1IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Protectee. BOND OF CONSERVATOR WITH CORPORATE SURETY I, as principal, and , as surety, are held and firmly bound to the State of Missouri to and for the use and benefit of , protectee, in the sum of Dollars, for the payment of which we bind ourselves, our heirs, executors, administrators and assigns jointly and severally. The condition of the bond is, that if , who has been appointed conservator of the estate, shall faithfully administer said estate, account for, pay and deliver all money and property of said protectee, and perform all other things touching such conservatorship required by law, or the order or decree of any court having jurisdiction, then the above bond to be void, otherwise to remain in full force. IN WITNESS WHEREOF, We have hereunto subscribed our names this day of . Principal Address Phone Number Principal Address Phone Number Surety By: Address Phone Number Attorney-in-fact Address Phone Number Agency executing bond Address Phone Number Approved on . (SEAL) Judge Commissioner Clerk American LegalNet, Inc. www.FormsWorkFlow.com 2ACKNOWLEDGMENT STATE OF SS. COUNTY OF Now on this day of I personally appeared before me in the county aforesaid, and , to me personally known as the persons described in and who executed the foregoing bond and each of them severally acknowledged that (he) (she) executed the same as (his) (her) free act and deed for the uses and purposes therein mentioned. IN TESTIMONY WHEREOF, I have at my office in the county aforesaid and on the day first above written set my hand and affixed my official seal. Notary Public Clerk (Seal) By Deputy Clerk Notary commission expires ACKNOWLEDGMENT BY CORPORATE ATTORNEY-IN-FACT STATE OF ) SS. COUNTY OF ) Now on this day of , personally appeared before me in the county aforesaid , to me personally known, who, being by me duly sworn did say that he is the true and lawful attorney-in-fact of a corporation and has authority for and on behalf of said corporation as surety to execute the foregoing bond; that the seal affixed thereto is the corporation seal of said corporation and that the said acknowledged that he executed the said bond as the free act and deed of said corporation. IN TESTIMONY WHEREOF, I have at my office in the county aforesaid and on the day first above written set my hand and affixed my official seal. Notary Public Clerk (Seal) By Deputy Clerk Notary commission expires (NOTE TO CORPORATE AGENT ISSUING BOND: Power of Attorney must be attached.) American LegalNet, Inc. www.FormsWorkFlow.com