Statement Of Confirmation Of Testamentary Trustee {MPC 275}

STATEMENT OF CONFIRMATION OF A TESTAMENTARY TRUSTEE Estate of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Date of Death: The Trustee of a testamentary trust makes the following statements: 1. Information about the Trustee: Name: First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (Address) (Apt, Unit, No. etc.) (City/Town) (City/Town) (State) (State) (Zip) (Zip) Mailing Address, if different: Primary Phone #: 2. The Decedent's Will was allowed on: (date) . 3. The Will gave certain estate in trust for the use and benefit of: (name(s)) and appointed the above-named Trustee. 4. A Bond with sureties with the penal sum amount of possession of the Court. A Bond without sureties accompanies this statement or is in the possession of the Court. A Bond without sureties is permissible because: The terms of the trust waive sureties on the bond. Other (include statutory reference): accompanies this statement or is in the 5. The Trustee is willing to accept said trust and furnishes bond according to law for the faithful discharge thereof. SIGNED UNDER THE PENALTIES OF PERJURY I certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief. Date: Signature of Trustee Date: Signature of Trustee MPC 275 (1/16/13) American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 2 Information on Attorney for Trustee, if any Signature of Attorney (Print name) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: B.B.O. # Email: AN ATTESTED COPY SHALL NOT ISSUE UNTIL APPROVAL OF THE BOND FOR COURT USE ONLY As Register of Probate having the care and custody of the records pertaining to this Court, I certify that the preceding document is a true, exact, complete, and unaltered copy of the Statement of Confirmation of a Testamentary Trustee filed with this Court. Date REGISTER OF THE PROBATE & FAMILY COURT MPC 275 (1/16/13) American LegalNet, Inc. www.FormsWorkFlow.com page 2 of 2