in the court of common pleas of lehigh county, pennsylvania

orphans’ court division

IN RE:	:
:	File No.
Full name of minor	:
Estate of:
AFFIDAVIT OF DEPOSIT OF MINOR’S FUNDS BY AUTHORIZED BANK PERSONNEL

Pursuant to the Pennsylvania Public Access Policy this Affidavit is not available for public inspection or viewable via Odyssey Attorney Access

COMMONWEALTH OF PENNSYLVANIA	)
)	ss:
COUNTY OF LEHIGH	)
I,	being duly sworn according to law
depose and say:
1.	I am employed by	as
name of financial institution
and in that capacity am authorized to make
job title at financial institution
this affidavit on behalf of the depository.
2.	Pursuant to Order of Court entered	on
filing date of Court Order
date of this deposit
deposited	$	to an insured interest-bearing:
Name of person who made the deposit
Savings Account	Certificate of Deposit
complete account number
complete CD number
entitled	, a minor
full name of minor
3.	The express prohibition of withdrawals of income or principal prior to the minor’s 18th
birthday on	WITHOUT FURTHER ORDER OF COURT
has been noted on the depository’s records and on the passbook/certificate.

Signature.
Printed Name.
Branch Address.
Phone No.

SWORN TO and subscribed before me
this
day of
,20
Notary Public

2

IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

Rachel A Wotring

2023-06-29

County of Lehigh