Trust Application Form

TRUST APPLICATION FORM

This Trust Application (the "Application") is executed on this Day: Month: Year: , by Applicant Name: , Applicant Address: ; and Trustee Name: , Trustee Address: .

RECITALS

WHEREAS, Applicant intends to establish a trust pursuant to the terms and conditions set forth in this Application and any subsequent trust agreement executed by the parties in accordance with applicable law; and

WHEREAS, Applicant desires Trustee to accept appointment to hold, manage, invest and distribute assets placed into the trust for the benefit of the Beneficiaries named herein in accordance with the powers and duties set forth below; and

WHEREAS, Trustee is willing to serve as trustee subject to the terms, conditions, representations and warranties contained in this Application and any trust instrument subsequently executed.

NOW, THEREFORE

In consideration of the mutual covenants and agreements contained herein and intending to be legally bound, Applicant and Trustee agree as follows:

1. TRUST IDENTIFICATION

1.1 Trust Name: .

1.2 Date of Declaration: / / .

2. TYPE OF TRUST

Applicant elects the following trust type (select all that apply):

Revocable trust Irrevocable trust Grantor trust

3. INITIAL FUNDING AND ASSETS

4. BENEFICIARIES

5. TRUSTEE POWERS AND DUTIES

5.1 Trustee shall hold, manage, invest, reinvest, sell, exchange and otherwise administer Trust assets and shall exercise the powers conferred by the trust instrument and applicable law. Trustee shall act in a fiduciary capacity, in the best interests of the Beneficiaries, and in accordance with any express directions set forth in the trust instrument.

5.2 Without limiting the generality of the foregoing, Trustee is authorized to: (a) retain or sell assets; (b) borrow and encumber Trust property; (c) invest without restriction as to classes of investments; (d) employ agents, advisors and legal counsel; and (e) compromise claims. Trustee shall exercise reasonable care in selecting agents and shall supervise their activities.

Investment powers Make loans to beneficiaries Sell trust property

6. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that Applicant has full legal capacity and authority to transfer the assets described in this Application to the trust; that all information provided in this Application is true, complete and correct to Applicant's knowledge; and that no transfer contemplated by this Application violates any law, contract, or court order.

Trustee represents that it is duly authorized and qualified to serve as trustee, will accept appointment only upon receipt of the trust instrument or such documentation as Trustee requires, and will perform its duties in accordance with the governing trust instrument and applicable fiduciary standards.

7. NOTICE

All notices, requests, consents and other communications required or permitted under this Application shall be in writing and delivered to the addresses set forth in this Application or to such other address as either party shall designate by notice to the other. Notice is effective upon personal delivery, confirmed telecopy, or three business days after deposit in the United States mail, postage prepaid, certified or registered mail.

8. ACCEPTANCE

By signing below, Trustee acknowledges receipt of this Application and indicates willingness to consider appointment. Trustee's acceptance shall be effective only upon execution of a separate written acceptance or the trust instrument executed by Trustee, and Trustee reserves the right to require additional documentation or to decline appointment if conditions are not met.

9. AMENDMENT; WAIVER

This Application may be amended only by written instrument signed by both Applicant and Trustee. No waiver by either party of any breach or default shall constitute a waiver of any other right or subsequent breach.

10. GOVERNING LAW

This Application shall be governed by and construed in accordance with the laws of the State of , without regard to principles of conflicts of law.

11. ENTIRE AGREEMENT; SEVERABILITY

This Application, together with the trust instrument and any schedules executed in connection herewith, constitutes the entire agreement between the parties with respect to the subject matter hereof. If any provision of this Application is held invalid or unenforceable, the remaining provisions shall continue in full force and effect.

12. COUNTERPARTS

This Application may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Signatures delivered by electronic transmission shall be binding.

13. ADDITIONAL INFORMATION

CERTIFICATION

Applicant certifies under penalty of perjury that the information provided in this Application is true, correct and complete to the best of Applicant's knowledge. Applicant authorizes Trustee to rely upon the representations contained herein and to request and receive such additional information it deems necessary to verify the identity of Applicant and the suitability of assets for trust funding.

Sign Now