MC­355 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NAME: CASE NUMBER: ORDER TO DEPOSIT MONEY INTO BLOCKED ACCOUNT 1. The petition of (name): as (specify capacity): blocked accounts came on for hearing on (date): in Dept.: to deposit funds in a blocked account or at (time): THE COURT ORDERS 2. Money that belongs to (name): shall be deposited in an interest-bearing, federally insured blocked account or accounts. 3. Each account shall indicate the name of the minor or other person who owns the account. 4. The total amount authorized for deposit, including any accrued interest, is: $ 5. Withdrawals (check a or b): a. No withdrawals of principal or interest shall be made from the blocked account or accounts without a written order under this case name and number, signed by a judge, and bearing the seal of this court. The money on deposit is not subject to escheat. The blocked account or accounts belong to a minor. The minor was born on (date): No withdrawals of principal or interest shall be made from the blocked account or accounts without a written order under this case name and number, signed by a judge, and bearing the seal of this court, until the minor attains the age of 18 years. When the minor attains the age of 18 years, the depository, without further order of this Court, is authorized and directed to pay by check or draft directly to the former minor, upon proper demand, all moneys including interest deposited under this order. The money on deposit is not subject to escheat. b. 6. The petitioner and the petitioner's attorney, if any, shall deliver a copy of this order to each depository in which funds are deposited under this order. The depository's acknowledgment of receipt of the order and the funds shall be filed with this court within 15 days of deposit. Date: JUDGE OF THE SUPERIOR COURT Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California MC-355 [Rev. January 1, 2007] ORDER TO DEPOSIT MONEY INTO BLOCKED ACCOUNT Code of Civil Procedure, § 372; Probate Code, § 3600, et seq.; Cal. Rules of Court, rules 3.1384, 7.953 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com