Fill and Sign the Termination Form

Termination of Trust By Trustee and Acknowledgement of Receipt of Trust Funds By Beneficiary The undersigned _________________________________________________ (Name of Trustee) , of _____________________________________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code), pursuant to the power granted to me in Section ___________of the trust agreement dated _________________________________________ (date), between myself as Trustee and __________________________________________________ (Name of Trustor) , as Trustor, in which _____________________________________________________ (Name of Beneficiary) is named as Beneficiary, do now terminate the Trust for the benefit of ___________________________________________________ (Name of Beneficiary). I do hereby pay over and assign to ______________________________________ (Name of Beneficiary), as Beneficiary, the property held in trust for his benefit, to be his absolutely and free from any claim. I am exercising my discretion to terminate this Trust for the following reasons: (e.g., Beneficiary is competent in all respects to manage his own property) ___________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ __ . I have executed this Termination of Trust Agreement on this the ______________________________________ (date). ____________________________________ (Signature of Trustee) STATE OF __________________________________________ COUNTY OF _________________________________ Personally appeared before me, the undersigned authority in and for the said county and state, on this _____ day of _____________________________________, 20_____, within my jurisdiction, the within named ______________________________ _____________________________ (Name of Trustee), who acknowledged that he is Trustee named in the Trust Agreement described in the above and foregoing instrument, and that in said representative capacity he executed the above and foregoing instrument, after first having been duly authorized so to do. ____________________________________ NOTARY PUBLIC My Commission Expires: ______________________ Acknowledgement of Receipt of Trust Funds By Beneficiary I, ______________________________________________________ (Name of Beneficiary) , of __________________________________________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code) , being over __________ (e.g., 21) years of age, consent to the termination of the above- referenced Trust Agreement of which I am a beneficiary. I acknowledge the delivery to me , of any and all monies and property of every kind, whether principal or income, in said Trustee’s possession under and by virtue of the Trust Agreement. I waive any and all rights that I may now have or may later acquire by virtue of any of the terms or provisions of the terminated Trust Agreement. Witness my signature this the _________________________________________ (date). ____________________________________ (Signature of Beneficiary) ____________________________________ (Printed Name of Beneficiary) STATE OF ___________________________________________ COUNTY OF _____________________________________ Personally appeared before me, the undersigned authority in and for the said county and state, on this _____ day of ________________________________________, 20____, within my jurisdiction, the within named _______________________________ _____________________________ (Name of Beneficiary), who acknowledged that he executed the above and fore going instrument. ___________________________________________ NOTARY PUBLIC My Commission Expires: ______________________