9/06 IN THE DISTRICT COURT OF
In the Matter of the ) (Guardianship)(Conservatorship) of ) ) ) )
JUDICIAL DISTRICT COUNTY, KANSAS
Case No. _________
Proceeding Pursuant to K.S.A. Chapter 59
ANNUAL
In the Conservatorship of , Comes now,
FINAL
,
ACCOUNTING
2 to 2 ,
Name City & Zip Code
Address Telephone Number
(guardian) (conservator) in the above entitled estate and submits the following (annual) (final) accounting in the conservatorship of
Name Address, City & Zip Code
Year of Birth
for the period from
,2
to
,2
.
I. Statement of Receipts and Disbursements RECEIPTS
DATE RECEIVED FROM
Balance Carried Forward
EXPLANATION $
AMOUNT
TOTAL RECEIPTS (Including balance carried forward)
$
DISBURSEMENTS
DATE PAID TO PURPOSE $ AMOUNT
TOTAL DISBURSEMENTS
$
SUMMARY Total Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Total Disbursements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Cash Balance on Hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ II. INVENTORY Your conservator accounts for the fair market value of the following assets: REAL ESTATE 1. 2. 3 4. $ $ $ $ $
Fair Market Value
TOTAL REAL ESTATE PERSONAL PROPERTY
1.
Financial Institution Accounts Description (a) Checking (b) Savings (c) Certificates of Deposit (d) Other $ $ $ $ Amount
2.
Stocks & Bonds Description Other Personal Property Description
$
Amount
3.
$ Total Personal Property . . . . . . . . . . . . $ Total Real Estate and Personal Property . . . . . . . . . . . . $
Amount
I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct.
Conservator