Fill and Sign the Fiduciary Deed for Use by Executors Trustees Trustors Administrators and Other Fiduciaries Pennsylvania Form

Prepared by U.S. Legal Forms, Inc. Copyright 2016 - U.S. Legal Forms, Inc. STATE OF PENNSYLVANIA FIDUCIARY DEED Control Number – PA - SDEED - 6 NOTE ABOUT COMPLETING THE FORMS The forms in this packet contain “form fields” created using Microsoft Word. “Form fields” facilitate completion of the forms using your computer. They do not limit you ability to print the form “in blank” and complete with a typewriter or by hand. If you do not see the gray shaded form fields, go the View menu, click on Toolbars, and then select Forms. This will open the forms toolbar. Look for the button on the forms toolbar that resembles a shaded letter “a”. Click in this button and the form fields will be visible. The forms are locked which means that the content of the forms cannot be changed. You can only fill in the information in the fields. If you need to make any changes in the body of the form, it is necessary for you “unlock” or “unprotect” the form. 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Prepared by: ____________ ____________ ____________ Return to: ____________ ____________ ____________ Parcel ID/UPI No. ____________ Official Use Only FIDUCIARY DEED THIS INDENTURE, made the ______ day of __________________ 20 ______ , BETWEEN ______________________________ , acting as * ________________________ , hereinafter called the Grantor, party of the first part and ______________________________ , as Trustee of ______________________ Trust, dated ________________ , hereinafter called the Grantee(s), party of the second part, WITNESSETH , that the said Grantor for valuable well and truly paid by the said Grantee(s) at or before the sealing and delivery hereof, the receipt whereof is hereby acknowledged, have granted, bargained, and sold, released and confirmed, and by these presents does grant, bargain and sell, release and convey with fiduciary covenants unto the said Grantee(s) and assigns, all of the following described property located in ________________________ County, Commonwealth of Pennsylvania, to wit: See Legal Description Attached as Exhibit A and incorporated by reference as though set forth in full Legal Description:       Fiduciary Deed Page 1 of 4 As used herein the term “party” shall be deemed to include all signatories to this deed and shall therefore include “parties”. NOTICE - THIS DOCUMENT MAY NOT/DOES NOT SELL, CONVEY, TRANSFER, INCLUDE OR INSURE THE TITLE TO THE COAL AND RIGHT OF SUPPORT UNDERNEATH THE SURFACE LAND DESCRIBED OR REFERRED TO HEREIN, AND THE OWNER OR OWNERS OF SUCH COAL MAY HAVE/HAVE THE COMPLETE LEGAL RIGHT TO REMOVE ALL OF SUCH COAL AND, IN THAT CONNECTION, DAMAGE MAY RESULT TO THE SURFACE OF THE LAND AND ANY HOUSE, BUILDING OR OTHER STRUCTURE ON OR IN SUCH LAND, THE INCLUSION OF THIS NOTICE DOES NOT ENLARGE, RESTRICT OR MODIFY ANY LEGAL RIGHTS OR ESTATES OTHERWISE CREATED, TRANSFERRED, EXCEPTED OR RESERVED BY THIS INSTRUMENT. [This notice is set forth in the manner provided in Section 1 of the Act of July 17, 1957, P. L. 984, as amended, and is not intended as notice of unrecorded instruments, if any.] IN WITNESS WHEREOF, the said Grantor(s) have caused these presents to be duly executed dated the day and year first above written. Sealed and Delivered IN THE PRESENCE OF US: Witness: Grantor Signature Type or Print Name Type or Print Name Grantor Signature Type or Print Name Type or Print Name NOTICE THE UNDERSIGNED, AS EVIDENCED BY THE SIGNATURES(S) TO THIS NOTICE AND THE ACCEPTANCE AND RECORDING OF THIS DEED, (IS/ARE) FULLY Fiduciary Deed Page 2 of 4 COGNIZANT OF THE FACT THAT THE UNDERSIGNED MAY NOT BE OBTAINING THE RIGHT OF PROTECTION AGAINST SUBSIDENCE, AS TO THE PROPERTY HEREIN CONVEYED, RESULTING FROM COAL MINING OPERATIONS AND THAT THE PURCHASED PROPERTY, HEREIN CONVEYED, MAY BE PROTECTED FROM DAMAGE DUE TO MINE SUBSIDENCE BY A PRIVATE CONTRACT WITH THE OWNERS OF THE ECONOMIC INTEREST IN THE COAL. THIS NOTICE IS INSERTED HEREIN TO COMPLY WITH THE BITUMINOUS MINE SUBSIDENCE AND LAND CONSERVATION ACT OF 1966. PARTY(IES) OF THE SECOND PART Grantee WITNESS: Type or Print Name Commonwealth of Pennsylvania County of __________________ On this, the ______ day of __________________ , 20 ______ before me the undersigned officer, personally appeared ______________________________ known to me (or satisfactorily proven) to be the person whose name subscribed to the within instrument and acknowledged that he or she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public Title of Officer My Commission Expires: CERTIFICATION OF GRANTEE’S ADDRESS: Grantee Name and Address:             Fiduciary Deed Page 3 of 4       I hereby certify under penalty of perjury that the above information is true and accurate. Date:       Signature Rank/Position __________________ ** Type name and title of fiduciary such as: “John Doe, as Executor of the Estate of John Doe, Sr.”, “John Doe, as Administrator of the Estate of John Doe, Sr.”, “John Doe, as Trustee of the John Doe, Sr. Family Trust”, “John Doe, as Guardian of the Person and Estate of John Doe, Sr.”, “John Doe, as Conservator of the Person and Estate of John Doe, Sr.” Fiduciary Deed Page 4 of 4 EXHIBIT A       Fiduciary Deed Exhibit A