Fill and Sign the How to Register Your Own Trademark with Forms PDF Free Download

JDF 868 SC R6/19 MOTION TO WITHDRAW FUNDS FROM RESTRICTED ACCOUNT Page 1 of 2 ❑ District Court ❑ Denver Probate Court _________________________________ County, Colorado Court Address: In the Interest of : Protected Person/Minor COURT USE ONLY Attorney or Party W ithout Attorney (Name and Address): Phone Number: E -mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom MOTION TO WITHDRAW FUNDS FROM RESTRICTED ACCOUNT I, (conservator (s) ), respectfully request authority to withdraw $ , on deposit in the restricted account (s) listed below: Attach current bank statement. Name and Address of Financial Institution Account Number (last 4-digits only) Current Balance in Account $ Total $ The funds are requested for the following purchase/ reasons(s): Attach supporting documentation for your request . ❑ By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. ❑ By checking this box, I am acknowledging that I have made a change to the original content of this form. Date: _______________________ _________ ____________________________ __ Signature of Minor if 12 years of age or over VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of Executed on the ______ day of (date) (date) _______________________, _________, _______________________, _________, (month) (year) (month) (year) at ______________________________________ at ______________________________________ (city or other location, and state OR country) (city or other location, and state OR country) _______________________________ _______________________________ (printed name) (printed name) _______________________________ _______________________________ (Signature of Conservator/Successor) (Signature of Co -Conservator/Successor , if any) JDF 868 SC R6/19 MOTION TO WITHDRAW FUNDS FROM RESTRICTED ACCOUNT Page 2 of 2 ________________________________________ __________________ Attorney Signature, (if any) Date CERTIFICATE OF SERVICE I certify that on ___________________ (date), a copy of this _______________ (name of document) was served as follows on each of the following: Name and Address Relationship to Decedent, Ward, or Protected Person Manner of Service* *Insert one of the following: hand delivery, first -class mail, certified mail, e -service, or fax. _____________________________________________ Signature