COURT NTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... .. : Index No. IRREVOCABLE TRUST AGREEMENT : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against- Agreement, entered into this This : day of by , : and between JAMES CISSELL, PROBATE JUDGE, COURT OF COMMON PLEAS, : HAMILTON COUNTY, OHIO, as Grantor pursuant to the statutory authority of Ohio Defendant(s) : . . . . . . . . . . . . . .Revised . Code. Section. 2125.03,. and ........ ..... ........ ......... . as Trustee. PEOPLE OF THE STATE OF NEW YORK Section 1 Trust Property. The Grantor desires to create a trust authorized by Ohio Revised Code Section 2125.03 for the purpose of receiving the sum of . Said sum is the proceeds from the wrongful ETINGS: death settlement due and excuses being the WE COMMAND YOU, that all business and payable to laid aside, you and each of you attend before , onorable at the Court ty of child of located at . om , on the day of , 20 , at o'clock in the noon, and at any recessed ourned date, to testify and give evidence as a witness in this action on the part of the sole beneficiary of said trust, Section 2. Disposition of Trust Property. The is to receive the principal and accumulated Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to undistributed was issued for a maximum penalty of he/she attains the age as a arty on whose behalf this subpoenanet income from the trust when$50 and all damages sustainedof twenty-five of your failure to comply. (25) years. The Trustee, may, if the beneficiary attends a college, technical school, or in Witness, Honorable , one of the Justices of the County,accredited institution ,of higher education, use the trust estate to pay the tuition, day of 20 other fees room and board, and other expenses associated with the beneficiary attending (Attorney must sign above and type name below) such school only with the permission of the Court. Attorney(s) for Additionally, the Trustee may also apply to the Court for permission to expend such amounts of the accumulated income and/or principal of the trust estate as the Office and P.O. Address Trustee deems necessary to provide for the beneficiary's health, education, comfort, maintenance and support, or to meet any emergency expense of the beneficiary. Telephone No.: Facsimile No.: Funds may be expended for the foregoing items in the paragraph only upon the E-Mail Address: Mobile Tel. No.: Page 1 of 2 H.C. FORM 124.50 - IRREVOCABLE TRUST AGREEMENT American LegalNet, Inc. www.USCourtForms.com 02/10/03 COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : approval of the Probate Court. : CASENo. Index NO. Calendar No. Section 3. Trustee's Responsibility and : Authority. The Trustee shall invest the JUDICIAL SUBPOENA Plaintiff(s) -against: trust funds as provided under Ohio Revised Code Section 2109.37, 2109.371 and : 2109.372. Further, the Trustee shall have the authority to pay all income annually as : is necessary to pay taxes on said income, college tuition and expenses, and to pay any Defendant(s) : ...................................................... other expenses incurred as a result of his/her duties under the Trust, including his/her fiduciary bond. The Trustee shall make accounts to the Court on a biennial basis, or at THE PEOPLE OF THE STATE OF NEW YORK TO such other times as the Court may require. The Trustee shall incur no liability in handling the Trust estate, provided he/she exercises duties and responsibilities in a reasonable and prudent manner, and complies with the terms of this agreement. The GREETINGS: WE COMMAND the Trust hereby created and agrees aside, you and each of you attend before Trustee accepts YOU, that all business and excuses being laidto carry out the provisions herein , the Honorable at the Court located performed, without compensation. County of her part to be done and at on in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Section 4. Miscellaneous. The Trust being created shall be deemed to be an Ohio Trust, and shall be governed by the laws of the State of Ohio. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued forparties hereto have executed this Agreement in a IN WITNESS WHEREOF, The a maximum penalty of $50 and all damages sustained as result of your failure to comply. duplicate as of the day and year first above written. Witness, Honorable Court inWITNESSES: County, day of , one of the Justices of the , 20 (Attorney must sign above and type name below) JAMES CISSELL, Probate Judge Attorney(s) for Trustee Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 2 of 2 H.C. FORM 124.50 - IRREVOCABLE TRUST AGREEMENT American LegalNet, Inc. www.USCourtForms.com