STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF:
) ) ) ) ) )
IN THE PROBATE COURT ACCOUNTING CASE NUMBER:
FINAL INTERIM #
The undersigned Personal Representative(s) submits this accounting, which covers the period from through . The documentation on the reverse side of this form sets forth a complete accounting for the period specified, which is summarized as follows:
Beginning Balance Plus: Receipts Subtotal Less: Disbursements Ending Balance
The Personal Representative declares that this account has been examined and that its contents represent a correct statement of all receipts and disbursements and are true to the best knowledge and belief of the Personal Representative(s). SWORN to before me this , 20 day of Signature: Name: Address: Telephone (O): (H): Signature: Name: Address: Telephone (O): (H):
Notary Public for South Carolina My Commission Expires:
FORM #361PC (7/87) 62-3-704, 62-3-1003
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RECEIPTS (assets received into estate)
DISBURSEMENTS (assets disbursed/paid out from estate)
TOTAL
FORM #361PC (7/87)
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