IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI Estate of ________________________________________________________________ Incapacitated/Disabled Person Minor No. ________________ Bond $ _____________ CORPORATE SURETY BOND (Conservatorship) __________________________________________________________________________________________________________ as principal(s) and ___________________________________________________________ as surety are held and firmly bound to the State of Missouri for the use and benefit of ____________________________________________________, incapacitated/disabled person minor, in the sum of $ _________________________________ for the payment of which we bind ourselves, our heirs, our personal representatives and assigns, jointly and severally. The condition of the bond is that if ____________________________________________,Conservator, shall faithfully administer the estate, account for, pay and deliver all moneys and property of the protectee and perform all other things touching the conservatorship as required by law, or the order of decree of any court having jurisdiction, then the above bond is void, otherwise to remain in full force. IN WITNESS WHEREOF, we have hereunto subscribed our names this _________ day of ________________________ , __________. ______________________________________________ Principal's Signature ___________________________________________ Principal's Signature ______________________________________________ Street Address ___________________________________________ Street Address ______________________________________________ City State Zip Code ___________________________________________ City State Zip Code ______________________________________________ Principal's Signature ___________________________________________ Principal's Signature ______________________________________________ Street Address ___________________________________________ Street Address ______________________________________________ City State Zip Code ___________________________________________ City State Zip Code Approved this _____ day of _________________, _____. JOAN M. GILMER, CIRCUIT CLERK Probate Division, Circuit Court St. Louis County, Missouri ___________________________________________ Surety By: _____________________________________ Attorney in fact (Surety Seal) By: __________________________________________ Deputy Clerk For Court's Use Only: KABO ­ Order Approving Bond KABOO ­ Additional Bond American LegalNet, Inc. www.FormsWorkFlow.com ACKNOWLEDGMENT OF PRINCIPAL STATE OF _________________________ } } SS. COUNTY OF _______________________ } Now on this _______ day of ___________________________________ , _______, personally appeared before me in the state aforesaid __________________________________________________________________________________ _____________________________________________________________ to me personally known as the person(s) described in and who executed the foregoing bond as principal(s) and acknowledge(s) that ________________________ executed the same as ____________________ free act and deed for the uses and purposes therein mentioned. IN TESTIMONY WHEREOF, I hereto sign my name and affix my seal at office in the state of _____________________ , this _______ day of ____________________________ , _______. (Notary Seal) Notary Commission expires: _____________________________________________ Notary Public ACKNOWLEDGMENT OF CORPORATE SURETY STATE OF _________________________ } } SS. COUNTY OF _______________________ } Now on this _______ day of ___________________________________ , _______, personally appeared before me in the state aforesaid __________________________________________________________________________________ , Attorney in fact, to me personally known as the person described in and who executed the foregoing bond on behalf of _________________________________________________________________________________________________ (surety) and acknowledged that ___________________ executed the same as ___________________________ free act and deed for the uses and purposes therein mentioned. IN TESTIMONY WHEREOF, I hereto sign my name and affix my seal at office in the state of _____________________ , this _______ day of ____________________________ , _______. (Notary Seal) Notary Commission expires: _____________________________________________ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com