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Page 1 of 1 Certificate of Depository 02/06/2013 ELEVENTH JUDICIAL CIRCUIT COURT McLEAN COUNTY, IL In the Matter of the Estate of: Case Number: , a minor. CERTIFICATE OF DEPOSITORY The undersigned hereby acknowledges that (Name of Guardian) Guardian of the estate of has deposited in the (Name of Ward) the (Name of Institution) sum of in the name of in account number It being understood that the same is to be held on deposit, in trust, until further order of the Eleventh Judicial Circuit Court, McLean County, Illinois. Date Signature Print Name Title