FORM 145.2. COMBINED MOTION AND ORDER FOR RELEASE OF MINOR SETTLEMENT FUNDS (Gen. R. Prac. 145.05) State of Minnesota District Court County of __________ _________ Judicial District Case Type: Plaintiff/Petitioner and Case No. COMBINED MOTION AND ORDER FOR RELEASE OF MINOR SETTLEMENT FUNDS (Pursuant to Rule 145 of the Minnesota General Rules of Practice) Defendant/Respondent 1. _______________("Movant") requests an order of permitting withdrawal of funds now held in a restricted account pursuant to a minor settlement approved in this action on _______________. Movant brings this Motion as the _____ (Minor, now past the age of majority­Date of Birth ______________) or ____ ______________________________to minor. (Specify whether trustee, custodian, parent, legal guardian, conservator, or other specified role). 2. Funds are now held on behalf of __________________ in the following account: Name of Depository: Branch Name: Branch Address: Account Number: Date Account Opened: Current Balance: $ (Place on separate form 11.1*) * = As required by Rule 11.2 of the Minnesota General Rules of Practice 3. Previous withdrawals from the account, each of which was approved by the Court, are as follows: _____ None. or _____ $ _________ on __________ for the purpose of _____________________ American LegalNet, Inc. www.FormsWorkFlow.com $ _________ on __________ for the purpose of _____________________ $ _________ on __________ for the purpose of _____________________ Check if additional space is necessary, and attach a separate sheet with that information. 4. Movant seeks the release of funds in the amount of $ ______________ for the following reason: _____ Minor has reached the age of 18 and this is a final distribution or _____ The funds will be used for the benefit of the minor in the following way: ___________________________________________________________ ___________________________________________________________ ___________________________________________________________. Check if additional space is necessary, and attach a separate sheet with that information. 5. Funds should be disbursed as follows: $ ______________ to ________________________________________________ $ ______________ to ________________________________________________ $ ______________ to ________________________________________________ Check if additional space is necessary, and attach a separate sheet with that information. I declare under oath and penalty of perjury under the laws of the State of Minnesota that the foregoing is true and correct and that any funds released pursuant to this request will be used for the benefit of the minor and in the way stated. Dated: _______________. Type or Print Name _____________________________ Signature: _____________________________ (sign only in front of notary public or court administrator) Sworn / affirmed before me this _________day of __________________, (DATE) (MONTH) (YEAR) ______________________________________ Notary Public/ Deputy Court Administrator American LegalNet, Inc. www.FormsWorkFlow.com ORDER APPROVING RELEASE OF FUNDS Pursuant to the foregoing Motion, IT IS HEREBY ORDERED that 1. Movant is authorized to withdraw funds to be made payable as follows: $ ______________ to ________________________________________________ $ ______________ to ________________________________________________ 2. _______ This is a final distribution of funds from this account and the account may accordingly may be closed following this final distribution or _______ This is not a final distribution of funds and this account must be maintained as to the remaining funds and subject to all restrictions on distribution previous ordered. 3. Other provisions: ___________________________________________________ __________________________________________________________________ Dated: _______________. Judge of District Court American LegalNet, Inc. www.FormsWorkFlow.com