MINNE­SOTA COURT RULES

GENERAL RULES OF PRACTICE

Forms provided here are for reference purposes. To download forms to fill out please visit the Minnesota Courts website.

FORM 145.1 - RECEIPT OF MINOR SETTLEMENT ORDER AND FUNDS

(Gen. R. Prac. 145.05)

State of Minnesota		District Court
County of ___________	__________ Judicial District
	Case Type: _
_
Plaintiff/Petitioner	Case No. _
and	RECEIPT OF MINOR SETTLEMENT
	ORDER AND FUNDS
_	(Provided Pursuant to Rule 145 of the
Defendant/Respondent	Minnesota General Rules of Practice)

1.__________ ("Financial Institution") acknowledges receipt of the sum of $__________ on behalf of __________ in this action.

2. Financial Institution acknowledges receipt of the Order Approving Settlement and For Deposit Into Restricted Account dated __________ in this action, and that the funds delivered remain subject to that order in the account specified below:

Name of Depository:	_
Branch Name:	_
Branch Address:	_
	_
Account Number:	_(Place on separate form 11.1*)_
Date Account Opened:	_
Current Balance:	$ _

3. This account is a federally insured, restricted account, and no withdrawal of either principal or interest shall be allowed by Financial Institution without a signed court order in this case.

Dated: ______________	Type or Print Name	_
	Signature:	_
	Title:	_

* = As required by Rule 11.2 of the Minnesota General Rules of Practice

(Added effective January 1, 2003; amended effective July 24, 2013.)