Free Agreement of Depositary for Deposit of Funds in Limited Access Account - Missouri

IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
AGREEMENT OF DEPOSITARY FOR DEPOSIT OF FUNDS IN LIMITED ACCESS ACCOUNT
Name of Institution: _____________________________________________________________________________ Address: _____________________________________________________________________________________

Depositor: _____________________________________________________________________, Conservator of the Estate of: _____________________________________________________________________________________ Probate Division File Number: _____________________________________________________________________ Savings Account or Certificate of Deposit Number: _____________________________________________________ Amount of Deposit: ______________________________________________________________________________ In consideration of deposit with undersigned of money in the above amount and reduction of the conservator's bond by the court, undersigned hereby certifies and agrees: That the above amount is now on deposit in this institution as evidenced by the attached letter. That neither the amount on deposit as indicated above nor any part thereof nor any additional deposits thereto nor any interest, dividends or income thereon may be withdrawn, paid, redeemed, transferred, negotiated or liquidated by anyone except upon written order of the Probate Division of the Circuit Court of St. Louis County, Missouri, expressly and specifically authorizing a withdrawal, payment, redemption, transfer, negotiation or liquidation and that the records of the institution have been marked or the necessary administrative steps have been taken to prevent such withdrawals, payments, redemptions, transfers, negotiations or liquidations without court order.

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.