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Rev. 4/25 CERTIFICATION BY FINANCIAL OR INVESTMENT INSTITUTION LR29-PR00-705.20; LR29-PR00-710.20; LR29-PR00-716.50 FORM PR00-5 IN THE HAMILTON SUPERIOR COURT CAUSE NO. CERTIFICATION BY FINANCIAL OR INVESTMENT INSTITUTION TO: FROM: (Guardian/Personal Representative’s Name) RE: Guardianship of/Estate of In order to comply with the rules of the Probate Court, I am required to file a Certification of Account or Investment Balances. Please certify the balances and names on the accounts or investments I have listed below. DATE: (Guardian/Personal Representative’s Signature) For Bank or Investment Institution Use Only: I certify that on the day of , 20 , the last day of the period covered by this accounting, there was on deposit in this institution an account or there exists an investment to the credit of the guardian/personal representative, showing the following balance: Name on Account/Investment Account/Investment Number Balance Date This/these account(s)/investment(s) contain(s) the following restriction: NO PRINCIPAL OR INTEREST SHALL BE WITHDRAWN WITHOUT WRITTEN ORDER OF SUPERIOR COURT OF HAMILTON COUNTY, INDIANA. Please check one: Yes No Name and Address of Institution: Signature of Certifying Officer: Printed: Title: Date: SIGN SIGN