Fill and Sign the Vt Trustee 497428825 Form

STATE OF VERMONT PROBATE COURT DISTRICT OF ____________ In Re the Estate of: ) DOCKET No. __________ ) __________________ ) , Deceased ) ) ) LATE OF ) ) __________________ . ) ) ) SUMMARY OF ACCOUNT OF TRUSTEE 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 __________________ . Initial or Current or Carrying Market Schedule* Value Value** PRINCIPAL Total from inventory or previous accounting ____ ____ Receipts A ____ ____ Netgain (or loss) on sales or Other disposition B ____ ____ Less disbursements C ____ ____ Balance before distributions ____ ____ Distributions to beneficiaries D ____ ____ Principal balance on hand E ____ ____ - 1 - For information only F ____ ____ A. Investments made B. Changes in investment Holdings INCOME Total from inventory or Previous accounting ____ ____ Receipts G ____ ____ Less disbursements H ____ ____ Balance before distributions ____ ____ Distributions to beneficiaries I ____ ____ Income balance on hand ____ ____ Combine balance on hand ____ ____ Proposed distribution to Beneficiaries, or income Balance in hands of trustee (For interim account only) J Notes * Use of the Attached Schedules is optional, as long as the information is provided in the manner specified on the Schedules. The detail for relatively simple or brief accounts may be put on one sheet. ** Use current value if known or if directed by the court. I, ___________________________ , trustee of the above named trust estate declare under oath that I have fully and faithfully discharged the duties of my office to the present date; that the foregoing account is true and correct and discloses all significant transactions occurring during the accounting period; - 2 - that all known expenses of the estate have been paid in full, except as provided herein; that, to my knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. Dated ___________ Signed __________________________________ Trustee Subscribed and sworn to this       day of __________ , 20       Before me, _________________________________________________________ Notary Public In re Trust of ____________________________________________ For the Benefit of ____________________________________________ Account Period: __________ to __________ NOTICE: A certificate of service must be filed with the court by the person who submits this document. The certificate must list 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. MOTION TO ALLOW ACCOUNT* I, ___________________________ , trustee of the above named trust, move the court to allow this account. 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. Dated at ______________ this ___ day of ______________ , 20 ___ . Signed ____________________________________ , Trustee - 3 - ORDER Examined on oath and allowed, Dated _________________________ Signed _______________________________________________, Judge Rev.9/5/95 - 4 -