ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address and Telephone No.): ATTORNEY FOR (Name): FOR COURT USE ONLY ATTORNEY BAR # SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Street Address: 341 The City Drive Mailing Address: Post Office Box 14171 City and Zip Code: Orange, CA 92863-1571 IN THE MATTER OF FUNDS BELONGING TO: 9A Minor 9Conservatee 9 Deceased PETITION FOR AUTHORITY TO WITHDRAW FUNDS DEPOSITED PURSUANT TO COURT ORDER CASE NUMBER: PETITIONER________________________________________________________________respectfully represents: 1. Petitioner is the G ______________________________________ of the above-named person. (PARENT/GUARDIAN/CONSERVATOR) G ______________________________________ of the above-entitled estate. (TRUSTEE/PERSONAL REPRESENTATIVE) G above-named former minor who is now 18 years of age or older. 2. By order filed on (date)________________________, the Court required the deposit in the sum of $__________________ in a blocked account in _________________________________________________ (NAME AND ADDRESS OF DEPOSITORY) __________________________________________________________________________________________________________. 3. Pursuant to such order on (date)__________________________, the funds were deposited accordingly in Account No. ___________________________, held in the name(s) of _______________________________ _______________________________________________________________________________________. 4. Deposits to and withdrawals from the account have been made as follows: Amount of Initial Deposit: $_____________________ Accumulated Income and Interest Deposits to Date: $_____________________ Total Deposits: $______________________ Withdrawals Date Purpose Amount _______________ ________________________________ $____________________ _______________ ________________________________ $____________________ _______________ ________________________________ $____________________ (If additional space is needed, insert separate page and attach to this petition). Total withdrawals from this page and all attachments $______________________ Balance of funds on hand $______________________ (Continued on Reverse) 69 (R1/99) PETITION FOR AUTHORITY TO WITHDRAW FUNDS DEPOSITED PURSUANT TO COURT ORDER 2000 © American LegalNet, Inc. 5. All previous withdrawals by petitioner have been used solely for the purposes authorized. 6. Petitioner now requests authority to withdraw the following amount for the purpose stated: Purpose (Explain in Detail - Use Attachments if Necessary) Amount ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ 7. $______________________ (Complete if funds were deposited for a minor) The minor was born on _______________________________ is now _______years of age, and attends school at _______________________________________________. Petitioner believes it is necessary and appropriate to withdraw funds from the minor’s blocked account for the following reasons (complete applicable section): G G 8. the minor has now reached the age of majority the parents of the minor are financially unable to pay for the requested expenditure as shown in the attached Income and Expense Declarations. If the minor is employed, a statement of employment and income is attached. WHEREFORE, petitioner prays that the Court authorize the withdrawal as requested. __________ _____________________________ DATE (SIGNATURE OF MINOR IF 14 YEARS OF AGE OR OLDER) __________ DATE ______________________________ (SIGNATURE OF PETITIONER/ FORMER GUARDIAN/FORMER TRUSTEE) VERIFICATION I am the petitioner in the above-entitled matter. I have read the foregoing petition and know the contents thereof. All of the statements are true of my own knowledge, except as to those matters which are stated therein on information and belief, and as to those matters, I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the above is true and correct. ______________________________ (DATE) ____________________________________________ (SIGNATURE OF PETITIONER) IT IS THE DUTY AND POLICY OF THE COURT TO PROTECT THE FUNDS OF MINORS AND NOT TO ALLOW WITHDRAWALS EXCEPT IN VERY URGENT AND UNUSUAL SITUATIONS. IT IS THE DUTY OF THE PARENTS OF MINORS TO PROVIDE FOR THEIR SUPPORT AND EDUCATION. FUNDS BELONGING TO MINORS SHOULD NOT ORDINARILY BE USED FOR SUCH PURPOSES. THE COURT WILL NEVER ALLOW WITHDRAWALS FOR THE BENEFIT OF PARENTS OR ANY PERSON OTHER THAN THE MINOR AND WILL NEVER ALLOW ANY COMMINGLING OF THE MINOR’S FUNDS WITH FUNDS OR ASSETS OF PARENTS. 69 (R1/99) PETITION FOR AUTHORITY TO WITHDRAW FUNDS DEPOSITED PURSUANT TO COURT ORDER 2000 © American LegalNet, Inc.