JDF 866SC R6/19 ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT AND ANNUAL FILING OF RESTRICTED ACCOUNT REPORT Page 1 of 2 District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Protected Person/Minor COURT USE ONLY Case Number: 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 person222s account does not justify the establishment of a conservatorship. It is therefore ordered that (name of fiduciary) must open an insured account in a financial or brokerage institution for the sole benefit of the minor/protected person. The account must be opened on behalf of the minor/protected person. The account must be opened using the sample title, 223 (Name of Fiduciary) as Next Friend/Parent for (Name of Minor/Protected Person)224. 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 must not permit 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 45 days. The court further orders that the fiduciary shall file a Motion to Withdraw Funds from Restricted Account (JDF 868) prior to any disbursement of funds. 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 must 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 minor222s/protected person222s birthday (date) or (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. American LegalNet, Inc. www.FormsWorkFlow.com JDF 866SC R6/19 ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT AND ANNUAL FILING OF RESTRICTED ACCOUNT REPORT Page 2 of 2 The court further orders: Copies of all future court filings will be provided to the following interested persons: Name Relationship to m inor / p rotected p erson Minor/ p rotected p erson when 12 years or older Parent or adult nearest in kinship Other : Dated: Judge Magistrate American LegalNet, Inc. www.FormsWorkFlow.com