Fill and Sign the Certificate Trust Form

CERTIFICATE OF TRUST UPON OATH, IT IS HE REBY CERTIFIED that: Name: _________________________________________________________________ Social Security Number: ___________________________________________________ Name: _________________________________________________________________ Social Security Number: ___________________________________________________ is/are entitled to th e use and occupancy as to an equitable li fe estate in the real property under the terms of the: Name of Trust: ___________________________________________________________ Dated: ___________________________ and therefore hold sufficient title to claim a Ho mestead Exemption in compliance with Section 196.041(2), Florida Statutes; and Rule 12D-7.011, Fl orida Administrative Code, on the property set forth below: Property Identification #: ______________________________________________________ Property Address: ______________________________________________________ City: ______________________________ Zip: ______________. _______________________________________________ S IGNATURE OF TRUSTEE _______________________________________________ P RINTED NAME OF TRUSTEE State of _____________________ County of ___________________ The foregoing instrument was acknowledged before me this _____ day of ____________________, 201__, by _________________________________________________, who is personally known by me or produced _________________________________________________ as identification, and who did take an oath. _________________________________________ ( S E A L) N ota ry P ublic _________________________________________ P rin t N am e