Exhibit 25
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM T-1
STATEMENT OF ELIGIBILITY UNDER
THE TRUST INDENTURE ACT OF 1939 OF A
CORPORATION DESIGNATED TO ACT AS TRUSTEE
Check if an Application to Determine Eligibility of
a Trustee Pursuant to Section 305(b)(2)
U.S. BANK NATIONAL ASSOCIATION
(Exact name of Trustee as specified in its charter)
31-0841368
I.R.S. Employer Identification No.
800 Nicollet Mall Minneapolis, Minnesota | 55402 |
| (Address of principal executive offices) | (Zip Code) |
Paul Henderson
U.S. Bank National Association
1349 W. Peachtree St., NW, Suite 1050
Atlanta, GA 30309
(404) 965-7218
(Name, address and telephone number of agent for service)
Omega Healthcare Investors, Inc.
And the Subsidiary Guarantors Listed in Schedule A
(Exact name of obligor as specified in its charter)
Maryland (State or other jurisdiction of incorporation or organization) | 38-3041398 (I.R.S. Employer Identification No.) |
200 International Circle, Suite 3500 Hunt Valley, Maryland (Address of principal executive offices) | 21030 (Zip code) |
5.875% Senior Notes due 2024
(Title of the indenture securities)
Schedule A
Subsidiary Guarantors
Exact name of registrant as specified in its charter (1) | State or other jurisdiction of formation | I.R.S. Employer Identification No. |
| Arizona Lessor - Infinia, Inc. | Maryland | 32-0008074 |
| Baldwin Health Center, Inc. | Pennsylvania | 25-1495708 |
| Bayside Alabama Healthcare Second, Inc. | Alabama | 38-3517839 |
| Bayside Arizona Healthcare Associates, Inc. | Arizona | 38-3518309 |
| Bayside Arizona Healthcare Second, Inc. | Arizona | 38-3520329 |
| Bayside Colorado Healthcare Associates, Inc. | Colorado | 38-3517837 |
| Bayside Colorado Healthcare Second, Inc. | Colorado | 38-3520325 |
| Bayside Indiana Healthcare Associates, Inc. | Indiana | 38-3517842 |
| Bayside Street II, Inc. | Delaware | 38-3519969 |
| Bayside Street, Inc. | Maryland | 38-3160026 |
| Canton Health Care Land, Inc. | Ohio | 20-1914579 |
| Carnegie Gardens LLC | Delaware | 20-2442381 |
| Center Healthcare Associates, Inc. | Texas | 38-3517844 |
| Cherry Street – Skilled Nursing, Inc. | Texas | 38-3592148 |
| Colonial Gardens, LLC | Ohio | 26-0110549 |
| Colorado Lessor - Conifer, Inc. | Maryland | 32-0008069 |
| Copley Health Center, Inc. | Ohio | 34-1473010 |
| CSE Albany LLC | Delaware | 20-5885886 |
| CSE Amarillo LLC | Delaware | 20-5862752 |
| CSE Anchorage LLC | Delaware | 26-1866499 |
| CSE Arden L.P. | Delaware | 20-5888680 |
| CSE Augusta LLC | Delaware | 20-5885921 |
| CSE Bedford LLC | Delaware | 20-5886082 |
| CSE Blountville LLC | Delaware | 20-8295288 |
| CSE Bolivar LLC | Delaware | 20-8295024 |
| CSE Cambridge LLC | Delaware | 20-5886976 |
| CSE Cambridge Realty LLC | Delaware | 20-5959318 |
| CSE Camden LLC | Delaware | 20-8295066 |
| CSE Canton LLC | Delaware | 20-5887312 |
| CSE Casablanca Holdings II LLC | Delaware | 26-0595183 |
| CSE Casablanca Holdings LLC | Delaware | 20-8724466 |
| CSE Cedar Rapids LLC | Delaware | 20-5884941 |
| CSE Centennial Village | Delaware | 20-6974959 |
| CSE Chelmsford LLC | Delaware | 20-5920451 |
| CSE Chesterton LLC | Delaware | 20-5885195 |
| CSE Claremont LLC | Delaware | 20-5883891 |
| CSE Corpus North LLC | Delaware | 20-5186415 |
| CSE Crane LLC | Delaware | 20-8684704 |
| CSE Denver Iliff LLC | Delaware | 20-8037772 |
| CSE Denver LLC | Delaware | 20-5884311 |
| CSE Douglas LLC | Delaware | 20-5883761 |
| CSE Dumas LLC | Delaware | 20-5883692 |
| CSE Elkton LLC | Delaware | 20-5887006 |
| CSE Elkton Realty LLC | Delaware | 20-5959253 |
| CSE Fairhaven LLC | Delaware | 20-8281491 |
| CSE Fort Wayne LLC | Delaware | 20-5885125 |
| CSE Frankston LLC | Delaware | 20-5862947 |
Exact name of registrant as specified in its charter (1) | State or other jurisdiction of formation | I.R.S. Employer Identification No. |
| CSE Georgetown LLC | Delaware | 20-5886126 |
| CSE Green Bay LLC | Delaware | 20-5888029 |
| CSE Hilliard LLC | Delaware | 20-5887347 |
| CSE Huntingdon LLC | Delaware | 20-8295191 |
| CSE Huntsville LLC | Delaware | 20-5887764 |
| CSE Indianapolis-Continental LLC | Delaware | 20-5885046 |
| CSE Indianapolis-Greenbriar LLC | Delaware | 20-5885096 |
| CSE Jacinto City LLC | Delaware | 20-5186519 |
| CSE Jefferson City LLC | Delaware | 20-8295101 |
| CSE Jeffersonville-Hillcrest Center LLC | Delaware | 20-5885261 |
| CSE Jeffersonville-Jennings House LLC | Delaware | 20-5885346 |
| CSE Kerrville LLC | Delaware | 20-8684872 |
| CSE King L.P. | Delaware | 20-5888725 |
| CSE Kingsport LLC | Delaware | 20-5887736 |
| CSE Knightdale L.P. | Delaware | 20-5888653 |
| CSE Lake City LLC | Delaware | 20-5863259 |
| CSE Lake Worth LLC | Delaware | 20-5863173 |
| CSE Lakewood LLC | Delaware | 20-5884352 |
| CSE Las Vegas LLC | Delaware | 20-5887216 |
| CSE Lawrenceburg LLC | Delaware | 20-5887802 |
| CSE Lenoir L.P. | Delaware | 20-5888528 |
| CSE Lexington Park LLC | Delaware | 20-5886951 |
| CSE Lexington Park Realty LLC | Delaware | 20-5959280 |
| CSE Ligonier LLC | Delaware | 20-5885484 |
| CSE Live Oak LLC | Delaware | 20-5863086 |
| CSE Logansport LLC | Delaware | 20-5885583 |
| CSE Lowell LLC | Delaware | 20-5885381 |
| CSE Marianna Holdings LLC | Delaware | 20-1411422 |
| CSE Memphis LLC | Delaware | 20-8295130 |
| CSE Mobile LLC | Delaware | 20-5883572 |
| CSE Moore LLC | Delaware | 20-5887574 |
| CSE North Carolina Holdings I LLC | Delaware | 20-5888397 |
| CSE North Carolina Holdings II LLC | Delaware | 20-5888430 |
| CSE Omro LLC | Delaware | 20-5887998 |
| CSE Orange Park LLC | Delaware | 20-5863371 |
| CSE Orlando-Pinar Terrace Manor LLC | Delaware | 20-5863043 |
| CSE Orlando-Terra Vista Rehab LLC | Delaware | 20-5863223 |
| CSE Pennsylvania Holdings | Delaware | 20-6974946 |
| CSE Piggott LLC | Delaware | 20-5883659 |
| CSE Pilot Point LLC | Delaware | 20-5862827 |
| CSE Ponca City LLC | Delaware | 20-5887495 |
| CSE Port St. Lucie LLC | Delaware | 20-5863294 |
| CSE Richmond LLC | Delaware | 20-5885427 |
| CSE Ripley LLC | Delaware | 20-8295238 |
| CSE Ripon LLC | Delaware | 26-0480886 |
| CSE Safford LLC | Delaware | 20-5883807 |
| CSE Salina LLC | Delaware | 20-5885669 |
| CSE Seminole LLC | Delaware | 20-5887615 |
| CSE Shawnee LLC | Delaware | 20-5887524 |
| CSE Spring Branch LLC | Delaware | 20-5186484 |
| CSE Stillwater LLC | Delaware | 20-5887548 |
Exact name of registrant as specified in its charter (1) | State or other jurisdiction of formation | I.R.S. Employer Identification No. |
| CSE Taylorsville LLC | Delaware | 20-5886196 |
| CSE Texarkana LLC | Delaware | 20-5862880 |
| CSE Texas City LLC | Delaware | 20-5862791 |
| CSE The Village LLC | Delaware | 20-5186550 |
| CSE Upland LLC | Delaware | 20-5891148 |
| CSE Walnut Cove L.P. | Delaware | 20-5888502 |
| CSE West Point LLC | Delaware | 20-5887119 |
| CSE Whitehouse LLC | Delaware | 20-8294979 |
| CSE Williamsport LLC | Delaware | 26-0480953 |
| CSE Winter Haven LLC | Delaware | 20-5863327 |
| CSE Woodfin L.P. | Delaware | 20-5888619 |
| CSE Yorktown LLC | Delaware | 20-5885163 |
| Dallas – Skilled Nursing, Inc. | Texas | 38-3592151 |
| Delta Investors I, LLC | Maryland | 54-2112455 |
| Delta Investors II, LLC | Maryland | 54-2112456 |
| Desert Lane LLC | Delaware | 20-3098022 |
| Dixon Health Care Center, Inc. | Ohio | 34-1509772 |
| Florida Lessor – Crystal Springs, Inc. | Maryland | 75-3116533 |
| Florida Lessor – Emerald, Inc. | Maryland | 22-3872569 |
| Florida Lessor – Lakeland, Inc. | Maryland | 22-3872564 |
| Florida Lessor – Meadowview, Inc. | Maryland | 56-2398721 |
| Florida Real Estate Company, LLC | Florida | 20-1458431 |
| Georgia Lessor - Bonterra/Parkview, Inc. | Maryland | 16-1650494 |
| Greenbough, LLC | Delaware | 27-0258266 |
| Hanover House, Inc. | Ohio | 34-1125264 |
| Heritage Texarkana Healthcare Associates, Inc. | Texas | 38-3517861 |
| House of Hanover, Ltd | Ohio | 34-6691713 |
| Hutton I Land, Inc. | Ohio | 20-1914403 |
| Hutton II Land, Inc. | Ohio | 20-1914470 |
| Hutton III Land, Inc. | Ohio | 20-1914529 |
| Indiana Lessor – Jeffersonville, Inc. | Maryland | 22-3872575 |
| Indiana Lessor – Wellington Manor, Inc. | Maryland | 32-0008064 |
| Jefferson Clark, Inc. | Maryland | 38-3433390 |
| LAD I Real Estate Company, LLC | Delaware | 20-1454154 |
| Lake Park – Skilled Nursing, Inc. | Texas | 38-3592152 |
| Leatherman 90-1, Inc. | Ohio | 20-1914625 |
| Leatherman Partnership 89-1, Inc. | Ohio | 34-1656489 |
| Leatherman Partnership 89-2, Inc. | Ohio | 34-1656491 |
| Long Term Care – Michigan, Inc. | Michigan | 04-3833330 |
| Long Term Care – North Carolina, Inc. | North Carolina | 04-3833335 |
| Long Term Care Associates – Illinois, Inc. | Illinois | 38-3592159 |
| Long Term Care Associates – Indiana, Inc. | Indiana | 38-3592160 |
| Long Term Care Associates – Texas, Inc. | Texas | 38-3592142 |
| Meridian Arms Land, Inc. | Ohio | 20-1914864 |
| North Las Vegas LLC | Delaware | 20-3098036 |
| NRS Ventures, L.L.C. | Delaware | 38-4236118 |
| OHI (Connecticut), Inc. | Connecticut | 06-1552120 |
| OHI (Florida), Inc. | Florida | 65-0523484 |
| OHI (Illinois), Inc. | Illinois | 37-1332375 |
| OHI (Indiana), Inc. | Indiana | 38-3568359 |
| OHI (Iowa), Inc. | Iowa | 38-3377918 |
| Exact name of registrant as specified in its charter (1) | State or other jurisdiction of formation | I.R.S. Employer Identification No. |
| OHI (Kansas), Inc. | Kansas | 48-1156047 |
| OHI Asset (CA), LLC | Delaware | 04-3759925 |
| OHI Asset (CO), LLC | Delaware | 84-1706510 |
| OHI Asset (CT) Lender, LLC | Delaware | 75-3205111 |
| OHI Asset (FL), LLC | Delaware | 13-4225158 |
| OHI Asset (FL) Lender, LLC | Delaware | 27-4450390 |
| OHI Asset (ID), LLC | Delaware | 04-3759931 |
| OHI Asset (IL), LLC | Delaware | 14-1951802 |
| OHI Asset (IN), LLC | Delaware | 04-3759933 |
| OHI Asset (IN) Greensburg, LLC | Delaware | 38-3879137 |
| OHI Asset (IN) Indianapolis, LLC | Delaware | 36-4736441 |
| OHI Asset (IN) Wabash, LLC | Delaware | 38-3879151 |
| OHI Asset (IN) Westfield, LLC | Delaware | 32-0381277 |
| OHI Asset (LA), LLC | Delaware | 04-3759935 |
| OHI Asset (MD), LLC | Delaware | 45-2611748 |
| OHI Asset (MI), LLC | Delaware | 27-3378345 |
| OHI Asset (MI/NC), LLC | Delaware | 04-3759928 |
| OHI Asset (MO), LLC | Delaware | 04-3759939 |
| OHI Asset (OH) Lender, LLC | Delaware | 51-0529744 |
| OHI Asset (OH) New Philadelphia, LLC | Delaware | 51-0529741 |
| OHI Asset (OH), LLC | Delaware | 04-3759938 |
| OHI Asset (PA) Trust | Maryland | 54-6643405 |
| OHI Asset (PA), LLC | Delaware | 90-0137715 |
| OHI Asset (SMS) Lender, Inc. | Maryland | 33-1067711 |
| OHI Asset (TX), LLC | Delaware | 04-3759927 |
| OHI Asset CSB LLC | Delaware | 27-2820083 |
| OHI Asset CSE – E, LLC | Delaware | 27-1675861 |
| OHI Asset CSE – U, LLC | Delaware | 27-1675768 |
| OHI Asset Essex (OH), LLC | Delaware | 83-0379722 |
| OHI Asset HUD SF, LLC | Delaware | 80-0830116 |
| OHI Asset HUD WO, LLC | Delaware | 45-2379675 |
| OHI Asset II (CA), LLC | Delaware | 20-1000879 |
| OHI Asset II (FL), LLC | Delaware | 27-1813906 |
| OHI Asset II (PA) Trust | Maryland | 84-6390330 |
| OHI Asset III (PA) Trust | Maryland | 84-6390331 |
| OHI Asset IV (PA) Silver Lake Trust | Maryland | 80-6146794 |
| OHI Asset, LLC | Delaware | 32-0079270 |
| OHI of Texas, Inc. | Maryland | 38-3506136 |
| OHI Sunshine, Inc. | Florida | 82-0558471 |
| OHI Tennessee, Inc. | Maryland | 38-3509157 |
| OHIMA, Inc. | Massachusetts | 06-1552118 |
| Omega (Kansas), Inc. | Kansas | 32-0142534 |
| Omega TRS I, Inc. | Maryland | 38-3587540 |
| Orange Village Care Center, Inc. | Ohio | 34-1321728 |
| OS Leasing Company | Kentucky | 38-3221641 |
| Panama City Nursing Center LLC | Delaware | 20-2568041 |
| Parkview – Skilled Nursing, Inc. | Texas | 38-3592157 |
| Pavillion North Partners, Inc. | Pennsylvania | 20-2597892 |
| Pavillion North, LLP | Pennsylvania | 75-3202956 |
| Pavillion Nursing Center North, Inc. | Pennsylvania | 25-1222652 |
| Pine Texarkana Healthcare Associates, Inc. | Texas | 38-3517864 |
Exact name of registrant as specified in its charter (1) | State or other jurisdiction of formation | I.R.S. Employer Identification No. |
| Reunion Texarkana Healthcare Associates, Inc. | Texas | 38-3517865 |
| San Augustine Healthcare Associates, Inc. | Texas | 38-3517866 |
| Skilled Nursing – Gaston, Inc. | Indiana | 38-3592171 |
| Skilled Nursing – Herrin, Inc. | Illinois | 38-3592162 |
| Skilled Nursing – Hicksville, Inc. | Ohio | 38-3592172 |
| Skilled Nursing – Paris, Inc. | Illinois | 38-3592165 |
| Skyler Maitland LLC | Delaware | 20-3888672 |
| South Athens Healthcare Associates, Inc. | Texas | 38-3517880 |
| St. Mary’s Properties, Inc. | Ohio | 20-1914905 |
| Sterling Acquisition Corp. | Kentucky | 38-3207992 |
| Sterling Acquisition Corp. II | Kentucky | 38-3207991 |
| Suwanee, LLC | Delaware | 20-5223977 |
| Texas Lessor – Stonegate GP, Inc. | Maryland | 32-0008071 |
| Texas Lessor – Stonegate, Limited, Inc. | Maryland | 32-0008072 |
| Texas Lessor – Stonegate, LP | Maryland | 32-0008073 |
| Texas Lessor – Treemont, Inc. | Maryland | 16-1650495 |
| The Suburban Pavilion, Inc. | Ohio | 34-1035431 |
| Washington Lessor – Silverdale, Inc. | Maryland | 56-2386887 |
| Waxahachie Healthcare Associates, Inc. | Texas | 38-3517884 |
| West Athens Healthcare Associates, Inc. | Texas | 38-3517886 |
| Wilcare, LLC | Ohio | 26-0110550 |
(1) Address, including zip code, and telephone number, including area code, of the principal executive offices of each subsidiary guarantor listed in Schedule A is c/o Omega Healthcare Investors, Inc., 200 International Circle, Suite 3500, Hunt Valley, Maryland, 21030 and the telephone number is (410) 427-1700.
FORM T-1
| Item 1. | GENERAL INFORMATION. Furnish the following information as to the Trustee. | |||||
| a) | Name and address of each examining or supervising authority to which it is subject. | |||||
| Comptroller of the Currency | ||||||
| Washington, D.C. | ||||||
b) | Whether it is authorized to exercise corporate trust powers. | |||||
| Yes | ||||||
| Item 2. | AFFILIATIONS WITH OBLIGOR. If the obligor is an affiliate of the Trustee, describe each such affiliation. | |||||
| None | ||||||
| Items 3-15 | Items 3-15 are not applicable because to the best of the Trustee’s knowledge, the obligor is not in default under any Indenture for which the Trustee acts as Trustee. | |||||
| Item 16. | LIST OF EXHIBITS: List below all exhibits filed as a part of this statement of eligibility and qualification. | |||||
| 1. | A copy of the Articles of Association of the Trustee.* | |||||
| 2. | A copy of the certificate of authority of the Trustee to commence business, attached as Exhibit 2. | |||||
| 3. | A copy of the certificate of authority of the Trustee to exercise corporate trust powers, attached as Exhibit 3. | |||||
| 4. | A copy of the existing bylaws of the Trustee.** | |||||
| 5. | A copy of each Indenture referred to in Item 4. Not applicable. | |||||
| 6. | The consent of the Trustee required by Section 321(b) of the Trust Indenture Act of 1939, attached as Exhibit 6. | |||||
| 7. | Report of Condition of the Trustee as of December 31, 2011 published pursuant to law or the requirements of its supervising or examining authority, attached as Exhibit 7. | |||||
| * Incorporated by reference to Exhibit 25.1 to Amendment No. 2 to registration statement on S-4, Registration Number 333-128217 filed on November 15, 2005. | ||||||
| ** Incorporated by reference to Exhibit 25.1 to registration statement on S-4, Registration Number 333-166527 filed on May 5, 2010. | ||||||
SIGNATURE
Pursuant to the requirements of the Trust Indenture Act of 1939, the trustee, U.S. BANK NATIONAL ASSOCIATION, a national banking association organized and existing under the laws of the United States of America, has duly caused this statement of eligibility and qualification to be signed on its behalf by the undersigned, thereunto duly authorized, all in the City of Atlanta, State of Georgia, on the 3rd day of July, 2012.
| By: | /s/ Paul Henderson | ||
| Paul Henderson | |||
| Assistant Vice President | |||
Exhibit 2
 | |
| Comptroller of the Currency | |
| Administrator of National Banks | |
| Washington, DC 20219 | |
| CERTIFICATE OF CORPORATE EXISTENCE | |
| I, John Walsh, Acting Comptroller of the Currency, do hereby certify that: | |
| 1. The Comptroller of the Currency, pursuant to Revised Statutes 324, et seq., as amended, 12 U.S.C. 1, et seq., as amended, has possession, custody and control of all records pertaining to the chartering, regulation and supervision of all National Banking Associations. | |
| 2. “U.S. Bank National Association,” Cincinnati, Ohio, (Charter No. 24), is a National Banking Association formed under the laws of the United States and is authorized thereunder to transact the business of banking on the date of this Certificate. | |
 | IN TESTIMONY WHERE OF, I have hereunto subscribed my name and caused my seal of office to be affixed to these presents at the Treasury Department, in the City of Washington and District of Columbia, this September 9, 2010. | ||
| /s/ John Walsh | |||
Acting Comptroller of the Currency | |||
Exhibit 3
| | |
| Comptroller of the Currency | |
| Administrator of National Banks | |
| Washington, DC 20219 | |
| CERTIFICATE OF FIDUCIARY POWERS | |
| I, John Walsh, Acting Comptroller of the Currency, do hereby certify that: | |
| 1. The Comptroller of the Currency, pursuant to Revised Statutes 324, et seq., as amended, 12 U.S.C. 1, et seq., as amended, has possession, custody and control of all records pertaining to the chartering, regulation and supervision of all National Banking Associations. | |
| 2. “U.S. Bank National Association,” Cincinnati, Ohio, (Charter No. 24), was granted, under the hand and seal of the Comptroller, the right to act in all fiduciary capacities authorized under the provisions of the Act of Congress approved September 28, 1962, 76 Stat.668, 12 U.S.C. 92 a, and that the authority so granted remains in full force and effect on the date of this Certificate. | |
| | IN TESTIMONY WHERE OF, I have hereunto subscribed my name and caused my seal of office to be affixed to these presents at the Treasury Department, in the City of Washington and District of Columbia, this September 9, 2010. | ||
| /s/ John Walsh | |||
Acting Comptroller of the Currency | |||
Exhibit 6
CONSENT
In accordance with Section 321(b) of the Trust Indenture Act of 1939, the undersigned, U.S. BANK NATIONAL ASSOCIATION hereby consents that reports of examination of the undersigned by Federal, State, Territorial or District authorities may be furnished by such authorities to the Securities and Exchange Commission upon its request therefor.
Dated: July 3, 2012
| By: | /S/ Paul Henderson | ||
| Paul Henderson | |||
| Assistant Vice President |
| Exhibit 7 |
| U.S. Bank National Association |
| Statement of Financial Condition |
| As of 12/31/2011 |
| ($000’s) |
| 12/31/2011 | ||||
| Assets | ||||
| Cash and Balances Due From Depository Institutions | $ | 13,960,499 | ||
| Securities | 69,485,200 | |||
| Federal Funds | 11,887 | |||
| Loans & Lease Financing Receivables | 204,182,862 | |||
| Fixed Assets | 5,472,961 | |||
| Intangible Assets | 12,446,662 | |||
| Other Assets | 24,910,739 | |||
| Total Assets | $ | 330,470,810 | ||
| Liabilities | ||||
| Deposits | $ | 236,091,541 | ||
| Fed Funds | 7,936,151 | |||
| Treasury Demand Notes | 0 | |||
| Trading Liabilities | 377,634 | |||
| Other Borrowed Money | 34,507,710 | |||
| Acceptances | 0 | |||
| Subordinated Notes and Debentures | 5,945,617 | |||
| Other Liabilities | 10,944,902 | |||
| Total Liabilities | $ | 295,803,555 | ||
| Equity | ||||
| Minority Interest in Subsidiaries | $ | 1,926,211 | ||
| Common and Preferred Stock | 18,200 | |||
| Surplus | 14,133,323 | |||
| Undivided Profits | 18,589,521 | |||
| Total Equity Capital | $ | 34,667,255 | ||
| Total Liabilities and Equity Capital | $ | 330,470,810 | ||