Free 10-GC-400(A)(6).v4.101207.ofm - California

GC-400(C)(8)
CONSERVATORSHIP GUARDIANSHIP OF Conservatee Minor
CASE NUMBER:

(Name):

Schedule C, Disbursements, Medical Expenses--Standard Account
Medical expenses of conservatee or ward (Net of direct medical insurance payments, but including insurance premiums paid
from estate. Show insurance reimbursements of estate payments as a receipt. You may use form GC-400(A)(6) for that purpose.)

Date
(mm/dd/yyyy)

Check No.

Payee and Purpose of Payment
$

Amounts

Subtotal, Medical Expenses:

$

(Add pages as required. Check the box at the bottom of the last page of this disbursement category and total the amount of the category. Include that sum in the total of disbursements on line 8 of the Summary of Account (form GC-400(SUM)/GC-405(SUM)). The page total to the right is the number of pages in Schedule C.)
Form Approved for Optional Use Judicial Council of California GC-400(C)(8) [New January 1, 2008] Page C of pages

SCHEDULE C, DISBURSEMENTS, MEDICAL EXPENSES-- STANDARD ACCOUNT
(Probate--Guardianships and Conservatorships)

Probate Code, §§ 1060­1064, 2620; Cal. Rules of Court, rule 7.575 www.courtinfo.ca.gov

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