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Designations. 1. Trust Information Name of Trust (Title) Date of Trust Tax ID or S.S. # Daytime Phone # Account Number(s) Street Address City State Tax ID or S.S. # Daytime Phone # Account Number(s) Street Address City State Zip Check here if this is a new address Qualified Plan Information Name of Qualified Plan Zip Check here if this is a new address 2. Certification of Trustee(s) Successor Trustee(s) The undersigned certify that the Trust/Plan indicated in section 1 has.
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