Verification Of Receipt And Or Deposit Of Custodian {35.11}

PROBATE COURT OF STARK COUNTY, OHIO DIXIE PARK, JUDGE TRUST UNDER THE WILL OF: CASE NO. VERIFICATION OF RECEIPT AND/OR DEPOSIT OF CUSTODIAN day of Whereas, the Probate Court of Stark County, Ohio on the , by order directing the fiduciary of this trust to deposit with the undersigned the following assets belonging to the estate: I NAME ACCOUNT NO. BALANCE MATURITY Whereas, the fiduciary has presented the assets for such deposit together with a certified copy of the entry of said order. Wherefore, the undersigned hereby acknowledges the deposit and/or receipt of the assets described above and agrees to hold the same subject to the further orders of the Court. By accepting the above assets, said institution agrees to hold all instruments verifying the deposits (Certificates, Passbooks, etc.) and not to release any funds from these assets unless so ordered in accordance with a certified entry issued by the Probate Court. EXPLANATION OF ACTION TAKEN BY DEPOSITORY CUSTODIAL DEPOSITORY AUTHORIZED OFFICER TYPED OR PRINTED NAME DATE SCPC FORM 35.11 - VERIFICATION OF RECEIPT American LegalNet, Inc. www.FormsWorkFlow.com