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Case No.______________________ Court_________________________ County_______________________ Division_______________________ _________________SETTLEMENT of________________________________________________as________________ of the_____________________________________________________________________________________________ Date Voucher No. Receipts Disbursements AOC-846 Doc. Code: SET Rev. 3-00 Page 1 of 2 Commonwealth of Kentucky Court of Justice KRS 395.600 - .657 Date Voucher No. Receipts Disbursements Total Receipts and Disbursements To The Judge of The________________________District Court: I hereby certify that the foregoing is a true and correct statement of the amounts received and paid out by me as ________________________of the__________________ ________________from__________________to this date. __________________________________________ Subscribed in my presence, and sworn to before me by the said______________________this the________day of ____________________________in the year _________. __________________________________________ Notary Public, _______________________________ County, ________________________. My commission as Notary Public will expire___________________________ ______________________________________________ Attorney Name & Address (If any)It is now ordered that this Settlement be filed in the Clerk's office; advertised in accordance with statutory regu- lations; and continued for exceptions. _____________________________________Judge Noted of record, and filed therein, this____________ __________________________________ _____________________________________Clerk By___________________________________, D.C. Having been appropriately advertised on__________ _____________________________, and no exceptions having been filed, this Settlement is now approved; ordered recorded; the estate now closed; the personal representa- tive discharged; and the surety relieved effective this date. _____________________________________Judge AOC-846 Doc. Code: SET Rev. 3-00 Page 2 of 2