Rev. 04/2018 IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE In the matter of: a person with a disability/minor CM # Know all Men by these Presents, that I, , Principal, am held and firmly bound unto the State of Delaware in the penal sum of $ without surety lawful money of the United States, to be paid to the State to which payment well and truly to be made I bind myself, and my heirs, executors, administrators and assigns, firmly by these presents Sealed with my seal and dated this date of , . The condition of this obligation is such that if the above named Principal who has been appointed guardian of the property by the Court of Chancery of the State of Delaware in the matter of shall as often as the Delaware Statutes, the Rules of Court or a judge thereof shall direct, make before the Court a just and true account of all assets and income of the said Estate which shall come into the hands, custody or possession of said Principal, and shall carefully perform all duties imposed on him by law and shall do whatever is necessary for the care, preservation and investment of the said Estate and shall in all respects comply with the orders of the Court then this obligation shall be null and void, otherwise it shall remain in full force and effect. I further acknowledge that if I do not carefully perform all duties imposed on me by law and fail to preserve said Estate or fail to comply with the orders of the Court then I may be subject to wage garnishment, driver222s license suspension, and the interception of State income tax refunds and lottery winnings or having a judgment entered against me. Signed, sealed and delivered STATE OF : COUNTY OF : This instrument was acknowledged before me on this day of , 20 by [Name of affiant]. (Seal) Notary/Register in Chancery/ Principal Attorney of Record (Bar ID # ) American LegalNet, Inc. www.FormsWorkFlow.com