Free PC-441 - Connecticut


File Size: 205.0 kB
Pages: 1
Date: June 13, 2007
File Format: PDF
State: Connecticut
Category: Court Forms - State
Word Count: 354 Words, 2,261 Characters
Page Size: 612 x 992.13 pts
URL

http://www.jud2.ct.gov/webforms/forms/pc-441ar.pdf

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FIDUCIARY'S PERIODIC OR FINAL ACCOUNT PC-441 REV. 6/01

STATE OF CONNECTICUT
RECORDED:

COURT OF PROBATE [To be used only for conservatorships and guardianships of minors' estates.] TO: COURT OF PROBATE, DISTRICT OF IN THE MATTER OF [Name, address where residing, and zip code of ward or minor.] DISTRICT NO.

Hereinafter referred to as the estate. FIDUCIARY [Name, address, zip code, and telephone number]

POSITION OF TRUST

THE FIDUCIARY HEREBY EXHIBITS this account to said Court for allowance and makes oath that the same is a true and complete account of all receipts and disbursements made in said capacity. This account covers the time period from:[List month, day, year for start and end of time period.] This account is being filed for the following type of estate:[i.e., conservator] This account is being filed for the following reason: [Check applicable box below.] Periodic account. C.G.S. §45a-177 For filing only. A hearing is requested. Final account. C.G.S. §45a-179 The fiduciary represents that there are no debts outstanding against said estate, except as herein stated and, accordingly, application is hereby made for an order of distribution or an order of transfer of the remaining assets of said estate. [Use Second Sheet, PC-180, for any supporting schedule.] ASSETS AND INCOME RECEIVED BY FIDUCIARY To amount of inventory/estate on hand as of last account To amount of income received: Dividends: Social Security payments: Pension Payments: Interest, Account # [Other ] in

$

0.00

0.00 0.00 0.00 0.00 0.00
Total $

0.00

PAYMENTS AND DISTRIBUTIONS BY FIDUCIARY By payments made to or for the benefit of: as per Schedule: By administration expenses Probate court costs: Fiduciary's fee [Show disbursements separately.]
0.00 0.00

0.00
Attorney's fees:[Show disbursements separately.]
0.00

[Other] Amount on hand/estate on hand for distribution Real property: Personal property: Total [If final account, attach schedule of proposed distribution or transfer.] The representations contained herein are made under the penalties of false statement. Date: FIDUCIARY'S PERIODIC OR FINAL ACCOUNT (Short Form) PC - 441 RESET .............................................................................. Fiduciary: $

0.00
0.00 0.00
0.00