Fs Form 1851 - Request To Reissue United States Savings Bonds To A Personal Trust Page 4
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5I CERTIFY that
, whose identity is known or was
(Name of Person Who Appeared)
,
proven to me, personally appeared before me this
day of
(Month / Year)
at
, and signed this form.
(City / State)
(Signature and Title of Certifying Officer)
(OFFICIAL STAMP
OR SEAL)
(Name of Financial Institution)
ACCEPTABLE CERTIFICATIONS: Financial institution's
official seal or stamp (such as corporate seal, signature
(Address)
guaranteed stamp, or medallion stamp). Brokers must
use a medallion stamp.
(City / State / ZIP Code)
(Notary certification is NOT acceptable.)
(Telephone)
I CERTIFY that
, whose identity is known or was
(Name of Person Who Appeared)
,
proven to me, personally appeared before me this
day of
(Month / Year)
at
, and signed this form.
(City / State)
(Signature and Title of Certifying Officer)
(OFFICIAL STAMP
OR SEAL)
(Name of Financial Institution)
ACCEPTABLE CERTIFICATIONS: Financial institution's
official seal or stamp (such as corporate seal, signature
(Address)
guaranteed stamp, or medallion stamp). Brokers must
use a medallion stamp.
(City / State / ZIP Code)
(Notary certification is NOT acceptable.)
(Telephone)
INSTRUCTIONS
USE OF FORM – Complete this form to reissue United States Savings Bonds to a personal trust created by:
a. The owner, both coowners, or either coowner
b. Some other person, provided the owner or a coowner is a beneficiary of the trust
c. For Series EE bonds or Series HH bonds, some other person, provided a beneficiary of the trust is related by blood (including
legal adoption) or marriage to the owner or a coowner
“Personal trust” as used in this form is a trust established by natural persons in their own right for the benefit of themselves or other natural
persons in whole or in part, and common trust funds comprised in whole or in part of such estates. A bank, trust company, or other financial
institution, appointed as trustee of a personal trust, should submit form FS Form 1455 with this form if the bonds are to be reissued in its name
as trustee of its common trust fund. FS Form 1455 is available at
This form should not be completed by a person under any legal disability, except for a minor of sufficient competency to sign the request and to
understand the nature of the transaction.
COMPLETION OF FORM – Print clearly in ink or type all information requested. If more space is needed for any item, use a plain sheet of
paper and attach it to this form.
FS Form 1851
Department of the Treasury | Bureau of the Fiscal Service
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