Fill and Sign the Q Guardian or Conservator for Minor Form

NOTICE TO GUARDIAN OR CONSERVATOR FOR MINOR AND TO CONSERVATOR FOR DISABLED PERSON: File this Settlement one (1) year after appointment and annually thereafter. If the net estate is $5,000 or less, �le this Settlement every two (2) years after the original report. (NOTE: YOU ARE NOT REQUIRED TO FILE THIS INVENTORY IF YOU ARE THE GUARDIAN FOR A DISABLED PERSON.) IN RE: Estate of ______________________________________________, a q Minor under 18 q Disabled Person. Comes ____________________________________________, appointed as q Guardian q Conservator of the above estate on ________________________, 2_____. This q Periodic q Final Settlement indicates, by itemize d statement and supported by receipts and vouchers, the assets received and disbursements made since the Inventory or last Settlement was �led. It is submitted pursua nt to: q KRS 387.710 OR q KRS 387.175, 395.610 - 395.657 and 395.990 ASSETS & INVESTMENTS ( Include anything of value to the estate including government bene�ts, Social Security and SSI pension plan bene�ts, savings and checking accounts, certi�cates of deposit, all personal property, rents from real estate, and proceeds from the sale of real estate and personal property. Attach additional sheets of paper if necessary ). ITEM AMOUNT _______________________________________________________________________ $ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ TOTAL ASSETS RECEIVED: $ ____________ DISBURSEMENTS AMOUNT _______________________________________________________________________ $ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ _______________________________________________________________________ ____________ TOTAL DISBURSEMENTS MADE: $ ____________ BALANCE ASSETS LESS DISBURSEMENTS: $ _________________ For Periodic Settlements - carry balance forward to next report. For Final Settlements - indicate to whom balance was paid and attach receipt. AOC-856 Doc. Code: SET or Rev. 7-18 SETFPage 1 of 2 Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 387.175; 387.710; 395.610-.657; 395.990 PERIODIC/FINAL SETTLEMENT q GUARDIAN OR CONSERVATOR FOR MINOR q CONSERVATOR FOR DISABLED PERSON lex et justitia COMMONWEALTHOFKENTUCKY COURTOFJUSTICE Case No. ____________________ Court ________________________County ______________________ Division ______________________ District IN PERIODIC SETTLEMENTS: PLAN FOR PRESERVING AND MAINTAINING ESTATE (not to be �lled out if estate has net value of $5,000 or less ) _______________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ IN FINAL SETTLEMENTS: UNPAID CREDITORS - ALLOWED CLAIMS AMOUNT ___________________________________________________________________________ $ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ TOTAL $ ____________ CREDITORS - DISALLOWED CLAIMS AMOUNT ___________________________________________________________________________ $ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ ___________________________________________________________________________ ____________ TOTAL $ ____________ Above-named Guardian/Conservator submits this Settlement to the Court, and if a Final Settlement, asks that the Surety be discharged. ________________________________ ___________________________________________ _ Date Guardian/Conservator Signature __________________________________ ____________________________________________ ____________________________________________ Address Subscribed and sworn before me on ________________________, 2_____. My commission expires: ______________________, 2_____. _____________________________________________________ Name/Title AOC 856 Rev. 7-18 Case No. ____________________________ Page 2 of 2 Guardian's/Conservator's Phone Number