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TELEPH ONE: SUPER IO R CO URT OF C ALIF O RNI A, C O UNTY OF STREET ADDRE SS: MAILIN G AD DRES S: CIT Y AND Z IP CO DE: BRAN CH NAM E:GUARDIANSHIP CO NSERVATO RSHIP O F (Name) : a. b.Ne w a cc o unt o pe n ed o n ( d ate ): Acc o u nt n um ber: Exis tin g a cco u nt c h a ng e d o n ( d ate ):Acc ou nt n um ber: B efo re c h a ng e : After c h a n ge : Nam e o n a cco unt b efo re c h ange (s ta te e a ch name) :Open in g b ala nce o f ne w acco un t or bala nce o f e xis tin g acco un t im m edia te ly a fter c h a n ge : $ Safe -d e po sit b ox s ta tu s (c h e ck o ne . I d entif y ad dit io na l sa fe -d e p osit b oxe s o n A tta ch me nt 5 ):a . New b o x r e nte d o n ( d ate ): re fle ctin g th e g u ard ia nsh ip o r c o n se rva to rs h ip .I de cla re u n de r pe n alty o f pe rju ry un d er t h e la w s of th e S ta te of C alifo rn ia th a t th e fo re go in g is tr u e a nd c o rre ct. Da te : ` (TY PE OR PRINT NAM E OF AUTH ORIZED OFFI CE R) (SIG NATU RE OF AUTH ORIZED O FFI CE R)              DEC LA R AN T (N ame) : IN STITU TION (N ame) : ADD RE SS:TITL E:FOR CO URT USE ONL YGC-0 51FAX (O ptio na l) :M INO R CONSERVATEE NO F IL IN G F E EN O TI CE OF O PEN IN G O R CHAN GI NG A G UAR DI AN SHI P O R CO NSER VATO RS HIP A C CO UNT O R SA FE -D EP OSI T BO XCASE N UM BE R:NO TE TO F IN AN CIA L IN STI TUT IO N: Wh en a g ua rd ia n o r c o nse rva to r o f th e esta te o f a pe rs o n o pe n s or ch an g es th e n am e o n an acco u nt o r a s a fe -d epo sit b ox in a “ fi n an cia l in stit u tio n” ( a ba n k, a t r u st, a s a vin gs a n d lo an asso cia tio n, a s a vi ngs ba n k, a n in dustr ia l ba nk, or a c re dit un io n), th e in stit u tio n m ust fil e a s ta te men t w it h th e c o urt h a vi ng ju ris dic tio n ove r th e p ro ce ed in g an d id entifie d in t h e Le tte rs o f G uard ia nsh ip o r Lette rs o f C onse rv a to rs h ip . Th e s ta te ment m ust co nta in t h e in fo rm atio n s p e cifi e d be lo w c o n ce rn in g e a ch new o r exis tin g a cco unt o r s a fe -d ep osit bo x in th e in stit u tio n. Th e s ta te m en t m ust b e s ig ne d by an a u th oriz e d o ffic er o f th e in stit u tio n.1. 2.I a m a n o ffi ce r o f th e fin ancia l in stit u tio n id entifie d in t h is sta te ment, a nd I a m a uth o riz ed to s ig n th is s ta te m ent o n it s beh alf. The gua rd ia n o r c o n se rva to r p re se nte d Le tte rs o f G ua rd ia nsh ip o r Le tte rs o f C onse rv a to rs h ip identify in g th e g u ard ia n o r co nse rva to r o f th e e sta te o f th e w ard or c o nse rva te e n a m ed abo ve .3.a. b.F in an cia l in stit u tio n ( n a me ): Br a nch ( n a me ): (s tr e et a d dre ss): (c it y a n d zip c o de ):(te le pho n e):4 .Ac co u nt s ta tu s (c h eck o n e; id entif y a dd it io na l n ew or e xis tin g a cco u nts o n A tta ch me nt 4 ):( 1 ) (2) (1)re fle ctin g t h e g ua rd ia nsh ip or co n se rva to rs h ip . to r e fle ct t h e g ua rd ia nsh ip o r c o n se rva to rs h ip .(2 ) (3)5.c.b. c. E xis tin g bo x r e n ta l ch a n ge d t o r e fle ct t h e g u ard ia nsh ip o r c o nse rva to rs h ip o n (d a te ): Ne w sa fe -d epo sit b ox nu m ber or c u rre nt n um be r a fter c h an g e: d .Th is in stit u tio nha s has n ot b ee n g ive n acce ss t o th e s a fe -d epo sit b ox id en tifi ed a b ove .e.(If y o u ch e cke d " h as," c o m ple te it e m 5 e.) The c o nte nts o f th e s a fe -d e posit b o x id entifie d a b ove a re a s fo llo ws (li s t th e c o n te nts in g e n era l te rm s, s u ch a s "c u rre ncy, co in s, je w elr y , ta b le w are , in su ra nce po lic ie s o r c e rtif ic ate s, sto ck c e rtif ic ate s, bo nds, d ee ds, a n d will s "):6 .Na me o f e a ch p ers o n w ho o pe n ed o r w hose n am e was a dd e d t o a bo ve -id en tifie d a cco u nt o r sa fe -d e po sit b ox (s ta te e ach n a me ):Pa ge 1 of 1F orm Ad op te d for M anda to ry U se Jud ici al C ou ncil o f Ca li fo rn ia GC-0 51 [R ev. J u ly 1, 20 05]N O TI CE OF O PEN IN G O R CHAN GI NG A G UAR DI ANS HIP O R CO NSER VATO RS HIP A C CO UNT OR SA FE -D EP OSIT BO X (Pro bate — Guard ia n sh ip s a n d C on serv a to rs h ip s)Pr ob ate Code , § 2 89 2ele ctr o nic f o rm  2 005 WWW.LawCA.com La w P ublis h ers