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Declaration Of Guardian Assets Held In Financial Institutions Form. This is a Washington form and can be use in King Local County.
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Tags: Declaration Of Guardian Assets Held In Financial Institutions, 16, Washington Local County, King
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IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON
IN AND FOR THE COUNTY OF KING
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In the Guardianship of:
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______________________________,
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An Incapacitated Person.
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Case No.:
DECLARATION OF GUARDIAN:
ASSETS HELD IN FINANCIAL
INSTITUTIONS
(DCLR)
The Guardian of the Estate of the person named above makes the following
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declaration pursuant to the provisions of RCW 11.92.096:
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1. Cause Number: ______________________________
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2. The Guardian was appointed by order entered on _____________________________
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3. The Incapacitated Person’s name is: _______________________________________
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4. The number of each account holding the assets of Incapacitated Person and the number
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of the Safety Deposit Box, if any, in the Incapacitated Person’s name are:
Account Number:
______________________________
Account Number:
______________________________
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Safety Deposit Box Number:
______________________________
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5. Address of Client or Depositor. The Incapacitated client of depositor has the following
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address: ______________________________
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6. Name and Address of Guardian to be provided assets or access to Assets: _________
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DECLARATION OF GUARDIAN
ASSETS HELD IN A FINANCIAL INSTITUTION- 1
12/2005 GUARDIANSHIP FORMS
American LegalNet, Inc.
www.USCourtForms.com
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7. The Description of and the Value of the assets, or, where the value cannot be readily
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ascertained, a reasonable estimate thereof is as follows, and the Guardian receives delivery
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or control of each asset solely in its capacity as Guardian.
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8. The date the Guardian assumed control over the assets was: ____________________
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9. A true and correct copy of the Letters of Guardianship duly issued by a Court to the
Guardian is attached to this declaration.
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE
STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
Signed at ________________, Washington, ___________, ____200__.
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Signature
Printed Name
Address
Telephone/Fax Number
City, State, Zip Code
Email Address
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Important information for the person completing this form:
DELIVERY OF ASSETS TO GUARDIAN
All financial institutions as defined in RCW 30.22.040 (12), all insurance companies holding
a certificate of authority under chapter 48.05 RCW, or any agent who constitutes a
salesperson or broker dealer of securities under the definitions of RCW 21.20.005 (hereafter
individually and collectively referenced as “institution”) shall provide the Guardian access
and control over the asset(s) described in (a)(vii) of RCW 11.92.096, including but not
limited to delivery of the asset to the Guardian, upon receipt of the affidavit as outlined
therein.
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DECLARATION OF GUARDIAN
ASSETS HELD IN A FINANCIAL INSTITUTION- 2
12/2005 GUARDIANSHIP FORMS
American LegalNet, Inc.
www.USCourtForms.com
