Proof Of Blocked Accounts {PROF}

1 PROF 2 3 4 5 DISTRICT COURT 6 CLARK COUNTY, NEVADA 7 8 In the Matter of the Guardianship of 9 10 CASE NO. 11 DEPT. NO. 12 13 A(n) Adult/Minor Ward. 14 15 PROOF OF BLOCKED ACCOUNTS 16 (GUARDIANSHIP) 17 18 The undersigned affirms that , as Guardian of the Estate of , a Ward, 19 has established an account, being Account No. , entitled , in the cash 20 sum of $ and/or for the securities and other personal assets listed on the 21 attachment to this Proof. 22 The undersigned acknowledges that these accounts bear a blocked/frozen 23 designation, and that no money, securities or personal asset may be withdrawn without 24 . . . 25 26 27 28 Proof Of Blocked Accounts {PROF}.doc/3/16/2005 American LegalNet, Inc. www.USCourtForms.com <<<<<<<<<********>>>>>>>>>>>>> 2 1 first presenting an Order from the Court authorizing the withdrawal. 2 DATED this day of , 20 . 3 ________________________________ 4 Name of Financial Entity 5 By:_____________________________ 6 Authorized Officer 7 Title:____________________________ 8 Submitted By: 9 ___________________________________ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 of _E n titAleffmt_ent_to Estate.doc 05/04 American LegalNet, Inc. www.USCourtForms.com