Orange — Petition for Withdrawal of Funds from Blocked

Orange — Petition for Withdrawal of Funds from Blocked Account (MC-357),¶

Source: https://courts.ca.gov/sites/default/files/courts/default/2024-11/mc357.pdf

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MC-357 ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: FAX NO.: EMAIL ADDRESS: ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

CASE NAME:

CASE NUMBER:

PETITION TO WITHDRAW FUNDS FROM BLOCKED ACCOUNT EX PARTE

Petitioner (name): requests an order authorizing the withdrawal of funds belonging to the person identified in item 2.
The person whose funds are to be withdrawn (name): is a. a minor. b. a conservatee. c. a beneficiary. d. other (specify):
Additional information about the person named in item 2: a. Date of birth: b. Address: c. Telephone number: d. Email address: e. Current school (name and address):

f. Current employer (name and address):
If the person identified in item 2 is a minor, the minor's parents are: a. (Name, address, phone number, and email):

b. (Name, address, phone number, and email):

Petitioner brings this petition as the parent guardian conservator Other (specify relationship): of the person named in item 2.
Account status a. Name and title on account: b. Depository (name): (1) Branch (name): (2) Address: c. Account number: d. Current balance: $

Form Adopted for Mandatory Use Cal. Rules of Court, rules 3.1384, 7.954 Judicial Council of California PETITION TO WITHDRAW FUNDS FROM BLOCKED ACCOUNT www.courts.ca.gov MC-357 [Rev. January 1, 2021]

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MC-357 CASE NAME: CASE NUMBER:

e. Previous withdrawals from this account (select one): (1) None. (2) As follows: (a) Amount: $ (b) Date: (c) Purpose of withdrawal: Additional previous withdrawals from this account are detailed in Attachment 6 (for each additional previous withdrawal, give the information required by item 6e(2)). f. Additional accounts from which petitioner seeks to withdraw funds are described in Attachment 6 (for each additional account, give all the information required by item 6a–6e).
Amount to be disbursed under this petition: a. Balance of account or accounts described in item 6. b. Other (specify total amount to be disbursed): $
Reasons for disbursement of funds: a. Minor has reached 18 years of age, and this is a final distribution. b. Other (describe):
Person(s) to whom funds will be paid: a. Payee (name): (1) Address: (2) Amount: $ (3) Purpose of payment: b. Payee (name): (1) Address: (2) Amount: $ (3) Purpose of payment: c. Payee (name): (1) Address: (2) Amount: $ (3) Purpose of payment: d. Payee (name): (1) Address: (2) Amount: $ (3) Purpose of payment: Additional payees and amounts to be distributed are listed on Attachment 9.
Number of pages attached:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)

SIGNATURE FOLLOWS LAST ATTACHMENT

MC-357 [Rev. January 1, 2021] PETITION TO WITHDRAW FUNDS FROM BLOCKED ACCOUNT Page 2 of 2

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