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Deed and Assignment / Supplemental Trust Schedule

INSTRUCTIONS Deed and Assignment / Supplemental Trust Schedule

Complete this form and make a photocopy. Sign the original and the photocopy in the presence of a Notary Public. Retain one copy for your records and return the other copy to Lee Kiefer & Park, 1707 Village Center Circle, Suite 150, Las Vegas, Nevada 89134-1655, Telephone (702) 333-1711. Each paragraph below contains brief instructions for completing the corresponding section of the form.

1. Grantor(s). Insert the name of the person(s) transferring the property to the trust exactly as shown on the applicable ownership documents. This is usually the Settlor(s) or Grantor(s) of the Trust, but it does not have to be. If the ownership documents for different assets reflect different forms of a grantor’s name, each form should be mentioned. [NOTE: Before listing an asset owned jointly with one or more non-Settlors, please contact us to see if the other joint owner(s) should also sign the supplemental schedule and/or another transfer document.]

2. Trustee. Insert the name(s) of the current Trustee(s) of the Trust.

3. Trust. Insert the name of the Trust. If the document does not give the trust a name, insert “Trust established by <name(s) of Settlor(s)>”.

4. Date of Trust. Insert the date the original Trust document was signed. [Amendment dates are unnecessary.]

5. Assets Transferred to the Trust. Describe each asset not shown on a prior trust schedule. EXAMPLES:

a. Checking account 123456 with Second Interwest Bank and Trust Company, Charleston Heights Branch, 6000 West Charleston, Las Vegas, NV 89102.

b. Lot 7, Block 4, of Red Cliffs Subdivision IIB, as shown on the map thereof in Book 7 of Plats, Page 45, in the records of Clark County, Nevada. (Assessor’s Parcel No. 200-234-123-234)

c. 100 shares of the common stock of Cielo Azul, Inc., a Nevada Corporation, 536 South Fourth Street, Suite 1400, Las Vegas, NV 89134-1655.

d. 2017 Saturn SL2, Serial No. XYC12390NIJ18576Q.

6. Assets No Longer In Trust. Itemize assets listed on previous trust schedules which are no longer assets of the trust. You may describe the asset or refer to the previous schedule. EXAMPLES:

a. 2017 Cadillac Coupe de Ville (Schedule 2 dated 1-6-82, Item Three).

b. Office building at 9536 South Fourth St., Las Vegas, NV 89134-1655 (Supplemental Schedule dated 1-4-89, Section E.)

7. Additional Pages. If the space on the form is insufficient, attach additional sheets as needed. Be sure to clearly distinguish between newly listed trust assets (Section E) and assets no longer in the trust (Section F).

8. Date. Fill in the date this form is signed.

9. Signature(s). Each grantor named in Section A should sign his or her name as it appears on the document(s) of title. Be sure to type or print each name under each signature line exactly as it was signed.

10. Notary. This form should be signed in the presence of a Notary Public. Be sure that all blanks are filled in, including the name of the County and the State, the date, and the name of each grantor as it was signed.

Listing the assets on a Trust Schedule is not a reliable substitute for changing ownership documents to reflect ownership by the Trust or its Trustee(s).


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