STATE OF SOUTH CAROLINA COUNTY OF: ____________________________ IN THE MATTER OF: _______________________________________ (Decedent) ) ) ) ) ) ) ) IN THE PROBATE COURT ACCOUNTING CASE NUMBER: _____________________________________ FINAL INTERIM # The undersigned Personal Representative(s) submits this accounting, which covers the period from _________________ through _________________________. The documentation on the following page(s) of this form sets forth a complete accounting for the period specified, which is summarized as follows: Beginning Balance from Inventory(ies) or prior Interim Accounting, if applicable Plus: Receipts (Rent, Refunds, Dividends, Interest, etc.) Subtotal Less: Disbursements and Distributions Ending Balance The Personal Representative(s) declares that this account has been examined and that its contents represent a correct statement of all receipts and disbursements and are true to the best knowledge and belief of the Personal Representative(s). SWORN to before me this , day of 20 Signature: Print Name: Address: Telephone (Work): (Home): (Cell): Email: Notary Public for South Carolina My Commission Expires: Co-Personal Representative Signature: Print Name: SWORN to before me this day of Address: , 20 Telephone (Work): (Home): Notary Public for South Carolina (Cell): My Commission Expires: Email: FORM #361ES (1/2016) 62-3-704, 62-3-1001 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com INVENTORY PROBATE ASSETS & RECEIPTS (probate assets received into estate) DISBURSEMENTS & DISTRIBUTIONS (probate assets disbursed/paid out from estate) TOTAL TOTAL FORM #361ES (1/2016) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com