Form 551pc Restricted Account Agreement County Of Lexington Probate Court
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1)
IN THE PROBATE COURT
STATE OF SOUTH CAROLINA
)
)
COUNTY OF LEXINGTON
)
RESTRICTED ACCOUNT AGREEMENT
)
IN THE MATTER OF
)
CASE NUMBER:
)
WHEREAS, _________________________, has petitioned to be appointed as Conservator for ______________________
_____________________________________ with the Lexington County Probate Court; and
WHEREAS, in order to avoid the necessity of posting a bond, the Proposed Conservator has agreed to deposit the assets of the
conservatorship with a domestic financial institution in a manner that prevents their unauthorized disposition, pursuant to the South
Carolina Code Section 62-5-411;
NOW, THEREFORE, THE CONSERVATOR AND THE FINANCIAL INSTITUTION (FI) AGREE AS FOLLOWS:
1. _______________________________ (FI) agrees to establish a restricted account(s) in the name
of _____________________________ as conservator for _________________________________.
2. The Financial Institution and the Proposed Conservator expressly agree that any withdrawal from the account(s)
shall be allowed only upon certified Order of the Lexington County Probate Court authorizing a specific withdrawal
for a specific amount at a specific time. THIS MEANS THAT NO CHECKS OR ATM CARDS ARE TO BE
ISSUED TO THE CONSERVATOR FOR THE ACCOUNT.
3. The Financial Institution and the Proposed Conservator understand that the original of this document will be
filed with the Lexington County Probate Court in order to induce the Court to appoint _____________________ as
Conservator for _______________________________.
4. Notwithstanding the restrictions provided in this Agreement, the Conservator once appointed is permitted to:
(a) transfer funds to or from a money market, savings account or a Certificate of Deposit, or
(b) renew an existing Certificate of Deposit, or
(c) invest funds in the following: Certificate of Deposit; Money Market accounts; Triple 'A' rated Municipal Bonds,
U.S. Agency Bonds, Government Bond Funds and Large Cap Mutual Funds invested primarily in S&P 500 companies;
so long as the assets are invested with the same Financial Institution and are held in the name of
_____________________ as Conservator for ____________________ and are subject to the withdrawal
restrictions set forth above.
5. The opening balance in the restricted is $___________ as of _____________; or if not yet deposited, it is expected to be in the
amount of $____________. Proof of deposit shall be filed with the court within 30 days of appointment.
6. The taxpayer identification number shall be the social security number of the incapacitated person or the minor.
7. The financial institution shall provide a duplicate statement to the Lexington County Probate Court, 205 East Main
Street, Suite 134, Lexington, SC 29072, Attn: Conservatorship Division, upon request.
8. Should disbursements be made without a court order the Financial Institution may be potentially liable for the
reimbursement of such unauthorized disbursements to the conservatorship account.
Executed this ________ day of __________, 20____.
Executed this ________ day of __________, 20____.
_________________________________________
__________________________________________
PROPOSED CONSERVATOR SIGNATURE
FINANCIAL INSTITUTION SIGNATURE
________________________________________
__________________________________________
NAME (PRINTED)
NAME (PRINTED) AND TITLE
Address:________________________________
Address:__________________________________
________________________________________
_________________________________________
Telephone No.:___________________________
Telephone No.:______________________________
FORM #551PC (2/2004)
62-5-411
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