Appendix B - Blank Forms

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2. Statement of Gift



I ________________________________________________________________(name of donor)

_________________________________________________________________ (address)

____________________________________________________________ (city, state, zip code)

desire and intend to make a gift of certain personal property, relinquishing all right, title, interest, and literary property rights in and to that property. To effectuate this intent, I hereby give, transfer, and deliver to

______________________________________________________ (name of recipient)

_______________________________________________________ (address)

_________________________________________________________ (city, state, zip code)

the property described herein:


(put description here)


This gift is made without any restrictions or conditions unless such restrictions are noted on the face of this instrument.

____________________________________________ (donor signature)

___________________________ (date)

____________________________________________ (witness signature)


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