IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA
ORPHANS’ COURT DIVISION
ORPHANS COURT NUMBER: [ENTER O.C. NUMBER]
IN THE MATTER OF: [ENTER FIDUCIARY’S NAME]
FOR THE PERIOD: [ENTER APPLICABLE DATES]
APPROVAL UNDER RULE 1.2K
[ENTER FILING ATTORNEY’S NAME]
[ENTER ADDRESS LINE 1]
[ENTER ADDRESS LINE 2]
[ENTER CITY, STATE, ZIP]
[ENTER ATTORNEY’S PHONE NUMBER]
To the Honorable Judges of the Philadelphia Orphans’ Court:
The Petition of [ENTER FIDUCIARY’S NAME], a Corporation of [ENTER STATE OF INCORPORATION], respectfully represents:
1. Principal Office:
The Principal Office is located at: [ENTER FIDUCIARY’S NAME]
[ENTER ADDRESS LINE 1]
[ENTER ADDRESS LINE 2]
[ENTER CITY, STATE, ZIP]
2. Matters Dealing with Approval:
The Officer to be contacted in matters dealing with approval under Rule 1.2K is:
[ENTER OFFICER’S NAME]
[ENTER OFFICER’S TITLE]
[ENTER OFFICER’S PHONE NUMBER]
3. Amount of Funds held as Fiduciary:
The TOTAL amount of funds held by the Petitioner as Trustee, Guardian, or other Fiduciary, calculated as of [ENTER DATE OF CALCULATION] was [ENTER $ AMOUNT] in [ENTER APPROXIMATE NUMBER OF ACCOUNTS] number of accounts.
4. Last Examination by Governmental Agency:
The last examination into the affairs of the Petitioner was made as of the close of business on [ENTER DAY, MONTH, YEAR] by the [ENTER AGENCY NAME].
5. Type of Banking Institution:
Petitioner is a [ENTER TYPE OF BANKING INSTITUTION] with fiduciary powers, licensed by [ENTER LICENSING AGENCY].
6. Certificate of Incorporation:
A copy of Petitioner’s Certificate of Incorporation is attached hereto as Exhibit “A”.
[ATTACH CERTIFICATE OF INCORPORATION AS EXHIBIT “A”]
7. Certificate of Good Standing:
A copy of Petitioner’S Certificate of Good Standing issued by the [ENTER ISSUING DEPARTMENT] is attached hereto as Exhibit “B”. Said Certificate is dated [ENTER DATE] and Petitioner has not been notified of any change in this status from that date to the date of this Petition.
8. Consent to Jurisdiction:
Petitioner, if approved to act as a Corporate Fiduciary in Philadelphia County under Rule 1.2K, consents to jurisdiction of the courts of the Commonwealth of Pennsylvania and agrees to comply with the laws of the Commonwealth of Pennsylvania.
WHEREFORE, Petitioner requests approval, in accordance with Rule 1.2K, to act as Fiduciary in matters pending in the Court for the period from JANUARY 1, [ENTER YEAR] to December 31, [ENTER YEAR].
IN WITNESS WHEREOF [ENTER FIDUCIARY’S NAME] has caused its corporate seal to be affixed, duly attested, this [ENTER DAY, MONTH, YEAR]
[ENTER FIDUCIARY’S NAME]
______
[ENTER NAME]
[ENTER TITLE]
ATTEST:
______
[ENTER NAME]