ESTATE INFORMATION
Name of Decedent/Conservatee/Minor _______________________________________________________________________________
Date of Birth of Conservatee/Minor __________________________________________________________________________________
Estate Cash _________________________ Securities ___________________________ Real Property_________________________
Other Assets ___________________________________________________ Annual Income (All Sources) _______________________
Bank where ESTATE ACCOUNT will be opened _______________________________________________________________________
Address ________________________________________________________________________________________________________
City ____________________________________________________ State ____________________ Zip _______________________
Where will securities be kept? ______________________________________________________________________________________
(Safe deposit box, Brokerage – Including Name and Address)
Does the estate contain a going business? _____________________ If yes, name ____________________________________________
Type _________________________________________________________ Will it be continued? ______________________________
If yes, do you understand you must have a court order to continue business? ___________________________________________________
Do you understand that the first year’s bond premium is not refundable? ______________________________________________________
Do you understand all increases and reductions of the bond must be ordered by the court? ________________________________________
Do you understand the bond is in effect until a final discharge is signed by the judge and a copy delivered to the Surety?
_______________________________________________________________________________________________________________
Do you understand the bond premium is to be paid annually? ______________________________________________________________
Do you understand you must retain an attorney throughout the administration of this estate/conservatorship? _________________________
INDEMNITY AGREEMENT - READ CAREFULLY AND SIGN
The undersigned Applicant and Indemnitor certifies that all the foregoing answers given are the truth without reservation and are made to induce the Surety to become
Surety on any or all bond(s) required to be posted by the Principal named herein as a result of his duties and obligations in administering the above-mentioned Estate.
In consideration of the Surety executing any such bond(s) as may be required of Principal, the undersigned agrees as follows:
________________________________________________________
SIGNATURE, APPLICANT
To reach us, CALL 215-862-6100
The undersigned Applicant and Indemnitor certifies that all the foregoing answers given are the truth without reservation and are made to induce the Surety to become
Surety on any or all bond(s) required to be posted by the Principal named herein as a result of his duties and obligations in administering the above-mentioned Estate.
In consideration of the Surety executing any such bond(s) as may be required of Principal, the undersigned agrees as follows:
1. To reimburse American Contractors Indemnity Company ("Surety") upon demand for all payments made for and to indemnify Surety from:
a) all loss, contingent loss, liability and contingent liability, claim, expense, including attorneys’ fees, for which Surety shall become liable or shall
become contingently liable by reason of such suretyship, whether or not Surety shall have paid same at the time of demand; and
b) to pay Surety an advance premium for the first year or a fractional part thereof that is fully earned and to pay annually thereafter such annual premium
for suretyship as is billed until satisfactory evidence of discharge or release of liability shall be furnished to Surety by the obligee.
c) Upon written demand, to deposit with the Surety a sum of money requested by Surety to cover any claim, suit, expense or judgment that Surety in its
absolute discretion determines necessary and the deposit shall be pledged as collateral security on any bond or other bonds the Surety may have issued
for the undersigned.
2. Surety and undersigned agree that the place of performance of this agreement, including the promise to pay Surety, shall be in Los Angeles County, California and
venue for any suit, arbitration, mediation or any other form of dispute resolution shall be in Los Angeles County, California.
3. Surety is authorized to investigate, at any time, the undersigned’s credit, employment history, and department of motor vehicle records. Privacy Notice: All
nonpublic personal information gathered pursuant to the application shall not be disclosed except as permitted by law.
Regardless of the date of signature, this indemnity is effective as of the date of execution and renewal of the aforementioned bond(s) and is continuous until Surety is
satisfactorily discharged from liability pursuant to the terms and conditions contained herein and in the bond(s).
Signed this _________ day of _______________________________, ___________.
