Free District Court Denver Probate Court - Colorado

District Court Denver Probate Court ___________________________________ County, Colorado Court Address: _______________________________________ In the Interest of:
COURT USE ONLY

________________________________________ Protected Person/Minor

Case Number:_______________

Division: ______ Courtroom: ______

ORDER ALLOWING WITHDRAWAL OF FUNDS FROM RESTRICTED ACCOUNT
This matter comes before the Court on the Motion to Withdraw Funds from Restricted Account filed on _______________________ (date). The Court, having reviewed the Motion and supporting documentation, if attached, and any responses received from interested persons, enters the following Orders:

The Motion is GRANTED.

The Conservator is authorized to withdraw $_____________ from the account(s) specified in the Motion and as identified below: Account Number (last 4-digits only) Amount to Withdraw from Account $ $

Name and Address of Financial Institution

Total

The Conservator is required to file a copy of the receipt(s) for the purchase with the Court within ten days. Note: All Conservators are required to keep all original receipt(s). The Motion is DENIED for the following reasons:

The Court further Orders:

Date: _____________________________ Judge Magistrate

CERTIFICATION
I certify that this is a true and correct copy of the original in my custody.

Date: __________________________________

______________________________________ Probate Registrar/(Deputy)Clerk of Court

JDF 869

R4/09

ORDER ALLOWING WITHDRAWAL OF FUNDS FROM RESTRICTED ACCOUNT