Free Statement of voluntary administration - New Hampshire

Instructions

Clear Form

THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

Estate of

STATEMENT OF VOLUNTARY ADMINISTRATION
ESTATE ASSETS AND INCOME
on estate assets.) (List personal estate assets as reported on Voluntary Administration Affidavit and income earned

A. B. C. 1. TOTAL ESTATE ASSETS AND INCOME

$ $ $ $

BILLS PAID FROM ESTATE ASSETS AND INCOME (List only expenses paid from estate assets reported on Voluntary
Administration Affidavit and income earned on estate assets.)

A. B.

Funeral expenses and last sickness Other bills paid such as debts, taxes and estate expenses
(List each specific bill and amount below.)

$ $

2. 3.

TOTAL BILLS PAID FROM ESTATE ASSETS AND INCOME EARNED BALANCE IN HAND TO BE DISTRIBUTED TO LEGATEES OR HEIRS ONLY AFTER RECEIVING THE COURT'S APPROVAL

$

$

, Voluntary Administrator of the estate, state the I, above is a true and accurate statement of my administration. I certify that a copy of this document has been provided to the parties who have filed an appearance for this case or who are otherwise interested parties.
Date Voluntary Administrator Signature (must be signed in presence of notarial officer)

State of
This instrument was acknowledged before me on

, County of
by
Date Voluntary Administrator Signature of Notarial Officer / Title
Page 1 of 2

My Commission Expires Affix Seal, if any
NHJB-2143-P (06/04/2008) (formerly AOC 203-003)

Case Name: Estate of Case Number: STATEMENT OF VOLUNTARY ADMINISTRATION

ORDER
This statement is approved. This statement is disapproved.

Date

Judge

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NHJB-2143-P (06/04/2008) (formerly AOC 203-003)

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