GC-400(A)(3) CONSERVATORSHIP GUARDIANSHIP OF Conservatee Minor CASE NUMBER: (Name): Schedule A, Receipts, Pensions, Annuities, and Other Regular Periodic Payments--Standard Account* * (Report veterans' pensions on form GC-400(A)(5), Schedule A, Receipts, Social Security, Veterans' Benefits, Other Public Benefits.) Pensions, annuities, and other regular periodic payments Date of Receipt (mm/dd/yyyy) Description* * (Report receipts from each source separately.) $ Amounts Subtotal, Pensions, Annuities, Other Regular or Periodic Payments: $ (Add pages as required. Check the box at the bottom of the last page of this receipt category and total the amount of the category. Include that sum in the total of receipts on line 3 of the Summary of Account (form GC-400(SUM)/GC-405(SUM)). pages The page total to the right is the number of pages in Schedule A.) Page A of Form Approved for Optional Use Judicial Council of California GC-400(A)(3) [New January 1, 2008] SCHEDULE A, RECEIPTS, PENSIONS, ANNUITIES, AND OTHER REGULAR PERIODIC PAYMENTS--STANDARD ACCOUNT (Probate--Guardianships and Conservatorships) Probate Code, §§ 1060­1064, 2620; Cal. Rules of Court, rule 7.575 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com