SELF-PROVING AFFIDAVIT FOR A REVOCABLE TRUST

State of _________________________ }
County of _________________________ }

1. Grantor’s Statement. I, being duly sworn, declare under oath that I am the Grantor of this Trust. I am a legal adult, a resident of the State of _________________________ and have the legal capacity to make this affidavit.

• Acknowledgment of Trust Document. I affirm that the attached document is the original trust document or a true and correct copy of this Trust.
• Execution of Trust Document: I declare that this Trust was duly executed on the date indicated therein, in compliance with State law.
• Purpose of Affidavit: This affidavit is made to affirm the validity of this Trust.

Grantor’s Signature: _________________________ Date: ____________
Print Name: _________________________

2. Witness Attestation. We, the Witnesses signed herein, hereby attest that Trustor, known to us, personally appeared before us and acknowledged that they freely and voluntarily executed this Trust document. We affirm that the Trustor appeared to be of sound mind and not under duress or undue influence. This document was signed by the Trustor in our presence, and we, in turn, at the Trustor’s request, and in the presence of each other, have subscribed our names as witnesses on this herein date.

Witness’s Signature: _________________________ Date: ____________
Print Name: _________________________

Witness’s Signature: _________________________ Date: ____________
Print Name: _________________________

3. Notary Acknowledgment.

SUBSCRIBED AND SWORN TO before me, a Notary Public, this ____ day of _________________________, 20____.

Notary Public: _________________________
Print Name: _________________________
My commission expires: ____________