Fill and Sign the North Carolina Uniform Act

TRANSFER UNDER THE NORTH CAROLINA UNIFORM CUSTODIAL TRUST ACT I, ___________________________________________ (name of transferor or name and representative capacity if a fiduciary), transfer to ______________________________ (name of trustee other than transferor), as custodial trustee for ___________________________ (name of beneficiary) as beneficiary and ________________________ as distributee on termination of the trust in absence of direction by the beneficiary under the North Carolina Uniform Custodial Trust Act, the following: _____________________________________________________________ _____________________________________________________________________________ (insert a description of the custodial trust property legally sufficient to identify and transfer each item of property). Dated: __________________________ ____________________________________ Seal ____________________________________ Signature ____________________________________ Witness ____________________________________ Witness STATE OF ____________________ COUNTY OF __________________ On this _______________ day of ____________, _____________, personally appeared before me, the said named _______________________________________ to me known and known to me to be the person described in and who executed the foregoing instrument and he (or she) acknowledged that he (or she) executed the same and being duly sworn by me, made oath that the statements in the foregoing instrument are true. ___________________________________ Signature of Notary Public My Commission Expires: ____________________ (Official Seal) NC-02239