Fill and Sign the Gn 3480 Annual Report on the Condition of the Ward Form

GN-3510, 10/06 Modified Annual Account of Married W ard or Married §§54.19(5), 54.62(4) and 54.66, Wisconsin Statutes This form shall not be modified. It may be suppleme nted with additional material. Page 1 of 3 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Amended Modified Annual Account of Married Ward Date of Birth Case No. For Official Use I am the Guardian and I certify that this is an acc urate account of the administration of the Guardian ship with marital property for the period from January 1, to December 31, . I am filing this Modified Annual Account of the Mar ried Ward as permitted by the court. Line Summary Explanation Total 1. Total assets of ward as determined under ch. 766 , on January 1 of the reporting year. (Attach Schedule A ) $ 2. Income in the name of the ward without regard to ch. 766, and the ward’s joint income. (Attach Schedule B ) $ 3. Expenses incurred on behalf of the ward includin g the ward’s proportionate share of household expenses if the ward and the spouse re sides in the same household, without regard to ch. 766. (Attach Schedule C) $ 4. Total marital property of the ward, as determined under ch. 766 , on December 31 of the reporting year . (Attach Schedule D) $ Status of Surety on Bond The status of the surety upon the guardian’s bond: has not changed. has changed. Explain: Signature of Guardian/ Signature of Spouse Name Printed or Typed Telephone Number Name Printed or Typed Telephone Number Address Address Subscribed and sworn to before me on Notary Public/Court Official My commission expires: Subscribed and sworn to before me on Notary Public/Court Official My commission expires: Name of Attorney Address Telephone Number Bar Number GN-3510 Modified Annual Account of Married Ward Page 2 of 3 Case No. GN-3510, 10/06 Modified Annual Account of Married W ard §§54.19(5), 54.62(4) and 54.66, Wisconsin Statutes This form shall not be modified. It may be suppleme nted with additional material. Page 2 of 3 Schedule A - Total assets of ward as determined under ch. 766 , on January 1 of the reporting year. See attached. Amount Total: (Enter in Summary on Line 1 on page 1.) $ Schedule B - Income in the name of the ward without regard to ch. 766, and the ward’s joint income. See attached. Amount Total: (Enter in Summary on Line 2 on page 1.) $ Schedule C - Expenses incurred on behalf of the ward includin g the ward’s proportionate share of household expenses if the ward and the spo use resides in the same household, without regard to ch. 766. See attached. Amount Total: (Enter in Summary on Line 3 on page 1.) $ GN-3510 Modified Annual Account of Married Ward Page 3 of 3 Case No. GN-3510, 10/06 Modified Annual Account of Married W ard §§54.19(5), 54.62(4) and 54.66, Wisconsin Statutes This form shall not be modified. It may be suppleme nted with additional material. Page 3 of 3 Schedule D - Total marital property of the ward as determined under ch. 766 , on December 31 of the reporting year. See attached. Amount Total: (Enter in Summary on Line 4 on page 1.) $ For Authorized Persons Only Display of Assets and Examination of Accounts: I am not the guardian or spouse. I am authorized b y the court to examine assets. I have examined all secur ities, depository accounts, and other investments, and such assets correspond with the account, except as indicated. Authorized Signature (Not guardian or spouse) Name Printed or Typed Title Date