Fill and Sign the Michigan Account of Fiduciary Long Form

(SEE SECOND PAGE) PC 584 (9/11) ACCOUNT OF FIDUCIARY, LONG FORM In the matter of JIS CODE: ACC Approved, SCAO FILE NO. Do not write below this line - For court use only ACCOUNT OF FIDUCIARY, LONG FORM Annual Final Interim AMENDED Number STATE OF MICHIGAN PROBATE COURT COUNTY OF 1. I, , am the of the estate and submit the following as my account, which covers the period from to (may not exceed 12 months). 2.SUMMARY Balance on hand from last account, or value of inventory if first account......................................... $ Add income in this accounting period ............................................................ $ Total assets accounted for ......................................................................................................... $ Subtract disbursements in this accounting period........................................... $ Total balance of assets remaining........................................ $ If additional sheets are required for Schedule A or B, place all itemization on those sheets and include only category totals on the schedules below. Investment gain Investment loss Disposition gain, if any, from Schedule C Disposition loss, if any, from Schedule C MCL 330.1631, MCL 700.3703(4), MCL 700.5418, MCR 5.308(A), MCR 5.310(C), MCR 5.313, MCR 5.409 Name Title Month, day, year Month, day, year (Total from Schedule A.) (Total from Schedule B.) (Itemize and describe in Schedule D.) SCHEDULE A: Income and gain in this accounting period SCHEDULE B: Expenses, losses, and other disbursements, including distributions to devisees and beneficiaries Total Expense, Loss, and Disbursement Total Income and Gain USE NOTE: If this form is being filed in the circuit court family division, please enter the court name and county in the upper left-hand corner of the form. In a guardianship or conservatorship, the ward's or protected individual's current address and telephone number are: SCHEDULE C: Gain and loss on disposition of assets (Use only if needed.) TOTAL GAIN (LOSS) .................................................... If gain, transfer to Schedule A. If loss, transfer to Schedule B. SCHEDULE D: Itemized assets remaining at end of accounting period If additional sheets are required, indicate on Schedule "See attached sheets." BALANCE OF ASSETS REMAINING (Show this amount on summary.) ............................ 3. The interested persons, addresses, and their representatives are identical to those appearing on the initial application/petition, except as follows: (For each person whose address changed, list the name and new address; attach separate sheet if necessary. ) 4. This account lists all income and other receipts and expenses and other disbursements that have come to my knowledge. 5. This account is not being filed with the court. 6. My fiduciary fees incurred during this accounting period (including fees that have already been approved and/or paid for this accounting period) are $ . Attached is a written description of the services performed. 7. Attorney fees incurred during this accounting period (including fees that have already been approved and/or paid for this accounting period) are $ . Attached is a written description of the services performed. I declare under the penalties of perjury that this account has been examined by me and that its contents are true to the best of my information, knowledge, and belief. NOTICE TO INTERESTED PERSONS 1. You must bring to the court's attention any objection you have to this account. Except in guardianships and conservatorships, the court does not normally review the account without an objection. 2. You have the right to review proofs of income and disbursements at a time reasonably convenient to the fiduciary and yourself. 3. You may object to all or part of an accounting by filing a written objection with the court before the court allows the account. You must pay a $20.00 filing fee to the court when you file the objection. (See MCR 5.310[C].) 4. If an objection is filed and is not otherwise resolved, the court will conduct a hearing on the objection. 5. You must serve the objection on the fiduciary or his/her attorney. DATEDATEVALUE AT TIME PROCEEDS OF SALE/ DESCRIPTIONACQUIRED SOLD/DISPOSED ACQUIRED BY DISPOSITION GAIN (LOSS) FIDUCIARY Address Attorney signature City, state, zipTelephone no. Attorney name (type or print) Date Address Fiduciary signature City, state, zip Fiduciary name (type or print) Telephone no. (For accounts that must be filed with the court.) Bar no. NOTE: In guardianships and conservatorships, except as provided by MCR 5.409(C)(4), you must present to the court copies of corresponding financial institution statements or you must file with the court a verification of funds on deposit, either of which must reflect the value of all liquid assets held by a financial institution dated within 30 days after the end of the accounting period.