GIFTS UNDER
UNIFORM GIFTS TO MINORS ACT

I, _________(1)________, an adult person, as donor, hereby deliver to _________(2)________, as custodian for ______(3)______ under the Gifts to Minors Act of the State of _____(4)____, the property described in Exhibit "A" which is attached hereto and by reference incorporated herein.

DATED: ________(5)________.

______________(6)______________

I, ________(7)_________, as custodian, hereby acknowledge receipt of the property described in Exhibit "A" which is attached hereto and by reference incorporated herein, as custodian for the above-named minor under the Gifts to Minors Act of the State of ______(8)_____.

DATED: ________(9)_______.

_____________(10)______________

EXHIBIT "A"

(Description of Property)

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