SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ INT _________ _________ IDD _________ In re: ________________________________ An Adult CERTIFICATE OF NO UNSETTLED LIABILITIES I, __________________________________, conservator of this estate, do hereby certify that there remain no unsettled liabilities of this estate. _______________________________________ Signature of filer _______________________________________ Typed name of filer _______________________________________ Address (actual address/not Post Office Box) _______________________________________ _______________________________________ _______________________________________ Telephone number Email address _______________________________________ _______________________________________ Unified Bar number (if filer is an attorney) April 2014 ­ 955.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com