Faculty Handbook 08 October 2016 / rev. 2.13 1 Introduction 5
STATE OF NEBRASKAPage 1 of 1 Certificate of Proof of Possession CC 16:2.13 Rev 04/2020. Nebraska...
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Page 1 of 1 Certificate of Proof of Possession CC 16:2.13 Rev 04/2020 Nebraska State Court Form REQUIRED CC 16:2.13 Rev. 04/2020 Neb. Ct. R. §6-1442 CERTIFICATE OF PROOF OF POSSESSION – BANK ACCOUNTS If ordered by the court, this form must be filed. IN THE MATTER OF Ward/Minor ward/Protected Person Case No. I CERTIFY that on , there was on deposit in this institution to the benefit of the above ward, minor ward, or protected person the following: Last 4 digits of account number Title on Account Type of Account (please check one) Restricted? Balance of: __ __ __ __ □ checking savings □ certificate of deposit □ yes □ no $ __ __ __ __ □ checking savings □ certificate of deposit □ yes □ no $ __ __ __ __ □ checking savings □ certificate of deposit □ yes □ no $ Please Note: Only accounts designated “NO WITHDRAWAL WITHOUT COURT ORDER” are considered restricted. Provide additional account information in the same format on an attached page if necessary. This certificate shall be completed by an authorized bank official. (Signature and Title of Certifying Official) (Address of Certifying Official) State of ) ) ss. County of ) The foregoing instrument was acknowledged before me by , this (Name) day of , . (Day) (Month) (Year) Notary Public (Signature of Person Taking Acknowledgment – CANNOT be the same as the Certifying Official signing above) My commission expires: (Title or Rank) (Serial Number, if any)
Transcript of STATE OF NEBRASKAPage 1 of 1 Certificate of Proof of Possession CC 16:2.13 Rev 04/2020. Nebraska...
Page 1 of 1 Certificate of Proof of Possession CC 16:2.13 Rev 04/2020
Nebraska State Court Form REQUIRED
CC 16:2.13 Rev. 04/2020 Neb. Ct. R. §6-1442
CERTIFICATE OF PROOF OF POSSESSION – BANK ACCOUNTS
If ordered by the court, this form must be filed.
IN THE MATTER OF
Ward/Minor ward/Protected Person
Case No.
I CERTIFY that on , there was on deposit in this institution to the benefit of the above ward, minor ward, or protected person the following:
Last 4 digits of account number
Title on Account Type of Account (please check one)
Res
tric
ted?
Balance of:
__ __ __ __ □ checking savings□ certificate of deposit
□ yes□ no $
__ __ __ __ □ checking savings□ certificate of deposit
□ yes□ no $
__ __ __ __ □ checking savings□ certificate of deposit
□ yes□ no $
Please Note: Only accounts designated “NO WITHDRAWAL WITHOUT COURT ORDER” are considered restricted. Provide additional account information in the same format on an attached page if necessary. This certificate shall be completed by an authorized bank official.
(Signature and Title of Certifying Official) (Address of Certifying Official)
State of ) ) ss.
County of )
The foregoing instrument was acknowledged before me by , this (Name)
day of , . (Day) (Month) (Year)
Notary Public (Signature of Person Taking Acknowledgment – CANNOT be the same as the Certifying Official signing above)
My commission expires: (Title or Rank) (Serial Number, if any)
