Free pc584.pmd - Michigan

Approved, SCAO

JIS CODE: ACC

STATE OF MICHIGAN PROBATE COURT COUNTY
CIRCUIT COURT - FAMILY DIVISION

FILE NO. ACCOUNT OF FIDUCIARY, LONG FORM Annual Final Interim Number AMENDED

In the matter of 1. I,
Name

, am the
Title Month, day, year

of the estate and submit the following as my account, which covers the period from to
Month, day, year

(may not exceed 12 months).

2. SUMMARY Balance on hand from last account, or value of inventory if first account ......................................... Add income in this accounting period (Total from Schedule A.) ............................................................ Total assets accounted for ......................................................................................................... Subtract disbursements in this accounting period (Total from Schedule B.) ........................................... Total balance of assets remaining (Itemize and describe in Schedule D.) ........................................

$ $ $ $ $

0.00 0.00 0.00 0.00

If additional sheets are required for Schedules A or B, place all itemization on those sheets and include only category totals on these schedules.

SCHEDULE A: Income in this accounting period

SCHEDULE B: Expenses and other disbursements, including distributions to devisees and beneficiaries

You must enter a number here, even if it is "0"

Net gain, if any, from Schedule C Total Income
0.00

Net loss, if any, from Schedule C Total Expenses and Disbursements
0.00

SEE SECOND PAGE
Do not write below this line - For court use only

PC 584 (9/08)

ACCOUNT OF FIDUCIARY, LONG FORM

MCL 330.1631, MCL 700.3703(4), MCL 700.5418, MCR 5.308(A), MCR 5.310(C), MCR 5.313, MCR 5.409

SCHEDULE C: Gains and losses on disposition of assets (Use only if needed.)
DESCRIPTION DATE ACQUIRED DATE SOLD VALUE AT TIME ACQUIRED BY FIDUCIARY NET SALES PRICE GAIN (LOSS)

0.00
0.00

0.00
0.00

TOTAL GAIN (LOSS) ....................................................
If gain, transfer to Schedule A; if loss, transfer to Schedule B.

0.00

0.00

0.00

SCHEDULE D: Itemized assets remaining at end of accounting period
(If additional sheets are required, indicate on Schedule "See attached sheets.")

BALANCE OF ASSETS REMAINING (Show this amount on summary.) ............................ NOTE: In guardianships and conservatorships, except as provided by MCR 5.409(C)(4), you must present to the court copies of corresponding financial institution statements or you must file with the court a verification of funds on deposit, either of which must reflect the value of all liquid assets held by a financial institution dated within 30 days after the end of the accounting period. 3. The interested persons, addresses, and their representatives are identical to those appearing on the initial application/petition, except as follows: (For each person whose address changed, list the name and new address; attach separate sheet if necessary.) 4. This account lists all income and other receipts and expenses and other disbursements that have come to my knowledge. 5. This account is not being filed with the court. 6. My fiduciary fees incurred during this accounting period (including fees that have already been approved and/or paid for this accounting period) are $ . Attached is a written description of the services performed. 7. Attorney fees incurred during this accounting period (including fees that have already been approved and/or paid for this accounting period) are $ . Attached is a written description of the services performed. I declare under the penalties of perjury that this account has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Date Attorney signature Attorney name (type or print) Address City, state, zip Bar no. Fiduciary signature Fiduciary name (type or print) Address

Telephone no. Telephone no. City, state, zip NOTE: If the decedent died before October 1, 1993, you must attach proof of inheritance tax paid. If the decedent died between October 1, 1993 and December 31, 2004, you must attach proof of estate tax paid. If the decedent died on or after January 1, 2005, there is no Michigan estate tax or inheritance tax.

For accounts that must be filed with the court.

NOTICE TO INTERESTED PERSONS

1. You must bring to the court's attention any objection you have to this account. The court will not review the account otherwise. 2. You have the right to review proofs of income and disbursements at a time reasonably convenient to the fiduciary and yourself. 3. You may object to all or part of an accounting by filing a written objection with the court before the court allows the account. You must pay a $20.00 filing fee to the court when you file the objection. (See MCR 5.310[C].) 4. If an objection is filed and is not otherwise resolved, the court will conduct a hearing on the objection. 5. You must serve the objection on the fiduciary or his/her attorney.