Fill and Sign the Receipt and Agreement Aoc E 901 Form

File No. STATE OF NORTH CAROLINA County In The General Court Of Justice Superior Court Division Before The Clerk Name Of Ward/Decedent IN THE MATTER OF THE ESTATE OF RECEIPT AND AGREEMENT G.S. 28A-8-1.1; 35A-1232 Name And Address Of Bank Or Insured Savings And Loan Association Name And Address Of Guardian/Personal Representative Ward Decedent Original-File Copy-Guardian Copy-Bank/Savings and Loan Association/Financial Institution Telephone No. FOR GUARDIANSHIP ESTATES ONLY: Name And Address Of Bank, Savings And Loan Association, Credit Union, Trust Company, Or Registered Securities Broker Or Dealer Guardian Personal Representative Telephone No. Of Bank/Savings And Loan Association/Financial Institution Account No. Date Received Amount Of Assets (Principal) Received $ To The Clerk Of Superior Court: The bank, savings and loan institution, or financial institution named above hereby acknowledges receipt of the sum indicated above, which was deposited in it by the guardian/personal representative named above. In consideration of the deposit, this bank or institution agrees that such money shall not be allowed withdrawn except on written authorization of the Court. (NOTE: “Money” as used on this form means either the principal of the ward’s estate that is on deposit or the principal of the decedent’s estate that is on deposit. ) It is understood that the income earned by the principal may not be withdrawn unless authorized by the Court in the Order set forth below. Date Name Of Authorized Official Title Signature Of Authorized Official B Y ORDER It is ORDERED that the amount indicated above be deposited in the above-named bank, insured savings and loan association, or financial institution and not be withdrawn without written authorization of the Court . NOTE: A Receipt And Agreement may not fully eliminate the requirement of post\ ing at least a minimum bond. Assistant CSC Clerk Of Superior Court Date Signature AOC-E-901, Rev. 12/17