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Fill and Sign the Under Oath I Verify Form

Fill and Sign the Under Oath I Verify Form

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PR-1814 , 11 /12 Estate Account (Informal Administration and Formal Administration) §§86 2.01, 862.05, 862.07, 862.11 and 865.16(1)(c), W isconsin Statutes This form shall not be modified. It may be supplemented with additional mater ial. Page 1 of 3 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF THE ESTATE OF Amended Interim Final Supplemental Estate Account Informal Administration Formal Administration Case No. UNDER OATH I VERIFY: I am the personal representative special administrator of this estate and this estate account is true and correct. The following is my account of the administration of this estate from [Date of Death or Date of prior account] to [Date] . List interested persons on page 2. RECEIPTS TOTAL DISBURSEMENTS TOTAL Net Value of property, subject to administration from Inventory (or assets on hand as of last account) Funeral Expenses Schedule (F) Added Property to which the decedent was entitled to on Date of Death not included in Inventory or Prior Account Schedule (A) Debts of Decedent (G) Dividends (B) Claims (including those by judgment) (H) Interest (C) Taxes Paid (I) Capital Gains (Losses) (D) Interest Paid (J) Other Receipts (E) Administration Expenses (K) Other Payments (L) Distributions Paid to Date (M) TOTAL DISBURSEMENTS Assets on Hand (N) TOTAL TOTAL Totals in each column must be the same. Proposed distribution of Assets on Hand (Schedule O) Total Fees Paid during Administration: Personal Representative Guardian Ad Litem Special Administrator Attorney State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: ► Personal Representative/Special Administrator Name Printed or Typed Address Telephone Number Date Estate Account (Informal Administration and Formal Administration) Page 2 of 3 Case No. PR-1814 , 11/12 Estate Account (Informal Administration and Formal Administration) §§862.01, 862.05, 8 62.07, 862.11 and 865.16(1)(c), W isconsin Statutes This form shall not be modified. It may be supplemented with additional mater ial. Page 2 of 3 State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: ► Personal Representative/Special Administrator Name Printed or Typed Address Telephone Number Date Form completed by: (Name) Telephone Number Bar Number (If any) Address ESTATE ACCOUNT SUPPORTING SCHEDULE List of Interested Persons The names and mailing addresses of all interested persons are as follows: (For any person with disabilities, also list any guardian of estate; for any person in the military, also list attorney or attorney in fact; and for any minor, list date of birth.) Name Mailing Address If Minor, Date of Birth Estate Account (Informal Administration and Formal Administration) Page 3 of 3 Case No. PR-1814 , 11/12 Estate Account (Informal Administration and Formal Administration) §§862.01, 862.05, 8 62.07, 862.11 and 865.16(1)(c), W isconsin Statutes This form shall not be modified. It may be supplemented with additional mater ial. Page 3 of 3 Schedule (A - O) Estate Account Supporting Schedules (List details of each schedule) Amount

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  4. Click Me (Fill Out Now) to prepare the document on your end.
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