Investment Certification
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Investment Certification Form. This is a New Hampshire form and can be use in Probate Court Statewide.
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Tags: Investment Certification, NHJB-2167-P, New Hampshire Statewide, Probate Court
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Case Name:
Case Number:
(if known)
INVESTMENT CERTIFICATION
I,
,
(Name)
(Official capacity or position)
of
,
(Name of Institution)
,
(Address of Institution)
do hereby certify and attest that in accordance with the decree of the
Probate Court dated
County
, the following deposits/investments were made by
, as guardian of
(Guardian name)
(Ward name)
Form of Deposit/
Investment
Account or
Certificate Number
Date of Deposit/
Investment
Amount
$
$
$
I further certify and attest that the foregoing deposits/investments have been restricted with
notation recited on its/their face, that no withdrawal, encumbrance or other disposition may be made
without express written court order; and a copy of the referenced court decree has been made part of
the investment records. My telephone number is
Date
Signature of official
State of
, County of
This instrument was acknowledged before me on
My Commission Expires
Affix Seal, if any
NHJB-2167-P (10/01/2006)
(formerly AOC-213-003)
.
by
Signature of Notarial Officer / Title
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