Legal Beneficiary Page

LEGAL BENEFICIARY PAGE

This Legal Beneficiary Page (the "Beneficiary Page") is made effective as of by and between Designating Party: , Address: and Recipient Party: , Address: .

Recitals

WHEREAS, Designating Party holds an interest in certain property, contractual rights, or proceeds (collectively, "Interest") under the instrument identified as: ; and

WHEREAS, Designating Party desires to designate one or more beneficiaries to receive all or a portion of the Interest upon the occurrence of the specified event(s) described herein and to set forth related provisions concerning allocation, contingency, revocation and notice; and

WHEREAS, Recipient Party will administer or otherwise act in accordance with this Beneficiary Page in respect of the Interest identified above.

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows:

1. Definitions

For purposes of this Beneficiary Page, the following terms shall have the meanings set forth below: "Beneficiary" means any natural person or legal entity identified in Section 3 as eligible to receive all or part of the Interest. "Primary Beneficiary" means a Beneficiary designated to receive a distribution prior to any Contingent Beneficiary. "Contingent Beneficiary" means one or more Beneficiaries designated to receive a distribution only if all Primary Beneficiaries predecease the Designating Party or otherwise fail to qualify to receive distribution under the terms hereof. "Per Stirpes" and "Per Capita" shall have their customary legal meanings in the jurisdiction identified below.

2. Designation of Beneficiaries

Designating Party hereby designates the persons and entities listed in Section 3 as Primary Beneficiaries and, where indicated, Contingent Beneficiaries of the Interest. Designation shall be effective upon receipt by Recipient Party of this duly executed Beneficiary Page. Unless otherwise specified, any share not expressly allocated shall be divided equally among the surviving Primary Beneficiaries.

This designation is: Revocable by Designating Party Irrevocable (unless all beneficiaries consent in writing)

3. Beneficiary Information — Primary Beneficiaries

Primary Beneficiary 1

Primary Beneficiary 2

Primary Beneficiary 3 (optional)

4. Contingent Beneficiaries

If no Primary Beneficiary is living or able to accept distribution at the time of distribution, the Contingent Beneficiaries identified below shall receive the Interest in the order and manner specified.

Contingent Beneficiary 1

Contingent Beneficiary 2 (optional)

5. Allocation and Manner of Distribution

Distributions to Beneficiaries shall be made in cash or in kind as determined by Recipient Party in accordance with the applicable instrument and applicable law. Distribution shall be made:

Manner of distribution: Per Stirpes Per Capita

If any Beneficiary is a minor, an incapacitated person, or an entity subject to legal restriction, Recipient Party may hold any distribution on behalf of such Beneficiary in a custodial account or make such other arrangements as permitted by law.

6. Representations and Warranties

Designating Party represents and warrants that (a) Designating Party is of legal age and capacity to execute this Beneficiary Page, (b) the information provided herein is true and correct to the best of Designating Party's knowledge, and (c) no other instrument of which Recipient Party has actual knowledge revokes or supersedes the beneficiary designations set forth herein except as expressly amended in writing.

7. Revocation and Amendment

Designating Party may revoke or amend this Beneficiary Page at any time prior to distribution, unless this Beneficiary Page is designated as irrevocable above. Revocation or amendment shall be effective only upon written notice delivered to Recipient Party at the address provided and acknowledged in writing by Recipient Party.

8. Notices

All notices, demands or communications required or permitted hereunder shall be in writing and shall be deemed given when delivered in person, by nationally recognized overnight courier, or three (3) business days after deposit in the United States mail, postage prepaid, addressed to the addresses set forth in the opening paragraph or to such other address as a party may specify by written notice to the other party.

9. Governing Law; Entire Agreement; Severability

This Beneficiary Page shall be governed by and construed in accordance with the laws of the State of without regard to conflicts of law principles. This Beneficiary Page, together with the referenced instrument, constitutes the entire agreement between the parties regarding the subject matter hereof and supersedes all prior designations and understandings. If any provision of this Beneficiary Page is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

10. Amendments; Waiver; Counterparts

Any amendment or waiver of any provision of this Beneficiary Page must be in a writing signed by the party against whom enforcement is sought. Failure to enforce any provision shall not constitute a waiver of future enforcement. This Beneficiary Page may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

11. Administrative Provisions

Recipient Party shall have the authority to request such documentation or proof as reasonably necessary to administer distributions under this Beneficiary Page, including, without limitation, death certificates, affidavits of survival, and proof of identity. Recipient Party shall not be liable for distributions made in good faith reliance upon reasonably believed facts and proper documentation.

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