Agreement Of Depository For Deposit Of Funds In Restricted Account Form - St Louis County, Missouri

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IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
In the Matter of
No.______________________
_________________________________________________
Deceased
Incap/Disabled
Minor
AGREEMENT OF DEPOSITORY FOR DEPOSIT OF
FUNDS IN RESTRICTED ACCOUNT
Name of Institution: ________________________________________________________________________________
Address: __________________________________________________________________________________________
Depositor: _______________________________________________
Personal Representative
Conservator
Savings Account No.: ________________________
Deposit $ _______________
Certificate of Deposit No.: ____________________
Deposit $ _______________
In consideration of deposit with undersigned of money in the above amount, and reduction of the personal
representative/conservator’s bond by the court, undersigned hereby certifies and agrees:
1.
That the above amount is now on deposit in this institution as evidenced by the attached letter.
2.
That the deposit as indicated above and all additions resulting from any interest, dividends or other income,
may not be withdrawn, paid, redeemed, transferred, negotiated or liquidated except upon
presentation of a certified copy of an Order of the above named court authorizing and approving
such transaction.
3.
That all records pertaining to the above described deposit and all interest, dividends or other income earned
on it may not be withdrawn, paid, redeemed, transferred, negotiated or liquidated without approval from
the Probate Division, Circuit Court, St. Louis County, Missouri, and the necessary administrative steps
have been taken to prevent such activity.
Dated this _________day of _________________________________, 20 _________.
________________________________________________
Name of Institution
By: ____________________________________________
________________________________________________
Title
THIS AGREEMENT MUST BE ATTACHED TO A VERIFICATION OF DOLLAR AMOUNT ON
THE LETTERHEAD OF THE FINANCIAL INSTITUTION AND BE SIGNED BY AN OFFICER OF
SAID INSTITUTION.
For Court’s Use Only:
KADEF – Agreement of Depository Filed
CCPR075-W 1/15

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