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Verification Of Stocks And Other Securities 15-UVS - Minnesota

Verification Of Stocks And Other Securities Form. This is a Minnesota form and can be used in Guardianship-Conservatorship District Court Statewide .
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State of Minnesota County of In Re: Conservatorship of , Protected Person District Court Judicial District: Probate / Mental Health Division Court File No. Case Type: 14, Conservatorship Verification of Stocks and Other Securities By Broker / Financial Advisor / Financial Institution (File as a Financial Source Document with Form 11.2) To: Name and Address of Financial Institution: I am the court appointed conservator in this matter and your financial institution has stocks and other securities for the above named protected person. Please provide me with verification of the assets listed below as of the following date: by completing and signing the bottom portion of this form and affixing your official seal. Dated: Signature of Conservator Conservator's name and address: Verification of Funds on Deposit by Financial Institution I certify that the foregoing amounts were on deposit as shown by the records of this financial institution listed below. The accounts listed below were accurate as of this date: Account Information: Name of Stock or Account Title Number of Units/Shares Note: Attach a separate sheet if more space is needed to list account information / remarks. By: SIGNATURE OF CERTIFYING BROKER / FINANCIAL ADVISOR / FINANCIAL INSTITUTION OFFICIAL DATE TITLE OF CERTIFYING OFFICIAL (Please affix official seal on this form) 15-UVS State ENG Rev 9/09 www.mncourts.gov/forms Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com
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