Nebraska > Statewide > County Court-Separate Juvenile Court > Guardianships-Conservatorships
Annual Accounting Or Statement Of Assets 16-4 - Nebraska
| Annual Accounting Or Statement Of Assets Form. This is a Nebraska form and can be used in Guardianships-Conservatorships County Court-Separate Juvenile Court Statewide . |
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STATE OF NEBRASKA CASE NUMBER FORM NO. 16:4 3/91 rev. Annual Accounting/Statement of Asset s Beginning_______________ Ending_______________ IN THE MATTER OF THE GUARDIANSHIP/CONSERVATORSHIP OF ______________________________________ ( Ward) STATE OF NEBRASKA ) ) ss. COUNTY OF _____________________ ) The undersigned Guardian/Conservator of person and property of the above named ward, being duly sworn, says this account is in all respects just and true, and that to the best of her/his knowledge and belief she/he has accounted for all the property of the ward that has come into her/his possession or knowledge, or the possession for anyone of her/him for said ward. DATE:______________________ GUARDIAN/CONSERVATOR:___________________________ Address: ________________________________ Phone: ________________________________ Subscribed and sworn to before me on this ________ day of ________________, ______. ________________________________ ( Notary Public) STATEMENT OF ASSETS Item V alue $ T OTAL: FORM NO. 16:4 (Certificate of Proof of Possession is required to be attached to this form) Page 1 of 2 <<<<<<<<<********>>>>>>>>>>>>> 2 CASE NUMBER_______________________ ______________________________________ ( Ward) Beginning Balance Amount paid Date Check No . Recd from/Paid to Purpose Balance or recd (Attach additional sheets if necessary) Ending Balance FORM NO. 16:4 (Certificate of Proof of Possession is required to be attached to this form) Page 2 of 2
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