Acceptance of Trust as Executor Form

Full Names and Surname:

Residential Address:

Business Address:

Telephone Numbers:

Identity Number:

Relationship to Deceased:

Deceased Full Names and Surname:

Deceased Date of Birth:

Deceased Date of Death:

Deceased Identity Number:

Deceased Income Tax Reference Number:

District where Deceased Resided:

Surviving Spouse Name:

Domicilium Citandi et Executandi:

Bond Security Value (R):

Agent Name and Address:

Location of Signing:

Signing Date: