Signed and dated as set out below.
Current Trustee
Dated:___________
By:_____________________________
Dated:___________
_____________________________
Settlor – if living
Dated:___________
________________________________
Current Beneficiary
Dated:___________
________________________________
Remainder Beneficiary
Dated:___________
________________________________
Remainder Beneficiary
Dated:___________
_________________________________
Remainder Beneficiary
Drafted 6/26/2015
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