CERTIFICATION OF TRUST

(Affidavit Form)

State of Nebraska

Pursuant to Neb. Rev. Stat. §§ 30-38,102 and 30-38,103

// GUIDANCE: Nebraska's certification of trust is UNIQUE among UTC states in
// several important ways: (1) it must be in the form of an affidavit, (2) it
// must be signed and acknowledged by ALL acting trustees, and (3) it must
// include the name of each beneficiary and their relationship to the grantor.
// See Neb. Rev. Stat. §§ 30-38,102 and 30-38,103.

AFFIDAVIT OF CERTIFICATION OF TRUST

STATE OF NEBRASKA
COUNTY OF [________________________________]

The undersigned affiant(s), being all of the currently acting Trustee(s) of the trust described herein, being first duly sworn upon oath, depose and state as follows, pursuant to Neb. Rev. Stat. §§ 30-38,102 and 30-38,103:

// GUIDANCE: Because Nebraska requires this document to be in the form of an
// affidavit, the opening recital must include the sworn oath language. All
// acting trustees MUST sign, unlike other states where any single trustee
// may sign. See § 30-38,102.

SECTION 1: TRUST EXISTENCE AND DATE

1.1 Trust Existence

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(1), the undersigned affirm under oath that a trust currently exists, known as:

Trust Name: [________________________________]

(hereinafter referred to as the "Trust").

1.2 Date of Creation

☐ Inter Vivos Trust: The trust instrument was executed on [__/__/____].

☐ Testamentary Trust: The trust was created under the Last Will and Testament of [________________________________], who died on [__/__/____].

// GUIDANCE: Per § 30-38,103(a)(1), for an inter vivos trust, provide the date
// of execution; for a testamentary trust, provide the date of death of the
// decedent. This distinction is expressly required by Nebraska statute.

SECTION 2: GRANTOR/SETTLOR AND TESTATOR IDENTIFICATION

2.1 Identity of Grantor, Settlor, or Testator

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(2), the identity of the Grantor, Settlor, or Testator of the Trust is:

// GUIDANCE: Nebraska uses the terminology "grantor, settlor, or testator" in
// § 30-38,103(a)(2), recognizing that the trust creator may be identified by
// any of these terms depending on the type of trust.

SECTION 3: CURRENTLY ACTING TRUSTEE(S)

3.1 Trustee Identification

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(2), each currently acting Trustee of the Trust is:

SECTION 4: TRUSTEE POWERS AND RESTRICTIONS

4.1 Powers of the Trustee

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(3), the powers of the Trustee and any restrictions imposed upon the Trustee in dealing with the assets of the Trust are as follows:

The Trustee has the following powers under the trust instrument and/or Neb. Rev. Stat. § 30-3880:

☐ To acquire, sell, exchange, convey, and otherwise deal with real and personal property
☐ To open, maintain, and close bank and financial accounts
☐ To borrow money, with or without security, and to encumber trust property
☐ To lease trust property for any term
☐ To invest and reinvest trust assets in any form of property or investment
☐ To collect, receive, and receipt for rents, income, and other trust proceeds
☐ To employ attorneys, accountants, investment advisors, and other professionals
☐ To execute deeds, contracts, promissory notes, and all instruments
☐ To manage, improve, maintain, insure, and protect trust property
☐ To prosecute, defend, settle, and compromise claims and legal proceedings
☐ To vote stock, exercise options, and participate in corporate reorganizations
☐ To make distributions of income and principal to beneficiaries
☐ To exercise all statutory powers under Neb. Rev. Stat. § 30-3880
☐ Other powers: [________________________________]

4.2 Restrictions on Trustee Powers

// GUIDANCE: Nebraska specifically requires disclosure of any RESTRICTIONS imposed
// on the Trustee, per § 30-38,103(a)(3). This is a distinctive requirement.

☐ There are no restrictions on the Trustee's powers beyond those set forth in the trust instrument and applicable law.

☐ The following restrictions are imposed on the Trustee's powers:

[________________________________]
[________________________________]
[________________________________]

SECTION 5: SUCCESSOR TRUSTEES

5.1 Name or Method of Choosing Successor Trustees

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(4), the name or method of choosing successor Trustees is as follows:

☐ The trust instrument provides the following method for choosing successor Trustees in the event no named successor is available or willing to serve:

[________________________________]
[________________________________]

// GUIDANCE: Nebraska requires disclosure of either the specific names of successor
// trustees OR the method of choosing them under § 30-38,103(a)(4). Include both
// if available.

SECTION 6: REVOCABILITY AND POWER TO REVOKE

6.1 Revocability Status

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(5), the Trust is:

☐ Revocable — The Trust may be revoked by the following person(s):

☐ Irrevocable — The Trust may not be revoked.

// GUIDANCE: Under the Nebraska Uniform Trust Code (Neb. Rev. Stat. § 30-3834),
// the settlor may revoke or amend a revocable trust unless the terms of the
// trust expressly provide that the trust is irrevocable.

SECTION 7: CO-TRUSTEE AUTHORITY

7.1 Co-Trustee Signing Requirements

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(6), if there is more than one Trustee, the following describes whether all of the currently acting Trustees must, or if less than all may, act to exercise identified powers of the Trustee:

☐ All currently acting Trustees must act jointly to exercise any power
☐ A majority of Trustees may act to exercise powers
☐ Any single Trustee may independently exercise powers
☐ Other arrangement: [________________________________]

SECTION 8: TRUST IDENTIFICATION NUMBER

8.1 Trust Identification Number

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(7), the identifying number of the Trust is:

Number: [________________________________]

☐ This is a Social Security Number (SSN) — used because the Trust is a grantor trust.
☐ This is an Employer Identification Number (EIN).

// GUIDANCE: Nebraska is one of the few states that REQUIRES disclosure of the
// trust's tax identification number in the certification. Exercise appropriate
// caution when disclosing Social Security Numbers. Consider whether a redacted
// version is sufficient for the requesting party's needs.

SECTION 9: BENEFICIARY IDENTIFICATION

9.1 Name of Each Beneficiary and Relationship to Grantor

Pursuant to Neb. Rev. Stat. § 30-38,103(a)(8), the name of each beneficiary and the relationship to the Grantor, Settlor, or Testator is:

// GUIDANCE: This is a CRITICAL and UNIQUE Nebraska requirement. Most states
// expressly do NOT require beneficiary disclosure in a certification of trust.
// Nebraska § 30-38,103(a)(8) mandates that each beneficiary's name AND their
// relationship to the grantor/settlor/testator must be included. This should
// be carefully discussed with the client regarding privacy concerns. There is
// no statutory exception to this requirement.

SECTION 10: TRUST PROPERTY AND TITLE

10.1 Form of Title

Pursuant to Neb. Rev. Stat. § 30-38,103(b), the name under which the Trust will take and hold assets is:

[________________________________]

10.2 Jurisdiction of Formation

Pursuant to Neb. Rev. Stat. § 30-38,103(b), the Trust was formed under the laws of the State of:

[________________________________]

10.3 Real Property Description (If Applicable)

If this Certification relates to a transaction involving real property situated in Nebraska, the legal description is:

[________________________________]
[________________________________]
[________________________________]
[________________________________]

County: [________________________________], Nebraska

☐ See attached Exhibit A for complete legal description.

// GUIDANCE: For Nebraska real property, include the full legal description
// including lot, block, and addition (for platted property) or section,
// township, and range (for unplatted/rural property).

SECTION 11: NEBRASKA STATUTORY DISCLOSURES

11.1 Purpose and Use of Certification

Pursuant to Neb. Rev. Stat. § 30-38,102, this Certification of Trust is an affidavit signed by each acting Trustee, containing sworn statements made in the presence of a notary public, which verifies the existence of the Trust and is an abstract of relevant provisions of the Trust in lieu of the entire trust instrument. This Certification may be presented by a Trustee or requested by any person doing business with a Trustee, particularly in transactions involving real property.

11.2 Reliance by Third Parties

Pursuant to Neb. Rev. Stat. § 30-38,104, any person may rely upon the statements contained in this Certification of Trust as factual. 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.

11.3 No Duty to Inquire

Pursuant to Neb. Rev. Stat. § 30-38,104, a person who relies in good faith upon this Certification of Trust need not inquire into the terms of the trust instrument or determine whether the Trustee is acting within the scope of the Trustee's authority.

11.4 Recording

This Certification of Trust may be recorded in the Register of Deeds office of the county in which any trust real property is located.

SECTION 12: CERTIFICATION STATEMENT

12.1 Sworn Certification

Pursuant to Neb. Rev. Stat. § 30-38,103(c), the undersigned Trustee(s) hereby certify and affirm under oath that:

(a) The Trust described herein currently exists and has not been revoked;

(b) The Trust has not been revoked or amended to make any representations contained in this Certification of Trust incorrect;

(c) The signatures below are those of ALL of the currently acting Trustees of the Trust;

(d) All information set forth herein is true, correct, and complete to the best of each affiant's knowledge and belief;

(e) The undersigned are the duly appointed, qualified, and currently acting Trustees of the Trust.

// GUIDANCE: Per § 30-38,103(c), the certification MUST include the statement
// that signatures are those of ALL acting trustees, and that the trust has not
// been revoked or amended to make representations incorrect. This is mandatory.

SECTION 13: EXECUTION BY ALL ACTING TRUSTEES

// GUIDANCE: Nebraska law requires ALL acting trustees to sign this affidavit,
// unlike other UTC states where any single trustee may sign. See § 30-38,102.
// If there are multiple trustees, EACH must sign and each signature must be
// notarized.

Trustee Signature — First Trustee

Signature: ________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

Trustee Signature — Second Trustee (if applicable)

Signature: ________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

Trustee Signature — Third Trustee (if applicable)

Signature: ________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

SECTION 14: NOTARIZATION (REQUIRED)

// GUIDANCE: Nebraska REQUIRES notarization because the certification must be
// in the form of an affidavit (sworn statement before a notary). See § 30-38,102.
// The document must be "signed and acknowledged by all acting trustees."

STATE OF NEBRASKA

COUNTY OF [________________________________]

Before me, the undersigned Notary Public, on this [______] day of [________________________________], [________], personally appeared:

[________________________________]
[________________________________]
[________________________________]

each personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the foregoing Affidavit, and each being by me first duly sworn, did depose and state that the matters set forth in the foregoing Certification of Trust are true, correct, and complete to the best of each affiant's knowledge and belief, and acknowledged that they executed the same as all of the currently acting Trustees of the Trust described herein.

WITNESS my hand and notarial seal.

Notary Public Signature: ________________________________________

Printed Name: [________________________________]

My Commission Expires: [__/__/____]

Notary Registration Number: [________________________________]

[NOTARY SEAL]

// GUIDANCE: Nebraska notary requirements are governed by Neb. Rev. Stat. §§ 64-101
// through 64-215. Nebraska notaries must include their registration number.
// The notary must verify the identity of ALL acting trustees who sign.

SECTION 15: NEBRASKA-SPECIFIC PRACTICE NOTES

15.1 Nebraska Uniform Trust Code

Nebraska adopted the Nebraska Uniform Trust Code, codified at Neb. Rev. Stat. §§ 30-3801 through 30-38,110. Nebraska's certification of trust provisions are unique in that they are spread across three separate statutes (§§ 30-38,102 through 30-38,104), rather than a single section as in most UTC states.

15.2 Beneficiary Disclosure Requirement

Nebraska is one of the few states that requires disclosure of beneficiary names and their relationship to the grantor in a certification of trust (§ 30-38,103(a)(8)). Attorneys should counsel clients about this privacy concern and explore whether the requesting party will accept a redacted version or alternative proof of trust existence.

15.3 Affidavit Requirement

Unlike most states, Nebraska requires the certification to be in the form of a sworn affidavit, not merely a signed certification. This means the document must be executed under oath before a notary public.

15.4 All Trustees Must Sign

Nebraska requires all acting trustees to sign the certification (§ 30-38,102). This differs from many UTC states where any single trustee may sign. Plan accordingly if co-trustees are in different locations.

15.5 Tax Identification Number Disclosure

Nebraska requires disclosure of the trust's tax identification number (§ 30-38,103(a)(7)). If the trust uses the grantor's Social Security Number, exercise caution in disclosing this information and consider whether a redacted version is appropriate.

15.6 Amendments

If the trust is subsequently amended in a manner that renders any representation in this Certification incorrect, a new Certification should be promptly executed by all acting Trustees.

This Certification of Trust has been prepared pursuant to and in compliance with the Nebraska Uniform Trust Code, Neb. Rev. Stat. §§ 30-38,102 and 30-38,103. This document should be reviewed by a Nebraska-licensed attorney before execution.

EXHIBIT A — LEGAL DESCRIPTION OF REAL PROPERTY
(Attach if applicable)

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]