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Receipt Of Minor Settlement Order And Funds - Minnesota
| Receipt Of Minor Settlement Order And Funds Form. This is a Minnesota form and can be used in Civil District Court Hennepin Local County . |
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STATE OF MINNESOTA COUNTY OF HENNEPIN ____________________________________ Plaintiff/Petitioner DISTRICT COURT FOURTH JUDICIAL DISTRICT Case No. _____________________ RECEIPT OF MINOR SETTLEMENT ORDER AND FUNDS vs ____________________________________ Defendant/Respondent (Form 145.1 Provided Pursuant to Rule 145 of the Minnesota General Rules of Practice) 1. _____________________________ ("Financial Institution") acknowledges receipt of the sum of $ ______________ on behalf of _______________________________ in this action. 2. Financial Institution acknowledges receipt of the Order Approving Settlement and For Deposit into Restricted Account dated _________________ in this action, and that the funds delivered remain subject to that order in the account specified below: Name of Depository: Branch Name: Branch Address: Account Number: Date Account Opened: Current Balance: __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ $_________________________________ 3. This account is a federally insured, restricted account, and no withdrawal of either principal or interest shall be allowed by Financial Institution without a signed court order in this case. Dated: _____________ Type or Print Name _______________________________ Signature: _______________________________________ Title: ___________________________________________ Receipt Minor Settlement Funds/Order Last Revised 1/6/03 American LegalNet, Inc. www.FormsWorkflow.com
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