(Brokerage Firm)
("Depository") certifies that they are qualified under Section 744.351(6), Florida Statutes, and hereby accepts the designation as the restricted depository for the above-named Ward per the above Court's order dated . The Depository hereby acknowledges receipt of the following assets ("Assets"):
The Depository acknowledges receipt of a copy of the Order Designating Depository for Assets, and agrees to hold the Assets, the duly collected proceeds therefrom, and all interest, dividends, principal, and other indebtedness subsequently collected on account thereof; in safekeeping per Section 69.031, Florida Statutes, subject to the instructions of the Guardian of the Ward's Property as authorized by court order. The Depository also agrees to be bound by Section 69.031, Florida Statutes, as though it were a bank, trust company, or savings and loan association, and acknowledges that it may not distribute, trade, or withdraw any of these Assets without a specific court order reciting the amount and payee of any authorized disbursements.
This Acceptance of Designation as Depository and Receipt of Assets is executed in the Depository's name by one of its authorized officers on . The original shall be filed with the Court within fifteen (15) days and a copy given to the Guardian of the Ward's Property.