You:
Spouse:
Jointly owned with:
Other interests of current or future value
1. Interests in trusts. Describe any trusts created by you, by any other person, such as a parent
or ancestor, in which you or a member of your immediate family has a right to receive distributions of
income or principal, whether or not such distributions are actually being received or anticipated in the
future. Be as specific as you can. If possible, submit a copy of the trust agreement. If the trust agreement
is not available, show the date the trust was created, whether it can be amended or changed, whether
someone has a power of appointment over it, when the trust terminates, and who will receive the trust
property upon termination. Also, state the approximate current value of the trust and the annual income
from it.
2. Anticipated inheritances. If you or any other members of your immediate family are likely to
receive substantial inheritances in the foreseeable future from persons other than yourself or your spouse,
describe your best estimate of the value and the nature of each inheritance.
3. Other assets or interests of value. Describe the general nature, form of ownership, and your
estimate of the value of any asset or interest of value that does not seem to fit in any of the categories
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