IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI PROBATE DIVISION AT __________________ IN THE ESTATE OF Deceased. CREDITOR'S BOND (Sec. 473.090, RSMo) ESTATE NUMBER We, , as principal, and as surety are held and firmly bound unto the State of Missouri, in the full and just sum of $ , to the payment whereof, well and truly to be made, we bind ourselves, our heirs, executors, administrators and assigns jointly and severally, firmly by these presents. The condition of the above bond is, that if , creditor of the estate of , deceased, shall faithfully account for and pay, so far as the assets of said estate will permit, the debts of the deceased in the order of their preference, and distribute the balance, if any, to the persons entitled thereto under the law, and perform all other things touching said estate 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 on PRINCIPAL PRINCIPAL Of SURETY BY: ATTORNEY - IN - FACT Agency Executing Bond Approved on Address Address Phone No. Phone No. Address Address of Agency . Phone No. Phone No. Judge/Commissioner Form 10501 ACKNOWLEDGMENT American LegalNet, Inc. www.USCourtForms.com 12/29/98 STATE OF MISSOURI COUNTY OF JACKSON ) ) SS ) On , personally appeared before me in the county aforesaid, to me personally known as the persons described in and who executed the foregoing bond as principal and each of them severally acknowledged that executed the same as 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 My Commission expires By Division Clerk Deputy Division Clerk ACKNOWLEDGMENT BY CORPORATE ATTORNEY- IN- FACT STATE OF MISSOURI COUNTY OF JACKSON ) ) SS ) Now on , personally appeared before me in the county aforesaid , to me personally know, who, being by me duly sworn did say that he is the true and lawful attorney-in-fact of a corporation and has full power and authority for and on behalf of said corporation as surety to execute the foregoing bond; that the seal affixed thereto is the corporate seal of said corporation and the said acknowledge that he executed thesaid bond as the free act and deed of said corporation. IN TESTIMONY WHEREOF, I have at my office the county aforesaid and on the day first above written set my hand and affixed my official seal. Notary Public My Commission expires By Division Clerk Deputy Division Clerk (NOTE TO CORPORATE AGENT ISSUING BOND: POWER OF ATTORNEY MUST BE ATTACHED.) FORM 10501 12/29/98 American LegalNet, Inc. www.USCourtForms.com