Cash Flow Statement

M15 SURROGATE'S COURT - QUEENS COUNTY If an application is made for extension of Preliminary or Temporary Letters, this SCHEDULE MUST BE SUBMITTED Name of Decedent: Date of Preliminary or Temporary Letters: Amount of Assets Collected to Date: File # Collected From (itemize) TOTAL COLLECTED: Debts Paid: (itemize) Expenses Paid: (itemize) Distributions Made: (itemize) TOTAL PAID OUT: BALANCE ON HAND: Funds are in an Account(s) as follows: Name of Depository: Name of Account: Type of Account: Balance in Account:$ $ Date: Signature of PrelirninaryiTernporaryFiduciary American LegalNet, Inc. www.FormsWorkflow.com