CERTIFICATION OF TRUST

State of Connecticut

Pursuant to Connecticut General Statutes Section 45a-499zzz
(Connecticut Uniform Trust Code)

// GUIDANCE: Connecticut enacted the Connecticut Uniform Trust Code (CUTC)
// effective January 1, 2020 (Conn. Gen. Stat. § 45a-499bb et seq.). Section
// 45a-499zzz requires eight specific elements in a certification of trust.
// The Connecticut version closely follows the Uniform Trust Code § 1013 but
// includes Connecticut-specific provisions regarding probate court jurisdiction.

SECTION 1: INTRODUCTORY CERTIFICATION

The undersigned, being the duly appointed, qualified, and currently acting Trustee(s) of the trust described herein, does/do hereby certify, pursuant to Connecticut General Statutes Section 45a-499zzz, the following facts to be true and correct. This Certification of Trust is furnished in lieu of providing a copy of the trust instrument to third parties who are not beneficiaries of the Trust, in order to establish the existence of the Trust and the authority of the Trustee(s) to act.

SECTION 2: TRUST EXISTENCE AND DATE OF EXECUTION

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(1) requires that the
// certification state that the trust exists and the date the trust
// instrument was executed.

2.1 Trust Existence. The undersigned hereby certifies that the following trust exists and is currently in full force and effect:

Trust Name: [________________________________]

2.2 Date of Original Trust Instrument: [__/__/____]

2.3 Amendments, Restatements, and Modifications:

☐ The Trust has NOT been amended or restated since its original execution.
☐ The Trust has been amended and/or restated as follows:

2.4 Trust Classification:

☐ Revocable Living Trust (Inter Vivos)
☐ Irrevocable Living Trust (Inter Vivos)
☐ Testamentary Trust (created under the Last Will and Testament of [________________________________], admitted to probate on [__/__/____] in the Probate Court for the District of [________________________________])
☐ Supplemental/Special Needs Trust (First Party — 42 U.S.C. § 1396p(d)(4)(A))
☐ Supplemental/Special Needs Trust (Third Party)
☐ Charitable Remainder Trust
☐ Charitable Lead Trust
☐ Qualified Personal Residence Trust (QPRT)
☐ Grantor Retained Annuity Trust (GRAT)
☐ Irrevocable Life Insurance Trust (ILIT)
☐ Other: [________________________________]

SECTION 3: SETTLOR IDENTIFICATION

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(2) requires the identity of
// the settlor. Connecticut uses the term "settlor" consistent with the UTC.

3.1 Settlor:

Full Legal Name: [________________________________]
Date of Birth: [__/__/____]
Residential Address: [________________________________]
Town/City: [________________________________]
State: Connecticut ZIP: [____________]

3.2 Co-Settlor (if applicable):

Full Legal Name: [________________________________]
Date of Birth: [__/__/____]
Residential Address: [________________________________]
Town/City: [________________________________]
State: Connecticut ZIP: [____________]

3.3 Status of Settlor(s):

Settlor 1:
☐ Living and competent.
☐ Living but incapacitated as determined by [________________________________] on [__/__/____].
☐ Deceased. Date of Death: [__/__/____]. Domiciled at death in [________________________________], Connecticut.

Settlor 2 / Co-Settlor (if applicable):
☐ Living and competent.
☐ Living but incapacitated as determined by [________________________________] on [__/__/____].
☐ Deceased. Date of Death: [__/__/____]. Domiciled at death in [________________________________], Connecticut.

// GUIDANCE: Connecticut imposes its own estate tax with different thresholds
// and rates than federal estate tax. If the settlor is deceased, consult
// Conn. Gen. Stat. § 12-391 regarding Connecticut estate tax obligations.

SECTION 4: TRUSTEE IDENTIFICATION AND ADDRESS

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(3) requires the identity and
// address of the currently acting trustee(s).

4.1 Currently Acting Trustee(s)

Trustee 1:
Full Legal Name: [________________________________]
Residential Address: [________________________________]
Town/City: [________________________________]
State: [____] ZIP: [____________]
Date of Appointment: [__/__/____]
Method of Appointment:
☐ Named as original Trustee in the Trust instrument.
☐ Appointed as Successor Trustee pursuant to the Trust instrument.
☐ Appointed by the Probate Court for the District of [________________________________] on [__/__/____].
☐ Other: [________________________________]

Trustee 2 (if applicable):
Full Legal Name: [________________________________]
Residential Address: [________________________________]
Town/City: [________________________________]
State: [____] ZIP: [____________]
Date of Appointment: [__/__/____]
Method of Appointment:
☐ Named as original Trustee in the Trust instrument.
☐ Appointed as Successor Trustee pursuant to the Trust instrument.
☐ Appointed by the Probate Court for the District of [________________________________] on [__/__/____].
☐ Other: [________________________________]

Corporate/Institutional Trustee (if applicable):
Entity Name: [________________________________]
Type: ☐ Connecticut-chartered bank or trust company ☐ National bank ☐ Other
State of Organization: [________________________________]
Principal Connecticut Office: [________________________________]
Authorized Representative: [________________________________]
Title: [________________________________]

// GUIDANCE: Connecticut-chartered trust companies are regulated by the
// Connecticut Department of Banking under Conn. Gen. Stat. § 36a-1 et seq.

4.2 Successor Trustee(s)

First Successor Trustee: [________________________________]
Address: [________________________________]

Second Successor Trustee: [________________________________]
Address: [________________________________]

Mechanism for Successor Selection:
☐ Designated in the Trust instrument.
☐ Selected by the Settlor (if living).
☐ Selected by majority of qualified beneficiaries.
☐ Appointed by the Connecticut Probate Court per Conn. Gen. Stat. § 45a-499oo.
☐ Other: [________________________________]

SECTION 5: POWERS OF THE TRUSTEE

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(4) requires disclosure of the
// powers of the trustee. Tailor this section to include powers relevant to
// the pending transaction. The statutory enumeration of trustee powers is
// found in Conn. Gen. Stat. § 45a-499vvv.

The Trustee(s) of the Trust possess the following powers as set forth in the Trust instrument and as provided under applicable Connecticut law, including the powers enumerated in Conn. Gen. Stat. § 45a-499vvv:

5.1 Real Property Powers

☐ To acquire, receive, hold, manage, and administer real property.
☐ To sell real property at public or private sale, for cash or upon credit.
☐ To execute and deliver warranty deeds, quitclaim deeds, or other instruments of conveyance.
☐ To mortgage or encumber real property.
☐ To lease real property for any term, including terms extending beyond the duration of the Trust.
☐ To manage, improve, maintain, insure, repair, and protect real property.
☐ To subdivide, develop, or change the use of real property.
☐ To grant easements, rights of way, and restrictions.
☐ To contest or compromise real property tax assessments.

5.2 Personal Property and Financial Powers

☐ To acquire, hold, sell, and dispose of personal property of every kind.
☐ To open, maintain, and close deposit accounts and investment accounts at banks and other financial institutions.
☐ To invest and reinvest trust assets in any investments the Trustee deems advisable.
☐ To borrow money and pledge or encumber trust property as security.
☐ To collect rents, dividends, interest, and other trust income.
☐ To endorse and deposit checks and other negotiable instruments.
☐ To execute wire transfers and electronic fund transfers.
☐ To purchase, maintain, and surrender insurance policies.

5.3 Business and Entity Powers

☐ To continue, participate in, or dispose of any business interest.
☐ To form, reorganize, or dissolve any business entity.
☐ To vote shares of stock, exercise membership rights, and participate in governance.
☐ To enter into partnership agreements and operating agreements.

5.4 Administrative and Fiduciary Powers

☐ To employ and compensate attorneys, accountants, financial advisors, and other agents.
☐ To prosecute, defend, compromise, settle, or abandon claims and litigation.
☐ To make distributions to beneficiaries as provided in the Trust instrument.
☐ To execute and deliver all instruments necessary for trust administration.
☐ To make tax elections and file state and federal tax returns.
☐ To allocate receipts and disbursements between income and principal.
☐ To pay trust expenses and trustee compensation as provided by law or the Trust instrument.

5.5 Powers Specific to Pending Transaction

Description of Pending Transaction: [________________________________]
Specific Trustee Authority: [________________________________]
Trust Instrument Reference: Article/Section [________________________________]

SECTION 6: REVOCABILITY AND POWER TO REVOKE

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(5) requires disclosure of
// revocability and the identity of any person holding a power to revoke.

6.1 Revocability:

☐ REVOCABLE. The Trust is currently revocable. The Settlor has retained the power to amend, modify, or revoke the Trust in whole or in part during the Settlor's lifetime, in accordance with Conn. Gen. Stat. § 45a-499ll.

☐ IRREVOCABLE. The Trust is irrevocable and may not be amended, modified, or revoked.

☐ BECAME IRREVOCABLE. The Trust was originally revocable but has become irrevocable:
☐ Upon the death of the Settlor on [__/__/____].
☐ By operation of the Trust's terms on [__/__/____].
☐ Other: [________________________________]

6.2 Person(s) Holding Power to Revoke:

☐ No person currently holds a power to revoke the Trust.
☐ The following person(s) hold a power to revoke:

6.3 Method of Revocation:

☐ As specified in the Trust instrument: [________________________________]
☐ By any method manifesting clear and convincing evidence of intent per Conn. Gen. Stat. § 45a-499ll.

SECTION 7: CO-TRUSTEE SIGNING AUTHORITY

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(6) requires disclosure of
// co-trustee signing authority and whether all or less than all co-trustees
// are required to exercise trustee powers. See also Conn. Gen. Stat.
// § 45a-499nn regarding co-trustee default rules.

7.1 Number of Currently Acting Trustees: [____]

7.2 Co-Trustee Action Requirements:

☐ All co-trustees must participate in and consent to every exercise of a trust power.
☐ A majority of co-trustees may exercise trust powers per Conn. Gen. Stat. § 45a-499nn.
☐ Any single co-trustee may act independently.
☐ The Trust instrument allocates authority as follows: [________________________________]

7.3 Document Signing Authority:

☐ All co-trustees must sign all documents and instruments.
☐ A majority of co-trustees may sign documents and instruments.
☐ Any one co-trustee may sign documents and instruments on behalf of the Trust.
☐ Different requirements apply depending on the type of transaction: [________________________________]

7.4 Vacancy Among Co-Trustees:

☐ If a co-trustee position is vacant, the remaining co-trustee(s) may act.
☐ A vacancy must be filled before the remaining co-trustee(s) may act.
☐ Other: [________________________________]

SECTION 8: TRUST TAXPAYER IDENTIFICATION NUMBER

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(7) requires the trust's
// taxpayer identification number. This is one of the eight mandatory elements
// in the Connecticut statute.

Trust Taxpayer Identification Number (EIN): [________________________________]

☐ The Trust has its own Employer Identification Number (EIN) as shown above.
☐ The Trust is a grantor trust and uses the Settlor's Social Security Number for tax reporting purposes. The SSN is: XXX-XX-[________] (last four digits only for security).
☐ An EIN application is pending.

SECTION 9: MANNER OF TAKING TITLE

// GUIDANCE: Conn. Gen. Stat. § 45a-499zzz(a)(8) requires disclosure of the
// manner of taking title to trust property. This is one of the eight
// mandatory elements in the Connecticut statute.

9.1 Title to Trust property shall be held as follows:

☐ [________________________________], Trustee of the [________________________________] Trust dated [__/__/____]

☐ [________________________________] and [________________________________], Co-Trustees of the [________________________________] Trust dated [__/__/____]

☐ The [________________________________] Trust dated [__/__/____]

☐ Other: [________________________________]

// GUIDANCE: Connecticut real property is recorded in the town clerk's office
// of the municipality where the property is located. Ensure the title
// designation is consistent with the requirements of the applicable town
// clerk's office.

SECTION 10: STATUTORY REPRESENTATIONS AND CERTIFICATIONS

Pursuant to Connecticut General Statutes Section 45a-499zzz, the undersigned Trustee(s) hereby certify and represent:

10.1 Existence. The Trust identified herein was validly created under applicable law and is currently in full force and effect.

10.2 No Revocation, Modification, or Amendment. As required by Conn. Gen. Stat. § 45a-499zzz(c), the Trust has not been revoked, modified, or amended in any manner that would cause the representations contained in this Certification of Trust to be incorrect.

10.3 Authority. The undersigned is/are the duly appointed, currently acting, and qualified Trustee(s) of the Trust, with full power and authority to act on behalf of the Trust in the pending transaction.

10.4 No Dispositive Terms. Pursuant to Conn. Gen. Stat. § 45a-499zzz(d), this Certification does not contain the dispositive terms of the Trust.

10.5 Completeness. This Certification contains all information required by Conn. Gen. Stat. § 45a-499zzz(a)(1) through (8).

10.6 Accuracy. All information contained herein is true, correct, and complete as of the date of execution.

10.7 No Pending Proceedings. There are no actions, suits, or proceedings currently pending in any court of the State of Connecticut or any other jurisdiction that would affect the validity of the Trust or the authority of the Trustee(s) to act, except: [________________________________]

10.8 No Bond Required. The Trustee is serving:
☐ Without bond, as provided in the Trust instrument.
☐ With bond in the amount of $[____________], filed with [________________________________].

SECTION 11: THIRD-PARTY RELIANCE AND PROTECTIONS

11.1 Reliance Protection. Pursuant to Conn. Gen. Stat. § 45a-499zzz(f), a person who acts in reliance upon this Certification without knowledge that the representations contained herein are incorrect is not liable to any person for so acting and may assume without inquiry the existence of the facts contained in this Certification. Knowledge of the terms of the Trust may not be inferred solely from the fact that a copy of all or part of the Trust instrument is held by the person relying upon this Certification.

11.2 Enforcement. Pursuant to Conn. Gen. Stat. § 45a-499zzz(g), a person who in good faith enters into a transaction in reliance upon this Certification may enforce the transaction against the Trust property as if the representations contained herein were correct.

11.3 Right to Excerpts. Pursuant to Conn. Gen. Stat. § 45a-499zzz(e), a recipient of this Certification may require the Trustee to furnish copies of those excerpts from the original trust instrument and later amendments that designate the Trustee and confer upon the Trustee the power to act in the pending transaction.

11.4 Demand for Trust Instrument. Pursuant to Conn. Gen. Stat. § 45a-499zzz(h), a person making a demand for the full trust instrument in addition to this Certification or excerpts may be liable for damages if a court determines that such person did not act in good faith.

11.5 Judicial Proceedings. Pursuant to Conn. Gen. Stat. § 45a-499zzz(i), this Certification does not limit the right of any person to obtain a copy of the trust instrument in a judicial proceeding concerning the Trust.

SECTION 12: CONNECTICUT-SPECIFIC PROVISIONS

// GUIDANCE: These provisions address matters specific to Connecticut trust
// law and practice. Connecticut has several unique features including its
// probate court system, estate tax regime, and real property recording
// practices.

12.1 Governing Law

This Trust is governed by the Connecticut Uniform Trust Code (Conn. Gen. Stat. § 45a-499bb et seq.) and the laws of the State of Connecticut. The CUTC became effective January 1, 2020.

12.2 Connecticut Probate Court Jurisdiction

// GUIDANCE: Connecticut has a unique probate court system with courts
// organized by district. Probate courts have jurisdiction over trust matters
// pursuant to Conn. Gen. Stat. § 45a-98.

The Trust is subject to the jurisdiction of the Probate Court for the District of [________________________________], located in the town of [________________________________], Connecticut.

12.3 Connecticut Real Property Recording

// GUIDANCE: Connecticut real property records are maintained at the town
// level by the town clerk. Each of Connecticut's 169 municipalities has
// its own recording office. If this certification relates to real property,
// it should be recorded on the land records of the appropriate town.

☐ This Certification relates to real property located in the Town of [________________________________], Connecticut.
☐ The property is known as: [________________________________]
☐ The property is described in Volume [____], Page [____] of the [________________________________] Land Records.
☐ This Certification will be recorded on the Land Records of the Town of [________________________________].
☐ This Certification does NOT relate to a real property transaction.

12.4 Connecticut Conveyance Tax

// GUIDANCE: Connecticut imposes a real estate conveyance tax under
// Conn. Gen. Stat. § 12-494 et seq. The state rate and any applicable
// municipal rate should be considered for the underlying transaction.

☐ The underlying transaction is subject to Connecticut real estate conveyance tax (Conn. Gen. Stat. § 12-494).
☐ The underlying transaction is exempt from conveyance tax. Basis: [________________________________]
☐ Not applicable — no real property conveyance is involved.

12.5 Connecticut Estate and Gift Tax

// GUIDANCE: Connecticut imposes its own estate and gift tax under
// Conn. Gen. Stat. § 12-391 et seq. The Connecticut estate tax threshold
// and rates differ from federal. If the settlor is deceased or the trust
// involves gifts, consult Connecticut tax provisions.

☐ The Settlor is deceased, and the Connecticut estate tax return (Form CT-706/709) has been filed or will be filed.
☐ The Trust was funded in part by taxable gifts subject to Connecticut gift tax reporting.
☐ Not applicable at this time.

12.6 Trust Registration

// GUIDANCE: Connecticut does not require registration of inter vivos trusts
// with the Probate Court during the settlor's lifetime for revocable trusts.
// However, testamentary trusts and certain irrevocable trusts may require
// Probate Court involvement.

☐ The Trust has been registered with the Connecticut Probate Court.
☐ The Trust is not required to be registered.
☐ Registration is pending.

SECTION 13: EXECUTION AND ACKNOWLEDGMENT

IN WITNESS WHEREOF, the undersigned Trustee(s) have executed this Certification of Trust on the date set forth below, in accordance with Connecticut law.

Date of Execution: [__/__/____]

Trustee Signature:

Signature: ________________________________________
Printed Name: [________________________________]
Capacity: Trustee of the [________________________________] Trust
Date: [__/__/____]

Co-Trustee Signature (if applicable):

Signature: ________________________________________
Printed Name: [________________________________]
Capacity: Co-Trustee of the [________________________________] Trust
Date: [__/__/____]

ACKNOWLEDGMENT

// GUIDANCE: Connecticut does not expressly require notarization of a
// certification of trust under § 45a-499zzz. However, notarization is
// required if the certification is to be recorded on the land records
// and is strongly recommended for all transactions. Connecticut
// acknowledgment requirements are found in Conn. Gen. Stat. § 1-34.

STATE OF CONNECTICUT
COUNTY OF [________________________________]
TOWN OF [________________________________]

On this [____] day of [________________], [________], before me, the undersigned officer, personally appeared [________________________________], known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged that he/she/they executed the same for the purposes therein contained, in his/her/their capacity as Trustee(s) of the [________________________________] Trust.

In witness whereof I hereunto set my hand and official seal.

Signature of Notary Public / Commissioner of the Superior Court: ________________________________________
Printed Name: [________________________________]
My Commission Expires: [__/__/____]

// GUIDANCE: In Connecticut, both notaries public and Commissioners of the
// Superior Court may take acknowledgments. Commissioners are appointed by
// the Superior Court and serve for the term of the court. Their commissions
// do not have printed expiration dates in the same manner as notaries.

☐ Notary Public, State of Connecticut
☐ Commissioner of the Superior Court

[SEAL]

SECTION 14: ADDITIONAL NOTES AND GUIDANCE

A. Connecticut Uniform Trust Code Transition

For trusts created before January 1, 2020, the Connecticut Uniform Trust Code applies except to the extent that application would impair vested rights or violate principles of equity. See Conn. Gen. Stat. § 45a-499dd.

B. Uniform Prudent Investor Act

The Trustee's investment powers are subject to the Connecticut Uniform Prudent Investor Act (Conn. Gen. Stat. § 45a-541 et seq.) unless the Trust instrument provides otherwise.

C. Trustee Compensation

Trustee compensation in Connecticut is governed by Conn. Gen. Stat. § 45a-499tt, which permits reasonable compensation unless the Trust instrument provides otherwise.

D. Copies and Electronic Transmission

A photocopy, facsimile, or electronic copy of this executed Certification shall have the same force and effect as the original, subject to the requirements of the Uniform Electronic Transactions Act (Conn. Gen. Stat. § 1-266 et seq.).

E. Updates

This Certification should be updated whenever there is a material change in the Trust, including but not limited to a change in trustees, an amendment to the Trust, or a change in the revocability status of the Trust.

END OF CERTIFICATION OF TRUST

This document consists of [____] pages, constituting the complete Certification of Trust.