Fill and Sign the Trust Beneficiary Form

Agreement between Trustor and Trustee Terminating Trust after Disclaimer by Beneficiary Agreement made on the ______________________________________________ (date), between __________________________________________________________ (Name of Trustor) of ______________________________________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code), referred to herein as Trustor, and ____________________________________________ (Name of Trustee), a corporation organized and existing under the laws of the state of ______________________________________________, with its principal office located at ______________________________________________________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code), referred to herein as Trustee.Whereas, Trustor has been advised that _________________________________ _________________________ (Name of Beneficiary), of ________________________ ________________________________________________________________________________________________________________________________________________ ___________________________ (street address, city, county, state, zip code), has executed and delivered an instrument, dated ____________________________________ ____________ (date), renouncing his claims under a trust instrument between Trustor and Trustee, dated _________________________________________________ (date); and Whereas, the trust estate is now held solely at the will and subject to the wishes of Trustor and is free from all claim to the estate by ________________________________ _________________________________ (Name of Beneficiary); andWhereas, with _____________________________________________________ (Name of Beneficiary) eliminated as a beneficiary, the Trust is too indefinite in its terms to be capable of judicial enforcement. Therefore, the Trust may be revoked, cancelled, and annulled by mutual agreement between the Trustor and Trustee; andWhereas, this instrument is intended to evidence such agreement of termination; Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1.Termination The grant evidenced by the trust instrument is now revoked and annulled. The trust created by such instrument is terminated effective the day and date of the execution and delivery of this instrument. 2.Accounting Immediately following the execution and delivery of this Agreement, Trustee will account for, transfer, assign, pay, deliver, and return to Trustor each and all of the assets then constituting the principal and undistributed income of the trust estate, less the reasonable charges and expenses due to Trustee in relation to the trust estate. 3.Indemnification of Trustee Trustor, Trustor's heirs, executors, and administrators, shall indemnify Trustee, Trustee's successors, and assigns, from all loss, costs, liability, and expense to which Trustee may now or later be subjected in connection with the turning over and return to Trustor of the assets constituting the trust estate or arising in any way out of the fact that Trustee has, at the request of Trustor, joined in the execution and delivery of this instrument. Pursuant to this Agreement, Trustee has transferred, assigned, and delivered to Trustor all of the assets constituting the trust estate. The parties have executed this Agreement on this the _______________________ _________________ (date). ____________________________________(Printed Name of Trustor)____________________________________(Signature of Trustor)____________________________________ (Name of Corporate Trustee) By: ________________________________(Printed Name of Officer)____________________________________(Signature of Officer) 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 Trustor), who acknowledged that he is Trustor 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 PUBLICMy Commission Expires:______________________STATE OF ________________________________________ COUNTY OF _________________________________ Personally appeared before me, the undersigned authority in and for the said County and State, on ______________________________________________ (date), within my jurisdiction, the within-named ______________________________________ (Name of Officer), who acknowledged that he is a (e.g., Vice-President and Trust Officer)___________________________________________________ of _______________________________________________________ (Name of Trustee), a ______________________________________________ (Name of State) corporation, Trustee in the Trust Agreement described in the above and foregoing instrument, and that for and on behalf of the said corporation, and as its act and deed in the capacity as Trustee, he executed the above and foregoing instrument, after first having been duly authorized by said corporation so to do. ___________________________________________NOTARY PUBLICMy Commission Expires:_____________________ Form of acknowledgement may vary from state to state)