Crummey Notice Template
[Trust Name]
[Trust Address]
[City, State, ZIP Code]
Date: [Date]
To: [Beneficiary Full Name]
[Beneficiary Address]
[City, State, ZIP Code]
Subject: Crummey Notice
This notice relates to the following trust:
Name of Trust: [Full Trust Name]
Date of Trust: [Trust Date]
Trustee: [Trustee Full Name]
You are receiving this notice because you are a beneficiary of the trust identified above and may have a temporary right to withdraw all or part of a recent contribution made to the trust.
Beneficiary Name: [Beneficiary Full Name]
3. Contribution to Trust
A contribution has been made to the trust as follows:
Date of Contribution: [Date]
Amount of Contribution: [Dollar Amount]
Contributor: [Name of Donor or Contributor]
Description of contributed property, if not cash:
[Describe property, if applicable]
4. Withdrawal Right
Pursuant to the terms of the trust, you have the right to withdraw up to the following amount from the recent contribution:
Withdrawal Amount Available: [Dollar Amount]
This withdrawal right is personal to you and must be exercised, if at all, within the time allowed under the trust.
5. Deadline to Exercise Right
Your right to withdraw must be exercised no later than:
[Deadline Date]
Any request to exercise this right must be received by the trustee on or before that date.
6. How to Exercise the Withdrawal Right
If you wish to exercise your withdrawal right, you must deliver written notice to the trustee stating that you elect to withdraw the amount available to you.
The written request should be sent to:
[Trustee Name]
[Mailing Address]
[Email Address, if permitted]
[Phone Number]
Delivery method permitted:
[Mail / Email / Hand Delivery / Other]
7. Effect of No Response
If you do not exercise your withdrawal right by the deadline stated above, your withdrawal right will lapse or terminate according to the terms of the trust, and the contributed property or amount remaining in the trust will continue to be held, managed, and distributed under the trust terms.
8. Additional Trust Terms
Any withdrawal you request may be subject to the specific terms, limits, and procedures stated in the trust instrument.
Additional explanation, if any:
[Insert any trust-specific language or write “None”]
9. Record of Notice
This notice is being provided to create a written record that you were informed of your withdrawal right relating to the contribution described above.
The trustee may retain a copy of this notice and any related acknowledgment, delivery confirmation, or response for trust administration purposes.
10. Trustee Signature
Sincerely,
Signature: __________________________
Name: [Trustee Full Name]
Title: [Trustee / Co-Trustee / Authorized Representative]
Date: [Date]
11. Optional Beneficiary Acknowledgment
I acknowledge receipt of this Crummey Notice.
Signature: __________________________
Name: [Beneficiary Full Name]
Date: [Date]
12. Optional Delivery Record
Method of Delivery: [Mail / Email / Hand Delivery / Other]
Date Sent: [Date]
Sent By: [Name]
Tracking, confirmation, or reference details, if any:
[Insert details]
