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Rev. 4/25 BIENNIAL REPORT BY THE GUARDIAN OF A MINOR WITH FUNDS IN A RESTRICTED ACCOUNT LR29-PR00-716.80 FORM PR00-16 STATE OF INDIANA ) IN THE HAMILTON SUPERIOR COURT ) SS: COUNTY OF HAMILTON ) CAUSE NO. IN THE MATTER OF THE GUARDIANSHIP OF: , A Minor with Funds in a Restricted Account. BIENNIAL REPORT BY THE GUARDIAN OF A MINOR WITH FUNDS IN A RESTRICTED ACCOUNT Comes now , guardian of the minor, and after being first duly sworn upon his/her oath, states as follows: 1. Petitioner was appointed as guardian of on the day of , 20 . The minor was years of age at the time of the guardian’s appointment. Petitioner/guardian resides at: , Indiana. 2. The minor, , is presently enrolled at School in , Indiana, and attends classes and is in the grade. 3. The minor resides with the guardian on a full-time basis at , Indiana. 4. At the time the guardianship was established, was the recipient of funds which were placed in a restricted account. The amount of funds received by the minor and placed in the restricted account was $ . The financial institution where the restricted account is held is (financial institution), (city), Indiana, and the value of the minor’s funds at this time is: $ . Attached is a copy of the most recent account statement. 5. As guardian, I understand that the minor’s funds cannot be withdrawn or spent without the Court’s prior written approval. 6. _ ---PAGE BREAK--- Rev. 4/25 WHEREFORE, , the guardian herein, hereby requests that the court approve this report and order any additional just and proper relief in the premises. Signature of Guardian of Minor I affirm, under the penalties of perjury, that the foregoing representations are true. Signature of Guardian of Minor SIGN SIGN ---PAGE BREAK--- Rev. 4/25 ORDER APPROVING BIENNIAL REPORT BY THE GUARDIAN OF A MINOR WITH FUNDS IN A RESTRICTED ACCOUNT LR29-PR00-716.80 STATE OF INDIANA ) IN THE HAMILTON SUPERIOR COURT ) SS: COUNTY OF HAMILTON ) CAUSE NO. IN THE MATTER OF THE GUARDIANSHIP OF: , A Minor with Funds in a Restricted Account. ORDER APPROVING BIENNIAL REPORT COMES NOW the guardian, , and files the Biennial Report of the Guardian in the words and figures following, to wit: The Court, being duly advised in the premises, NOW FINDS that the same should be approved. IT IS THEREFORE ORDERED, ADJUDGED, AND DECREED by the Court that the Biennial Report of the Guardian is hereby approved. SO ORDERED . JUDGE, HAMILTON SUPERIOR COURT Dist: RJO Counsel of Record Guardian