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sec2481

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PDF page 1

FACE AMOUNT
(Denomination) SERIAL NUMBERTITLE OF SECURITY
(Identify by interest rate, title, call and maturity dates)
REGISTRATION
(Exact inscription on each security)
APPLICATION FOR RECOGNITION AS  
NATURAL GUARDIAN OF MINOR NOT UNDER  
LEGAL GUARDIANSHIP AND FOR DISPOSITION  
OF MINOR’S INTEREST IN REGISTERED SECURITIES
OMB No.1530-0041
PRINT IN INK OR TYPE ALL INFORMATION
1. DESCRIPTION OF SECURITIES
SOCIAL SECURITY NUMBER:
NAME:
DATE OF BIRTH:
NAME:
ADDRESS:
TELEPHONE:
RELATIONSHIP TO MINOR:
I request that I be recognized as natural guardian of the minor and request disposition and assignment of the described 
securities as follows:
Conversion to book-entry form for the account of
Payment of called or matured securities
FURNISH CHIEF SUPPORTPARENT OTHER (specify)
MARRIED?  If your spouse did not apply as natural guardian with you, your spouse must sign after the following statement:
I consent to the above-named parent acting as the guardian for our minor child.
SEPARATED OR DIVORCED?  You must furnish a certified copy of court records showing you have custody of the minor.
2. MINOR
3. GUARDIAN
Signature
(Account Information)
If you checked “FURNISH CHIEF SUPPORT,” please provide names and addresses of others who regularly contribute to the 
minor’s support, and the percentage of their contributions:
Does the minor reside with you?
If no, provide the name and address of the person with whom the minor resides:
Yes No
IMPORTANT:  Follow instructions in filling out this form. You should be aware that the making of any false, fictitious, or fraudulent claim or 
statement to the United States is a crime under the laws of the United States.
Visit us on the Web at www.treasurydirect.gov
FS Form 2481 Department of the T reasury | Bureau of the Fiscal Service   Revised October 2015
FS Form 2481

PDF page 2

Page 2
You must wait until you are in the presence of a certifying officer to sign this form.
(If there are two owners joined by the word “and,” both must sign.)
I request that I be recognized as natural guardian of the said minor for purposes of furnishing the payment instructions for the 
security(ies) listed and to execute any necessary requests for those security(ies). 
I certify that no legal guardian or similar representative has been appointed for the said minor and no such application is  
contemplated and that the said minor has an interest in whole or in part in securities held in the accounts listed.
In consideration for my recognition as natural guardian of the minor, I agree that I will promptly notify the Bureau of the Fiscal 
Service if (a) the minor reaches the age of majority or is emancipated by court order or marriage under the laws of the state of his 
or her residence, (b) a legal guardian or similar representative is appointed for the minor’s estate, (c) I no longer furnish chief sup -
port for the minor (when support is the basis for recognition), or (d) the minor dies.
  Instructions to Certifying Officer:
1. Name of person(s) who appeared and date of appearance MUST be completed.
2. Medallion stamps require an original signature.
3. Person(s) must sign in your presence.
TELEPHONE
CITY/STATE/ZIP CODE
ADDRESS
NAME OF FINANCIAL INSTITUTION
SIGNATURE AND TITLE OF CERTIFYING OFFICER
4. AUTHORIZATION
5. CERTIFICATION The signature(s) in section 4 above MUST be certified by an authorized certifying officer.
I certify that , whose identity(ies) is/are 
known or proven to me, personally appeared before me this   day of
at  and signed this form.
MONTH/YEAR
CITY/STATE
NAME(S) OF PERSON(S) WHO APPEARED
ACCEPTABLE CERTIFICATIONS:
Financial Institution’s Official Seal or 
Stamp (Such as Corporate Seal, 
Signature Guaranteed Stamp, or
Medallion Stamp). Brokers must
use a Medallion Stamp.
SIGNATURE
SIGNATURE (IF NECESSARY)
FS Form 2481 Department of the Treasury | Bureau of the Fiscal Service    Revised October 2015

PDF page 3

Page 3
APPLICATION FOR RECOGNITION AS NATURAL GUARDIAN OF
MINOR NOT UNDER LEGAL GUARDIANSHIP AND FOR
DISPOSITION OF MINOR’S INTEREST IN REGISTERED SECURITIES
INSTRUCTIONS FOR COMPLETING
PURPOSE
This form can be used to:
• apply for recognition as a natural guardian of a minor who owns, wholly or in part, registered securities in an estate
where a legal representative has not been appointed.
•  apply for recognition as a natural guardian when a designated natural guardian is no longer acting.  (A death certificate,
physician’s certificate, or certified 
evidence of court action must be submitted as proof of the designated natural guardian’s 
inability to act.)
IMPORTANT NOTE
• Only original signatures and forms will be accepted (stamped signatures are not acceptable).
• Unless all the required information is provided legibly, there may be a delay in processing this form. To avoid delays, read the
instructions carefully and type or print clearly in ink only.
• This form MUST be signed in all cases.
• APPLICATIONS WILL NOT BE ACCEPTED WITH ALTERATIONS OR CORRECTIONS.
WHO MAY APPLY
• The parent with whom the minor resides may apply. If the minor resides with both parents, either or both may apply. The parent who
has not joined in the application must consent by signing the statement within the box in Section 3. If the parents are separated or 
divorced, no consent is required provided that a certified copy of court records is furnished showing that the parent applying has  
custody. 
• If the minor does not reside with either parent, the person who furnishes the minor’s chief support may apply.
No application will be considered if the Department of the Treasury is on notice that 1) the minor has reached the age of majority or is 
emancipated by court order or marriage under the laws of the state of his/her residence, 2) a legal guardian or similar representative 
of the minor’s estate has been appointed, 3) the applicant is not entitled to act as natural guardian, or 4) the minor has died.
Provide a complete description of all securities owned wholly or in part by the minor.
Check the appropriate box to show the requested disposition of the security(ies).
Provide the minor’s name, Social Security Number, and date of birth.
Provide your name and address, and indicate your relationship to the minor. Remember: If you are married and your 
spouse did not apply as natural guardian with you, your spouse must sign the statement within the box. If you’re separated
or divorced, furnish a certified copy of court records showing you have custody of the minor.
If you are applying as the furnisher of chief support for the minor, provide the names and addresses of others who regularly 
contribute to the minor’s support and the extent of their contributions (expressed as a percentage of the minor’s total support).
Indicate whether the minor resides with you.  If not, provide the name and addresses of the person with whom the minor resides.
Read the authorization statement carefully.  In the presence of an authorized certifying officer, sign the form in ink.
2. MINOR
1. DESCRIPTION OF SECURITIES
3. GUARDIAN
4. AUTHORIZATION
Certification of your signature is required.  Acceptable certifying officers include authorized employees of insured depository institutions 
and corporate central credit unions. 
5. CERTIFICATION
FS Form 2481 Department of the Treasury | Bureau of the Fiscal Service    Revised October 2015

PDF page 4

After completing and signing the application, submit it, together with the securities and any necessary evidence, to the Department 
of the Treasury, Bureau of the Fiscal Service, PO Box 426, Parkersburg, WV 26106-0426. We suggest that you send the securities 
by registered mail.
WHERE TO SEND
FEE FOR BONDS OR NOTES REQUESTED IN CERTIFICATE FORM
A fee is charged for each Treasury bond or note requested in certificate form. Unless we are specifically instructed otherwise, any 
unmatured securities will be converted to TreasuryDirect
®.
Page 4 
We estimate it will take you about 10 minutes to complete this form. However, you are not required to provide information requested 
unless a valid OMB control number is displayed on the form.  Any comments or suggestions regarding this form should be sent to 
the Bureau of the Fiscal Service, Forms Management Officer, Parkersburg, WV 26106-1328.  DO NOT SEND completed form to 
this address; send to the address shown in “WHERE TO SEND” in the Instructions.
NOTICE UNDER THE PRIVACY ACT AND PAPERWORK REDUCTION ACT
The  collection of the information you are requested to provide on this form is authorized by 31 U.S.C. Ch. 31 relating to the public 
debt of the United States. The furnishing of a social security number, if requested, is also required by Section 6109 of the Internal 
Revenue Code (26 U.S.C. 6109).
The purpose of requesting the information is to enable the Bureau of the Fiscal Service and its agents to issue securities, process 
transactions, make payments, identify owners and their accounts, and provide reports to the Internal Revenue Service. Furnishing 
the information is voluntary; however, without the information the Fiscal Service may be unable to process transactions.
Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR, Part 323) 
and the Privacy Act. This information may be disclosed to a law enforcement agency for investigation purposes; courts and counsel 
for litigation purposes; others entitled to distribution or payment; agents and contractors to administer the public debt; agencies or 
entities for debt collection or to obtain current addresses for payment; agencies through approved computer matches; Congressional 
offices in response to an inquiry by the individual to whom the record pertains; as otherwise authorized by law or regulation.          
FS Form 2481 Department of the Treasury | Bureau of the Fiscal Service    Revised October 2015