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Edward ones <br /> Trust Account Authorization and Agreement Form/Substitute W-J <br /> Account Registration: Date: Jan 26,2016 <br /> Account Number(10-digits): <br /> Vernon L Lindner 8 Steve T. Lindner TTEES <br /> U/W Grace Lindner FT-3 7 — 0 4 0 8 1 —�_a <br /> Grace Lindner Family Trust Branch#: 25582 <br /> 1335 Woodlawn <br /> Canon City, CO 81212 Financial Advisor#: 436781 <br /> Destination:New Accounts <br /> Scan Title: SENDDOC,TRUSTLIV <br /> A. Certification of Trust <br /> This form Is not a trust Instrument and is used to provide and certify to Edward Jones the accuracy of the information <br /> about the trust. An answer Is required for all of the following questions. <br /> 1. Title/Name of Trust: Grace Undner Famity Trust ' ` <br /> 2. Name(s)of the grantor(s)/settlor(s)/person(s)/court who signed/created the trust: V e,1 I1ar` L.in Ay\t/— ct,1A <br /> S�-ci ---,r. T L 1 A ex n t,r' <br /> 3. Date of original Trust Agreement,Will,or Court Order that created the trust: <br /> 4. The trust is: Q�Revocable and amendable Q Irrevocable and amendable Q Irrevocable and not amendable <br /> 5. ❑Check this box if the trust was created by a court order. <br /> 6. Number of current trustees(identified at the and of this document)required to give or approve Instructions to Edward Jones <br /> regarding this account: I (O, Lo <br /> 7. Indicate any investments that are not allowed by the trust: <br /> Asset Backed Securities CMO Cash Equivalent Certificates of Deposit <br /> Corporate Debt Deferred Annuities Government Bonds Life Insurance <br /> Limited Partnership Municipal Securities Mutual Funds Real Estate Investment Trust <br /> Stocks/ETFs H Unit Trusts <br /> 8. Does the trust allow trust assets to be used as collateral for margin and non-margin loans? Yes O No <br /> B. Successor Trustee Information <br /> If successor trustee(s)are named,please list the first Individual(s)who is named to serve after you. If no successor trustees are <br /> named, please indicate"N/A"on the first line below: <br /> 1. N /A 4. <br /> 2. 5. <br /> 3. 6. <br /> C. Certification—Substitute W-9 <br /> By signing this form, I certify under penalties of pedury unless otherwise indicated that: <br /> 1. The taxpayer identification number below is my correct Taxpayer Identification Number(or I am waiting for a number to be <br /> Issued to me). <br /> 2. 1 am not subject to backup withholding because: <br /> (a)I am exempt from backup withholding,or <br /> (b)I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure <br /> to report all Interest or dividends,or <br /> (c)the IRS has notified me that I am no longer subject to backup withholding. <br /> You must check this box if you have been notified by the IRS that you are subject to backup withholding. <br /> 3. 1 am a U.S.citizen(including U.S.resident alien). <br /> 4. The FATCA codes(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.' <br /> 84-6296918 Grace Lindner Family Trust <br /> Social Security Number/Tax Identification Number Print Individual's Name or Entity Name as registered WIRS <br /> *FATCA codes are only applicable to accounts held outside the U.S. <br /> Revised 26 Oct 2015 <br /> Page 1 of 2 <br />