Common use of Beneficiary(ies) Clause in Contracts

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Primary Beneficiary Name (First, Middle, Last) Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Absolute Capital Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Absolute Capital Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Contingent Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Contingent Beneficiary predeceases me, his share is to be divided among the Alternate Contingent Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Contingent Beneficiary. Proportions for Beneficiaries must total 100%If more than one primary beneficiary is designated and no distribution percentages are indicated, the beneficiaries will be deemed to own equal share percentages in the account(s). Multiple contingent beneficiaries with no share percentage indicated will also be deemed to share equally. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number SSN Address Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number SSN Address Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate SSN Address Contingent Beneficiaries Contingent Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth SSN Address Contingent Beneficiary Name (month/day/yearFirst, Middle, Last) Taxpayer ID Number Share % Relationship Date of Birth SSN Address Contingent Beneficiary Name (First, Middle, Last) Share % Relationship Date of Birth SSN Address This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Pinnacle Funds, or the Sponsorinvestment advisor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) ** This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Pinnacle Funds, nor the Sponsor investment advisor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Xxxxxxxx Xxxxxxxx Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Xxxxxxxx Xxxxxxxx Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Primary Beneficiary Name (First, Middle, Last) Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Absolute Capital Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Absolute Capital Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Centerstone Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Centerstone Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Primary Beneficiary Name (First, Middle, Last) Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Red Cedar Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Red Cedar Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company First National Bank of Omaha Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Contingent Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Contingent Beneficiary predeceases me, his share is to be divided among the Alternate Contingent Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Contingent Beneficiary. Proportions for Beneficiaries must total 100%If more than one primary beneficiary is designated and no distribution percentages are indicated, the beneficiaries will be deemed to own equal share percentages in the account(s). Multiple contingent beneficiaries with no share percentage indicated will also be deemed to share equally. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number SSN Address Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number SSN Address Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate SSN Address Contingent Beneficiaries Contingent Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth SSN Address Contingent Beneficiary Name (month/day/yearFirst, Middle, Last) Taxpayer ID Number Share % Relationship Date of Birth SSN Address Contingent Beneficiary Name (First, Middle, Last) Share % Relationship Date of Birth SSN Address This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund XXXX Funds, or the Sponsorinvestment advisor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) ** This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund XXXX Funds, nor the Sponsor investment advisor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Xxxxxxxx Funds, or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Xxxxxxxx Funds, nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund BTS Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund BTS Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund PRINCETON PREMIUM FUND or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund PRINCETON PREMIUM FUND nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRAXXX, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund the HCM Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund the HCM Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Primary Beneficiary Name (First, Middle, Last) Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund USA Mutuals or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund USA Mutuals nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Centerstone Funds or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Centerstone Funds nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund USA Mutuals or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund USA Mututals nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) Share % / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund THE XXXXXX FUND or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund THE XXXXXX FUND nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.

Beneficiary(ies). As Owner, I hereby make the following designation of beneficiary in accordance with the Constellation Trust Company Traditional Individual Retirement Custodial Account or Xxxx Individual Retirement Custodial Account: In the event of my death, pay any interest I may have under my Account to the following Primary Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Primary Beneficiary predeceases me, his share is to be divided among the Primary Beneficiaries who survive me in the relative proportions assigned to each such surviving Primary Beneficiary. If none of the Primary Beneficiaries survives me, pay any interest I may have under my Account to the following Alternate Beneficiary or Beneficiaries who survive me. Make payment in the proportions specified below (or in equal proportions if no different proportions are specified). If any Alternate Beneficiary predeceases me, his share is to be divided among the Alternate Beneficiaries who survive me in the relative proportions assigned to each such surviving Alternate Beneficiary. Proportions for Beneficiaries must total 100%. Primary Beneficiaries Primary Beneficiary Name (First, Middle, Last) Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Primary Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiaries Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % Relationship Date of Birth (month/day/year) Taxpayer ID Number Alternate Beneficiary Name (First, Middle, Last) / / Share % / / Relationship Date of Birth (month/day/year) Taxpayer ID Number This Designation of Beneficiary may have important tax or estate planning effects. If you cannot accomplish your estate planning objectives by using this Section to designate your beneficiary(ies) (for example, if you wish to provide that the surviving children of a beneficiary who predeceases you should take that beneficiary’s share by right of representation), you may submit another form of written beneficiary designation to the Custodian. Any amount remaining in the Account that is not disposed of by a proper Designation of Beneficiary will be distributed to your estate (unless otherwise required by the laws of your state of residence). You may change the beneficiary(ies) named above at anytime by filing a new Designation of Beneficiary with the Custodian. Any subsequent Designation filed with the Custodian will revoke all prior Designations, even if the subsequent designation does not dispose of your entire Account. Spousal Consent* I am the spouse of the above-named Owner. I acknowledge that I have received a full and reasonable disclosure of my spouse(s) spouse’s property and financial obligations. Due to any possible consequences of giving up my community or marital property interest in this IRA, I have been advised to see a tax professional or legal advisor. I hereby consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequence that may result. No tax or legal advice was given to me by the Custodian, Empiric 2500 Fund Xxxxxxxx Funds, or the Sponsor. / / Signature of Spouse Date (month/day/year) / / Signature of Witness Date (month/day/year) *This section should be reviewed if the Owner is married and designates a beneficiary other than the spouse. It is the Owner(s) Owner’s responsibility to determine if this section applies. The Owner may need to consult with legal counsel. Neither the Custodian, Empiric 2500 Fund Xxxxxxxx Funds, nor the Sponsor are liable for any consequences resulting from a failure of the Owner to provide proper spousal consent.