"CERTIFICATE OF INDEPENDENT REVIEW
I, _________ , have reviewed
(attorney's name)
_________ and have counseled the transferor,
(name of instrument)
_________ , on the nature and consequences of any
(name of transferor)
transfers of property to _________
(name of person described in § 33-19.1-3) that would be made by the instrument.
I am an "independent attorney" as defined in § 33-19.1-2 and I am in a position to advise the transferor independently, impartially, and confidentially as to the consequences of the transfer. On the basis of this counsel, I conclude that the transfers to __________ that would (name of person described in § 33-19.1-3) be made by the instrument are not the product of fraud or undue influence.
_________________________"
(Name of Attorney) (Bar#) (Date)
R.I. Gen. Laws § 33-19.1-5