Verification Of Restricted Deposit Of Securities
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Verification Of Restricted Deposit Of Securities Form. This is a Missouri form and can be use in 16th Circuit (Jackson County) Local Circuit Courts.
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Tags: Verification Of Restricted Deposit Of Securities, 10533, Missouri Local Circuit Courts, 16th Circuit (Jackson County)
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION
AT _
_
IN THE ESTATE OF
_
ESTATE NUMBER
_,
_
_
Protectee.
VERIFICATION OF RESTRICTED DEPOSIT
OF SECURITIES
This is to certify that _
_the fiduciary of the above captioned estate, maintains the
securities described on the reverse side of this verification for which securities constitute
fiduciary funds and are accepted subject to section 473.207 RSMo and the order of the court
herein, and no withdrawals of securities or dividends therefrom may be made except on order of
the Probate Division of the Circuit Court of Jackson County, Missouri.
The above named fiduciary has no ownership interest in or right of survivorship to any of
the securities described herein except as follows:
_
_
The undersigned swears that the matters set forth herein are true and correct to the best
knowledge and belief of the undersigned, subject to the penalties of making a false affidavit or
declaration.
Dated: __________________.
SIGNATURE: ___________________________________________________________
TITLE: _________________________________________________________________
DEPOSITORY: __________________________________________________________
ADDRESS: _____________________________________________________________
TELEPHONE NUMBER: __________________________________________________
1
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Stocks, Bonds,
Notes, Etc.
Serial No.s
Interest Rate
2
Date of Maturity
Face Value
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