Free Certificate of Proof of Possession (must be attached to CC 16:4) - Nebraska

County Court General Rules Rule 49

CERTIFICATE OF PROOF OF POSSESSION
___________________________________________________________________________________ Name of Fiduciary ___________________________________ ( ) Guardian ( ) Conservator of ________________________________________________

CERTIFICATE OF BALANCE ON DEPOSIT

(Name and Address of Institution) I CERTIFY that on the day of credit of this Fiduciary the following: Checking Account, No. including interest of $ Savings Account, No. including interest of $ , , there was on deposit in this Institution to the

Balance of $ paid during period of statement of account. Balance of $ paid during period of statement of account. ____________________________________ (Signature and Title of Certifying Official)

(*Extend above format for additional accounts as required)

CERTIFICATE AS TO SECURITIES

Line No.

KIND OF BOND OR SECURITY
(Identify U.S. Savings Bonds by series, number, purchase date and cost. Accounts by Number.)

Date of Purchase

Cost

Interest Rate

Present Value

(*Extend format for additional bonds or securities as required)

I CERTIFY that the securities listed on lines 1 through _____ were exhibited to me by the above-named fiduciary as being the property of the estate of the ward, said securities then and there being in the custody and control of the fiduciary. Date of Signature Address of Certifying Official Signature and Title of Certifying Official

NOTE: This certificate may be executed by a bank official, an authorized official or agent of the company which is surety on your bonds; by a judge or clerk of the court.

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