Backup Documents 09/24/2019 Item #16E 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 E 3
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#I through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. County Attorney Office County Attorney Office 1012A } 19
2. BCC Office Board of County \O►�.
Commissioners \s-A 7
3. Minutes and Records Clerk of Court's Office P6 Id1*tei
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Erin Page,Accounting Stkervisor Contact Information 239-252-37
Contact/Department Administrative Services epartment
Agenda Date Item was September 24,2019 f Agenda Item Number 16.E.3
Approved by the BCC
Type of Document Receipt of Beneficiary, Waiver of Judicial Number of Original 1
Attached Accounting,and Release of Liability Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable Colum. .. -r is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signatur- 'TAMP OK EGP
2. Does the document need to be sent to another agency for additiona signatures? If yes, EGP
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be EGP
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's EGP
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the EGP
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's EGP
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip EGP
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 09/24/2019 and all changes made during EGP N/A is not
the meeting have been incorporated in the attached document. The County option for
Attorney's Office has reviewed the changes,if applicable. this ine.
9. Initials of attorney verifying that the attached document is the version approved by the N/A 's not
BCC,all changes directed by the BCC have been made,and the document is ready for th ,, an o tion for
Chairman's signature. t ' line.
16E3
MEMORANDUM
Date: October 23, 2019
To: Erin Page, Accounting Supervisor
Emergency Services
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Receipt of Beneficiary, Waiver of Judicial Accounting and Release
of Liability
Attached is one (1) original document as referenced above, (Item #16E3) as approved
by the Board of County Commissioners on Tuesday, September 24, 2019.
The Board's Minutes & Records Department has kept the original as part of the
Board's Official Records.
If you have any questions, please contact me at 239-252-8411.
Thank you.
Attachment
16E3
RECEIPT OF BENEFICIARY,
WAIVER OF JUDICIAL ACCOUNTING,
AND RELEASE OF LIABILITY
WHEREAS, pursuant to the terms of the Raymond Carl Howard Credit Shelter Trust
created UAD April 4, 2003, as amended and restated on January 3, 2006 (the "Trust"), upon the
death of Barbara J. Howard, and after the payment of debts, taxes and expenses of
administration, after making all preresiduary distributions, and after approval (or waiver of
approval) of the Trustee's accounting through the date of distribution, the balance of the Trust is
to be distributed as follows:
•
a. Bryan S. Howard—Forty-seven and one-half of one percent (47.5%);
b. Cheryl Lothian—Twenty-three and three-fourths of one percent(23.75%);
c. Timothy J. Lothian—one-third(1/3) of Twenty-three and three-fourths of one
percent (1/3 of 23.75% or 7.92%);
d. Katharine G. Lothian—one-third(1/3) of Twenty-three and three-fourths of one
percent (1/3 of 23.75% or 7.92%);
e. Robert J. Lothian—one-third(1/3) of Twenty-three and three-fourths of one
percent (1/3 of 23.75% or 7.92%);;
f. Collier County Emergency Medical Service (Florida), to be used for their rescue
work—Three percent(3%); and
g. Barry United Methodist Church,Barry, Illinois, to be used for the work of the
church—Two (2%); and
WHEREAS, Devan Hitt, as Trustee of the Trust, has made or provided for the payment
of all debts, taxes and expenses of administration, and all preresiduary distributions, and are
ready to distribute the remaining assets of the Trust to the beneficiaries listed above after
obtaining their signatures on this Receipt of Beneficiary, Waiver of Judicial Accounting, and
Release of Liability; and
WHEREAS,in order to avoid the delay and expense of a judicial accounting, Devan Hitt
as Trustee of the Trust, has prepared and provided to the beneficiaries an informal accounting
and other financial information (the "accounting") regarding the Trust for their examination and
approval.
NOW, THEREFORE, the undersigned,in consideration of the foregoing and the final
distribution from the Trust, does hereby:
(1) Acknowledge the receipt of the accounting of the Trust to date and
acknowledge having no objections to the accounting;
(2) Certify that he or she has examined the accounting, and in all respects
accepts and approves the same and ratifies and confirms all of the acts of the Trustee as
shown therein;
(3) Acknowledge receipt of complete distribution of the share of the Trust to
which the undersigned was entitled;
(4) Waive the filing of the accounting with any court and any judicial review
of same, and the issuance and service of any citation or other process in any action or
-1-
16E3
proceeding for the judicial settlement of the accounting, and consents that a judgment or
decree may be entered in any court, without notice to it, settling the accounting and
discharging the Trustee from all liability and accountability in respect of all matters
embraced therein or in this instrument;
(5) Release and discharge the Trustee from any and all liability or claims with
respect to the investment, management and administration of the Trust assets as disclosed
in the accounting;
(6) Agree unconditionally, to the extent it is later determined in a judicial
proceeding that the property so distributed exceeds that to which it is entitled to receive,
to refund to the Trustee such excess promptly upon written request by the Trustee;
(7) To the extent of the payments made and the property transferred to the
undersigned, agree to indemnify and hold harmless the Trustee from all liabilities, claims
or demands that may be made against the Trust or the Trustee, including without
limitation the amount of any income or other taxes (and interest thereon), hereafter
demanded from or assessed against the Trust or the Trustee, whether as the result of any
return heretofore or hereafter filed by the Trustee or otherwise; and
(8) Warrant to the Trustee that the undersigned has authority to execute this
instrument and has not assigned, mortgaged or otherwise encumbered its interest in the
Trust or any part thereof.
The provisions hereof shall bind and inure to the benefit of the heirs, legal
representatives, successors and assigns of the undersigned and of the Trustee.
EXECUTED this_ Jay ofe,2019.
Witnesses `xsis"ccx-ive,r
Collier).Co1 ; .
' . 1st' _
Print ame: Wi ifYhm L. McDanie",Jr.
Its: Chairman
STATE OF FLORIDA )
COUNTY OF COLLIER ) %413..a
�.a C
On this day of June 2019, before me personally came_ _--- who is
personally known to me, is personally known to and has•been identified by a witness personally
known to me, or who exhibited a dricr's license or other form of identification to me, and who
acknowledged executio..of the foregoing.
Notary Public, State of Florida
.�!' 4 !QO Printed Name:
AST:••'*.• ,�
1 ,Kri< -L, CLERKc ,
Ama+•--, +�ierk Approved as to form and legality
'hest as f � \C_)
sigtattu¢� il�ji.,: -2-
-,,,s • ,y`s►°, Ant County Att�y �j ��
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