(Copy Receipt) (Clerk’s Date Stamp) SUPERIOR COURT OF WASHINGTON COUNTY OF SPOKANE In the Guardianship of: CASE NO. ORDER FOR WITHDRAWAL FROM BLOCKED ACCOUNT ORDER TERMINATING GUARDIANSHIP (CLERK’S ACTION REQUIRED) The Petition for Withdrawal from Blocked Account having come before the Court and the Court having reviewed the file and records and finding good cause, IT IS HEREBY ORDERED: A. Bank/Financial Institution is authorized and directed regarding account # digits only), type of account disburse the sum of $ (last four to: dollars OR disburse the entire balance OR transfer control and possession of the account to (name of person to receive funds or account) for the purpose stated in the Petition for Authorizing Withdrawal from Blocked Financial Account. B. The funds #57B-ORDER FOR WITHDRAWL FROM BLOCKED ACCOUNT PAGE 1 OF 3 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com shall not be repaid OR shall be repaid as set forth in the Petition. C. The person receiving the funds shall file receipts for the expenditures within 30 days. D. The Court Clerk shall issue a certified copy of this order upon payment of the fee. E. This distribution does OR does not terminate the Guardianship and/or this case file. F. This matter is set for hearing at: Location of court: , 20 . At (time) on the day of , for the Guardian, Guardian ad Litem, Attorneys and parties to appear and present receipts for expenditures or transfers of the assets, if they have not already filed them. G. This Petition is denied without prejudice because the Petition does not have an inventory, report and accounting, OR financial statement attached. A new Petition may be filed when all documents are complete and attached. H. The Petition is denied with prejudice, because: DATED AND SIGNED IN OPEN COURT THIS DAY OF , 20 . Judge/Court Commissioner Presented by: Signature of Guardian/Attorney Printed Name of Guardian/Attorney, WSBA/CPG# Address City, State, Zip Code #57B-ORDER FOR WITHDRAWL FROM BLOCKED ACCOUNT PAGE 2 OF 3 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com *Telephone/Fax Number Email Address *Under GR 22 (b) (6), parties’ personal telephone number(s) are confidential information. If you do not want your personal phone number(s) on this public form, complete form #S2Sealed Confidential Information and file in the confidential file. #57B-ORDER FOR WITHDRAWL FROM BLOCKED ACCOUNT PAGE 3 OF 3 Revised 3/07 American LegalNet, Inc. www.FormsWorkflow.com