Professional Documents
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O ffic e r/P o rtfo lio D a te B a n k eM A C r B a n k eA U r A o o o u n t bes) num
B a n k en a m e r B a n ke ph o n e r COlD S to e n u m b e r r P ro d u c t
1/W e the undersigned, as all of the currently acting Trustee(s) certify to Wells Fargo Bank, N.A. (Wells Fargo): Provisions - To be completed by trustee(s) 1. Legal name of the Trust to which this certification applies and in which title to assets is held:
2.
D Irrevocable D Revocable
If rv a ,- - - - - - - ec l --------ob -------e 3. The Grantor(s) ("Grantor" also refers to Settlor, Trustor, or Testator) of the Trust is:
N a m eo f G ra n to r N a m eof G ra n to r N a m eo f G ra n to r N a m eo f G ra n to r
4.
5. The Trust is governed under the state law o -f -- -6. The Tax Identification Number used by the Trust i--s --The number is the (s e le c o n lyone box): t
F001-00000DSG5533-01
011 Wells Fargo Bank, N.A. All rights reserved. Member FDIC. DSG5533 (3-11 FO)
Page 1 of 3 Wells Fargo Internal Use When Blank; Wells Fargo Confidential When Completed
A cc o u nnu m b er(s ) t
7.
Name(s) of currently acting Trustee(s) who may act: (selec o n lyo n e box) t
Joint Or
Joint
S ta te
Z ip C o d e
C n try
S ta te
Z ip C o d e
entry
S ta te
Z ip C o d e
e ntry
S ta te
Z ip C o d e
C n try
8.
9.
The Trustee(s) will not direct Wells Fargo to take any action unless the Trustee(s) has/have the power to act and such powers are properly exercised.
10. Pursuant to the terms of the Trust, the Trustee(s) has/have the power to contract for banking and other financial services and to transfer, purchase and/or sell financial assets and investments, including securities. 11. If requested, 1/we will provide Wells Fargo with copies of excerpts of the original Trust instrument and amendments designating the Trustee and/or powers conferred on Trustee in support of any pending transaction under this certification. 12. The Trust has not been revoked, modified or amended in any manner which would cause the representations contained in this certification to be incorrect. 13. All information contained in this certification is true and correct, and you (Wells Fargo), as a third party conducting business with the Trustee may rely on this information until you receive written notice of any changes signed by the Trustee(s).
011 Wells Fargo Bank, N.A. All rights reserved. Member FDIC. DSG5533 (3-11 FO)
Wells Fargo Interna l Use When Blank; Wells Fargo Confidentia lWhen Completed
Page 2 of 3
A c co u nnum bes) t
NOTARIZATION IS REQUIRED FOR ALL TRUSTEES INVe declare under penalty of perjury under the laws of the State o --f --- -foregoing is true and correct.
N a m eo f T ru s te e (o ro -T ru s te e ) C N a m eo f C o -T ru s te e a n y ) (if N a m eo f C o -T ru s te e (if a n y ) N a m eo f C o -T ru s te ea n y ) (if S ig n a tu ro f T ru s te (o rC o T ru s te)e e e -
X
S ig n a tu ro f C o -T ru s te e a n y ) e (if
D a te : D a te : D a te : D a te :
X
S ig n a tu ro f C o -T ru s te e n y ) e (if a
X
S ig n a tu ref C o -T ru s te e a n y ) o (if
X
State of County of _ _
On (m m ld d /y y yy ), before me, (na m ean dtitle o f th e o ffic e r) personally appeared , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrumentand acknowledgedto me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/theirsignature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State o-f--is true and correct. WITNESS my hand and official seal. S ar- - - - - - - i nu - - - - - - - g t e ------ (Seal) -that the foregoing paragraph
Instructions to Notary (access Forms Onlne for all purpose Acknowledgement if needed):
If the Acknowledgement language does not meet your state requirements attach the correct Jurat or Acknowledgement for the
state of execution. Attach separate Jurat/Acknowledgements for each additional Trustee signing the form.
II
Page 3 of 3 Wells Fargo Internal Use When Blank; Wells Fargo Confidential When Completed
2011 Wells Fargo Bank, N.A. All rights reserved.Member FDIC. DSG5533 (3-11 FO)