Fill and Sign the Colorado Deposit Form

 District Court  Denver Probate Court ___________________________________ County, Colorado Court Address: IN THE MATTER OF THE ESTATE OF:  Minor  Protected Person COURT USE ONLY Case Number: Division: Courtroom : ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT IT IS ORDERED that (name) ________________________________, as * ___________________, (“Fiduciary”) shall open an account in a federally insured financial institution for the sole benefit of the minor/protected person. The account shall be opened in the name of the minor/protected person. The Fiduciary shall deposit $ _______________________ and funds received subsequently in the account. This person may make internal transfers of funds in order to take advantage of changes in interest rates. IT IS ORDERED that, except for internal transfers, the financial institution shall permit no withdrawals from the account(s), except by separate certified Order of this Court. IT IS FURTHER ORDERED that the following acknowledgment must be returned to the Court within ______days. Dated: __________________________ ___________________________________________  Judge  Magistrate  Registrar ACKNOWLEDGMENT ___________________________________________, a federally insured financial institution, acknowledges that funds have been deposited in the name of _______________________________ by ______________________ as * ____________________________________________ in the following amounts and account numbers: ACCOUNT NUMBER AMOUNT TOTAL $____________________ This institution submits itself to the jurisdiction of this Court and agrees that it shall not permit any withdrawal of funds except upon being furnished a certified copy of an Order of this Court authorizing such withdrawal. Dated: ______________________________________ By: ___________________________________ Authorized Bank Officer ___________________________________ Type Name and Title of Authorized Bank Officer RETURN TO: (Court name and address as shown above) ___________________________________ Name, Address and Tele. No. of Financial Institution ___________________________________ *Insert applicable title: Conservator, Next Friend, Guardian or Parent ___________________________________ CPC 55 R7/01 ORDER FOR DEPOSIT OF FUNDS TO RESTRICTED ACCOUNT This form conforms in substance to CPC 55.