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Probate Court Form No. 117A (page 1 of 2) Summary of Account of Trustee Alternate Form STATE OF VERMONT PROBATE COURT DISTRICT OF ,SS. DOCKET NO. IN RE TRUST OF FOR THE BENEFIT OF SUMMARY OF ACCOUNT OF TRUSTEE (Alternate Form) I, , trustee of the above named trust estate account to the court as provided in this summary and the schedules attached hereto for the period to . Total from Inventory │ ║ │ ║ │ or previous │ ║ │ ║ │ Accounting │ ║ │ ║ │ │ ║ │ ║ │ Other Receipts │ ║ │ ║ │ │ ║ │ ║ │ Net gain (or loss) │ ║ │ ║ │ on sales or other │ ║ │ ║ │ disposition │ ║ │ ║ │ │ ║ │ ║ │ Distributions to │ ║ │ ║ │ beneficiaries │ ║ │ ║ │ │ ║ │ ║ │ │ ║ │ ║ │ │ ║ │ ║ │ │ ║ │ ║ │ │ ║ │ ║ │ Balance: │ ║ │ ║ │ │ ║ │ ║ │ The foregoing is a just and true account, (Trustee) Subscribed and sworn to this day of , 20 . Before me, Judge-Register-Justice of the Peace-Notary Public NOTICE: A certificate of service must be filed with the Court by the person who submits this document. The certificate must lest each person to whom copies of this document have been sent, together with the person's address, the date of service and the manner of service (e.g., first class mail). See Form 124. Probate Court Form No. 117A (page 2 of 2) Summary of Account of Trustee IN RE TRUST OF FOR THE BENEFIT OF MOTION TO ALLOW ACCOUNT* I, , trustee of the above named trust, move the court to allow this account. Dated at this day of , 19 . Signed , Trustee ORDER Examined on oath and allowed, Dated Signed , Judge Note * V.R.P.P. 66(d) requires that, in a trust proceeding, a motion to allow account be filed no less frequently than every third year. R 10/88

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