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Financial Accounting (Annual) - Utah

Financial Accounting (Annual) Form. This is a Utah form and can be used in Guardianship Conservatorship Statewide .
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Name Address Phone Fax E-mail I am the Guardian Conservator Conservator I am the attorney for Guardian My Utah State Bar number is In the Court Address: In the Matter of: Judicial District Court County, Utah [ ] Guardian's Financial Accounting to Conservator [Section 75-5-312] [ ] Guardian's/Conservator's Financial Accounting to the Court [Section 75-5-312 and Section 75-5-419] Case Number Judge (Ward). 1. I am the following to the above-named Ward: [ ] Guardian [ ] Conservator [ ] Guardian and Conservator 2. (Check all of the boxes which apply. Fill in the blanks if appropriate.) [ ] This is my first report. [ ] My previous report covered the period from ______________ to ______________. [ ] This is my final report. 3. This accounting covers the period from ______________ to ______________. Guardian or Conservator Accounting Report Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com 4. There is an estate plan to guide investment and distribution: [ ] No [ ] Yes [ ] The plan is on file with the court. [ ] The plan is being submitted along with this accounting. 5. Balance Summary (Beginning Balance must agree with Ending Balance of the Inventory or the previous accounting, whichever is later.) Gains and Ending Beginning Losses Balance Schedule Category Balance A Real Estate B Stocks and Bonds C Money Owed to Ward D Miscellaneous Property E Debts and Encumbrances F Cash and Cash Accounts ** * Total * This amount should equal the money in all of the Ward's bank accounts on the last day of the reporting period for this accounting. **The total Gains and Losses for Cash and Cash Accounts should equal the total for Receipts and Payments. Summary of Receipts and Payments 1 Receipts Total 2 Payments Total 3 Total ** **The total Gains and Losses for Cash and Cash Accounts should equal the total for Receipts and Payments. Receipts during the reporting period Item Description 1 Wages 2 Interest 3 Dividends 4 Social Security 5 Annuities 6 Insurance 7 Real Estate Sold 8 Stocks/Bonds Sold Guardian or Conservator Accounting Report Amount Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Item 9 10 11 Description Money owed to Ward that was received Miscellaneous Property Sold Other (Describe) Amount 12 Total Payments during the reporting period Item Category 1 Mortgage/Rent 2 Utilities (gas, electricity, water, sewage, phone, internet, etc.) 3 Home Maintenance (Include maintenance, cleaning, repairs, etc.) 4 Home Improvement (Include additions, remodeling, etc.) 5 Home Furnishings 6 Health Care (physicians, dentists, psychiatrists, psychologists, etc.) 7 Food 8 Education 9 Clothes 10 Personal Effects 11 Activities 12 Transportation 13 Taxes 14 Charge for Conservator's Services 15 Charge for Guardian's Services 16 Charge for other Professional Services 17 Court Fees 18 Other (Describe) (Amount) 19 Total Schedule A ­ Real Estate* Value on First Day of this Reporting Period Value on Last Day of this Reporting Period Amount of Gain (Loss) Item Description 1 2 3 * Attach a copy of the most recent tax assessment for each piece of real property. Guardian or Conservator Accounting Report Page 3 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Schedule B ­ Stocks and Bonds* Value on First Day of this Reporting Period Value on Last Day of this Reporting Period Amount of Gain (Loss) Item Description 1 2 3 4 5 * Attach a copy of the most recent account statement if one has been issued. Schedule C ­ Money owed to Ward Value on First Day of this Reporting Period Value on Last Day of this Reporting Period Amount of Gain (Loss) Item 1 2 3 4 5 Description Schedule D ­ Miscellaneous Property Value on First Day of this Reporting Period Value on Last Day of this Reporting Period Amount of Gain (Loss) Item 1 2 3 4 5 Description Schedule E ­ Debts and Encumbrances Debts on First Day of this Reporting Period Debts on Last Day of this Reporting Period Amount of Gain (Loss) Item 1 2 3 4 5 Description Guardian or Conservator Accounting Report Page 4 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Schedule F ­ Cash Accounts (Such as checking or savings accounts)* Amount on First Amount on Last Day of this Day of this Reporting Period Reporting Period Item Description 1 2 3 4 5 * Attach a copy of the most recent bank statement for each account. Amount of Gain (Loss) I declare under criminal penalty of Utah Code Section 46-5-101 that this document is true and correct. __________________ Date __________________________ __________________________ (Type or Print Name Here) Guardian or Conservator Accounting Report Page 5 of 5 American LegalNet, Inc. www.FormsWorkFlow.com
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