Annual Accounting Form

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IN THE DISTRICT COURT OF ____________________ COUNTY, KANSAS
Filed Pursuant to K.S.A. Chapter 59
IN THE MATTER OF THE (GUARDIANSHIP)
(CONSERVATORSHIP) OF
CASE NO. ____________
_______________________________________
(ANNUAL)(FINAL) ACCOUNTING
PLEASE PRINT AND USE BLACK INK TO COMPLETE THIS FORM.
In the Conservatorship of _______________________________,
For period beginning _________________, 20____ and ending ________________, 20____.
Comes now, _______________________________ ________________________________
Conservator Address
_______________________________ ________________________________
City, State and Zip Code Telephone Number
conservator in the above entitled estate and submits the following (annual)(final) accounting in
the conservatorship of:
______________________________ _________________ _________________________
Name of Ward Date of Birth Social Security Number
______________________________
Address, City, State & Zip Code
SUMMARY FOR ACCOUNTING PERIOD
TOTAL RECEIPTS $_______________
TOTAL DISBURSEMENTS $_______________
CASH BALANCE ON HAND $______________

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ACCOUNTING - CASE NO. _____________
ATTACH DETAILED ACCOUNTING OF RECEIPTS, DISBURSEMENTS AND
INVENTORY OF PROPERTY ON THE FOLLOWING PAGES:
RECEIPTS
DATE
RECEIVED FROM
EXPLANATION
AMOUNT
BALANCE FORWARD
TOTAL RECEIPTS
$
ATTACH ADDITIONAL PAGES IF NECESSARY.
ACCOUNTING - CASE NO. ___________
SHEETS CAN BE ATTACHED FOR FURTHER DETAILS.
DISBURSEMENTS

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DATE
PAID TO
PURPOSE
AMOUNT
TOTAL DISBURSEMENTS
$

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ACCOUNTING - CASE NO. __________
SHEETS CAN BE ATTACHED FOR FURTHER DETAILS
(ANNUAL)(FINAL) INVENTORY
(For Period Ending _______________, _____)
Including the above cash balance, your accounts for the following assets:
REAL ESTATE
1. _______________________________________________ $______________
2. _______________________________________________ $______________
3. _______________________________________________ $______________
TOTAL REAL ESTATE $______________
PERSONAL PROPERTY
1. Financial Institution Accounts (Location)
(a) Checking ____________________________________ $______________
(b) Savings _____________________________________ $______________
(c) Certificates of Deposit __________________________ $______________
(d) Other _______________________________________ $______________
2. Stocks & Bonds (Description)
_______________________________________________ $______________
_______________________________________________ $______________
_______________________________________________ $______________
3. Other Personal Property (Description)
_______________________________________________ $______________
_______________________________________________ $______________
_______________________________________________ $______________
TOTAL PERSONAL PROPERTY $______________
TOTAL REAL ESTATE AND PERSONAL PROPERTY $______________
____________________________
CONSERVATOR'S SIGNATURE
STATE OF KANSAS, COUNTY OF _________________ SS:
____________________________, of lawful age, being first duly sworn on oath states: That __________
is the conservator above named; that _________ has read the above (annual)(final) accounting in the
conservatorship of _______________________ that _______ knows the content thereof, and that all the
statements made therein are true.
__________________________________
CONSERVATOR'S SIGNATURE
Subscribed and sworn to before me this ______ day of __________________________, ________.
____________________________
NOTARY PUBLIC