"I have designated [identify trust] as beneficiary of my death benefit, a lump sum under an optional form of retirement elected by me at retirement, or other lump sum payment due from the system following my death, as applicable. In accordance with the requirements of the Internal Revenue Service, I hereby certify as follows:

1. Attached to this certification and furnished with it is a list which is, to the best of my knowledge, a true, correct and complete list of all the beneficiaries of the trust (including any contingent or remaining beneficiaries with a description of the conditions to their entitlement).

2. The trust is a valid trust under State law, or would be but for the fact that there is no corpus.

3. The trust is irrevocable or will, by its terms, become irrevocable upon my death.

4. The beneficiaries of the trust who are beneficiaries with respect to the trust's interest in my benefit are identifiable from the trust instrument.

5. If the trust instrument is ever amended at any time after the date of this certification, I will, within a reasonable time, provide the system with corrected certification(s) to the extent that the amendment changes any of the information to which I have previously certified.

6. I agree to provide a true copy of the trust instrument to the system upon demand.”

"I am the trustee of [identify trust] which had been designated by [identify member or retiree] as a beneficiary of a death benefit, lump sum under an optional form of retirement elected at retirement, or other lump sum payment due from the system following the death of the member or retiree, as applicable. In accordance with the requirements of the Internal Revenue Service, I hereby certify as follows:

1. Attached to this certification and furnished with it is, to the best of my knowledge, a true, correct and complete final list of all the beneficiaries of the trust (including any contingent or remaining beneficiaries with a description of the conditions to their entitlement) as of the end of the calendar year following the calendar year in which the above named member or retiree died.

2. The trust is a valid trust under State law, or would be but for the fact that there is no corpus.

3. The trust is irrevocable or has, by its terms, become irrevocable upon the death of the above named member or retiree.

4. The beneficiaries of the trust who are beneficiaries with respect to the trust's interest in the above named member or retiree's benefit are identifiable from the trust instrument.

5. I agree to provide a true copy of the trust instrument to the system upon demand.”