary of the trust on account of any such action or distribution. During our lives we
shall represent the interest of all beneficiaries of the hust, present and future, contingent or
vested, in any action regarding the trust and our action shall be binding on all such
beneficiaries.
ADDITIONS TO
TRUST ASSETS
REVOCATION
AND AMENDMENT
RESIGNA TION
ARTICLE III
It is understood that at any time we may add cash or other property to the Trust created
hereunder, provided the same is acceptable to the Tmstee, which cash or propet1y shall
become subject to the terms and conditions of this agreement. In addition, any other person
may add cash or other property to the Tmst created hereunder, provided the same is acceptable
to the Tmstee. In the event of any addition to the Tmst hereunder, the Tmstee shall have no
responsibility for filing any gift tax retums with respect thereto, unless othetwise agreed to in
writing by the Tmstee.
ARTICLE IV
We expressly reserve the right at any time and from time to time to revoke, alter or amend this
agreement by written notice delivered to the Tmstee, provided that the duties, powers,
compensation or liability of the Tmstee shall not be changed without its written consent. Any
such notice must be signed by both of us or by the survivor of us. However, if at the time of
such revocation one of us is then incapacitated, then only the non-incapacitated spouse need
sign such revocation notice. Upon receipt of a revocation notice hereunder, the Tmstee shall,
within ninety (90) days thereafter, deliver all propet1y held hereunder as the revoking spouse
or spouses may direct in writing, with any real property distribution hereunder being made to
us as tenants by the entireties if both of us are then living, or to the survivor of us, if one of us
is then deceased. The Tmstee shall be relieved of all liability for acting in accordance with
any such directions.
One or both of us shall be considered as "incapacitated" or "incapable of managing our
affairs", for purposes of this tlUst when the Tmstee receives written certification fi'om two
physicians, one of whom shall be the regular attending physician of the individual whose
incapacity is at issue, that one of us (or both of us as the case may be) has become unable to
act rationally and prudently in his of her financial best interest, regardless of whether there has
been any adjudication of incapacity, mental illness, or need for a committee, conservator,
guardian or similar representative. A recovety from incapacity for purposes of this trust shall
be upon the receipt by the Trustee of written cet1ification from two physicians, one of whom
shall be the regular attending physician of the individual whose incapacity is at issue, that such
person is no longer incapacitated and is again able to manage his of her own financial affairs.
The Trustee shall not have any duty to monitor the health of either of uS" or to institute any
inquity into the possible incapacity of one or both of us. However, should any such inquity
be reasonably instituted, the expenses of the inquiry shall be paid from the ttust estate.
The Trustee shall not be liable to anyone, including either or both of us, for relying in good
faith on the aforementioned physicians' certifications. A physician shall not be liable to
anyone, including either of us, for certifying (or failing to certify) in good faith that either of
us is or is not incapacitated for purposes of this instrument, and such physicians shall be
indemnified and held harmless from any loss occasioned by such certification or non-
cet1ification made in good faith.
ARTICLE V
The Tmstee may resign at any time without stating cause by delivering thirty (30) days written
notice of such resignation to us. In resigning hereunder, the Tmstee shall deliver, within
ninety (90) days of the effective date of its resignation notice, all propet1y held under this
agreement to us or as we may direct in writing. Any directions to the Tmstee with respect to
the transfer of the property held hereunder, shall be made by both of us, or in the event that
one of us is then incapacitated, by the non-incapacitated spouse, and following the death of the
first to die, by the survivor of us.
4
COMPENSATION
CHOICE OF LAW
MERGER
OF TRUSTEE
PROPERTY
SCHEDULE
CONSUL T A TION
WITH ATTORNEY
Any real property distribution hereunder shall be made to us as tenants by the entireties ifboth
of us are then living, or to the survivor of us, if one of us is then deceased.
ARTICLE VI
The Trustee shall be entitled to deduct as compensation for its services hereunder a fee which
shall be in accordance with its schedule of charges in effect at the time such services are
perfonned, and which shall be payable at such time and in such manner as the Trustee may
from time to time establish. For any special or extraordinary services, the Trustee shall be
entitled to additional reasonable compensation for such services.
ARTICLE VII
This agreement and the Trust hereby created shall be construed and govemed by the laws of
Pennsyl vania without regard to its conflict oflaws provisions.
ARTICLE VIII
Any corporation resulting from any merger, conversion, reorganization or consolidation to
which the Trustee may be a party, or any corporation otherwise succeeding generally to all or
the greater pari of the assets or business of the Trustee, shall be the successor to it as Trustee
hereunder without the execution or filing of any paper and without any further action on the
part of any pariy.
ARTICLE IX
The Trustee acknowledges receipt of the property listed below and accepts such property upon
the telms and conditions herein set fmih.
o The property schedule is attached.
ARTICLE X
We understand that this agreement with the Trustee does not serve as a substitute for a
Last Will and Testament and that we are hereby advised and encouraged to discuss the
terms of this agreement and its relation to our estate plans with an attorney of our
choice. Furthermore, we understand that the Trustee's acceptance of this Trust does not
constitute in any way a recommendation for or an endorsement of the joint form of
ownership of our estates.
5
ARTICLE XI
AUTHORIZATION
Unless the context otherwise clearly requires a contrary result, the Tmstee is authorized to act
in any matter hereunder upon directions by either of us, or in the event that one of us is then
incapacitated, by the non-incapacitated spouse, and following the death of the first to die, by
the survivor of liS. The Tmstee shall be relieved from any liability for acting in accordance
with any directions given hereunder.
ARTICLE XII
ENTIRE
AGREEMENT
This agreement constitutes the entire agreement between the Tmstee and us and supersedes all
prior or contemporaneous discussions, understandings or agreements between us.
IN WITNESS WHEREOF, this agreement has been executed, as of the day and year first written above, by us and on behalf
of the Tmstee by its duly authorized officer.
Tmstee:
MANUFACTURERS AND TRADERS TRUST COMPANY
,/"'~
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L~Uth?';~D;'''' ,
Gmnto'Si~~le
Date
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Date
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,,-.~.~,~tL m 'VL~1'~' ~.
Grantor Signature Isabelle M. Grenoble
\-l'?~ 11/~oo.f
Date .'
6
CoM I'M ~weA I i-h 0 ~ A k
COUNTY OF CVvw\.\'<< l~-,
On the ! q ~ day of (V\.~ , in the year 20JJL, before me, the undersigned, a notary public
in and for said C i) M N"<)r\ Ill'@ a/Vt+- , personally appeared ~T h fvr-. cr, G-rP,~ bhe ,
personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is
subscribed to the within instrument and acknowledged to me that A.~ executed the same in ,,; 5
capacity, and that by ~,. S signature on the instrument, the individual, or the person upon behalf of
which the individual acted, executed the instrument.
)
:88.
)
~~~[.;<~
Notary Public
(!:() '" fV\l J 11 W e ct-l U. b \- fit
COUNTY OF Qu..~la r\-j
One the t q f-k day of ~ \'ch , in the year 20~, before me, the undersigned, a notary
public in and for said 4 f)'\. Y\"-~ a.ft+.. , personally appeared .r <,q)'fdJ..e. fY\ Gre (l.obl-e_ ,
personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is
subscribed to the within instrument and acknowledged to me that ~ e#- executed the same in h ~
capacity, and that by ,,~.~ signature on the instmment , the individual, or the person upon behalf of
which the individual acted, executed the instrument.
)
:8S.
)
!'Jatarial Seal
Gwendolyn E Killian, Notary PUblic
Carlisle BOlO, Cumberland COUrilv
My Commission Expires Nov. 22.~!6Cl"
Memt1er. PennsvlWil1lCl p."SOGla!!on N f'j.:;'", '0.',
CLM^~1Jea. kt of f~
COUNTY OF Q.W\ ~~H.r la-"c:l
AJ~fY' Z,k~
Notary ~ub1ic .,'
)
: SS.
)
Notai ;al :3E~d!
! Gwendolyn f K,illian, Notaxy!'ul-,;"
I Carli<lie BOlO, Cumbellsl1ct (,oun: j
! My Commission Expires Nnv. 2? ';'ii}i
~.'_~'~'''''''''~'''A~''''''''____'~'-''''''''.__'._~_;_''__''-''~_~_''''-&~-', .--"" .._~.- ---
IVIHlnber, PGnn~j~i!\i(.',n!:::!. ,t:J..S~}OC\8tl;Al oj'
On thi ---1 't t-l , 20.Qt, before me personally appeared
G:: v , to me personally- lmown, who, being
by me duly sworn, did depose and say that deponent resides at "Rd.
in the (It(t'' (/"':JlfJ 130 '0 , ~ ~b"^~ d1f1 t County,
P(2^I\~/Vl1 "-,....0, ; that deponent is V r' esi e~ of
\tIANUF A URERS AND TRADERS TRUST COMPANY, the corporation described in and which executed
he foregoing instrument; that deponent knows the seal of said corporation, that it was so affixed by order of the
loard of Directors of such corporation; and that deponent signed such instrument by like order.
~~ ~_ k~~
Notary Publtc
ASSET SCHEDULE
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M&Tlnvestment Group
INVESTMENT SERVICES FEE SCHEDULE
Annual Administrative or Trustee Fee Based on Market Value of Assets
.35% ofthe market value of assets
Annual Investment Mana~ement Fee Based on Market Value of Assets
The annual investment management fee does not apply to investments in any of the
fluctuating NA V portfolios of the MTB Funds, excluding the MTB Equity Index Fund.
.70% on the first $500,000;
.55% on the next $500,000;
.35% on the next $1,000,000; and
.10% on the balance over $2,000,000.
Annual Base Fee
$1,200 prorated and paid monthly
Additional Char~es For Trust Accounts Onlv
This fee schedule is for normal services required in the management of a trust. Additional fees are
charged ifthe trust demands services beyond those normally required or if the trust holds real estate,
closely-held business interests or life insurance. For services required in the partial or complete
termination of a trust, reasonable and appropriate charges, not to exceed 2% of trust assets, will be
assessed commensurate with the work performed and the responsibility assumed. There will be no
termination fee assessed if a revocable trust is revoked or transferred by the Grantor. The allocation
of fees between income and principal shall be within the discretion of the trustee.
MTB Funds
MTB Investment Advisors, an affiliate of M&T Investment Group, receives investment advisory
fees directly from the MTB Funds, and Manufacturer's & Trader's Trust Company receives fees as
the custodian for the MTB Funds and for certain administrative services provided to MTB Funds.
These fees and other operating expenses are described in the MTB Funds prospectus accompanying
this fee schedule, which should be read carefully and retained for future reference. Investment
advisory fees for all money market portfolios held in IRA Rollover accounts shall be rebated to the
account.
Updated January, 2001
Schedule#453
,c,:' ",_~,,'~~--, " ,,', ,/ "',, ~ -_:' ;,', "'-' : ~~: --:' -' " _ ," ", ", 'iM
M&T Investment Group
INVESTMENT SERVICES FEE SCHEDULE
Sample Annual Account Fees
Account Size:
Annual Fee -- (Base +%)
If MTB Funds Not Used:
$ 500,000
$ 600,000
$ 700,000
$ 800,000
$ 900,000
$ 1,000,000
$ 2,000,000
$ 3,000,000
$ 4,000,000
$ 5,000,000
$10,000,000
$ 6,450 (129.0 basis points)
$ 7,350 (122.5 basis points)
$ 8,250 (117.8 basis points)
$ 9,150 (114.4 basis points)
$ 10,050 (111. 7 basis points)
$ 10,950 (109.5 basis points)
$ 17,950 (89.7 basis points)
$ 22,450 (74.8 basis points)
$ 26,950 (67.3 basis points)
$ 31,450 (62.9 basis points)
$ 53,950 (53.9 basis points)
Annual Fee --
If MTB Funds Used
For All Investments*:
$ 2,950
$ 3,300
$ 3,650
$ 4,000
$ 4,350
$ 4,700
$ 8,200
$ 11,700
$ 15,200
$ 18,700
$ 36,200
* This fee only reflects account level expenses. Additional expenses are incurred by each individual
portfolio ofMTB Funds. For more details on these expenses, please consult the MTB Funds
prospectus accompanying this fee schedule.
Revised, January,200l
Form#453
INSTITUTIONAL CLASS PROSPEC;TUS : August 25,2003
r-~
m M&I'lnvestmentGroup
GRANTOR / BENEFICIARY
MUTUAL FUND DISCLOSURE STATEMENT
ACCOUNT NUMBER(S): <Io fJiV (l- 'ii- -r::::;N i2>filAJJ?- hI") G ((1Sivof?, LJ5; rfLuCT
M&T Bank is committed to providing the above trust account(s) ("Account") with the care and attention that it deserves - and
the high level of professional services you expect With this commitment in mind, we are pleased to make available quality
mutual funds, including the MTB Group of Funds.
M&T Bank plans to invest the Account's cash balances in a money market mutual fund and may use one or more other mutual
funds in the Account's portfolio as we feel appropriate for the Account. These mutual funds may include: (1) the MTB Group
of Funds ("MTB Funds") advised by MTB Investment Advisors, Inc. ("MTBIA"), a subsidiary of M&T Bank; and (2) mutual
funds advised by parties not affiliated with M&T Bank (''Third Party Funds"). (MTB Funds and Third Party Funds are
collectively referred to herein as "Funds.")
MUTUAL FUND FEES:
MTBIA, M&T Bank and their affiliates ("M&T") provide investment management, shareholder services, administrative
services, and services under 12b-l plans to the MTB Funds and may provide eertain services to Third Party Funds. M&T is
entitled to receive compensation for the services that it provides to Funds. The t:ees paid to M&T may change from time to time
and, if M&T provides additional services to the Funds, it would be entitled to receive additional compensation from the Funds.
MTB Funds: The fees that M&T currently receives from the Funds are describ(:d in the Funds' prospectuses.
Federated Funds: M&T also provides certain services with respect to mutual funds advised by Federated Investment
Management Company ("Federated Funds"). These services may include transfer agent and subtransfer agent services,
aggregating and processing purchase and redemption orders, providing shareholder statements, processing dividend payments,
subaccounting services, forwarding shareholder communications, and proce:ssing shareholder proxies. Currently, M&T
receives the following fees for services provided to the Federated Funds:
Up to .35% of the average daily net assets of the Pennsylvania Municipal Cash Trust and the Automated Government
Money Trust held by clients of M&T Bank.
Up to .25% of the average daily net assets of the Government Obligations, the Prime Value Obligations, the California
Municipal Cash Trust and the Treasury Obligations Fund held by clients of M&T Bank.
The fees described above are computed daily and paid at least monthly. The Account will not pay a sales commission in
connection with the purchase or sale of the shares of any Funds.
The fees described above are in addition to the fees M&T Bank receives for providing services to the Account.
{(fP .
J;rn .J;J
Mutual Fund Disclosure Statement
Rev (09/03)
Page I of I
60-2956128
313
4476
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SCENIC AMERICANA
March 19, 2004
Mr. Thomas E. Morkin
M&T Investment Group
1 West High St.
P.O. Box 220
Carlisle, PA 17013
Re: John J. Grenoble and Isabelle M. Grenoble, T/A
Dear Mr. Markin:
Please transfer the income produced from the above mentionesl trust on a qt.40 J(7t;~ (" i
basis to our joint checking account with M&T Bank, Account # 3 ~ 7 )"'3..J'o. .
/
Sincerely,
~~
Jo n J. Grenoble
/7 1 "1 i1 .'7-
,-J~ d tfJk~~ >17. ~~
Isabelle M. Grenoble
MANUFACTURERS AND TRADERS TRUST COMPANY
AUTHORIZA TlON FOR
DIRECT DEPOSIT OF TRUST DISTRIBUTIONS
TO BE COMPLETED BY DONORlBENEFICIARY (Please Print):
Social Security Number: ()cf6 -~ ~ - d~(j,? ll:1-.J '(-3"['/57
Grenoble
I, John J. Grenoble & Isabelle M. , authorize and request that Manufacturers and Traders Trust Company ("M&T Bank")
deposit the distributions which I am entitled to receive as a donorlbeneficiary of the _ John J. & Isabelle M. Grenoble Trus t
Trust in the account ("Account") at the depository bank ("Depository Bank") designated below according to the following instructions:
Beginning Date: When Requested
Name of Depository Bank: M&T Bank
Address of Depository Ballie 1 W. High St.
(StreetJP.O. Box Number)
Carlisle, PA 17013
(City, State Zip Code)
Account Type:
Account Number:
Account Title:
Depository Bank ABA Routing No. & Check Digit:
022000046
I agree to be bound by all M&T Bank's regulations governing funds transfers as in effect from time to time and applicable law. I
understand that M&T Bank, all intermediary banks, and the Depository Bank are each entitled to rely on the account number for the
Account and the bank identifying number provided above even if the numbers and names given for me and the Depository Bank refer to
different persons or banks. Banks have no duty to discover any discrepancy between names and numbers. I am hereby warned to verify
all account numbers and bank numbers with extraordinary care.
I hereby authorize M&T Bank to withdraw from my Account any deposits made in error (e.g. subsequent to my death) and I specifically
authorize and direct the Depository Bank to debit my Account and refund said amounts to M&T Bank as disbursing agent.
I understand I have the right to revoke and cancel this authorization. Such revocation or cancellation will take effect when I notify M&T
Bank in writing. M&T Bank can at any time cancel any future automatic transfer by notifying me orally or in writing that it is doing so.
The cancellation by M&T Bank will take effect when M&T Bank sends or delivers the notice to me unless M&T Bank tells me in the
noti,,,h,t it will take effect l.teL f ~W<AA/~ ...?'" Date, YnG0?e-,?u 19:, 2CX5f
Signature of Donor/Beneficiary: ~Q o"QtLz.- VJ; - /~'....-- Date:. >)(.-(~...-IL.-<'-A I 'j 1<;< 0 oy::
Address of Donor/Beneficiary:
270 Frost Rd.
(StreetJP.O.Box Number)
Gardners, PA 17324
(City, State Zip Code)
Telephone Number:
TO BE COMPLETED BY DEPOSITORY BANK (Please Print):
This authorization is acceptable to M&T Bank , the Depository Bank, and the Depository Bank agrees to accept the funds
for deposit as described herein. The Depository Bank further agrees to refund to M&T Bank any payments received, in accordance with
this authorization, which were paid subsequent to the death of the donor/beneficiary or otherwise in error. The liability of the Depository
Bank is limited to the funds available in the donor/beneficiary's Account at the time M&T Bank requests a refund. The Depository Bank
represents and warrants that all of the information relating to the Account and itself provided in the instructions above is correct.
ACH Affiliated: Yes X No
Depository Bank ABA Routing No. & Check Digit: 022000046
Telephone Number: 717 240-4508
Authorized Signature of Depository Bank Representative:
Date:
Title:
Please Return To: Private Client Services, M&T Bank,
Gwen Killian, P.O. Box 220, Carlisle, PA 17013
[M&T - complete appropriate regional address]
Form W-9
Request for Taxpayer
Identification Number and Certification
GiVE! form to the
requester. Do not
send to the IRS.
(Rev. January 2003)
Department of the Treasury
Internal Revenue Service
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Name
Isabelle M. Grenoble
Business name, if different from above
O Individual!
Check appropriate box: Sole proprietor
Address (number, street, and apt. or suite no.)
o Corporation
270 Frost Rd.
City, state, and ZIP code
List account number(s) here (optional)
O Exempt from backup
withholding
Requester's name and address (optional)
o Partnership 0 Other ~ __ __ _ _ _ h . __ __ __ _ _
Enter your TIN in the appropriate box. For individuals, this is your social security number (S.SN).
However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions onX
page 3. For other entities, it is your employer identification number (EIN). If you do not havl~ a number,
see How to get a TIN on page 3.
Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number
to enter.
IDI1J
Certification
Under 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 withholding as a result of a failure to report all interest or dividends, or (e) the IRS has
notified me that I am no longer subject to backup withholding, 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 and dividends on your tax return. For real estate transactions, item 2 does not apply.
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 the instructions on page 4.)
Sign
Here
Signature of
U.S. person ~ X
Purpose of Form
A person who is required to file an information return with
the IRS, must obtain ,your correct taxpayer identification
number (TIN) to report, for example, income paid to you, real
estate transactions, mortgage interest you paid, acquisition
or abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien), to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding,
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note: If a requester gives you a form other than Form W-9
to request your TIN. you must use the requesters form if it is
substantially similar to this Form W-9.
Foreign person. If you are a foreign person, use the
appropriate Form W-8 (see Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities).
Date ~ X /71..~ I ~~ .2 a CJ 4
./
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a ta)( treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a
provision known as a "saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain types of income,
you must attach a statement that specifies the following five
items:
1. The treaty country. Generally, this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under
the terms of the treaty article.
Form W-9 (Rev. 1-2003)
Cat. No. 10231X
Form \lV-9
Request for Taxpayer
Identification Number and Certification
GiVE! form to the
requester. Do not
send to the IRS.
(Rev. January 2003)
Department of the Treasury
Internal Revenue Service
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Name
John J. Grenoble
Business name. if different from above
O Individual/
Check appropriate box: Sole proprietor
Address (number. street. and apt. or suite no.)
270 Frost Rd.
City. state. and ZIP code
Gardners PA 17324-881
List account number(s) here (optional)
o Corporation
O 0 0 Exempt from backup
Partnership Other ~ _ __. _ __ _.. __ _. _ _ __ withholding
Requester's name and address (optional)
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 the Part I instructions on X
page 3. For other entities, it is your employer identification number (EIN). If you do not have a number,
see How to get a TIN on page 3.
Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number
to enter.
mDII
Certification
Under 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 withholding as a result of a failure to report all interest or dividends, or (e) the IRS has
notified me that I am no longer subject to backup withholding, 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 and dividends on your tax return. For real estate transactions, item 2 does not apply.
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 the instructions on page 4.)
Sign I Signature of Q..QAA _ (jJ2v.. _,
Here u.s. person ~ X U'" Vy~ ;:J-. t:? ~~.0-tf-4
Purpose of Form
A person who is required to file an information return with
the IRS, must obtain your correct taxpayer identification
number (TIN) to report, for example, income paid to you, real
estate transactions, mortgage interest you paid, acquisition
or abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien). to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding,
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note: If a requester gives you a form other than Form W-9
to request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Foreign person. If you are a foreign person, use the
appropriate Form W-8 (see Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities).
Date ~71-10-Yzd~ I? Z.OO~
X I I
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a
provision known as a "saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain lypes of income,
you must attach a statement that specifies the following five
items:
1. The treaty country. Generally, this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under
the terms of the treaty article.
Form W-9 (Rev. 1-2003)
Cat. No. 10231X
M&T Investm~nt Group
STATEMENT of INVESTMENT GUIDELINES
for
John J. and Isabelle M. Grenoble Joint Revocable Trust
Thefollowing is a summary of the major investment guidelines which our investment manager, M&T Bank, is expected to
follow in the management of this portfolio. These guidelines are understood by us and will remain applicable until further
notice.
Portfolio Objectives: Generate a competitive return from capital appreciation and income f(eneration over a
longer-term investment horizon. Utilize a mix of equity and fixed income investments that will provide the
opportunity for long-term capital growth and current levels of income. Risk, measured in terms of portfolio
volatility, is anticipated to be similar to that of the broader financial markets.
Asset Ran e & Tar ets: FIXED INCOME TILT- TAX EXEMPT
0%
30%
5%
60%
90%
70%
10%
40%
25%
Primary Fixed Income Style: Active Management
- Strategy: Opportunistic approach focused upon total rate of return and capitalizes on market
opportunities. A lonf(-term orientation is used to evaluate underlvinf( market as well as investment specific
fundamentals.
- Quality:
- Maturity:
- Diversification:
Investment f(rade securities.
A veraf(e ten years or less.
- Benchmark:
u.s. Treasury. agencv & corporate securities and/or Municipal obligations.
Lehman Intermediate Government & Corporate Index.
Primary Equity Style: Large-Cap Core
- Objective: Capital appreciation.
- Strategy: A balanced investment approach between value and f(rowth stocks. This style of investinf(
will blend typical value strategies such as low price to book values, low price to cash flow, low price to earninf!s
multiples, and hif(h dividend yields, with growth stratef(ies such as hif(h price to book ratios, hif!h price to
earnings ratios, hif(h price to sales ratios. and low dividend yields. Security selection is primarily based upon
u.s. stocks issued bv well-established companies. The market capitalization for the maioritv of the securities will
be $10 billion or more.
- Diversification: Amonf( several different economic sectors.
- Benchmark: Standard & Poor's 500 Stock Index.
Cash Flow Requirements:
Other Investment Considerations:
Approved by:
Signature
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