Trust Information Form - Ccr-J-150 Page 2
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2If the person seeking appointment is not a Virginia resident, bring a Virginia resident to the
appointment with you to either qualify as a co-trustee, or to be appointed as resident agent.
5. Value of the trust estate: $__________________________
6. Name of attorney, if any: __________________________________________________________
Attorney’s mailing address & telephone number: _______________________________________
_______________________________________________________________________________
INFORMATION TO BE FURNISHED BY EACH PERSON SEEKING QUALIFICATION
7. Are you a person under a disability? (See Instructions for Explanation)
Yes
No
8. Have you ever been convicted of a felony?
Yes
No
9. Have you ever filed for bankruptcy?
Yes
No
10. Are you now, or have you ever been, an attorney at law in Virginia or elsewhere?
Yes
No
(If yes, and you do not now possess and active license from the Virginia State Bar, explain the
details on a separate sheet of paper.)
I (we) hereby certify that to the best of my (our) knowledge and belief this is an accurate statement of facts,
and I (we) acknowledge a continuing duty to report any later discovered errors or inconsistencies to the
Clerk of Court.
_________
____________________________________
____________________________________
Date
Printed Name of Requesting Person
Signature of Requesting Person
_________
____________________________________
____________________________________
Date
Printed Name of Requesting Person
Signature of Requesting Person
_________
____________________________________
____________________________________
Date
Printed Name of Requesting Person
Signature of Requesting Person
_________
____________________________________
____________________________________
Date
Printed Name of Requesting Person
Signature of Requesting Person
INSTRUCTIONS – TRUST INFORMATION FORM
GENERAL: This form provides the Clerk of Court with the information necessary to qualify trustees.
This sheet contains special instructions to help you fill out this form. If you have any questions, you should
contact the Fiduciary Section. You should contact the Clerk’s office for an appointment before you go to
the courthouse. Please complete as much of this form as possible before you meet with the Probate Clerk.
Line 1: If this is a trust created by a will, then state the decedent’s full name, followed by the work
“Deceased”. If this is an inter vivos trust created by a person who was living at that time, state that
person’s name. If this is a trust created or augmented by court order (or authorized by court to be created
or augmented by an individual or organization) as part of a settlement of a legal action, put the work
“Court” on this line.
Line 4: This line is to be used to identify the trustee or co-trustees, if more than one.
Line 5: Because of the difficulty on determining exact values at the time of qualification, the Clerk will
accept a reasonable estimate of the fair market value of the trust’s personal property and if you do not know
the actual value of the trust’s real property, then you may use its assessed value for local real estate tax
purposes.
Line 7: A person under a disability as defined in Virginia Code §8.01-2 is not eligible to qualify. You are
considered to be under a disability if (1) you have been convicted of a felony and are still in prison; (2) you
are under 18 years of age; (3) you are a drug addict or alcoholic as defined in Virginia Code §37.2-100; (4)
you are an incapacitated person as defined in Virginia Code §64.2-2016.
Lines 8-10: A “yes” answer does not automatically disqualify a person from serving. Each case must be
decided by the court based on its specific facts.
J-150 Trust Information Form OCT 2012
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