IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
In the matter of
_________________________________________ Deceased No. ______________________________
CONSENT OF DESIGNATED AGENT
The following, _________________________________________________________________, resident or (Name Typed) corporation of the State of Missouri, is hereby designated as agent for service of process and receipt of notice for the above matter.
__________________________________ Date
__________________________________________ Signature __________________________________________ Street Address __________________________________________ City State Zip Code