PROBATE COURT OF SUMMIT COUNTY, OHIO GUARDIANSHIP OF: CASE NO. APPLICATION TO TRANSFER FUNDS FROM GUARDIAN'S CUSTODIAL ACCOUNT Now comes the undersigned, guardian for the above-named ward, and makes application for authority to secure the transfer of the following funds from the guardian's custodial account, to-wit: TO RELEASE FUNDS IN Name of Institution Account Number IN THE SUM OF $ AND TRANSFER SAID FUNDS TO Account Number Monthly or Named Payee One Time The applicant further states that it is for the best interest of the ward that authority be granted so that the guardian may obtain access to the funds. Guardian ORDER AUTHORIZING TRANSFER OF FUNDS This day of , 20 , this cause came on to be heard upon the application of the guardian of the above-named ward and the evidence, and the Court, being fully advised in the premises, hereby authorizes the transfer of the above funds, AS ABOVE REQUESTED. IT IS SO ORDERED. APPROVED: JUDGE ELINORE MARSH STORMER Attorney/Guardian Form GA.3 American LegalNet, Inc. www.FormsWorkFlow.com