Verification Of Restricted Deposit Of Securities {10533}

IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Protectee. VERIFICATION OF RESTRICTED DEPOSIT OF SECURITIES This is to certify that , thefiduciary of the above captioned estate, maintains the securities described on the reverse side of thisverification for which securities constitute fiduciary funds and are accepted subject to section473.207 RSMo and the order of the court herein, and no withdrawals of securities or dividendstherefrom may be made except on order of the Probate Division of the Circuit Court of JacksonCounty, Missouri. The above named fiduciary has no ownership interest in or right of survivorship to any of thesecurities described herein except as follows: The undersigned swears that the matters set forth herein are true and correct to the bestknowledge and belief of the undersigned, subject to the penalties of making a false affidavit ordeclaration. Dated: . SIGNATURE: TITLE: DEPOSITORY: ADDRESS: TELEPHONE NUMBER: Page 1 of 2 <<<<<<<<<********>>>>>>>>>>>>> 2Stocks, Bonds, Serial No.s Interest Rate Date of Face ValueNotes, Etc. Maturity FORM 10533 Page 2 of 2 8/2/96