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ANNUAL RETURN FINAL RETURN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Conservator that may be formerly known as Guardian - Executor - Administrator) PERIOD FROM TO: In Account with Estate of (Minor - Incapacitated Adult - Deceased) Itemize all receipts and disbursements. If there is not adequate space on this form, you may use as many additional forms as you need. DATE RECEIPTS: (Indicate source of original funds: list any assets, such as savings accounts, stocks, etc. OR pick up balance from last return) Balance from Last Return, if any (Beginning Balance) $ Interest to Date Other Receipts: TOTAL RECEIPTS $ DATE DISBURSEMENTS: List to whom paid and purpose of payment $ TOTAL DISBURSEMENTS (deduct from receipts) $ NET BALANCE ON HAND $ DEPOSITED IN: I have compared the original vouchers with the items listed on the return and certify that the return is correct. Signature of Attorney, if any, representing fiduciary (Conservator that may be formerly known as Guardian - Executor - Administrator) It is ORDERED that the within return be allowed Sworn to and subscribed before me this this day of day of Judge of the Probate Court (Notary Public or C.C.)