Addendum Regarding Blocked Account Annuity Or Trust Deposit Form. This is a Washington form and can be use in King Local County.
Tags: Addendum Regarding Blocked Account Annuity Or Trust Deposit, Washington Local County, King
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. ADDENDUM REGARDING BLOCKED ACCOUNT, ANNUITY, OR TRUST DEPOSIT : JUDICIAL SUBPOENA Plaintiff(s) 1. The net proceeds of the settlement to the minor :or incapacitated person shall be in -againstthe form of a check made payable to ¨ Settlement Guardian ad Litem, ¨ Plaintiff's: counsel, ¨ Defense counsel, or ¨ the Clerk of the Court. : 2. The check shall then be endorsed by the person designated in paragraph 1 and held Defendant(s) : pending. disposition. according. to .the.terms .of. this .order. by .the ....... ......... ........ .. .. ..... . ... .... .. . ¨ Settlement Guardian ad Litem, ¨ Plaintiff's counsel, or ¨ Defense counsel 3. The ¨ Guardian; ¨ Settlement Guardian ad Litem; ¨ Plaintiff's counsel; ¨ Defense THE PEOPLE OF THE STATE OF NEW YORK counsel shall: ¨ Open a blocked account with a state or federally regulated and insured financial institution located in the State of Washington, using the incapacitated person's Social Security number. He or she shall then inform the person designated in Paragraph 2 of the financial institution's name, address, and account number for the blocked account, GREETINGS: which person shall then be responsible for the deposit of the check to the blocked account and for the completion and filing of the "Receipt of Funds into Blocked Account." WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ¨ Cause the purchase of an annuity contract consistent with the terms of the , the Honorable at the Court foregoing order. located at County of ¨ Deposit the funds with a court-approved guardian or trustee and, if the guardian or in room , on the day of , 20 , at o'clock in the noon, and at any recessed trustee is constituted in another proceeding, file proof of letters of guardianship or copy of or adjourned date, to testify and give evidence as a witness in this action on the part of the trust. TO 4. The Settlement Guardian ad Litem shall not be discharged and counsel will not Your failure to comply with this subpoena is punishable as a contempt of court receipt or copy withdraw from the case until the actions specified above are completed and the and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a of annuity contract or letters of guardianship or copy of trust has been filed with the court, result of your failure to action dismissal of the injurycomply. or civil proceeding notwithstanding. Witness, Honorable the ¨ receipt, ¨ annuity, ¨ trust is not filedthe Justices of the of , one of within 30 days 5. In the event that entry in this Order County, this period is extended by the court, for good cause shown), the (unless Court of day of , 20 persons designated in Paragraphs 2 and 3 shall be required to appear on the Probate Review Calendar and show cause why the blocked account has not been opened, why the funds have not been deposited, why the receipt has not been filed, (Attorney must sign above and type name below) and/or why an annuity has not been purchased. 6. In the event of any inconsistencies between the terms of the Addendum and the order Attorney(s) for to which it is attached, the terms of the Addendum shall supersede those of the order. Dated and signed in open court this _______ day of _________________, _______. Office and P.O. Address Telephone No.: Judge / CourtFacsimile No.: Commissioner E-Mail Address: Mobile Tel. No.: ADDENDUM REGARDING BLOCKED BANK ACCOUNT – 02/01 American LegalNet, Inc. www.USCourtForms.com