SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ GDN _________ In re Estate of ________________________________ Minor PETITION FOR AUTHORITY TO EXPEND FUNDS 1. Guardian of the estate of the minor hereby requests permission to make the following proposed expenditures from the funds of the minor for the maintenance of the minor in accordance with Superior Court, Probate Division Rule 222: [ ] Monthly expenditure of $________ per month; [ ] Annual expenditure of $_______ per year; or [ ] One-time only expenditure of $____________. (For example, a monthly expenditure for clothing of $100.00 per month; a $1,500.00 per year expenditure for clothing, birthday, and holiday gifts; or a $1,000.00 onetime only expenditure for purchase of a computer for the minor.) 2. The type of expenditure requested is as follows: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 3. The reason for the request is as follows: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 4. Petitioner provides the following information: a. Age of minor: ___________________________________________________________________ Jan. 2010 American LegalNet, Inc. www.FormsWorkFlow.com b. Residence of minor: ___________________________________________________________________ c. Total current assets of minor: ___________________________________________________________________ d. Annual income of minor: ___________________________________________________________________ e. Ending balance of last approved account: ___________________________________________________________________ f. Past expenditures authorized: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 5. If the petitioner is a parent of the minor, explain why the parent is not paying, and attach a financial statement for the parent. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 6. State whether the expenditure [ ] will or [ ] will not require a sale of all or part of the principal of the minor’s estate and why. (If a sale is required, D.C. Code, sec. 21-147 must be complied with.): ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ __________________________________ Signature of Attorney ____________________________ Signature Jan. 2010 American LegalNet, Inc. www.FormsWorkFlow.com ________________________________ Typed Name of Attorney __________________________ Typed Name ____________________________________ Address (Actual address/not Post Office Box) ____________________________ Address (Actual address/not Post Office Box) __________________________________ ____________________________ __________________________________ Telephone number ____________________________ Telephone number __________________________________ Unified Bar number __________________________________ E-mail address (optional) VERIFICATION I ____________________________, being first duly sworn, on oath, depose and say that I have read the foregoing pleading by me subscribed and that the facts therein stated are true to the best of my knowledge, information, and belief. _________________________________ Signature of petitioner Subscribed and sworn to before me this ____ day of _________________, 20__. _________________________________ Notary Public/Deputy CERTIFICATE OF SERVICE I hereby certify that on the _____ day of ________________, 20__, a copy of the foregoing petition was served by first class mail, postage prepaid, on the following parties (list names and addresses of all parties): _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ ____________________________________ Signature Jan. 2010 American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ GDN_________ In re Estate of ________________________________ Minor ORDER REGARDING PETITION FOR AUTHORITY TO EXPEND FUNDS Upon consideration of the Petition for Authority To Expend Funds filed on __________________, 20__, by _____________________________, it is hereby this _____ day of _____________, 20__, ORDERED 1. That the petition is [ ] Granted [ ] Denied 2. That the following expenditures are approved subject to proper accounting: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ____________________________ JUDGE cc: _________________________________ _________________________________ _________________________________ ______________________________ ______________________________ ______________________________ _________________________________ __________________________________ __________________________________ ______________________________ ______________________________ ______________________________ __________________________________ __________________________________ __________________________________ ______________________________ ______________________________ ______________________________ __________________________________ __________________________________ __________________________________ ______________________________ ______________________________ ______________________________ Jan. 2010 American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION FINANCIAL STATEMENT In re Estate of _________________________________________, minor NAME: OCCUPATION: NAME AND ADDRESS OF CURRENT EMPLOYER: INCOME INFORMATION * 1. Monthly gross wages ....................... 2. $ __________ Less Mandatory Monthly Deductions: Federal Income Tax ........... $________ State Income Tax ............. $________ Retirement: FICA ................................ $________ Social Security .................. $________ Medical Insurance ................. $________ Other .................................. $________ TOTAL ................................. $________ 3. Monthly Net Wages ................................ (Subtract Line 2 from Line 1) 4. Monthly income from all other sources (e.g., part-time or overtime wages, fees, rents, dividends, commissions, unemployment compensation, disability, social security, retirement, interest, bonuses, etc.) ...................................... 5. 6. 7. 8. $ __________ $ __________ Less Other Mandatory Monthly Deductions: Federal Income Tax ........... $________ State Income Tax ............. $________ Retirement: FICA ................................ $________ Social Security .................. $________ Medical Insurance ................. $________ Other .................................. $________ TOTAL ................................. $________ Monthly Net Income from All other sources (Subtract Line 5 from Line 4) Total Monthly Net Disposable Income Total Monthly Gross Income .................... (Add Lines 1 and 4) I claim ________ exemptions for withholding tax purposes. AVERAGE MONTHLY EXPENSES Wife/Husband Children Housing, etc. Rent/Mortgages .......... Utilities ...................... Taxes ........................ Food Groceries/Household Supplies ..................... Meals Out ................... Automobile Payment .................... Gas/Oil ...................... Repairs ...................... Insurance ................... Tags .......................... Life Insurance (List Beneficiaries) ____________________ ____________________ ____________________ $ __________ $ __________ $ __________ SUMMARY 9. __________ GDN ______ Total Monthly Net Disposable Income (line 7) $ __________ 10. Less Total Monthly Expenses $ __________ 11. Difference ............................................ $ __________ Health Insurance (not listed as income deduction) School Tuition Supplies/Fees Child Care Expenses To allow for employment/education To allow for recreation Lesson (e.g. music, dance, art) Allowance Clothing/Uniforms Dry Cleaning/Laundry Medical Expenses (Unpaid by Insurance) Charitable Contributions Recreation Vacations Miscellaneous: ____________________ ____________________ ____________________ Period Payments Required on Bills: ____________________ ____________________ ____________________ Total Monthly Expenses $ ___________ ___________ ___________ $ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ * NOTE: If you are paid weekly, multiply your weekly gross wages by 4.3 to arrive at your monthly gross wages. If you are paid every two weeks, multiply your bi-weekly gross wages by 2.15 to arrive at your monthly gross wage. American LegalNet, Inc. www.FormsWorkFlow.com