Missouri > Local Circuit Courts > 7th Circuit (Clay County) > Probate > Minors And Adults
Application For Support And Maintenance 400 - Missouri
| Application For Support And Maintenance Form. This is a Missouri form and can be used in Minors And Adults Probate 7th Circuit (Clay County) Local Circuit Courts . |
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CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of , *minor - *disabled. APPLICATION FOR SUPPORT AND MAINTENANCE The Conservator__ herein states__ to the Court that the Protectees assets presently consist of approximately $ , in Real Property and $ , Personal Property and, that the monthly income is anticipated to be as follows: Social Security $ Supplemental Security Income $ Veterans Administration $ Interest Income $ Other Income (state source) $ $ $ Total Per Month $ The regular monthly expenses are expected to be as follows: Room and Board $ Medical Care $ Drugs $ Other: $ $ Total Per Month $ WHEREFORE, the Conservator___ requests___ that the Court allow the Conservator___ to expend up to $ , per month, of the Protectees funds for the support and maintenance of the Protectee, and to account for the expenditures on each annual settlement. THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date: Conservator Form 400 Page 1 of 1 Revised 3/14/2003
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