Fill and Sign the Assignment for Value Received the Wvhdf Form

FINANCIAL ACCOUNT TRANSFER TO TRUST To: THIS Assignment, is being made on this the ________ day of _______________, 20_____, by _______________________, _______________________ County, State of West Virginia, as the Assignor(s), whether one or more, and _______________________, as Trustee of THE _______________________ REVOCABLE TRUST dated _______________ , as the Assignee. Assignor(s) do hereby assign, convey, and deliver to the Assignee all of the Assignor’s right, title, and interest in and to the following described property: Checking Account No(s): at . Checking Account No(s): at . Savings Account No(s): at . Savings Account No(s): at . Account No(s): at . Account No(s): at . Account No(s): at . Brokerage Account No(s): at . This assignment includes, but is not limited to, all cash and securities held in said Accounts. These account shall hereafter be titled in the name of _______________________ , as Trustee of THE _______________________ REVOCABLE LIVING TRUST, with an address of _______________________.TO HAVE AND TO HOLD unto the Trustee and his or her successors and assigns forever. DATED this the _____ day of ______________________, 20___. __________________________________ Trustor Signature Print Name: _________________________________________________________ Trustor Signature Print Name: _______________________ STATE OF WEST VIRGINIACOUNTY OF __________________This instrument was acknowledged before me on __________________________ (date) by _______________________________________________ (name or names of person or persons acknowledging). ______________________________Notary PublicPrinted Name: __________________ My Commission Expires: _____________________