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[This document in MS Word format]
I, ___________________________ , do hereby consent to serve as an initial trustee of (name of corporation).
Signature _________________________
Typed name
STATE OF NEW YORK )
ss:
COUNTY OF ____________)
On this ___________ day of ____ 20 before me personally came (insert name of trustee) to me known to be the person described in and who executed the foregoing application, and (s)he duly acknowledged to me that (s)he executed the same.
(Typed name, stamp and signature of notary public)