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LLA 1989-068CITY OF LA U' A PLANNING 6 DEVELOPMENT DEPARTMENT 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 APPLICATION FOR LOT LINE ADJUSTMENT li OFFICE USE ONLY u it Zoning: LLA No.-� u Related Cases: n n Reviewed By: Date: - u ------------ APPLICANT-L ------------------------ 1G(f�7Z FIJ7?/t y %7tU(f Name: c10 I"&T ��L-!7✓h?L-LsS Address: '.' GSBo I 'it nL 13Lvd Oo Daytime (m L-vl j ) LDS fvL=ZI%s of aoL Phone. 12i3•N7t-�&7G (City) (State) (Zip) PROPERTY OWNERS Do rc 7,v� 14, LL /Ut} �� 1 /+ 1 Owner "All Name: -Ll -� T MiL7 ?7Zvtj Address: A--T /rAC{ VL- Phone: M' '1avE (City) (State) (Zip) Owner "B" Name: Address: Phone: (City) (State) (Zip) Owner "C" Name: Address: Phone: (City) (State) (Zip) PROPERTY DATA Property A: Assessor's Parcel Number: 77Y 113 - 0?�_ Street Address (if any): Property B: Assessor's Parcel Number: 77`{ Street Address (if any): Property C: Assessor's Parcel Number: 77y- //3 - r-y"=( Street Address (if any): ADJUSTMENT REQUESTED: .11 n.-, -_ "' - Lv &JISIj /)-&,VC 3 r-0/ L-0T5 REASON FOR REQUEST: flubucF- /iSSAT�M(V� 0 I/We hereby certify that: 1) I all parcels proposed for merger knowledge of and consent to the 3) The information submitted is true and correct. Representative Signature: am/we are the record owner(s) of by this Application; (2) I/We have filing of this Application; and, in connection with this Application Owner "A": Name C,�r ' Date ' Owner "B": Name Date Owner "C": Name Date (Attach Letter(s) of Authorization) Date MR/FORMLLA.001 APRIL 1988 Case No. P1-L,9 Applicant: Address: Owner:. Address: kl CASE INFORMATION Application Received'by Date Application Checked by Date ll�ti ,y am C?Co2 c� azate Zip Code Phone: Street Cty tate p o e Representative: Phone:.. Address: ...... I. Subject:fEm_ 2. Location: ,q-Y Y'q 3. Environmental Information E.A. No. Notice of Declaration 4. Related Files: E.I.R.No. G Filing Fee $ E.A. Fee i Total s Additional Fees s S Receipts for Fees: 5• Parcel Size/Acreage � E '� 9. Circulation Element _ ov �Ivrucxcle� 6. General Plan Designation 10. Housing Element 7. Zoning JZ 11. Council District 8. Surrounding Zoning 12. Assessor's -7-7 .1PS vz� „ IJ. 14. 15. 16. 17. 18 19 20 21 22 23, Tentative Hearing Date Agency. Deadline Date Plot Plan Checked Legal Description Transmittals A2ency Ex "A" Notice He Da Aoencv cY 11e.1 on urncr-ai ieie none Cit o Lount annin CVCWD Parks :MW Hea th De t. JEEE�E it n sneer transmittals sent by: Date: Public Hearing Notice Date: Notice Mailed by: Notice Posted by: Date: Entered in: Counter Book: Page Parcel By Applicant Notified of Action: Agencies Notified: File Closed: 24. Additional Pertinent Information:• Dorothy H. Leichner AND BELOW. WHEN RECORDED DMAIL THIS DEED AND, UNLESS OTH ESHOWN 3t Name Leichner Family Trust Address c/o J. Arthur Greenfield & Co. atys 10880 Wilshire Blvd., #500 +lid state I Los Angeles, CA 90024 J IV ZIP l� Title Order No. Escrow No. � ' m ti�0 0 A� W �Y d \ cc I LL SPACE -ABOVE -THIS LINE FOR RECORDER'S USE GRANT DEED and is The undersigned declares that the documentary transfer tax is $ computed on the full value of the interest of property conveyed, or is computed on the full value less the value of liens or encumbrances remaining thereon at the time: of sale. The land, tenements or realty is located in and unincorporated area —city of FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Dorothy Helene Leichner; as co -trustee of the Leichner Family Trust, dated June 1, 1966 hereby GRANT(S) to Dorothy H. Leichner, Robert Leichner, and Peter G. Greenfield, as trustees of the Leichner Family Trust, dated June 1, 1966 the following described real property in the state of California: county of Riverside of nta lita t Vale La ta Lot 12 and South erama of in Book 1090Pagesa33-34aofeMaps,ain the office as of Unit No. 19 asp P the County Recorder of said County This deed reflects Lot Line Adjustment No. 89-068 As approved by the City of La Quinta Dated / Dorothy l4elene Leichner STATE OF CALIF IA, ss. COUN F On C before me, the under- signs a Notary Public in and for said State, personally appeared Dorothy Helene Leichner who proved to me on the basis of satisfactory evidence to be the person — whose name is subscribed to the within instrument and acknowl- edged that she executed the same. WITNESS my hand and official seal. Si atu c MAIL TAX STATEMENTS TO PA R'FY SHOWN ON FOLLOWING LINE: Sucel Addass FOR NOTARY SEAL OR STAMP 0"U LL SEAL MAFIY E1NEl IxEMEW NOTARY I MIC 0008" PANICW%L OFFICE 0 US ANGLES CDUWV kb CmrmiWw,W Dec. 2& IAi Assessors Parcel No. IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE. City A State Name 251 Ll EXHIBIT --- LJ-A CASE NO.B 6 OLDLo1 LINt. r NLW Lai 0 L.{) L r'i l N► r LPit- LL' �12fi0f3f; / T-II-Rt-E i ;I 78.105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246 July 25, 1989%� G County Recorder County of Riverside P.O. Box 751 Riverside, CA 92502 SUBJECT: LOT LINE ADJUSTMENT NO. 89-068 Dear Sir: Attached please find Grant Deeds for Lot Line Adjustment 89-068 , with Exhibit(s). Recordation is requested by and for the City of La Quinta, in accordance with Government Code Section 6103, to insure compliance with zoning requirements prior to any construction taking place. Please record and return a copy of these documents to this office so our records can be updated. Thank you. Very truly yours, 8/28/89 Al� It is not clear the type of service �� e��ou desire from this office. The kN ;�(o enclosed appears to be a copy of ue, Glenda Lainis �. C "� a recorded � sgrant deed. we would not Assistant Planne`/ J�� a� record two of the same document. GL/bja 4 Attachments cc: Property Owner LLA File BJ/FORMLAWI-LM( ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 NHEN RECORDED MAIL THIS DEED AND. `U—NLLEESSStO'T�Hfl ESHOWN-- -- - r v s� L7 Name Leichner Fa Madre:: c/o JJ/Arr Gree,nfiel C City& 108$6 W-1shire Blvd., f1500 Gj / stale La's Angeles, CAlifornia 900 C Title Order No. Escrow No. 0 O ! <S • OD C 1CD a �6 SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED U The undersigned declares that the documentary transfer tax is S (77) and is computed on the full value of the interest of property conveyed, or is computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. The land, tenements or realty is located in unincorporated area city of _ and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Dorothy Helene Leichner, as co —trustee of the Leichner Family Trust, dated June 1, 1966 hereby GRANT(S) to Dorothy H. Leichner, Robert Leichner, and Peter G. Greenfield, as trustees of the Leichner Family Trust, dated June 1, 1966 the following described real property in the county of Riverside , state of California: Lot 10 and North half of Lot 11 in Block 190 of Santa Carmelita at Vale La Quinta Unit No. 19 as per map recorded in Book 10, Pages 33-34 of Maps, in the office of the County Recorder of said County This deed reflects Lot Line Adjustment No. 89-068 as approved by the City of La Quinta. Dated STATE OF CALIF IA, COUN F _--2j SS. On 6 before me, the under- signe a Notary Public in and for said State, personally appeared Dorothy Helene Leichner , who proved to me on the basis of satisfactory evidence to be the person . whose name d s subscribed to the within instrument and acknowl- edged that she executed the same. WITNESS my hand and official seal. re MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE: i �GYYtE ✓' Doroth Helene Leichner FOR NOTARY SFAi, nR STAMP OFFICIAL SEAL MARY ETH11 CLEMEW NOTARY PUBLIC CALWORMA PRINCIPAL OFFICE IN _ LOS ANGELES COUNTY Ip Commission Ew Dee. 23, 1992 Assessor's Parcel No IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE. Name Street Address 251 City & State 0 Ty 4X4P QU&r6U 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246 July 25, 1989 County Recorder County of Riverside P.O. Box 751 Riverside, CA 92502 SUBJECT: LOT LINE ADJUSTMENT NO. 89-068 Dear Sir: Attached please find Grant Deeds for Lot Line Adjustment 89-068 , with Exhibit(s). Recordation is requested by and for the City of La Quinta, in accordance with Government Code Section 6103, to insure compliance with zoning requirements prior to any construction taking place. Please record and return a copy of these documents to this office so our records can be updated. Thank you. Very truly yours, � n L we s. Glenda Lainis Assistant Planner GL/bja Attachments cc: Property Owner LLA File BJ/FORML�WILYQS ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 RECORDING REQUESTED BY — Dorothy H. Leichner AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO'. Name F Leichner Family Trust Address c/o J. Arthur Greenfield & Co. Day 10880 Wilshire Blvd., #500 state Los Angeles, California 90024 LP L Title Order No. Escrow No. SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED The undersigned declares that the documentary transfer tax is $ and is —computed on the full value of the interest of property conveyed, or is — computed on the full value Tess the value of liens or encumbrances remaining thereon at the time of sale. The land, tenements or realty is located in unincorporated area _ city of and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Dorothy Helene Leichner, as co —trustee of the Leichner Family Trust, dated June 1, 1966 hereby GRANT(S) to Dorothy H. Leichner, Robert Leichner, and Peter G. Greenfield, as trustees of the Leichner Family Trust, dated June 1, 1966 the following described real property in the county of Riverside , state of California: Lot 10 and North half of Lot 11 in Block 190 of Santa Carmelita at Vale La Quinta Unit No. 19 as per map recorded in Book 10, Pages 33-34 of Maps, in the office of the County Recorder of said County This deed reflects Lot Line Adjustment No. 89-068 as approved by the City of La Quinta. Dated STATE OF CALI`ali�1A, COUN� F �'�� .c.G/ SS. On lJ betoce o',c, ;he under- signe a Notary Public m and for said State, personally appeared Dorothy Helene Leichner , who proved to me on the basis of satisfactory evidence to be the person _ whose name is subscribed to the within instrument and acknowl- edged that she executed the same. WITNESS my hand and official seal. s�nrellCt MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE: OP Doroth Helene Leichner FOR NOTARY SEAL OR STAMP OFFlCIAL SEAL MARY ETHEL CLEMEM MNOTARY PUBLIC CAUP;k N PRINCIPAL OFFICE N1 LOS ANGELES CWNTY F4 CUIIIIeIM100 EY4 Dee. 23, IM Assessor's Parcel No. IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE. Street Address City & Slate RECORDING REQUESTED BY Dorothy H. Leichner AND WHEN RECORDED MAIL THIS DEED AND. UNLESS OTHERWISE SHONN BELOW, MAIL TAX STATEMENTS T0. C Name Leichner Family Trust 7 Address c/o J. Arthur Greenfield & Co. Cdya 10880 Wilshire Blvd., #500 Slate Los Angeles, CA 90024 z'n L _J Title Order No. Escrow No. SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED The undersigned declares that the documentary transfer tax is $ and is computed on the full value of the interest of property conveyed, or is computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. The land, tenements or realty is located in unincorporated area city of and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Dorothy Helene Leichner, as co —trustee of the Leichner Family Trust, dated June 1, 1966 hereby GRANT(S) to Dorothy H. Leichner, Robert Leichner, and Peter G. Greenfield, as trustees of the Leichner Family Trust, dated June 1, 1966 the following described real property in the county of Riverside state of California: Lot 12 and South half of Lot 11 in Block 190 of Santa Carmelita at Vale La Quinta Unit No. 19 as per map recorded in Book 10, Pages 33-34 of Maps, in the office of the County Recorder of said County This deed reflects Lot Line Adjustment No. 89-068 As approved by the City of La Quinta 1 " Dated Dorothy delene Leichner STATE OF CALIFQBeNIA, / ] COUN CIPF !%., U"Xs�.l�-'r/ _ J SS. On before me, the under- signe a Notary Public in and for said State, personally appeared Dorothy Helene Leichner , who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowl- edged that She executed the same. WITNESS my hand and official seal. Si 'atu FOR NOTARY SEAL OR STAMP OFFlCYLL. SEAT VARY ETHEL MEWNf �. NOTARY PUBLIC CILLIFORNIA PRINCIPAL OFFICE Ill LOS ANGELES COUNTY pb faamissi n iI Dec. 23. 1992 Assessor's Parcel No. 251 MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE: IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE. Name Street Address City & State 9 sk'-' l-� r, 6 s, R, 6 r- (-R'LLl< ARP-Or3A R6'F6iUC9 BY VIC. I 6Y 0 EXHIBIT - 11-Or CASE NO. B 9-2-- 8 DLD LOr L-)Nt- N tW Lor L I JW 0I.c for L 10, Crli-Rt'E sn' LaFj' rn ) rat—cn., t 2 -,S/ 4-07-1 J. Arthur Greenfield & Co. MAURICE J. CREAMER, C.P.A. TELEPHONE NATHAN BESSIN CP.A. CERTIFIED PUBLIC ACCOUNTANTS @13) 4750676 PETER G. GREENFIELD, C.P.A. 1213) 8793436 BURTON D. ROCKOFF. C.P.A. 10680 WILSHIRE BOULEVARD - SUITE 500 FAX SEVMOUR BOND. C.P.A. LOS ANGELE S. CALIFORNIA 90024 12131 470-8698 RICHARD A. DIIRANTE. C.P.A. HELEN B. WU C.PA. June 16. 1989 Ms. Glenda M. Lainis City of La Quinta 78-105 Calle Estado La Quints, CA 92253 RE Dear Ms. Lainis: .Iurl 19 01989 � IYY OF LA �'i;INTA PLANNING & DEVELOPMENT CEPT. Request for Lot Line Adjustment We enclose completed application and grant deeds, as per your instructions. Also enclosed, in order to establish current trusteeship of the Leichner Family Trust: Declaration of Trust First Amendment thereto Certificate of Death - Benjamin Leichner Very truly yours, LEICHNER FAMILY TRUST n Peter G. Greenfield, ,1Trustee PGG:mbh Encl. ® 7 p MAURICE J. CREAMER, f_.P.A. V • Arthur Greenfield W Co. NATHAN BESSIN. C.P.A. PETER c. GREENFIELD. C.P.A. CERTIFIED PUBLIC ACCOUNTANTS BURTON D. ROCKOFF, C.P.A. 10880 WILSHIRE BOULEVARD SUITE 500 SEYMOUR BOND, C.P.A. LOS ANGELES. CALIFORNIA 90024 RICHARD A. DURANTE. C.P.A. HELEN B. WU, C.P.A. May 25, 1989 City of La Quinta P.O. Box 1504 La Quinta, CA 92253 RE: La Quinta Lots MAY 2 6 1969 (C911V PIANNfNB� FVF(UP ENT DEPT. TELEPHONE (2131 475.0676 (2131 8793436 FAX (2 t 31 4 70-8898 Pursuant to your letter of May 16 (copy enclosed), the Leichner Family Trust would like to merge its three 50' lots into two 75' lots. Please send an application. LEICHNER FAMILY TRUST Peter G. Greenfield, %Co -Trustee PGG:mbh Encl. cc: Dot Leichner 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 (619) 564-2246 r / May 16, 1989 Dear Property Owners in Phase II of the Cove Improvements Project: The records available to us indicate that you own two, or more adjacent lots in the Cove area between Calle Madrid and Calle Colima. If that information is correct, you stand to save a significant amount of money if the assessment district for sanitary sewers goes forward and if you merge your lots. Property owners in Phase I, which is now underway south of Calle Madrid, found that by merging their lots they realized a savings of 28% to 42%, depending upon whether they merged three adjacent 50 foot lots into two or two adjacent 50 foot lots into one. To merge your lots or get more information on the procedure involved all you have to do is stop by the Planning and Development Department at City Hall. Should you decide to merge lots, the City will process your application and have your grant deed recorded, all at no cost to you. This is a savings of $175.00 in customary processing fees. Very t ly yours, Fra k ynolds, Director of Public Works/ City Engineer 774-113-021 13.033 C/O GREENFIELD CO 10880 WILSHIRE STE 506 LOS ANGELES CALIF 90024 774-113-023 12.035 C/O GREENFIELD CO 10880 WILSHIRE STE 50G LOS ANGELES CALIF 90024 774-113-022 13.034 C/O GREENFIELD CO 10880 WILSHIRE STE 506 LOS ANGELES CALIF 90024 MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 •RECORDING REQUESTED BY ®'Dorothy Helen\\`\\Leichner AND WHEN RECORDED MAIL TO Leichner Family Trust c/o J. Arthur Greenfield & Co.<-- 453 S. Spring Street L Los Angeles, California 90013 aL J MAIL TAX STATFNfNR TO Leichner Family Trust c/o J. Arthur Greenfield & Co. 453 S. Spring Street Los Angeles, California 90013 L 0403E 7 1? De 0, •� G N V tD 3 ` o W CD o .- ¢ tj G 00I r LL � 10 0 _ Tc u C Wm N O J s Yb a v 0 \ M. Eti .: :_ _ ra SPACE ABOVE THIS LINE FOR RECORDER'S USE --txrw. C v 00 O LO U .. E o o d u m fin= AFFIX I.R.S. $ ....................IN THIS SPACE — I Grant Deed I THIS FORM FURNISHED BY TITLE INSURANCE AND TRUST COMPANY FOR A VALUABLE C6SIDERATION, receipt of which is hereby acknowledged, Dorothy Helene Leichner, a married woman hereby GRANT(S) to Benjamin Leichner and Dorothy Helene Leichner, as trustees of the Leichner Family Trust, dated June 1, 1966 the following described real property in the County of Riverside , State of California: Lots 10, 11, and 12 in Block 190 of Santa Carmelita at Vale La Quinta Unit No.�19 as per map recorded in Book 10, Pages 33-34 of Maps, in the office of th,e County Recorder of said County This transfer is made without consideration. Dated July k! , 1966 STATE OF CALIFORNIA }SS. COUNTY OF Riverside J On July 1966 before me, the under- signed, a Notary Public in and for said State, personally appeared Dorothy-Helpne LeicbnPr known to me to be the person —whose name 1S subscribed to the within instrument and acknowledged that She executed the same. WITNESS my hand and official seal. Signature - —� BESSlN My Commission Expires Mq 28,1279 Name (Typed or Printed) Dorothy Ifelene Leichner ^.......................................... I ....... I........ ......... L ,asp S• NAI-HRN BESSiN NOIA.n PUBLIC-CALIFCRNIA t°.•1 PRINCI?AI O:FICE IN 5 LOS ANGF'I.ES COUNn' i L.a.....o......................I..................... ITIIIS area too oMClal notarial Hall Tide Order No. Escrow or Loan No. MAIL TAX STATEMENTS AS DIRECTED ABOVt DECLARATION OF TRUST LEICHNER FAMILY TRUST BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER, hereinafter called "Trustees", hereby declare that BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER, husband and wife, as Trustors, have, without consideration, transferred and delivered to the Trustees all their right, title and interest in and to the property de- scribed in Schedule "A" hereto attached, which the Trustors state is community property in which their interests are present, vested and equal. The said prop- erty, together with any other property that may later become subject to this trust, shall constitute the trust estate (and be more particularly identified and known as "the LEICHNER FAMILY TRUST") and sha11 be held, man- aged, administered and distributed by the Trustees and successor Trustees as provided herein. ARTICLE I The Trustors shall have the right at any time, either during their lifetime or by Will at their death, to add to this trust other property acceptable to the Trustees, which additional property, upon its receipt and acceptance by the Trustees, shall become a part of the trust estate. 1 ARTICLE II If either BENJAMIN LEICHNER or DOROTHY HELENEE LEICHNER, the initial Trustees, shall die or become incapacitated fully and permanently or shall be adjudi- cated legally incompetent, then and in such event J. ARTHUR GREENFIELD shall be appointed and act as Trustee hereunder together with the remaining acting Trustee. If J. ARTHUR GREENFIELD shall die, become :in- competent or for any reason fail to serve as Trustee hereunder, then PETER GORDON GREENFIELD shall act as a Trustee hereunder in his place and stead. Upon the death or incompetency of both BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER, then J. ARTHUR GREENFIELD shall act alone as Trustee hereunder, and in the event of his :fail- ure to act as such for any reason, then PETER GORDON GREENFIELD shall act alone as Trustee hereunder. If both initial Trustees, J. ARTHUR GREENFIELD and PETER GORDON GREENFIELD, are deceased, adjudged incompetent or for any reason fail to serve as Trustees hereunder, then SECURITY FIRST NATIONAL BANK, a national banking association of Los Angeles, California, shall be appointed and act as sole Trustee hereunder. ARTICLE III (1) The net income of the trust estate shall be paid in monthly or other convenient installments to or for the benefit of the Trustors while both shall live. In addition to the net income, the Trustees may pay to or for the benefit of the Trustors, out of the principal of the trust estate, such sums as shall be deemed neces- 2 0 . . 0 sary for their care, support and comfort, without limi- tation. (2) Upon the decease of either Truster, the Trustees may, in their discretion, pay the expenses of his or her last illness and funeral, and any inherit•- ance, estate or death taxes that may be due, whether attributable to the trust estate, to properties subject to probate administration or to outside transfers. (3) Upon the decease of the first of the Trus- tors to die, the Trustees shall segregate and divide the then remaining trust estate into two (2) trusts of equal value, to be designated Trust "One" and "Two", which shall constitute separate trusts, and shall be thence- forth held and administered as such. References herein to "trust" or "trust estate" are intended to and shall refer to each of said separate trusts and to the trust estate of each of them. The Trustees may hold undivided interests in property in each of said trusts. (4) Trust One shall include the deceased Trus- tor's vested interest in the community property of the trust estate, and Trust Two the survivor's vested interest in such property. Such division shall be made on the basis of values used in determining the State Inheritance Tax. All state death taxes and Federal Estate Taxes payable on the first Truster to die shall be charged to the prin- cipal of Trust One, and on the death of the surviving Truster, shall be charged to Trust Two. 3 0 , . ARTICLE IV (1) The net income from Trust One shall be paid, in monthly or other convenient installments, to or for the benefit of the surviving Trustor during the remain- der of his or her life. (2) Upon the death of the surviving Trustor, Trust One shall be held in further trust and adminis- tered as hereinafter set forth in Article VII. ARTICLE V (1) The net income from Trust Two shall be :paid, in monthly or other convenient installments, to or for the benefit of the surviving Trustor during the remainder of his or her life. (2) If the income payments from both Trusts One and Two to which the surviving Trustor is entitled, shall be insufficient, in the discretion of the Trustees, to provide for his or her reasonable care, comfort and sup- port, the Trustees may pay to said survivor such sums out of principal of Trust Two as the Trustees shall deem necessary for such purposes, up to the whole thereof. (3) If all of the principal of Trust Two is exhausted during the 'Lifetime of the surviving Trustor, the then acting Trustee other than the surviving Trustor (either J. ARTHUR GREENFIELD, PETER GORDON GREENFIEI.D or SECURITY FIRST NATIONAL BANK, as the case may be) in his or its sole, absolute and untrammeled discretion may invade the principal of Trust One to the extent neces- sary to provide for the reasonable care, comfort and maintenance of the surviving Trustor. 4 (4) Upon the decease of the surviving Trustor, Trust Two shall be held in further trust and adminis- tered as hereinafter set forth in Article VII. ARTICLE VI (1) The Trustors, while both shall live, by written instrument may revoke this trust in whole or :in part, and may alter or divest the interests of or change beneficiaries, and may amend the trust in any other re- spect. (2) Following the death of either Trustor, the survivor, by written instrument, may revoke or amend Trust Two in whole or in part; but Trust One shall be irrevocable and not subject to amendment upon the death of the first Trustor to die. (3) Following the death of both Trustors, the entire trust estate (including both Trusts One and Two) shall be irrevocable and not subject to amendment. ARTICLE VII Upon the death of the last Trustor, the Trustee shall combine Trusts One and Two and then divide such trust estate into two equal shares, one share for each of Trustors' two children, JANE LEICHNER (born June 1, 1948) and ROBERT LEICHNER (born September 13, 1951), without the necessity of segregating the assets there- under and without the necessity of maintaining separate books and records of account, except as required to carry out the distributions as hereinafter provided. Each such share shall constitute and be held and administered as a k, separate trust as hereinafter provided. The Trustee shall then hold, administer and distribute the trust estate in accordance with the fol- lowing uses, terms and provisions: (1) Receive and collect the principal and in- come of the trust estate, and after the payments and deductions hereinafter mentioned, to pay or accumulate, or use or invest, hold, apply and distribute the same to or for the purposes hereinafter stated, for the use and benefit of the beneficiaries herein named; and to convey and transfer the corpus or principal of the ac- cumulated income, if any, as hereinafter provided. (2) The primary and principal purpose of the trusts herein created is to provide proper and ade- quate support, maintenance, care and education for Trustors' children according to their accustomed standard of living, and any questions to be resolved at the discretion of the Trustee during the course of administration hereunder shall be resolved by the Trus- tee with this thought in mind. (3) The Trustee may expend so much of the net income from each such trust set aside for a living child as the Trustee, in its discretion, shall deem advisable Y or necessary for the care, support, maintenance and \ suitable education of such child. Any income not so \expended shall be added to the principal of the trust: for such child. (4) If the income payments from this trust to which any such child is entitled shall be insufficient C. L:I in the discretion of the Trustee to provide for his or her reasonable support, care, maintenance and educdtional requirements (after taking into consideration to the ex- tent the Trustee deems advisable such child's income from sources outside of this trust of which the Trustee has actual knowledge), the Trustee may pay to such child or apply for his or her benefit so much of the principal as the Trustee may deem proper or necessary for that purpose, but in no event shall such payments exceed the principal share of the trust estate set aside for the benefit of such child, and shall be deducted from it. (5) The principal of each share set aside for the children of Trustors shall be distributed as follows: (a) As to JANE LEICHNER, one-third (1/3) when she attains the age of thirty (30) years; one-half (1/2) of the remainder when she attains the age of thirty-four (34) years; and the remainder of her share when she attains the age of thirty-eight (38) years. (b) As to ROBERT LEICHNER, one-third (1,13) when he attains the age of twenty-seven (27) years; one-half (1/2) of the remainder when he attains the age of thirty-one (31) years; and the remainder of his share when he attains the age of thirty-five (35) years. (c) Should either of Trustors' children die before becoming entitled to receive distribution. of the entire share set aside for him or her, such share or its undistributed remainder shall go and be distributed to his or her lawful issue, living on the date of such 7 0 1 1 9_ child's death, by right of representation, or should no such issue be then living, such share shall go to aug- ment the share then held for the benefit of, or previously distributed to, the other surviving child of Trustors;, or if also deceased, then to his or her surviving lawful issue by right of representation. (6) While any grandchild of Trustors is a minor, the Trustee shall hold, administer, invest and reinvest such minor's share of the trust estate for his or her benefit, and apply so much of the net income and such portion of the principal thereof as the Trustee in his discretion (after consulting with the legal guardian of such minor) shall deem necessary for such minor's proper care, maintenance, support and education. When a grand- child of Trustors for whom a part of the trust estate shall have been retained under the foregoing provisions, attains the age of twenty-one (21) years, any of such part then held for such person shall be distributed to him or to her. (7) If, upon the death of both Trustors and the death of their children and grandchildren prior to distribution of the entire trust estate to the above j Y beneficiaries, the then remaining trust estate shall continue in trust for the benefit of ROSE WEISMAN, '> mother of DOROTHY HELENE LEICHNER, and the trustee shall distribute to said ROSE WEISMAN during her lifetime all of the net income from the trust estate and such portion of the principal thereof as the Trustee in his discretion I shall deem necessary for the care, support and maintenance W d of said ROSE WEISMAN. Upon the death of ROSE WEISMAN, the then remaining trust estate shall continue in trust for the. benefit of BEATRICE CAINE, sister of DOROTHY HELENE LEICHNER, and the Trustee shall distribute to said BEATRICE CAINE during her lifetime all of the net in- come from the trust estate and such portion of the principal thereof as the Trustee in his discretion shall deem necessary for the care, support and maintenance of said BEATRICE CAINE. Upon the death of BEATRICE CAINE, this trust shall terminate and the trust estate shall be distributed outright to the remaindermen as set forth in paragraph (8) below. (8) In any event, unless terminated at an earlier date under the foregoing provisions the trust estate (and each separate trust created thereunder) shall nevertheless cease and terminate twenty-one (21) years after the death of the last survivor of the following: BENJAMIN LEICHNER, DOROTHY HELENE LEICHNER, JANE LEICHNER, ROBERT LEICHNER, ROSE WEISMAN and BEATRICE CAINE; and upon such termination, be distributed to the beneficiaries who are at that time entitled to the income (whether in the discretion of the Trustee or not) in the same proportions as they are, .at such time, entitled to receive such income. If there be no such income beneficiaries then surviving, the principal and undistributed income of the trust estate shall go and be distributed, free of trust, in equal shares, share and share alike, to the following named persons living at such time: DOROTHY ROSEN, BERTHA KENNEDY, BEATRICE LEVY, SIDNEY BOGIN, ALVIN BOGIN, E. J. WEISMAN, EDWIN CAINE and ROBERTA \PURINTON. 9 ARTICLE VIII The Trustee, in the administration of this trust, is vested with the following rights, powers and discre:- tions, in addition to any now or hereafter conferred by law: (a) To receive, hold, retain, maintain and continue in trust the assets of the trust; to sell, ex: - change, convey, assign, transfer, deliver or otherwise: dispose of any and all of said assets; to receive, collect and recover, and pay out all income (including; all dividends, interest, rents, issues, gains and profits) that may accrue to or be paid respecting the trust estate; to manage, invest and reinvest the assets of the trust: in such domestic and foreign securities, mineral leases;, royalties and oil and gas interests, properties, bus: nesses, interest obligations and investments, as the Trustee may deem proper in his sole discretion, without any limitations or restrictions as to number, character or class thereof, or any other limitation or restriction whatsoever thereupon, and whether or not permissible by law as legal investment for trust funds; and in all :re- spects to manage, handle and dispose of each and every part of the assets of the trust in such manner and upon such terms and conditions as the Trustee may deem proper; and no purchaser of any of the assets of the trust from the Trustee shall be bound to see to the application of the purchase money arising therefrom or to inquire into the validity, expediency or propriety of any such sale, (b) To borrow money for any purpose for 10 the benefit of the trust, to secure repayment thereof by mortgage, pledge or hypothecation of any part of the assets of the trust, and to sell any of the assets of the trust in order to repay the same; to make, enter into, execute and issue, for any purpose for the benefit of the trust, any and all contracts, agreements, and obligations of every kind and charac- ter; and to charge and encumber, to such extent and in such manner as the Trustee may deem advisable, any of the assets of the trust for the performance and dis- charge of any and all such contracts, agreements and obligations; to assume obligations existing against property acquired by the Trustee, not exceeding in amount the value of such property, and to sell any of the assets of the trust in order to repay the same; to open and maintain one or more bank accounts and one or more brokerage accounts, designating the same as trust accounts, or without so designating the same, to the extent that it may be lawful to fail to designate such accounts as trust accounts. (c) To form and enter into, from time to time, one or more partnerships, and become partners with such persons, corporations, or trusts as the Trustee hereof may deem proper; to form and enter into, from time to time, any such partnership without regard to whether or not the Trustors, or any Trustee, or both, in their individual capacities or otherwise, may be a partner or partners therein; to loan money from time to time to any partnership in which the trust is a partner, lei with or without security being furnished, and upon such terms and conditions as the Trustee may, in his sole discretion determine. (d) To maintain an office or offices, to employ or appoint, from time to time, and pay reason- able compensation to, such officers, agents, assistants, attorneys, advisors, or investment counselors, that the Trustee may deem necessary or desirable in administering the trust, and to incur any expense that the Trustee may consider necessary or desirable in the conduct of the affairs of the trust. (e) To pay, out of income and/or principal, any and all expenses connected with the administration of the trust, including any expenses, taxes or fees incident to the transfer or vesting in him of the title to any of the assets of the trust, and any and all taxes, assessments and governmental exactions of every kind and nature which may be levied, assessed or charged against or in respect of any of the assets of the trust. (f) To vote in person or by proxy upon all securities held by him as Trustee; to exchange assets for other assets; to consent to or oppose the reorganiza- tion, consolidation, merger, liquidation or financial readjustment of any corporation or other entity in which the trust may have an interest, or to participate in corporate financing by making treasury donations of any portion of the corporate shares (which are among the assets of the trust) to the corporation issuing such shares when such a donation is deemed expedient by the 12 Trustee for the protection of an interest of the Trust, or to the sale or lease of trust properties or any portion thereof, or to the purchase or lease of property by it; to pay assessments, subscriptions or other sums of money as the Trustee may deem expedient for the protection of the interest of the trust in any securities; to exercise any options contained in or incident to any such securi- ties; and to take advantage of any subscription rights appertaining to such securities. (g) To sell or dispose of any real estate belonging to the trust, either at public or private sale, on such terms as the Trustee may deem proper, and to execute sufficient deeds therefor; to lease, mortgage, hypothecate or transfer in trust as security for an o'bli- gation, any such real estate on such terms as the Trustee may deem proper; to construct buildings or improvements, or to join with any co-owner or tenant in the construc- tion thereof; to lease such buildings or improvements; to cause partition or division to be made of any such real estate held by the Trustee in common or jointly with third parties, or to join with such third parties in the sale or disposal thereof. (h) To prosecute, sue upon, enforce, aban- don, or defend or adjudicate by legal proceedings, arbitration, compromise or settlement, any claim or demand whatsoever arising out of or which may exist in favor of or against the trust or any of the assets thereof. (i) To invest and reinvest all of the 13 assets of the trust in a single security, loan, partner- ship, investment or other business entity in which the Trustee in his sole and uncontrolled discretion deems advisable and proper. (j) To determine exclusively in the Trus- tee's sole discretion, but not in contravention to the provisions of this instrument, what receipts and expendi- ture shall be allocated to principal and to income; and to determine what, if any, charges to income and/or principal to make for waste, obsolescence, amortization, depletion and depreciation allowable under the then exist- ing Federal Internal Revenue Code. (k) To make distributions under the terms hereof.in kind, at fair market value, including undivided interests therein, in cash or partly in cash and partly in kind, and to sell such property as the Trustee may deem necessary to make distribution. The judgment of the Trustee in making any determination hereunder in the valuation of assets for purposes of distribution shall be conclusive and binding on all parties in interest in the absence of fraud. (1) The Trustee shall be authorized to hold trust funds uninvested for such periods of time and in such amounts as it may deem necessary or advisable, if such retention might reasonably be expected of a prudent man in the conduct of his own affairs. (m) Whenever the right of any beneficiary to payments from income or principal hereunder shall terminate, either by reason of death or otherwise, all 14 payments accrued or undistributed by the Trustee at the date of such termination shall go to the beneficiaries entitled to the next succeeding interest in the propor- tions in which they take such interest. (n) The 'Trustee may make payments to any beneficiary under disability by making them to the guard- ian of the person of such beneficiary. (o) Any Trustee shall have the right to resign this trusteeship at any time. If not otherwise provided herein, upon such resignation, a successor shall be appointed by a court of competent jurisdiction upon petition of the resigning Trustee or upon the petition of any adult person interested in the Trust. ARTICLE IX The interests of beneficiaries (after the death of the Trustors) in principal or income hereunder shall not be assigned, transferred, sold, or in any manner whatever anticipated, mortgaged or encumbered by any of such beneficiaries; nor shall any such income or princi- pal be subject to or :Liable for the debts, liabilities, contracts or obligations of any beneficiary, or subject to any assignment or other voluntary alienation or dis- position whatever. Any such attempt of a beneficiary to anticipate, dispose of, encumber or change his or her interest, or any part thereof, whether income or princi- pal, shall be void. ARTICLE X During the lifetime and service of BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER as Trustees herein, 15 they may, where convenient and expedient to do so, hold, manage, control, invest, reinvest and otherwise deal in property of the trust estate in their individual name or names (but acting as Trustee therefor) but shall maintain separate books and records and render separate account- ings and tax returns for trust property. However, any other or successor trustee hereunder shall be required to deal in trust property solely in the trust name. ARTICLE XI The Trustors expressly declare, and it is agreed, that this Trust instrument, including each and every pro- vision hereof, shall be governed by and construed accord- ing to the laws of the State of California. In the event any part or portion, paragraph, phrase, clause or sen- tence of this instrument shall be declared by a court of competent jurisdiction, by a final judgment thereof, to be invalid, unlawful, void or unenforceable, such decla- ration and such invalidity or unenforceability shall not affect the remaining part of this Trust. ARTICLE XII No Trustee shall be personally liable for any of its acts in the administration or performance of this Trust, except for willful negligence or malfeasance; .and in no event shall any Trustee be liable for any action or failure or refusal to act with respect to any matter relating to the administration or performance of this Trust if such action, failure or refusal be upon advice of reputable counsel. 16 ARTICLE XIII In this Declaration of Trust, whenever the con- text requires, the masculine gender includes the femi-- nine or the neuter, the neuter includes the masculine or the feminine, and the singular number includes the plural, and the plural number includes the singular number. The term "issue", as used herein, shall mean all lawful children and lineal descendants, and shall include legally adopted children. IN WITNESS WHEREOF, the undersigned, as Trustees, have executed this Declaration of Trust this day of Si 1966. t BENJ IN LEICHNER DOROTHY HE ENE LEIC ER�✓ Trustees CERTIFICATION We certify that we have read the foregoing Diecla- ration of Trust and that it correctly states the terms and conditions under which the Trust Estate is to be held, managed and disposed of by the Trustees. We approve the Declaration of Trust :in all particulars. C� BENJ IN LEICHNER " DOROTHY HInEME LEICHNER Trust.ors 17 LEICHNER FAMILY TRUST SCHEDULE "A" We, the undersigned Trustors, do hereby trans- fer, convey and assign all of our right, title and interest in and to the herein described assets to the LEICHNER FAMILY TRUST. CASH $5,000.00 LEI 0 LEICHNER FAMILY TRUST CREATED UNDER DATE OF JUNE 1, ].966 SCHEDULE "9' - DATED OCTOBER 14, 1966 We, the undersigned trustors, have hereunto transferred, conveyed and assigned all of our rights, title and interests in and to the herein described assets effective under the respective dates (as set forth below) to the Leichner Family Trust. Description of Asset Transferred Cash transferred under Exhibit "A" - $5,000 Cash - $40,000 Cash - $50,000 Limited Partnership Interests in T.P.M.I. Limited Partnerships #1 - #6, inclusive and Delta Development Limited Partnership Effective date ]Form of Assignment of Transfer Under Trust Agreement 6/l/66 Deposited in Agency Account in Security 1st Nat'l Bank, Main ]Branch, as Agent for the Trust in the name of Benjamin Leichner as auth- orized under Par. 10 of the Trust Agreement 9/28/66 10/13/66 6/30/66 Real Estate Residence - Casiano Rd., Los Angeles,Calif. 7/6/66 3 Lots - La Quinta, Calif. 7/6/66 11.43 Acres - Calabasas, Calif. 7/6/66 Securities As above As above Direct assignment Assignment by Deed 11 11 11 IP 11 11 1100 Shares of The Bali Company 10/12/66 Assigned herein and held in the name of Benjamin Leichner as Agent for the Trust - as authorized under Par. 10 of the Trust Agreement All the above property is community property and shall retain, its character as community property while held by the Trust. All transactions made or to be made from the Agency Checking and. Savings Bank Accounts at Security 1st National Bank (Main Branch) constitute valid trans- actions made for and in behalf of the Leichner Family Trust as authorized under Paragraph 10 of the Trust Agreement dated June 1, 1966. Signed: Under date of October 14, 1966 Signed: Under date of October 14, 1966 l 4BenLeichner or ,eic ner u LEICHNER FAMILY TRUST CREATED UNDER DATE OF JUNE 1 1966 SCHEDULE "C" - DATED DECEMBER 5 1966 We, the undersigned trustors, have hereunto transferred, conveyed and assigned all of our rights, title and interests in and to the herein described assets effective under the respective dates (as set forth below) to the Leichner Family Trust. Description of Asset Transferred An undivided one-half interest in and to Lots 8, 9, 10, 11, 12, 13, 14, 15, 16, 16-A and 16-B of Coconut Grove Warehouse Center Amended, a Subdivision of Dade County, Florida, according to the Plat thereof, recorded in Plat Book 25, at Page 66, of the Public Records of Dade, County, Florida; TOGETHER with the buildings and im- provements situate thereon and the personal property contained therein. 15% interest in Mauritz oil and gas lease and equipment, Jackson County, Texas 500 A.D.R. Western Holdings Limited Effective date Form of Assignment of Transfer Under Trust Agreement 12/5/66 Assigned herein and held in the name of Benjamin Leichner as gent for the Trust - .as authorized under Par. 10 of the Trust Agree- ment ll/1/66 Direct assignment 12/5/66 Assigned herein and held in the name of Benjamin Leichner as Agent for the Trust - as authorized under Par. 10 of the Trust Agree- ment All the above property is community property and shall retain its character as community property while held by the Trust. Signed: Under date of December 5, Signed: Under date of December 5, Benjamin Leichner 1966 Dorothy Leichner 1966 FIRST AMENDMENT TO DECLARATION OF TRUST LEICHNER FAMILY TRUST WHEREAS, BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER, both as Trustors and Trustees, executed on June 1, 1966 a Declaration of Trust; and WHEREAS, the aforesaid Trustors, pursuant to powers reserved to them in said Instrument, desire to amend said Declaration of Trust; NOW, THEREFORE, the undersigned Trustors do here- by amend certain Articles and provisions of said De- claration of Trust as hereinbelow set forth: A. Article II is amended to read as follows: ARTICLE II If either BENJAMIN LEICHNER or DOROTHY HELENE LEICHNER, the initial Trustees, shall die or become incapacitated fully and permanently, or shall be ad- judged legally incompetent, then and in such event, PETER GORDON GREENFIELD and ROBERT LEICHNER shall be appointed and act as Co -Trustees hereunder together with the remaining acting initial Trustee. Upon the -1- P death or incompetency of both BENJAMIN LEICHNER and DOROTHY HELENE LEICHNER, then the said PETER GORDON GREENFIELD and ROBERT LEICHNER shall continue to act: as Co -Trustees hereunder. In the event of the death of ROBERT LEICHNER or his inability to act for any reason, then PETER GORDON GREENFIELD shall act alone as Trustee hereunder.In the event of the death of PETER GORDON GREENFIELD or his inability to act for any reason, then and in such event, the following in.- dividuals, in the order named, shall act in his place and stead: NATHAN BESSIN, BURTON D. ROCKOFF, SEYMOUR BOND. In the event all of the individuals named as a Trustee hereunder are deceased or for any reason unable to act as such, then SECURITY PACIFIC NATIONAL BANK, a national banking association of Los Angeles, Calif- ornia, shall be appointed and act as Trustee hereunder. B. Article V paragraph (3) is amended to read as follows: (3) If all of the principal of Trust Two is exhausted during the lifetime of the surviving Trustor, the then acting Trustees other than the sur- viving Trustor, in their sole, absolute and untram- meled discretion, may invade the principal of Trust One to the extent necessary to provide for the reason- able care, comfort and maintenance of the surviving Trustor. -2- C. Article VII paragraph (3) is amended to read as follows: (3) The Trustee shall pay to or apply for the benefit of JANE LEICHNER and ROBERT LEICHNER all of the net income from each such trust set aside for them, annually or at more frequent intervals, during the ex- istence of their respective trusts. D. Article VII paragraph (5)(a) is amended to read as follows: (a) As to JANE LEICHNER, she is not to re- ceive any of the principal of her share of the trust as a matter of right but only in the discretion of the Trustee as more particularly set forth in Article VII paragraph (4) hereinabove. E. Article VII paragraph (7) is deleted in its entirety. F. Article VII paragraph (8) (now paragraph (7)) is amended to read as follows: (7) Upon the death of both Trustors, and the death of their children and grandchildren prior to dis- tribution of the entire trust estate to said beneficiaries, this trust shall terminate and the then trust estate shall be distributed outright, free of trust, in equal shares, share and share alike, to the following named persons living at such time: BEATRICE CAINE, DOROTHY ROSEN, BERTHA KENNEDY, BEATRICE BOGIN TUBIN and EDWIN CAIN:E. -3- In any event, unless terminated at an earlier date under the foregoing provisions, the trust estate (and each separate trust created thereunder) shall nevertheless cease and terminate twenty-one (21) years after the death of the last survivor of the following: BENJAMIN LEICHNER, DOROTHY HELENE LEICHNER, JANE LEICHNER, ROBERT LEICHNER and those grandchildren of the Trustors living at the time of the death of the last to die of the two Trustors, and upon such term- ination, be distributed to the beneficiaries who are at that time entitled to the income (whether at the discretion of the Trustee or not) in the same propor- tions as they are, at such time, entitled to receive such income. If there be no such income beneficiaries then surviving, the principal and undistributed in- come of the trust estate shall go and be distributed„ free of trust, in equal shares to the then living persons named in the preceding paragraph. IN WITNESS WHEREOF, the undersigned, as Trustees, have executed this First Amendment to Declaration of Trust this 15th day of April, 1974. DOROTHY HELENE LEICHNER Trustees -4- L CERTIFICATION We certify that we have read the foregoing First Amendment to Declaration of Trust (Leichner Family Trust) and that it correctly states the changes in terms and conditions under which the trust estate is henceforth to be held, managed and disposed of by the Trustees in being upon our demise. In all other respects we approve and reaffirm the Declaration of Trust. -5- c B jr /INN%LEICHNER DOROTHY AELENE LEICHNER L CERTIFICATE OF DEATH STATE OF CALIFORNIA-DEPARTMENT OF HEALT - - --"-- "--'- IA. NAME OF DECEASED-pIRST NAME I . OLE NAME - •••^--•••••••� wuu ncbnlxATOR u6IMLI AND CERTIFICATE NUMBER a LAST NAME 2e. DATE OF DEATH-Moxtx DAY. 2e HOUR Benjamin rEen I4 Leichnor Sept 11 1975 110110 P COLOfl OR RACE S. BIRTHPLACE -o ATOOA FO..... I M 6. DATE pFBIRTH 7. AGE �usr «w.T.A,. IF U. EA I TEAR IF uxotR U nomrs sale nano Conneociont May 17 1912 63 DECEDENT 8, NAME AND BIRTHPLACE OF FATHER YEARS V. MAIOEN NAME AND BIRTHPLACE OF MOTHER PERSONAL Jaoob Loichmer- Roumenia Lena Began-Roumenia DATA In CITIZEN OF WHAT COUNTRY II. SOCIAL SECURITY NUMBER 12. MARRIED. NEVER MARRIED. WIDOWED. 13, NAME OF SURVIVING SPOUSE OF MIT ENTER MAIDEN NAM , U.S.A. 046 03 1114 DIYORCUfftea I)orettW Weisman. I4. LAST OCCUPATION IS. !„,��•[°:ulox' 16, NAME OF CAST EMPLOYING COMPANY OR FIRM 17. KIND OF INDUSTRY OR BUSINESS Vice President 8 " XWNCe. Department Store IBA. PLACE OF DEATH -NAME OF HOSPITAL OR OTHER INPATIENT FACILITY I8B. STREET ADDRESS-ISTINUF AND NUMBER. OR LOCATION, IDc. INSIDE TIDY coxvnx,n LI Mil, PLACE II, C.L.A.Medie8l Center 10833 LeConte St. I,SFECIFY YES OR NO, No DEATH IBo. CITY OR TOWN GIBE. COUNTY IIBr. ...... arum°x,r or m.n' IBo • ra«. x num.,.. Los. Ragelee Les'Angeles i 24 24 USUAL YEARS I TEAR I9A. USUAL RESIDENCE --STREET ADDRESS UREFT AND NUMBER OR LOCATION 19.. INSIDE CITY CORPORATE LIMITS 20. NAME AND MAILING ADDRESS OF INFORMANT RESIDENCE 295pp Heethsroliff Rd 1'511CIRr ON No, DorovW Leichner Or DEATH OCcuARED IN OI No MYTNTDTTDN. ENTER 19c. CITY OR TOWN I 19D. COUNTY 119E. STATE A MCE BEFORE ROBINSON) Malibu Los Angeles I Calif same I 21A. CORONER. ^ n^'n r u 21,. PHYSICIAN: "Yx^� [[""^ wo' °[+'Ys- [ wu AT Tx. INI o , wn. A E, ITIM TO. r` «A. yE, PHYSICIAN OR CORONER-H, °"uxoo[wIE °nn.[ I 21D. DATE SIGNED PHYSICIAN'S Aoe«. O.I[ ,N..LI. nA IBe AEer[ Rex rw 11... FEE 4w[f HAD. Y.OM A.. I""I uprx°I°`,`Nr N11AI1° T c.,DT IIATI. m.. A.. NA, IRAN, .11. ON I T OR CORONER'S ,. ANo r� o :�E x.�xT or ouono ,. A[wn,.nu. lad[>rMoxlx. 1 AAV y CERTIFICATION x1� .r.T NIU No "..A...u,� 4• t N `°,Puy E•, I�' 21E. ADDRE�SS rx Rx:I lxo«xl. 6 ��[xPEFtiudYlIi ---uvNEME,iK3AIWRETT----'. /(sr . 7s 12/1r�E 1( P � FUNERAL BURIAL. ENroMwENI r 228. DATE 22A. SIECIFYCREMATION w.nox OR cx 23. NAME OF CEMETERY OR CREMATORY 24. EMBALMER -SIGNATURE OF BODY E.PALNEDI LICENSE NUMBER DIRECTOR Cremation-'.1...:9-15-75 Usetwood Memorial Park - embalmed AND .not LOCAL wo L..A 25. NAME OF FUNERAL DIRECTOR TOR FERBON ACTING AS SOCHI 26. 'F.1DMIDID. � [ 28. •ATE A¢nru rw v.unumxu i,&ouln m.o conox :, 27 CA REGIST AR -SIG T =:.4=111 REGISTRAR Weetvoeu Village: Mortuary .cl nI TII4 ION �g b 17s 29. PAflT L DEATH WAS CAUBED MY: ENT M ONLY ONE CAUSE PER LINE`FOR A. B. AND C IMYFDIATE CA E CAUSE CONDITIONS. IF ANY. WHICH DUE TO. OR AS A CONSEQUENCE OF - . - MATE INTERV9 4❑ GAVE RISE TO THE IMMEDI- LE) / . �• CjK bETWEC OF ATE CAUSE JAI. STATING ONSET THE UNDERLYING CAUSE DUE TO. OR AS AXIIINSEQUENCE OF AND DEATH j DEATH w AST G z 30. PART 11: OTHER SIGNIFICANT CONDITIONS-DTHI;H"O« TODEATH ITT NOT nuns TO THE MMVHATE -HIT mrn, I. IT. 31.:x o°nunox oA nonY 11RFON111 FOR co�nonloR uuus .. oR ..... ui,• 32A..aii°;', 329. Inu. ueuE° p u xmw�.mu^v son T`�O e aR1.r oNIIH II.[o..... °Ax e a -I/✓ I 33. SPFCIFY ACUDEM, S RCIDE OA MADRID F 34. PACE OF IMJuxr rA 35. INJURY 0.T WORK D "[[rT rr¢E lw,omc. u0`I 'A' "'c".1.vaT ORN 36A. DATE OF INJURY -..AIM. nA, nA "..I. HOUR ^- „rI[Ir, n. CAR x° 1368, u �l M w INJURY 37A. PLACE OF INJURY IURE' AND NUMBER OR LOCATION AND CITY ON TORRE �378. mnANCI rinae iucE °r u[ uewuo"r run oo", r°I °xucl 39 '^• ueoRAl : 38. INFORMATION""'"'• e`n m.m cxrngAu �.vmD, ru OR xO� E ""° l nrT rs ae 1 MILfS l N 40, DESCRIBE HOW INJURY OCCURRED TINTER uQUExce of rYmn AH¢x Ix.Pum a O-1 xAI°AI Ur N-1 A...1..1 Ixr... 0 IN nu .0 STATE A' B' C. D. E. F. REGISTRAR THIS�HUE CERTTrm- •. - ULAItS THIS SEAL OF HEALTH SEIIi FLC IN THE COUNRY OF LOS ANGEL 1LEe OcrAn.:••- SERVICES IF IT f E £ PURFL.E INK. / SEP i7 1975 sz.00 (E E M 4 H Iq s«a•`U v ND6Tro1r.r LHIDD A. WltMrlll, DHNMM DI H.BItD SBWIaB .Rd •