Fillable 90.1.1 (Minnesota Department of Revenue)

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90.1.1 (Minnesota Department of Revenue)

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(Top 3 inches reserved for recording data)
(v2) Page 1 of 2
CERTIFICATE OF TRUST
by Individual
Minn. Stat. 501B.56
Minnesota Uniform Conveyancing Blanks
Form 90.1.1 (2011)
State of Minnesota, County of
, being first duly sworn,
on oath says:
1. The name of the Trust is: .
2. The date of the Trust Instrument is: .
3. The name of each Grantor of the Trust is:
.
4. The name of each original Trustee is:
.
5. The name and address of each Trustee empowered to act under the Trust Instrument at the time of execution of this Certificate is:
6. The Trustees are authorized by the Instrument to sell, convey, pledge, mortgage, lease, or transfer title to any interest in real or
personal property, EXCEPT as limited by the following:
(if none, so indicate)
7. Any other Trust provisions the undersigned wishes to include:
Page 2 of 2 (v2) Minnesota Uniform Conveyancing Blanks Form 90.1.1
8. The Trust has has not terminated or been revoked.
(check one box)
9. The statements contained in this Certificate of Trust are true and correct and there are no other provisions in the Trust Instrument or
amendments to it that limit the powers of the Trustee(s) to sell, convey, pledge, mortgage, lease, or transfer title to interests in real or personal
property.
Trustee or Grantor
(signature)
(signature)
Signed and sworn to before me on , by
(month/day/year)
(insert name of person making statement)
.
(Stamp)
(signature of notarial officer)
Title (and Rank):
My commission expires:
(month/day/year)
THIS INSTRUMENT WAS DRAFTED BY:
(insert name and address)
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90.1.1 (Minnesota Department of Revenue)

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Completed 11 November 2020

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