Trustees Accounting {417.02}

FORM 417.02 State of Minnesota County: TRUSTEE'S ACCOUNTING District Court Judicial District: Court File No.: Case Type: In the Matter of the Trust Created under Article __________ of the Last Will of _________________. ALTERNATIVE FOR INTER VIVOS TRUSTS: In the Matter of the Trust Created under Agreement By and Between ___________________, Settlor, and _______________ and ___________________, Trustees, dated _____________________. TRUSTEE'S ANNUAL ACCOUNT Principal Assets on hand as of ___________ (Schedule 1) Increases to Assets: Interest (Schedule 2) Dividends (Schedule 3) Capital gains distributions (Schedule 4) Gains on sales and other dispositions (Schedule 5) Return of capital (Schedule 6) Other increases (Schedule 7) Decreases to Assets: Losses on sales and other dispositions (Schedule 8) Administration expenses (Schedule 9) Taxes (Schedule 10) Trustee fees Attorney fees Other decreases (Schedule 11) Balance Before Distributions Distributions to Beneficiaries (Schedule 12) Principal and Income Balances Total Assets on Hand as of ________________ (Income plus principal) (Schedule 13) [FORM CONTINUED ON NEXT PAGE] 1 American LegalNet, Inc. www.FormsWorkFlow.com Income $ $ $ $ $ $ $ $ $ $ $ $ $ $ ($ ($ ($ ($ ($ ($ $ ($ $ ) ) ) ) ) ) ($ ($ ($ ($ ($ ($ $ ($ $ $ ) ) ) ) ) ) ) ) [NAME OF TRUST] ASSETS ON HAND [Beginning DATE] Schedule 1 Values at Cost Market Value or Basis as of [DATE] Principal Cash or Cash Equivalents Checking account Savings account Money market account Stocks and Bonds Stocks Corporate bonds Municipal bonds Real Estate $ $ $ $ $ $ $ $ $ Values at Cost or Basis Income $ $ $ $ $ $ $ $ $ $ $ $ 0.00 0.00 0.00 0.00 Other Assets Life insurance policies (cash value) $ Other assets $ Total Assets on Hand as of [DATE] $ $ $ $ $ $ $ Note: This schedule reflects assets on hand at the beginning of the period. Identify each asset thoroughly. Provide the name of the bank and account number for each account holding cash or cash equivalents. Under Minn. Gen. R. Prac. 11, financial account numbers must be submitted on a separate Form 11.1 Confidential Information Form that is not accessible to the public. Provide the number of shares or par value of each security. Provide the address of each parcel of real estate. 2 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] INTEREST Schedule 2 Income Checking account(s) 1. 2. Savings account(s) 1. 2. Corporate bonds 1. 2. 3. Municipal bonds 1. 2. 3. Other interest 1. 2. 3. Total interest $ $ $ $ $ $ $ $ $ $ $ $ $ $ Identify each interest-producing asset. List each bank account by name and account number. Under Minn. Gen. R. Prac. 11, financial account numbers must be submitted on a separate Form 11.1 Confidential Information Form that is not accessible to the public. Identify each bond or other asset that pays interest. 3 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] DIVIDENDS Schedule 3 Income Stocks 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total Dividends Identify each security that paid dividends. 4 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] CAPITAL GAINS DISTRIBUTIONS Schedule 4 Principal Capital gains distributions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total Capital Gains Distributions Identify each security that paid a capital gains distribution. 5 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] GAINS ON SALES AND OTHER DISPOSITIONS Schedule 5 Principal Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Total Gains 6 American LegalNet, Inc. www.FormsWorkFlow.com $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ $ ($ ) $ ) $ $ ($ ) $ $ [NAME OF TRUST] RETURN OF CAPITAL Schedule 6 Principal Return of capital: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Total Return of Capital Identify each security that paid a return of capital. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 7 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] OTHER INCREASES Schedule 7 Principal Securities added to trust by Settlor Income 1 2 3 4 5 6 7 8 9 Income transferred to principal Other increases: 1 2 3 4 5 6 7 8 9 Total Other Increases $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 8 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] LOSSES ON SALES AND OTHER DISPOSITIONS Schedule 8 Principal Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Sale of _______ shares of ____________: Proceeds received Less cost or basis Total Losses $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ ($ ) $ $ 9 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] ADMINISTRATIVE EXPENSES Schedule 9 Principal Bank account fees Check charges Broker annual fees Photocopies Postage Maintenance of real estate (schedule attached) Other (schedule attached) $ $ $ $ $ $ $ Income $ $ $ $ $ $ $ Total Administrative Expenses $ $ 10 American LegalNet, Inc. www.FormsWorkFlow.com [NAME OF TRUST] TAXES Schedule 10 Principal Foreign dividend tax U.S. fiduciary income tax Minnesota fiduciary income tax $ $ $ Income $ $ $ Total taxes $ $ Note: The portion of fiduciary income tax allocated to capital gains is charged against princ