Guardians ad litem shall where applicable attach to their report to be filed with the register of probate the certification of the corporate fiduciary, custodian or agent described in G.L. c. 167G, § 3, para. 5 , in substantially the following form, that securities filed by issue, held in bulk, or deposited in a securities depository, clearing corporation or federal reserve bank are, in fact, held by the corporate fiduciary, custodian or agent. Such certification shall relieve the guardian ad litem of any further duty to verify the existence of such securities.


In accordance with G.L. c. 167G, § 3, para. 5, we hereby certify that the securities contained on the attached list of assets are held by us in our capacity as _________, for the amount of _________.

We agree to hold harmless any interested party, or fiduciary or guardian representing such party for loss arising from reliance upon this certificate.


Bank and Trust Company



Amended December 4, 1979, effective December 17, 1979; December 15, 1986, effective January 2, 1987.