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08720'71 74:3
Code sections 16200 to 16249, which are incorporated by reference
in this declaration of trust and made a part of it, in addition
to those powers now and hereafter conferred by law affecting the
trust and the trust estate; provided, however, anything herein to
the contrary notwithstanding, the Trustees shall exercise powers
and discretions only in a manner consistent with the allowance of
the full federal estate tax marital deduction to which a deceased
Trustor's estate shall otherwise be entitled:
4.1.1 To hold, manage, invest, lend, and control
the trust estate and to encumber, sell, convey, deed or
otherwise dispose of any of the trust property; to lease for
any purpose and for terms within or extending beyond the
duration of this trust.
4.1.2 To invest and reinvest the trust estate in
every kind of property real, personal or mixed and every
kind of investment, specifically including, but not by way
of limitation, corporate obligations every kind,
preferred or common stocks, shares of investment trusts,
investment companies and mutual funds, and mortgage
participations which men of prudence, discretion, and
intelligence acquire for their own account, and any common
trust funds administered by the Trustees.
4.1.3 To buy, sell, and trade securities of any
nature (including "short sales on margin, and for such
purpose may maintain and operate margin accounts with
brokers; and may pledge all securities held or purchased by
them, with such brokers as security for loans and advances
made to the Trustees.
4.1.4 To hold securities or other property in the
Trustees' name as Trustees under this Trust, or in the
Trustees' own name, or in the name of a nominee, or
unregistered in such condition that ownership will pass by
delivery.
4.1.5 To borrow money for any trust purpose, to
hypothecate the trust estate or any part thereof and to
replace, renew, and extend any encumbrance thereon, upon
such terms, conditions, and security as may be determined by
the Trustees and to pay loans or other obligations of the
trust as deem advisable.
4.1.6 To participate in any plan of liquidation,
reorganization, consolidation or merger of any business or
corporation which may at any time form a part of the trust
estate.
4.1.7 To determine what is principal or income of
the trust estate, to apportion and allocate in the Trustees'
discretion receipts and expenses as between these accounts.
To the extent that the Trustees shall fail to exercise the
Page 2.
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08720"71
to incorporate or
business in which
disincorporate or
business in which
participate in the incorporation of any
the trust estate has an interest; and to
participate in the disincorporation of any
the trust has an interest.
4.1.14 To resume, with Court approval, the duties
of Trustee by any Trustee who may have resigned, at any time
and from time to time thereafter, and to replace the Trustee
appointed in his or her place, if one was so appointed.
4.1.15 To hold income accrued or undistributed at
the termination of any interest or estate under this trust,
and to distribute such income to the beneficiaries entitled
to the next eventual interest in the same proportions in
which they take such interest. The Trustees shall not be
required to prorate taxes and other current expenses to the
date of any such termination.
4.1.16 To possess in and by the status of
successor Trustee, unless otherwise specifically stated, all
of the authority and powers, including discretionary powers,
conferred upon the original Trustees.
4.1.17 To incur no liability for any loss to the
trust estate caused by the Trustees' acts in good faith; the
Trustees shall be liable for the Trustees' own willful
default and not for honest errors of judgment.
4.1.18 The Trustors, either directly, by Will or
by any other method may give to the Trustees any property,
either real or personal, and the Trustees shall be auth-
orized to accept, hold, manage, administer, and disburse the
same and all income therefrom in the same manner, to the
same extent, with the same effect, and to all purposes and
intents as if such property originally had been delivered to
the Trustees upon the express terms of this instrument."
irrevocable.
4. ..The John M. and Josephine M. Masson Trust is
5. The signatures of all Trustees are required on all
documents under which the Trustees exercise the powers of
trustees under the Trust.
Page 4.
08'72071 4 6
6. The Trust federal identification number (FEIN) is
95- 7005536.
7. The manner in which title to Trust assets should be
taken is "John T. Masson and Denise Ann Gray, Trustees U /D /T dtd.
Sept. 12, 1990."
8. The John M. Masson and Josephine M. Masson
Declaration Of Trust has not been revoked, modified or amended in
any manner which would cause the representations herein to be
incorrect.
9. This Certification is signed by the currently
acting Trustees of the Trust, JOHN T. MASSON and DENISE ANN GRAY.
THE UNDERSIGNED declare under penalty of perjury that
the foregoing is true and correct and that this Declaration is
signed on 7
1996.
OHN T. MASSON S
Page 5.
08'72071
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
On rn,4 y 9
Notary Public in and for
MASSON, personally known
JOYCE NICHOLS
Q� sr'' COMM. #1079803
NOTARY PUBLIC CALIFORNIA
LOS ANGELES COUNTY 3
My Comm. Expires Dec. 7, 1999
ss.
1996, before me, 7fte /0 0LS a
said State, personally appeared JOHN T.
to me (or proved to me on the basis of
satisfactory evidence) to be the person whose name is subscribed
to the within instrument and acknowledged to me that he executed
the same in his authorized capacity, and that by his signature on
the instrument the person, or the entity upon behalf of which the
person acted, executed the instrument.
WITNESS my hand and official seal.
7 4 7
Page 6.
•L. abed
1
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•guamnagsuT aug pagnoaxa 'pagog uosied
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uo eanggubTs .zag &q ggtg pug 'AgTagdgo pazT.zo .zag UT amgs
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pagT.zosgns sT amgu asogt uos.zad at;g aq og jeouapTAa Aaogog;sT4gs
jo sTsgq agg uo am og panoad 1o) am oq UMOUN ATTguosiad 'Ayup NNE
ssIN:3a paagedde ATTguosaad 'agggS pTgs 1o3 pug uT
'am a.zo ;eq '9661 CC r )1'� uo
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999 UM U01 O
Z3 iVA N VNNVSOil
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viN2io it vo o auras
(1119P071
STATE FILE NUMBER
THIS IS A TRUE CERTIFIED COPY OF THE RECORD
FIELD HEATH SERVIIC S BEARS THIS SEAL IN l
URPLE INK.
T r• r1
81
CERTIFICATE OF DEATH
STATE 01 CAUPORMA
USE BLACK INK ONLY /NO ERASURES. WHITEOUT'S OR ALTERATIONS
:'49
1 rv.nni. naVial nn 1IVn I,UMCYR
DECEDENT
PERSONAL
DATA
1. NAME OP DECEDENT -FIRST (GIVEN)
JOSEPHINE
4. DATE OP
2. MIDDLE
M.
3. LAST (FAMILY)
MASSON
BIRTH M M/ D O/ C C Y V
03/19/1925
5. AGE YRS. F 1
11 UNDER 4 1400 5
8 01 811 7. DATE OP DEATH M M/ D D/ C C Y Y
F 1 04/04/199
U
DAYS
71 1
1
1
8. HOUR
1926
9. STATE OF BIRTH
Ny
14.
10. SOCIAL SECuRITY NO.
1 1. MILITARY SERVICE
19 TO 18_
NONE
12. MARITAL STATUS 13. EDUCATION -YEARS COMPLETED
WIDOWED 12
RACE
WHITE
18. HISPANIC-SPECIFY
YES NO
15. USUAL EMPLOYER
SELF EMPLOYED
17. OCCUPATION
HOMEMAKER
18. KIND OP BUSINESS
OWN HOME
19. YEARS IN OCCUPATION
51
USUAL
RESIDENCE
20. RESIDENCE STREET AND NUMBER OR LOCATION
210 MARGUERITA AVENUE
21. CITY
SANT MONICA
22. COUNTY
LOS ANGELES
23. ZIP CODE
90402
24. YRS IN COUNTY
35
25. STATE OR POREIGN COUNTRY
CA
INFORMANT
28. NAME. RELATIONSHIP
JOHN T. MASSON (SON)
28. NAME OF SURVIVING SPOUSE -FIRST
29. MIDDLE
27. MAILING ADDRESS
3718 MOUNTAIN
(STREET AND NUMBER OR RURAL ROUTH NUMBER, CITY OR TOWN, STATE, ZIP)
VIEW AVE. LOS ANGELES, CA 90066
30. LAST (MAIDEN NAME)
SPOUSE
AND
PARENT
INFORMATION
31. NAME OF FATHER -FIRST
GAETANO
32. MIDDLE
33. LAST
TRIPICIANO
34. BIRTH STATE
ITALY
38. BIRTH STATE
ITALY
35. NAME OF MOTHER -FIRST
MONICA
38. MIDDLE
37. LAST (MAIDEN)
SPENO
OIBPOSITONIB)
39. DATE M M/ D D/ C C Y Y
04/11/1996
40. PLACE OF FINAL DISPOSITION
HOLY CROSS CEMETERY CULVER CITY, CALIFORNIA
FUNERAL
DIRECTOR
AND
LOCAL
REGISTRAR
41. TYPE or DISPOBITION(8)
BU
42. SIGNATURE OP MBALMER
4,
ENN NO.
43. UC
l
44 NAME OP FUNERAL 01550105
GATES, KINGSLEY GATES SM
45. LICENSE N O.
FD -451
81
48. 0NA OF CA REGISTRAR
C
47. DATE MM/DD CYY
04 /1 0 1996
PLACE
OF
DEATH
101. PLACE OF DEATH
RESIDENCE
102. IF HOSPITAL, SPECIFY ONE:
IP ER /OP DOA
1032FACIUTY OTHER THAN HOSPITAL:
Ho 5. ;ill REB, II oTHBR
10 COUNTY
LOS ANGELES
105. STREET ADDRESS- STREET AND NUMBER OR LOCATION
201 MARGUERITA AVENUE
108. CITY
SANTA MONICA
CAUSE
OF
DEATH
107. DEATH WAS CAUSED BY: (ENTER ONLY ONE CAUSE PER LINE FOR A, B, C, AND D)
IMMEDIATE
CAUSE (A) METASTATIC SPINDLE CELL CARCINOMA OF THE BREAST
TIME INTERVAL
'BETWEEN ONSET
AND DEATH
108. DEATH REPORTED TO CORONER
YES NO
REFERRAL NUMBER
3 YRS
O11E T1' I RI
109.
910581 PERFORMED
p
A YH8
NO
DUE TO (C)
1 10.
A ',TOPS: PE,IA.)0:4EG
III YES
111 NO
DUE TO (D)
1 1 1.
USED
IN DETERMINING CAUSE
YES NO
112. OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH BUT NOT RELATED TO CAUSE GIVEN IN 107
NONE
113. WAS OPERATION PERFORMED FOR ANY CONDITION IN ITEM 107 OR 1127 IF YES, LIST TYPE OP OPERATION AND DATE.
YES: MASTECTOMY AND RIB RESECTION 03/16/199
PHYSI.
CIAN'S
CERTIFICA-
TION
114. I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE
DEATH OCCURRED AT THE HOUR, DATE AND
PLACE STATED PROM THE CAUSES STATED.
DECEDENT ATTENDED SINCE DECEDENT LAST SEEN ALIVE
M M/ D D/ C C Y Y i M M/ D D/ C C Y Y
05/05/1995 1 03/20/1996
115. 8 AND TI PIER
V
118. LICENSE NO.
G20643
117. DATE M M D D O C Y Y
04/05/1996
118. TYPE ATTENDING PH IAN'S NAME, MAILING AD 588 ZIP
PETER D. BOASBERG MD 1 1 TREET 580 SANTA MONICA. CA 90404
2
CORONER'S
USE
ONLY
7 CI
1 CERTIFY THAT IN MY OPINION DEATH OCCURRED
AT THE HOUR, DATE AND PLACE STATED PROM
THE CAUSES STATED.
119. MANNER OF DEATH
I I
E NATURAL L� SUICIDE I 1 HOMICIDE
n PENDING COULD NOT BE
ACCIDENT INVESTIGATION C DETERMINED
120. INJURY AT WORK
YEe NO
121. INJURY DATE M M 0 0 C C y Yr122. HOUR
123. PLACE OF INJURY
124. DESCRIBE HOW INJURY OCCURRED (EVENTS WHICH RESULTED IN INJURY)
125. LOCATION (STREET AND NUMBER OR LOCATION AND CITY AND ZIP CODE)
128. SIGNATURE 01 CORONER OR DEPUTY CORONER
127. DATE MM /LID /CCYY
128. TYPED NAME, TITLE OF CORONER OR DEPUTY CORONER
STATE
REv13 HAR
A
B
C
D
1
E
F
I
O
1
H
?.Y. AU n
CENSUS TRACT
(1119P071
STATE FILE NUMBER
THIS IS A TRUE CERTIFIED COPY OF THE RECORD
FIELD HEATH SERVIIC S BEARS THIS SEAL IN l
URPLE INK.
T r• r1
81
CERTIFICATE OF DEATH
STATE 01 CAUPORMA
USE BLACK INK ONLY /NO ERASURES. WHITEOUT'S OR ALTERATIONS
:'49
DECEDENT
PERSONAL
DATA
IA. NAME OF OECEOENT -FIRST 18. MIDDLE
IGIvIN1
JOHN I M.
IC. LAST
MASSON
(FAMLYI
2A. DATE OF DEATH -MO, DAT. TR 28. HOU1 3 SE:
OCTOBER 24, 1992 113 M
4, RACE
CAUCASIAN
W
S. SPAN /HI!PANIC- SF[CIPY
YE, X❑ No
6. DATE OF B DAY. YR
NOV. 27, 1926
U VI
7. AGE IN IF UNDER 1 YR
MA
IF uNDE 4 r.ow
YEARS I MONTHS 1 OATS
65 1
HOURS IMINUTEJ
1
8. STATE OF
BIRTH
NY
9. CITIZEN OF WHAT
COUNTRY
USA
10A, FULL NAME OF FATHER 1 108. STATE or
1 BEM
JOHN MASSON ;ITALY
11A. FULL
GIOVANNA
1
MAIDEN NAME OF MOTHER
PIAZZA
1
1 T1B. STATE
1 BIRTH
1 ITALY
12. MILITARY SERVICE?
19. 4To IIIT..SJ_ NON[
13. SOCIAL SECURITY NO.
1111111111.1111.
14. MARITAL STATUS
MARRIED
1S. NAME OF SURVIVING SPOUSE OF YYIFE. OTTER MAIDEN NA1
JOSEPHINE TRIPICIANO
16A, USUAL OCCUPATION I 188. USUAL KIND OF BUSINESS 16C. USUAL EMPLOYER i 160. YEARS IN
OR INDUSTRY I OCCUPATION
OWNER /PROPRIETOR ;CHEESE MANIJFACIURING I SELF EMPLOYED 1 50
17. EDUCATION YEARS COmPLRi
12
USUAL
RESIDENCE
18A. RESIDENCE STREET ANO NUMBER OR LOCATION I i6B. CITY 1 ZIP COO[
I
201 MARGUERITA AVENUE SANTA MONICA 90402
180. COUNTY 1 16E. NUMBER OP YEARS 1 18F. STATE OR FOREIGN COU1Y 20. NAME. RELATIONSHIP, MANO ADORESO
I IN THUS Cautery 1 1( M IU AND ZIP C00( 00 IN0ORMANT
LOS ANGELES 32 i CA JOSEPHINE MASSON (WIFE)
PLACE
OF
DEATH
19A. PLACE OF DEATH 1 198. IF HOSPITAL. SPECIFY l IBC. couNTY 20 1 MARGUERITA AVENU
BARLOW HOSPITAL I Omelet, ER/OP, DOA
LO ANGELES SANTAONICA CA 90402
190. STREET ADDRESS--STREET AH0 NUMBER OR LOCATION 1 19E. CITY
I
2000 STADIUM WAY LOS ANGELES
nM[INT[RV AL
SE Ho o[ATH
22. WAS DEATH REFERRAL REPORTED NUMB TO CORONER?
Y[! RI NC
CAUSE
OF
DEATH
21. DEATH WAS CAUSED BY: (ENTER ONLY ONE CAUSE PER LINE FOR A, B. ANO 0)
C (IA) CARDIAC ARREST
MINUTES
23. WAS BIOPSY PERPORMEDT
Yes 10 No
CARDIAC ARRYTHMIAS
DUE TO 18i MINUTES
24A. WAS AUTOPSY PERFORMED?
YE! NO
1
I
DUE To t0 PR0BABLE CORONARY ARTERY DISEASE YEARS
25.
248. WAS 17 USED IN DETERMINING CAUSE
00 DEATH?
yes X No
OTo8 S+G(PICANT CONDITIONS CONTM.UTING TO DEATH BUT NOT RELATED TO CAUSE GIVEN IN 21
RESPIRATORY FAILURE, COPD, ANXIETY
26. WAS OPERATION PERFORMED POR ANY CONORION IN ITEM 21 OR 257
O TES. UST TYPE OF OPERATION AND DATE.
NO
PHySI
CIAN'S
CERTIFICA.
noN
i 1 CERTIFY THAT TO THE BEST OF MY KNOWLEDGE DEATH
OCCURRED AT 7H[ HOUR, DATE AND PLACE STATED PROM THE
CAUSES STATED.
27A. DECEDENT ATTENDED 51NCE DECEDENT LAST SEEN ALIVE
MONTH. OAT. YEAR I MONTH, DAY. YEAR
10/21/92 i 10/23/92
278. NONATWHE AND DEGREE OR, not OP PHYSICIAN 1 27C. PHYSICIAN'S UCENSE MAMMA 1 270. DATE 51GNE0
I 1
1 I
H I I 10/27/92
27E. TYPE ATTENDING P NTSICIAiS NAME ANO ADDRESS
MARTA SOVILJ, M.D., 2000 STADIUM WAY, LOS ANGELES, CA
CORONER'S
USE
ONLY
1 CERTIFY THAT 10 MY OPINION DEATH OCCURRED AT
10E HOUR. OAT% AND PLACE STATED FROM THE CAUSES
STATED.
28A. SIGNATURE AND TITLE OP CORONER 011 Deliver CORONER 288. DATE SIGNED
0111' I
I
29. MANNER OP DEATH OK: Bluli1, 1RIdgIL
yes, holmmde. Boom enestFOOA or Ca4d A01 be dlerlWEO
30A. PLACE OF INJURY 7 308. INJURY AT WORK 1 30C. DATE OF INJURY
I MONTH. DAY. TEAR
1 II Yes NO 1
31. HOUR
32. LOCATION (MEET AND NUMBER OR LOCATION AND CITY)
33, D%SCRIB[ HOW INJURY OCCURRED ((YENTs WHICH RESULTED IN 114JIJR71
FUNERAL
DIRECTOR
AND
LOCAL
REGISTRAR
34A. DISPOSTONIS) 348 0
PLACE OF FINAL SPOSINON --NAM( AND ADDRESS
I HOLY CROSS CEMETERY
ENTOMBMENT 15815 W_ ST.AITSfN,CTTT.yF.R CTTY, C
34C'
DAY. YEAR
OCT 27 1990
35 p0* 00 5 AeR 1338. NUMBER
i 4530
36A. NAM[ OF FUNERAL DIRECTOR (OR PERSON Acme AS wCN) i 368. LICENSE NO.
GATES KINGSLEY GATES C.C. 1 FD1016
;SIC 1R�AL RE �7. LL�•
s
Q A 7 X992
STATE
REGISTRAR
A
B.
C.
O.
E.
P.
CENSUS TRACT
V5 (REV. 3 -88
08
STATE FILE NUMBER
CERTIFICATE OF DEATH
STATE OF CALIFORNIA
USE BLACK INK ON
MAKE NO ERASURES. WHITEOUTS. OR OTHER ALTERATIONS
I THIS IS A TRUE CERTIFIED CC?PY
I. FILED IN THE COUNTY OF LOS A` (EI. E` DEPARKIEWT
OF HEALTH SERVICES IF IT DEA116 THIS SEAL It:
PURPLE INK.
OCT
70 A /0-
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