| IF THE GRANTOR OR GRANTEE IS: | PLEASE PROVIDE THE FOLLOWING: |
|---|---|
| A Corporation | State of Formation, and who the Authorized Signer(s) will be and their title(s) |
| A General Partnership | State of Formation, and who the Authorized Signer(s) will be and their title(s) |
| A Limited Partnership | State of Formation, and who the Authorized Signer(s) will be and their title(s) |
| A Limited Liability Company | State of Formation, and who the Authorized Signer(s) will be and their title(s) |
| A Trust | Name of each Trustee, Complete Name of Trust and Date of Trust Agreement |
| An Estate | Name of personal representative and name of decedent, if necessary provide papers showing authority |