Receipt (Acknowledgment Of Receipt Of Minor)

MISSOURI CIRCUIT COURT, TWENTY-SECOND JUDICIAL CIRCUIT PROBATE DIVISION, CITY OF ST. LOUIS In the matter of the Estate of No. a minor R E C E I P T Received of Conservator, the following personal property, in full settlement and satisfaction of all moneys or property whatsoever due or coming to me on final settlement of my estate, as per order of the Probate Division of the Circuit Court, City of St. Louis heretofore entered herein, to wit: (Signature of Protectee) STATE OF MISSOURI } SS CITY OF ST. LOUIS } On this day of , , before me, a Notary Public, personally appeared (Protectee) to me known to be the person described in and who executed the foregoing receipt and acknowledged that he executed the same as h own free act and deed; and the said protectee did declare h self to be of lawful age. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal the day and year above written. Notary Public My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com