Washington > Local County > Spokane > Superior Court > Guardianship
Receipt Of Funds Into Blocked Financial Account GDN 04.0600 - Washington
| Receipt Of Funds Into Blocked Financial Account Form. This is a Washington form and can be used in Guardianship Superior Court Spokane Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Superior Court of Washington County of In the Guardianship of: No. Receipt of Funds into Blocked Financial Account (RCP) _______________________________, Incapacitated Person Receipt is hereby acknowledged of $____________________, deposited with the undersigned by ______________________________, who is the [ ] Guardian, [ ] Guardian ad Litem, or [ ] Attorney for (name of Incapacitated Person) ________________________________________ . The deposit was made into Account No. (last four digits) __________________________. The undersigned, financial institution agrees to hold this account and any subsequent deposits to the account and not to allow any withdrawals of the funds or securities from the institution, except under Order of this court. However, the institution may move the funds into different accounts, securities or investment vehicles without prior court order, provided the proceeds are not released from the control of the institution as a part of the transfer or transaction. This receipt is binding on all successors, transferees, assignees, agents and employees of the undersigned financial institution. I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Signed at (city) ________________________, (state) __________ on (date) _____________________. __________________________________ Signature ___________________________________ Name of Bank/Financial Institution ____________________________________ City, State, Zip Code ____________________________________________ Print Name and Title ____________________________________________ Telephone/Fax Number ____________________________________________ Email Address Receipt of Funds into Blocked Account (RCP) - Page 1 of 1 WPF GDN 04.0600 (01/2009) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
