CERTIFICATION OF TRUST
Name of trust: ..............................................
Date trust instrument was executed: ..........................
Tax Identification Number of trust (SSN or EIN): ..............
Name(s) of settlor(s) of trust: ..............................
Name(s) of currently acting trustee(s): ......................
Address(es) of currently acting trustee(s): ..................
.... This trust states that.... of.... co-trustee(s) are required to exercise the powers of the trustee.
.... The co-trustees authorized to sign or otherwise authenticate on behalf of the trust are: ......................
.... There are no co-trustees authorized to sign or otherwise authenticate on behalf of the trust. Name(s) of successor trustee(s): ............................
The trustee(s) has (have) the power to (state, synopsize, or describe relevant powers): ..................................
Title to the trust property shall be taken as follows (for example, "John Doe and Jane Doe, co-trustees of the Doe Family Living Trust, dated January 4, 1999"): ......................
.... This is an irrevocable trust.
.... This is a revocable trust. Name(s) of person(s) holding power to revoke the trust: ..................................
.... This is an unamendable trust.
.... This trust is amendable. Name(s) of person(s) holding power to amend the trust:
....................................
I (we) certify that the above-named trust is in full force and has not been revoked, modified, or amended in any manner that would cause the representations in this Certification of Trust to be incorrect.
IN WITNESS THEREOF, each of the undersigned, being a trustee of the above-named trust with the authority to execute this Certification of Trust, does hereby execute it this ..... day of .......... ,.......
Trustee Signature: .............
Printed Name: ..................
Trustee Signature: .............
Printed Name: ..................
[OPTIONAL:
State of .................)
County of ................)
This instrument was signed and acknowledged before me on .......... ,...... (date) by (name/s of person/s):
............
(Signature of Notary Public):
............................
(SEAL)]
760 ILCS 3/1013