Fill and Sign the Financial Account Transfer to Living Trust Nebraska Form

FINANCIAL ACCOUNT TRANSFER TO TRUST To:                         THIS Assignment, is being made on this the ________ day of _______________ , 20 _____ , by _______________________ , _______________________ County, State of Nebraska, 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 NEBRASKA COUNTY OF _____________________ The foregoing instrument was acknowledged before me this _____________________ (date) by ____________________________________ (name of person acknowledged). _________________________________ Notary Public Printed Name: _____________________ My Commission Expires: _____________________