District Court Denver Probate Court __________________ County, Colorado Court Address: In the Interests of: COURT USE ONLY Case Number: Protected Person/Minor Division: Courtroom: ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT AND ANNUAL FILING OF RESTRICTED ACCOUNT REPORT THE COURT finds the limited nature of the protected person's account does not justify the establishment of a conservatorship. It is therefore Ordered that ________________________________________ (name of Fiduciary) shall open an account in a federally insured financial institution for the sole benefit of the Minor/Protected Person. The account shall be opened on behalf of the Minor/Protected Person. The account shall be opened using the sample title, "____ (Name of Fiduciary) as Next Friend/Parent for _____ (Name of Minor/Protected Person)". The Fiduciary shall deposit $ _______________________ and funds received subsequently into the account. This person may make internal transfers of funds in order to take advantage of changes in interest rates. It is Ordered that, except for internal transfers, the financial institution shall permit no withdrawals from the account(s), except by separate certified Order of this Court. It is Ordered that an Acknowledgment of Deposit of Funds to Restricted Account (JDF 867) must be returned to the Court within 30 days. No attorney fees may be paid in this case until the Acknowledgment form is signed and returned to the Court. It is further Ordered that the fiduciary shall file a Restricted Account Report (JDF 896) along with a copy of the most recent bank statement for the restricted account each year on the Minor's/Protected Person's birthday __________________________________(date) or on ______________________________(date). Failure to file an annual Restricted Account Report and bank statement may result in the imposition of sanctions by the Court which could include removal of the fiduciary from further duties and an order freezing the restricted account until further order of the Court. The Court may also order the appointment of a professional fiduciary. The Court further orders: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ JDF 866 R8/15 ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT AND ANNUAL FILING OF RESTRICTED ACCOUNT REPORT ©2015 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com Copies of all future court filings shall be provided to the following interested persons: Name Relationship to Minor/Protected Person Minor/Protected Person if 12 years or older Parent or adult nearest in kinship Other: Dated: __________________________ ___________________________________________ Judge Magistrate JDF 866 R8/15 ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT AND ANNUAL FILING OF RESTRICTED ACCOUNT REPORT ©2015 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com