Trustees Account {50.6}

IN THE WARREN COUNTY, OHIO COMMON PLEAS COURT PROBATE DIVISION IN THE MATTER WRONGFUL DEATH TRUST TESTAMENTARY TRUST SPECIAL NEEDS TRUST OTHER OF: _________________________________________________________, Deceased, Grantor for the Benefit of: _______________________________________________________________ CASE NO. _______________________ TRUSTEE'S ACCOUNT [R.C. 2109.30] The trustee offers an account of the trust and has attached an itemized statement of receipts and disbursements. The trustee states that the account is true and correct, and asks that it be approved and settled. [Check one of the following] This is the _______________ partial account for the period from _____________________ to (Number) _________________. A statement of the assets remaining in the trustee's hands is attached. This is a final and distributive account, and the trustee asks to be discharged upon its approval and settlement. This account is recapitulated as follows: RECEIPTS Balance brought forward from inventory or previous account.... Income ........................................................................................ Other Receipts............................................................................ Total receipts .............................................................................. DISBURSEMENTS Fiduciary fees (this accounting period)....................... $ __________________ Attorney fees (this accounting period) ........................ $ __________________ Other administrative costs and expenses .................. $ __________________ Other disbursements .................................................. $ __________________ Total disbursements ................................................... $ __________________ BALANCE REMAINING IN FIDUCIARY'S HANDS .............................. $ __________________ _____________________________________ Date WCPC Form 50.6 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com $__________________ $__________________ $__________________ $__________________ ________________________________ Trustee CASE NO. _______________________ _________________________________________________________________________________________________ BANK CERTIFICATE N.B. must be executed when funds are on deposit. I HEREBY CERTIFY that the within named trustee, on the date named below, had on deposit in the ____________________________________ of __________________________________, Ohio the sum of $ ______________________ on _______________________________ to the credit Nature of Deposit of the trust of ______________________________. ______________________________________ Bank Dated __________________________ By____________________________________ Cashier ______________________________________ Trustee _________________________________________________________________________________________________ BANK CERTIFICATE N.B. must be executed when funds are on deposit. I HEREBY CERTIFY that the within named trustee, on the date named below, had on deposit in the ____________________________________ of __________________________________, Ohio the sum of $ ______________________ on _______________________________ to the credit Nature of Deposit of the trust of ______________________________. ______________________________________ Bank Dated __________________________ By____________________________________ Cashier ______________________________________ Trustee Page 2 of 2 WCPC Form 50.6 Eff. 04/04/11 American LegalNet, Inc. www.FormsWorkFlow.com