Free Instructions - New Hampshire

Instructions for completing Investment Certification
(NHJB-2167-P) Form use. Used in some guardianship of minor cases when the bond and annual accounts have been waived. The form certifies that the investment company or bank has flagged the account so that monies may not be withdrawn without approval of the court.

Top section of form ·COURT NAME: Enter the name of the county probate court where the document will be filed. (example: Belknap County Probate Court; Rockingham County Probate Court). ·CASE NAME: Enter the name of the case (example: Guardianship of John Adams; Guardianship of Susan Jones). ·CASE NUMBER: Leave blank if not yet assigned by court OR fill in case number if it is known. Main body of form · On the first 4 blank lines, you will enter information about the person completing this form who is from the financial institution where the money is deposited per court order. Enter the person's Name. Official capacity or position, enter the official title of the person from the financial institution completing this form. Name and Address of the Institution, enter the name and address of the financial institution where the money has been deposited. On the line before County, enter the name of the county where the case is currently open. At Probate Court dated, enter the date of the Court Order that instructed the money to be deposited at the financial institution. Guardian Name, enter the name(s) of the Guardian(s) as appointed by this Court. Ward Name, enter the name of the child for whom a guardian(s) has been appointed by the Court. On the line for Form of Deposit/Investment, enter how the funds are being held by the financial institution (CD, savings account, etc.). On the line for Account or Certificate Number, enter the number of the account or certificate that is being held at the financial institution. On the line for Date of Deposit/Investment, enter the date the funds were actually deposited with the financial institution and the account/certificate was opened. On the line for Amount, enter the amount of money that was deposited with the financial institution on the date the account/certificate was initially opened. Read the next paragraph and on the line following My telephone number is, enter the telephone number of the financial institution where the funds have been deposited.
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NHJB-2167-P Instructions (06/26/2007)

Signature section Sign the form on the SIGNATURE OF OFFICIAL line, and date it in the appropriate space to the left. The form must be signed in the presence of a Notary Public or Justice of the Peace. They would complete the section immediately following your signature.

Review the completed form for accuracy prior to filing it with the court. If completing this form on-line, some fields may be filled in automatically based on entries in other fields. If more space is needed for any question, please attach additional sheets of paper.

NHJB-2167-P Instructions (06/26/2007)

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