Affidavit of Closing/ Receipt and Release of Guardian of Estate of a Minor PC - 580 REV. 4 /19 CONNECTICUT PROBATE COURTS Affid avit of Closing/Receipt and Release of Guardian of Estate of a Minor PC-580 RECEIVED: Instructions: 1) A guardian of the estate of a minor shall file this form not later than 30 days after completing distribution of all assets on hand to the minor once the minor has turned 18 years old. The minor may also use this form to acknowledge receipt of assets held by the guardian. 2)The guardian shall send a copy of this form to each party and attorney of record and certify to the courtthat it has been sent. 3)For more information, see Probate Court Rules of Procedure, section 36.12.4)Type or print the form in ink. Use an additional sheet, or PC-180, if more space is needed. Probate Court Name District Number In the Matter of (Name, address and telephone number) Hereinafter referred to as the minor Minor222s Date of Birth Guardian of the Estate (Name, address and telephone number of each guardian) Date of Appointment Date of Appointment I hereby make return under penalty of false statement that all monies and property of every description in the guardian222s hands and control have been paid over and distributed to the minor who is entitled thereto according to the orders of the court, and that so far as the guardian has any knowledge, the estate of the minor is now fully administered and settled. The guardian further certifies that the following is a true and complete statement of any transactions since the end of the accounting period of the guardian222s final financial report or account on file, including, but not limited to, the disposition of (a) the reserve shown on the final financial report or account; (b) any additional income and/or assets received subsequent thereto and not reflected therein; and (c) amounts disbursed from the reserve and additional income and assets: None Second Sheet, PC-180, or separate accounting is attached hereto. American LegalNet, Inc. www.FormsWorkFlow.com Affidavit of Closing/ Receipt and Release of Guardian of Estate of a Minor PC - 580 REV. 4 /19 CONNECTICUT PROBATE COURTS In the Matter of Affid avit of Closing/Receipt and Release of Guardian of Estate of a Minor The representations made in this affidavit of closing are made under penalty of false statement. Signature of Guardian of the Estate Type or Print Name Date Signature of Guardian of the Estate Type or Print Name Date Certification I certify that a copy of this affidavit of closing was sent to the following persons: Name and Address RECEIPT AND RELEASE I, having attained the age of majority according to law, hereby acknowledge and declare that I have received from the guardian of the estate named above full satisfaction and payment of all sums of money and other property belonging to me. I hereby release the guardian named above declaring myself satisfied and paid as specified above. The representations made herein are made under penalty of false statement. Signature of Minor Type or Print Name Date ACCEPTED AND ORDERED TO BE RECORDED Date Judge/Clerk PC-580 American LegalNet, Inc. www.FormsWorkFlow.com