The

*
Declaration and Instrument of Trust
Revocable Trust Agreement

This Revocable Trust Agreement made effective and dated the ____ day of
_______________________, 20, is between *, as Grantor and said * as Trustee, and is
designated the “* REVOCABLE TRUST” dated ____________________________.

I. TRUST NAME
This Trust shall be known as the “* REVOCABLE TRUST.”

II. BACKGROUND
A. The Grantor and the Trustee are as above designated.
B. The named Beneficiaries under this instrument are: Grantor’s
(relation/name) * of (city/state)*.
C. The terms “Trustee(s)” or “Successor Trustee(s)” as used throughout this
instrument shall refer to whomever shall be acting as trustee or trustees from time to
time of the trust or trusts provided for herein. Said terms shall also include any
corporate trustee or professional individual trustee subsequently appointed.

III. ESTABLISHMENT AND PURPOSE OF TRUST

Simultaneously with the execution of this instrument, Grantor has transferred to
*her/himself as Trustee certain assets constituting the initial principal of this trust, thereby
establishing this Trust. Grantor declares that it is Grantor’s purpose in establishing this
Trust to provide a means for the conservation and management of income producing
assets and other properties, to provide for the comfortable maintenance, support,

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welfare, education, and medical care of Grantor and Grantor’s family, and to provide for
the disposition of the trust assets thereafter.

IV. TRUST PROPERTY

A. * called the “Grantor” or “Trustor,” declares that *she/he has set aside and
holds in the Revocable Trust all Grantor’s interest in that property described in the
attached Schedule “A”.
The trust property shall be used for the benefit of the trust beneficiary, and shall
be administered and distributed by the Trustee in accordance with this Trust instrument.
B. Additional or after-acquired property may be added to the Trust by listing it
on the appropriate schedule.

V. LIFETIME RESERVATIONS BY GRANTOR

A. Grantor reserves the power and right, exercisable from time to time and at
all times, by written direction signed by Grantor, and effective upon delivery to Trustee
(or to any beneficiary if for any reason there shall then be no Trustee):
(1) to revoke this instrument and the trust or trusts created thereby in
their entirety, and to receive back from Trustee all of the then trust properties
(after making payment or provision for payment of all expenses connected with
the administration thereof);
(2) to alter, amend, or otherwise modify this instrument and the trust or
trusts created thereby in any and every particular (except the powers and duties
of Trustee, which may be so altered only with the consent of said Trustees);
(3) to change the identity or number or both of the Trustee;
(4) to withdraw from the principal and operation of this Trust some or all
of the trust properties; and
(5) to authorize and direct Trustee to hypothecate some or all of the
trust properties for the debts of Grantor or others.

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 B. With respect to all life insurance policies which at any time may be part of
the trust properties, Grantor reserves the power and right, exercisable from time to time
and at all times, without the necessity of written direction to the Trustee:
(1) to sell, assign, or hypothecate any or all of said policies;
(2) to exercise any option or privilege granted by said policies,
including, without limitation, the right to change the beneficiaries thereof;
(3) to borrow monies from the insurer or other, and to pledge said
policies as security for said loan;
(4) to receive all payments, dividends, returns of premium, surrender
values, benefits or privileges of any kind incident to said policies;
(5) to withdraw from this Trust any or all of said policies.
C. Grantor reserves the right to reside upon any real property placed in this
Trust as Grantor’s permanent residence during Grantor’s remaining lifetime, it being the
intent of this provision to grant to Grantor the requisite beneficial interest and
possessionary right in and to such real property to comply with Section 196.041(2),
Florida Statutes, such that said beneficial interest and possessionary right shall
constitute in all respects “equitable title to real estate” as that term is used in Section 6,
Article VII, Florida Constitution. Notwithstanding anything contained in this Instrument
to the contrary, the interest of Grantor in any real property upon which Grantor resides
pursuant to the provisions of this Instrument shall be deemed to be an interest in real
property and not an interest in personalty.
D. Grantor reserves the right, exercisable from time to time and at all times, to
receive or direct the payment of, for Grantor’s direct or indirect benefit, or the direct or
indirect benefit of others, all of the income and principal of this Trust, by written direction
signed by Grantor, and effective upon delivery to Trustee.

VI. ADMINISTRATION DURING GRANTOR'S LIFETIME

During Grantor's lifetime, the trust properties shall be administered and the
principal and income thereof distributed in the following manner:

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 A. As long as Grantor serves as sole Trustee, Grantor shall carry out all the
duties of trusteeship, including without limitation, the investing and reinvesting of the
principal of the trust properties and the distributing of the net income therefrom to
Grantor or as Grantor may direct.
B. When Grantor is no longer serving as a Trustee, then the Successor
Trustee shall commence and shall continue for the balance of Grantor's lifetime (or until
Grantor directs otherwise) to collect all income from trust properties, pay all debts, fees,
charges and expenses of Grantor which Trustee has knowledge, cause to be prepared
and file all requisite tax returns and Medicare and insurance claims, and distribute the
net income to or for the direct or indirect benefit of Grantor. If in the judgment of the
Successor Trustee said net income is insufficient to provide for the comfortable
maintenance, support and medical expenses of Grantor, then the Trustee is authorized
and directed to sell and convert to cash so much of the principal of the trust properties as
necessary to meet said needs.
C. Grantor hereby expressly releases and discharges the Successor Trustee
of and from any and all claims, losses, liabilities, or causes of action which Grantor or
anyone claiming by or through Grantor shall or may have against said Trustee for any
and all actions exercised by said Trustee under this item.

VII. DISPOSITION AFTER DEATH OF GRANTOR

A. Distribution. Upon the death of Grantor, the Successor Trustee shall
distribute from the principal of the trust estate the following gifts:
*

In the event that * has not yet reached the age of 21 upon the date of Grantor’s
death, then *his/her respective gifts shall be held in a specified trust for *his/her
respective benefit.

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 B. Residual Distribution. Upon the death of Grantor, the Successor Trustee
shall distribute the rest, residue and remainder of the Trust to *.
C. Principal Distributions if Beneficiary Under 21. Whenever any part of the
principal of any trust created hereunder shall become distributable to a person who is
then less than 21 years of age, as his or her absolute property, and no specific
instructions to the contrary are contained in this Trust Agreement, Trustee may in
Trustee's discretion either:
(1) If the beneficiary is a minor, distribute the share of such beneficiary
to a Custodian (to be selected by Trustee) under the Uniform Transfers to Minors
Act or similar law of the jurisdiction in which the beneficiary resides, and upon
making such distribution Trustee shall be discharged from further responsibility for
the administration of the property so distributed to the Custodian; or
(2) Withhold distribution of such property and administer the same as a
separate trust estate hereunder, to be designated by the name of the beneficiary
for whom the separate trust estate was created followed by the word “Trust.”
Trustee shall invest and reinvest any such separate trust estate, collect the
income therefrom, and until the beneficiary thereof attains 21 years of age,
Trustee shall apply so much of the net income or principal to the maintenance,
education, support, and health of such person as Trustee deems necessary or
advisable, without the intervention of any guardian or curator, and shall
accumulate, invest and reinvest the balance of such income, if any, until the
beneficiary attains the age of 21 years, at which time Trustee shall pay over to
him or her the unexpended principal and income so withheld. With respect to the
administration of any such separate trust estate, Trustee shall have all of the
powers, authority and discretion vested in Trustee under the provisions of this
Agreement. If Trustee also serves as legal guardian of the person of a minor
beneficiary whose separate trust estate is being administered under the
provisions of this subparagraph, no presumption of irregularity or breach of
fiduciary duty shall arise by reason of Trustee having made distributions to himself

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 or herself as reimbursements for expenses incurred as such legal guardian for the
maintenance, education, support, and health of the beneficiary. Unless expressly
provided to the contrary elsewhere in this Trust Agreement, the authority
conferred upon Trustee by this paragraph shall not operate to suspend or prevent
the absolute vesting of any property in the beneficiary of the separate trust estate,
and if the beneficiary dies before attaining the age of 21 years, all of the
undistributed principal and income of the deceased beneficiary's separate trust
estate, as then constituted, shall be paid over to the estate of the deceased
beneficiary.
D. Payment of Taxes. Any estate inheritance or other death taxes which may
be imposed on the property of this Trust due to Grantor's death, whether by the laws of
the United States or of any state, shall be paid as directed in Grantor's Will or, if there is
no such direction, in accordance with the appropriate law of the State of Florida, Chapter
733.817.

VIII. APPOINTMENT OF TRUSTEE

A. Grantor shall be the initial, sole Trustee of this Trust. Grantor may change
the identity or number, or both, of the Trustee at any time during Grantor’s lifetime.
Unless Grantor provides otherwise hereafter, upon the discharge of Grantor as Trustee,
Grantor hereby appoints *, as Successor Trustee to serve in place of Grantor as Trustee.
In the event that * shall predecease the Trustee or is unable or unwilling to act as
Successor Trustee, then Grantor hereby appoints * as Alternative Successor Trustee to
serve in place of Grantor as Trustee. The Successor Trustee shall be liable,
responsible, and accountable only for those trust properties receipted for at the time of
the acceptance of appointment; further, said Trustee shall not be responsible for or liable
for any pending or completed business transactions initiated prior to said acceptance.
Further, such Successor Trustee shall be qualified and acting as Trustee immediately
upon delivery of a written acceptance in recordable form accompanied by documentation
substantiating the event causing the appointment of said Successor Trustee to any other

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then Trustee or to the then current income beneficiaries (and guardian of minor or
incompetent income beneficiaries) and to the other Trustee(s), if any, of the trust or other
trusts involved.
B. For the purposes of this item, Grantor, as Trustee, shall be considered
“disabled” upon the written certification that Grantor is physically or mentally incapable of
continuing to serve as Trustee under this instrument by: (1) the Successor Trustee, and
(2) two medical doctors practicing medicine in Grantor's county of residence. Grantor
hereby expressly releases and discharges said Successor Trustee and said doctors,
individually and jointly, of and from any and all claims or cause of action which Grantor or
anyone claiming by or through *her/him shall or may have against said Trustee and said
doctors for all actions exercised hereunder, provided that the same are exercised in
good faith and with reasonable diligence.
C. Any Trustee shall be discharged as a Trustee, without the necessity of any
other affirmative act, upon his or her: (1) dying; (2) becoming disabled; (3) being
adjudicated incompetent; or (4) submitting a written resignation to the Successor
Trustee.
D. Upon the discharge of Grantor as Trustee and continuing thereafter until
the termination of all trusts provided for in this Instrument, Successor Trustee is
authorized and empowered, but not required, from time to time, to appoint a corporate
trustee or an individual professional trustee to serve as an additional Trustee. Said
corporate trustee or individual professional trustee shall serve at the pleasure of said
Successor Trustee. Any corporate or individual professional fiduciary authorized by the
law of any state to serve as a fiduciary shall be eligible for appointment. Each such
corporate trustee or individual professional trustee shall be liable, responsible, and
accountable only for those trust properties receipted for at the time of his or her
acceptance of appointment; further, said corporate trustee shall not be responsible for or
liable for any pending or completed business transactions initiated prior to said
acceptance. Further, each said corporate trustee shall be qualified and acting as
trustee immediately upon delivery of its written acceptance in recordable form to said

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Successor Trustee without the necessity of any other act, conveyance, or transfer from
any personal representative, prior trustee, or other person, or any order of any court.
Recordation of this trust instrument and of said written acceptance shall vest title in said
corporate trustee to all real properties held under this trust instrument.
E. As compensation for services rendered, each corporate Trustee shall
receive fees according to its schedule of fees in existence at the time said services are
rendered, or such other arrangement for compensation as may be agreed upon between
said trustee and the Successor Trustee; and each individual professional trustee shall
receive such fees as may be agreed upon from time to time between said trustee and
said Successor Trustee.
F. The Trustee shall be relieved of all further liability for the assets of each
trust upon making final distribution of the assets thereof and receiving a receipt therefor
from the beneficiary or beneficiaries thereof.
G. No Trustee shall be required to post bond for the faithful performance of
the duties; the Trustee may operate without the supervision of any court.
H. When Grantor is no longer serving as Trustee, except as specifically
provided for elsewhere in this instrument, all of the powers and responsibilities of
trusteeship shall require the joinder and consent of a majority of the then Trustees.
Notwithstanding the foregoing, any one Trustee shall be authorized and empowered to
deposit and withdraw from checking accounts, money market accounts, certificates of
deposit and other cash deposits of trust properties, upon his or her signature only and
without the joinder of any other Trustee.

IX. TRUSTEE'S POWERS AND RESPONSIBILITIES

All Trustees under this trust instrument shall be governed by the provisions of
Section 736.0801 and Chapter 738, Florida Statutes, not in conflict with this instrument,
and shall have all additional powers and responsibilities granted and imposed by statute
to trustees at the time of application thereof that are not in conflict with this instrument;
and in addition thereof, and not in limitation of any common law or statutory authority,

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and without application to any court, said Trustee shall have the following powers and
responsibilities:
A. To purchase, buy, acquire, retain, improve, manage, protect, invest,
reinvest, exchange, lease, grant, bargain and sell, or option to grant, bargain and sell,
borrow, mortgage, pledge, transfer, and convey trust properties in real property, tangible
personal property, and intangible personal property (including without limitation stocks,
bonds, obligations, mortgages, money market accounts, checking accounts, and other
cash deposits, and other securities and interests therein), without regard to any law,
court ruling, or rule or regulation governing fiduciaries in such manner, and on such
terms without limit as to time as Trustees may deem advisable, even for terms beyond
the expected term of any trust provided for herein; to open, maintain, and operate
checking accounts, money market accounts, and other cash deposits, and brokerage
accounts (not including, however, a margin account thereto to the trading in listed or
covered options) all in the name of the Trust; and to invest, reinvest, hold, and vote as an
asset of the trust properties the capital stock of any corporate trustee of any trust created
by this instrument, and to invest and reinvest said trust properties in common funds of
said corporate trustee.
B. To vote stock in any corporation or exercise voting privileges with respect
to any partnership interest or interest in any other entity for any purpose in person or by
proxy, to enter into a voting trust, to consent to an election or revocation of Corporation
status, and to participate in activities with respect to such corporation, partnership, or
other entity related to any trust created hereunder in any capacity permitted by law.
C. To invest and reinvest in any property including but not by way of limitation
bonds, notes debentures, mortgages, certificates of deposit, common and preferred
stock, shares or interest in investment trust without the requirement that such property
yield any specified amount of income as may be required by Florida law as it now exists
or may hereafter be amended.
D. To inspect, review, and monitor or require the inspection, review, and
monitoring of any and all real property held as a trust asset or tendered to the Trustees

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for the purpose of determining compliance with all laws, rules, and regulations affecting
said real property and to charge the expense thereof to the
income or principal of the trust without reimbursement or adjustments. Further, to take
all actions Trustees deem necessary to prevent, abate, clean-up, or otherwise respond
to any actual or threatened violations of said laws, rules or regulations or that are known
to pose a hazard to the environment or human health and to charge the expense thereof
to the income or principal of the trust without reimbursement or adjustments.
E. To employ counsel, accountants, or other agents for the handling of trust
business and to determine the reasonable amount to be paid for said services and make
payment thereof.
F. To accept from anyone a contribution to the principal of any trust provided
for herein to be administered under the terms of this trust instrument.
G. To pay the expenses that are reasonable in their judgment for the delivery
of all gifts and distributions.
H. To charge or credit to principal any premiums and discounts on interest-
bearing securities purchased at more or less than par.
I. To disclaim a power that they consider to be burdensome, unnecessary, or
otherwise.
J. To set aside and keep on hand whatever reserves Trustees deem wise for
anticipated expenses, including reasonable compensation for the services of said
Trustees and amounts held in reserve to provide for fluctuations in gross income.
K. To hold unproductive assets that are part of the trust properties at the time
of death of Grantor and to pay from income the costs of holding said properties, except
as may be otherwise provided for in this trust installment.
L. To elect and utilize all applicable provisions of the Code for federal estate,
gift, and income tax purposes, to affect the lowest tax liability to the trust estate and its
beneficiaries, and to extend the time for payment of said taxes; and to make or join with
any other taxpayer in effecting said elections permitted by said Code.

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 M. Notwithstanding any other provisions of this instrument to the contrary, if
any part of the trust estate consists of bonds redeemable at par and accrued interest to
date of payment for the purpose of payment of federal estate
taxes, then up to the amount of said taxes and to the extent of the par value of said
bonds, Trustee shall make payment of said taxes with said bonds.
N. If at any time in the judgment of the Trustee the value of the principal held
in any trust created under this instrument does not warrant the continuance of the trust
under the economic circumstances then existing, Trustee, in his or her sole discretion, is
authorized and empowered to terminate said trust and to distribute its assets to the
beneficiary or beneficiaries to whom income may be distributed immediately prior to said
termination; and the assets shall be distributed in the proportions in which the
beneficiaries are eligible to receive distributions of income if made.
O. Despite any of the foregoing provisions, the Trustee of each trust under this
instrument may postpone any distributions of income and/or principal otherwise required
to the then beneficiary upon or after the beneficiary's attainment of a specified age or the
death of a third person, and may postpone the termination of such trust which might
otherwise be required. The Trustee may do so if, in the Trustee's sole and absolute
discretion, the Trustee determines that the postponement is consistent with the Grantor's
overall intent to provide for and protect the beneficiary. In exercising such discretion,
the Grantor authorizes and approves the Trustee's use of such information as may be
available and pertinent, such as (a) the beneficiary's significantly impaired mental or
physical health; (b) the beneficiary's incarceration; ( c ) a pending divorce; (d) the
beneficiary's present or imminent financial difficulty; (e) a significant tax disadvantage in
making a distribution; (f) the beneficiary's affiliation with a cult, religious order, or other
organization in a manner that might result in the contribution of all or a substantial portion
of the beneficiary's assets to that organization if the Trustee determines a distribution is
not necessary for the basic health and support needs of the beneficiary; and (g) the
beneficiary's use of alcohol, drugs, narcotics, or other substance abuse. Any
postponement may be continued or renewed by the Trustee from time to time, up to and

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including the entire lifetime of the beneficiary. The Trustee's exercise of discretion in
these postponements will be final and binding upon all parties interested in this Trust.
No Trustee will at any time be held liable for any action taken or not taken pursuant to
this Section, nor will any Trustee be required to take any affirmative action pursuant to it.
No Trustee will be required to inquire into or investigate any beneficiary's status as it
may relate to this Section. If there is more than one acting Trustee and the Trustees are
not in agreement with respect to this Section, the decision of the Disinterested Trustee
will control.

X. RECEIPTS AND COVENANTS OF TRUSTEE

A. Trustee hereby receipts for the properties shown on the attached Schedule
“A” forming the initial principal of this Trust. Trustee agrees to receive and receipt for,
from time to time such further properties as may be transferred to Trustee by Grantor or
by any third person. All subsequent properties shall become a part of the principal of
this Trust, shall be subject to the terms hereof, and shall be designated on subsequent
attached receipts or schedules. (The designation on a receipt shall not, however,
constitute a condition precedent to the receipt of properties or the subjection of said
properties to the terms of this instrument.) Further, Trustee agrees to receive and
receipt for such properties as may be transferred to Trustee under the provisions of
Grantor's probated Will.
B. The Trustee agrees to hold all properties received by Trustee in trust
properties and to manage, invest, and reinvest the same, and the proceeds thereof,
pursuant to the terms of this instrument and for the uses and purposes set forth
hereinafter.
C. The Trustee agrees to use Trustee’s best efforts to collect when due and
thereafter to administer as part of the principal of this Trust the proceeds of any life
insurance policies insuring the life of the Grantor and designated to become part of this
Trust. The insurance companies having issued said policies shall have no responsibility
other than to pay to Trustee the net proceeds of said policies when the same shall

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become due and payable. Trustee shall not be required to take any legal proceedings
concerning said policies unless indemnified to their satisfaction.
D. The Trustee agrees to furnish each then income beneficiary quarterly
accountings setting forth receipts, disbursements, and assets held at the end of said
quarter. Grantor waives this requirement during Grantor’s lifetime.
E. Upon written request from Grantor, the Trustee agrees to execute any
instrument presented to Trustee by Grantor and designated to enable Grantor to avail
Grantor of any of the rights reserved to Grantor by other provisions of this Instrument.

XI. GENERAL PROVISIONS

A. Spendthrift Provision. No income or principal payable to or held for any
beneficiary shall, while in the possession of Trustee, be alienated, disposed of, or
encumbered in any manner other than by Trustee's action authorized hereby.
Throughout the duration of all trusts provided for by this instrument, no beneficiary
thereof shall have the power voluntarily or involuntarily to sell, alienate, convey, assign,
transfer, mortgage, pledge, or otherwise dispose of or encumber any principal or income
thereof or any interest whatever therein until physical distribution or payment is made to
said beneficiary and no interest of said beneficiary in or claim to any trust assets or
benefits shall be subject to the claims of said beneficiary's creditors or to judgment, levy,
execution, sequestration, garnishment, attachment, bankruptcy, or other insolvency
proceedings or any other legal or equitable process. Notwithstanding the foregoing,
nothing in this provision shall interfere with the exercise of any right or power reserved to
Grantor, expressly given herein to Trustees or to any beneficiary.
B. Presumption of Survivorship. In the event that any beneficiary under this
Trust and the Grantor die under such circumstances as to render it uncertain as to who
survived the other, then it shall be conclusively presumed for the purpose of making
distributions under this trust instrument and of property owned as an estate by the
entirety that such beneficiary shall be deemed to have predeceased Grantor or such
other beneficiary, as the case may

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be.
C. Rule Against Perpetuities. In the event the interest of any beneficiary of
any trust created hereunder shall violate the Florida Uniform Statutory Rule Against
Perpetuities as determined under Section 689.225, Florida Statutes, as amended, the
terms of such trust shall be reconstrued to require such interest to vest within the time
period specified for a valid interest under such statutory provisions. In the event it is
impossible to reconstrue the terms of such trust to require such interest to vest within the
time period specified for a valid interest under such a statutory provision, upon
termination, the property held in such trust shall be distributed free of all trusts to the
then income beneficiaries thereof, in accordance with their respective income interest in
such trust.
D. The validity of the * REVOCABLE TRUST and the construction of its
beneficial provisions shall be governed by the laws of the State of Florida.
E. If any provision of this Trust is held to be unenforceable, the remaining
provisions shall be nevertheless carried into effect.
I certify that I have read this Declaration and Instrument of Trust and that it
correctly states the terms and conditions under which the trust estate is to be held,
managed, and disposed of by the Trustee. I approve the Declaration and Instrument of
Trust.
Dated at St. Petersburg, Pinellas County, Florida, this ____ day of
__________________, 20.

______________________________________
_
*, Grantor

The foregoing instrument was signed, declared and published by * in the

presence of us, the undersigned, who, at *her/his special instance and request, to attest

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as witnesses, after the said Grantor has signed *her/his name thereto and in *her/his
presence and in the presence of each other.

_________________________________ of St. Petersburg, Florida.

Lee R. Carr, II

_________________________________ of St. Petersburg, Florida.

Peter M. Cardinal

STATE OF FLORIDA
COUNTY OF PINELLAS

I, *, declare to the officer taking my acknowledgment of this instrument, and to the

subscribing witnesses, that I signed this instrument as my Declaration and Instrument of
Trust.

______________________________________
_
*, Grantor

Acknowledged and subscribed before me by the Grantor, *, ( ) who is personally

known to me or ( ) who produced ______________________ as identification, and
subscribed by me in the presence of the Grantor and the subscribing witnesses, all on
this ____ day of _______________________, 20.

______________________________________
Notary Public
Print Name:
Commission No.:

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My Commission Expires:

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SCHEDULE “A”