Trust Amendment Form

This   Type a label   Amendment to the Trust Agreement made this   Type a labelday of   Date  ,   Type a label   executed between  (Grantor) First Name   Last Name   and  (Trustee) First Name   Last Name.

Whereas the Grantor and the Trustee entered into the   Type a label   dated   Date  , hereinafter called the Trust Agreement and, whereas Article   Type a label   of the Trust Agreement provided that the Grantor reserves the right to amend in any matter revoke in whole or in part the Trust Agreement and, whereas the Grantor is desirous of modifying and amending the Trust Agreement and the Trustee is agreeable to modify and amend contained herein,

Now therefore, it is agreed that:

In witness whereof, the Grantor has hereunto subscribed his/her name to the amendment to this trust this   Type a label   day of   Date.

Grantor Name   First Name   Last Name   

Grantor Signature   Signature   

State of   Type a label   

Country of   Type a label   

Notary Public   Type a label   

Notary Signature  Signature   

The Commission Expires   Date