1. Settlor: 

2. Foreign Trustee: 

3. Alternative Trustee: 

4. Revocable Irrevocable 

FIRST SCHEDULE

Assets to be Settled on Trust

To be described in First Schedule of Trust Deed or transferred by Deed of Donation 

Company Name 

Jurisdiction of Incorporation 
 

No. of Shares   Percentage of Total Issued Shares 
 

Manager 

Address 

Other Assets to be Settled 
 
 
 

SECOND SCHEDULE

Other Beneficiaries During Life of Settlor 

Please provide on separate sheet information if more beneficiaries during life of Settlor 

Settlor Yes No

Name 

Relationship to Settlor 

Contact Address 

Telephone 

Fax 
 

THIRD SCHEDULE

Beneficiaries After Death of Settlor 
 

Name 

Place and Date of Birth 

Relationship to Settlor 

 Contact Address 

Telephone 

Fax 
 

Name 

Place and Date of Birth 

Relationship to Settlor 

Contact Address 

Telephone 

Fax 
 

Name 

Place and Date of Birth 

Relationship to Settlor 

Contact Address 

Telephone 

Fax 
 
 

Name 

Place and Date of Birth 

Relationship to Settlor 

Contact Address 

Telephone 

Fax 
 

FOURTH SCHEDULE

Protector

Name: 

Contact Address: 

Telephone: 

Fax: 

Power to Remove and Appoint New Protector 

Name: 

Nationality: 

Contact Address: 

Telephone 

Fax 
 

FIFTH SCHEDULE

Persons with Power to Appoint New Trustees

Settlor Yes No

If not Settlor 

Name 

Nationality 

Contact Address 

Telephone 

Fax 
 
 

Person with Power to Appoint New Trustee, After Death of Settlor

Protector Yes No

If not Protector 

Name 

Nationality 

Contact Address 

Telephone 

Fax