This Revocation of Trust is made this _(1)_ day of ________(2)________, 19_(3)_.
WHEREAS, on the _(4)_ day of ________(2)________, 19_(3)_, I created by written declaration of a revocable trust a copy of which is attached hereto, and having reserved the right to revoke, annual and cancel said trust and the declaration creating it, I do now hereby revoke said trust, with all of the principal thereof reverting absolutely to me, with all right and title thereto. I further declare the Trustee of said trust free and discharged from all further responsibility for the administration and management of said trust and the principal thereof.
STATE OF ________(9)___________)
COUNTY OF _______(10)___________)
On this _(11)_ day of _______(12)________, 19_(13)_, before me personally came and appeared _________(14)___________, known, and known to me, to be the individuals described in and who executed the foregoing instrument, and who duly acknowledged to me that they executed same for the purpose therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission Expires: _________(16)___________
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