Missouri > Local Circuit Courts > 7th Circuit (Clay County) > Probate > Minors And Adults
Agreement To Accept Restricted Account 412 - Missouri
| Agreement To Accept Restricted Account Form. This is a Missouri form and can be used in Minors And Adults Probate 7th Circuit (Clay County) Local Circuit Courts . |
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CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of , *minor - *disabled. AGREEMENT TO ACCEPT RESTRICTED ACCOUNT The Hereby contracts and agrees to restrict and/or accept a transfer of funds directly from on behalf of , as Conservator of the estate of , *minor - *disabled; and further agrees that said funds, accumulated interest, and any subsequent deposits, will be placed in a federally insured investment as designated by Conservator and; said funds will not be released to the possession or control of the Conservator except upon order of the Court. THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date: Depository Address By Title *strike if inapplicable Form 412 Page 1 of 1 Revised 3/14/2003
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