Affidavit of Trust

AFFIDAVIT OF TRUST

OF

________________________________

Now comes, the undersigned:

q Settlor of the above named Trust Trust (this form of affidavit must be signed by each settlor);

q ______________________ Trustee of the above named Trust (this form of affidavit must be signed by each current trustee)

upon oath and, in accordance with R.I.G.L. Section 34-4-27, hereby deposes and says as follows:

1. That the name of the Trust is as follows: ________________________________________________;

2. That the name of each Settlor is as follows:

__________________________, and __________________________;

3. That the name of each Original Trustee is as follows:

__________________________; and __________________________;

4. That the Date of the Original Trust Instrument is as follows:

_________________________________________________________;

5. That the Trust:

q Has not been amended since the date of its creation;

q Has been amended, and said amendment(s) has/have been recorded; The date of such amendment(s) is/are as follows:

______________________________________________________;

6. That the Names of the Current Trustee(s) is/are as follows:

________________________ and __________________________;

7. That the Trustee(s) q do q do not, have the power to perform discretionary acts as trustees without the consent, concurrence or direction of the beneficiaries;

8. That the Trustees have the authority under the declaration of trust to q convey, q mortgage, q lease, q grant restrictions or easements, q other interests relating to the real estate located at: ; (relevant provisions of the trust attached hereto.) ,, and nothing in the Declaration of Trust derogates from said powers;

9. That as of the date hereof:

q The Trust has not been revoked, or otherwise terminated and is still in full force and effect,

q The Trust has been revoked, recinded or otherwise terminated but the trustee(s) have the power to convey trust property to effectuate said revocation or termination (attach applicable provisions of the trust);

10. That pursuant to the declaration of trust the Trustee(s) may be replaced and successor Trustee(s) appointed as follows: (attach applicable provisions of the trust)

____________________________________________________________;

11. That pursuant to the Declaration of Trust the time and manner that the above named trust may be terminated are as follows: (attach applicable provisions of the trust)

____________________________________________________________;

12. That as of the date hereof the Settlor is:

q alive;

q deceased (D/O/D ) and died in: _________________________;

13. That, if the is more than one settlor, as of the date hereof the second Settlor is:

q alive;

q deceased (D/O/D ) and died in: _________________________;

Affiant

Subscribed and sworn to before me this day of , A.D. 20 .

_________________________________

(print or type name)

Notary Public

My commission expires:

3