Amendment to Trust

1, __________, (“Grantor”) of ________________, hereby amend _________________
("Trust") as follows: ____________________________________________________.

Except as expressly modified by this Amendment I approve, ratify and affirm the Trust.

Date:

_________________
Grantor

_________________
Trustee

STATE OF _________________
COUNTY OF _______________

This instrument was acknowledged before me on this __ day of __________, 20__ by Grantor, __________________ and Trustee, ___________________.

___________________
Notary Public
My Commission Expires on:

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