Free Microsoft Word - 562PC.dot - South Carolina

STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF:

) ) ) ) ) )

IN THE PROBATE COURT CONSERVATOR ANNUAL ACCOUNTING CASE NUMBER: through .

The undersigned Conservator submits this accounting, which covers the period from

The documentation on page 2 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 Conservator declares that this account has been examined and that its contents represent a correct statement of all receipts and disbursements and is true to the best knowledge and belief of the Conservator.

Executed this

day of

, 20

.

SWORN to before me this , 20

day of

Signature: Name: Address: Telephone (O): (H):

Notary Public for South Carolina My Commission Expires:

FORM #562PC (2/2004) 62-5-419

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RECEIPTS (assets received into estate)

DISBURSEMENTS (assets disbursed/paid out from estate)

TOTAL

FORM #562PC (2/2004)

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