Verification Of Conservators Possession Of Securities {10535}

IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Protectee. VERIFICATION OF CONSERVATORS POSSESSION OF SECURITIES This is to certify that , the fiduciary of the above captioned estate, maintains the securities described on the reverse side of thisverification for which securities consist of fiduciary property. 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, Notes, Serial No.s Interest Rate Date of Maturity Face Valueetc. FORM 10535 Page 2 of 2 8/2/96