IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division SIMPLIFIED ACCOUNTING OF GUARDIAN OF PROPERTY ANNUAL ACCOUNTING FOR THE PERIOD COMMENCING: The undersigned 1. The undersigned is the duly qualified and acting guardian of the property of , (the Ward). 2. Pursuant to order of this Court, all the assets of the Ward are in the following designated , ENDING: , , alleges: depositories under Florida Statutes Section 69.031: a. (Name of Institution) Account Number: b. (Name of Institution) Year end balance $________________ Account Number: c. (Name of Institution) Year end balance $________________ Account Number: Year end balance $________________ TOTAL $________________ 3. The original or certified copies of the year-end statement(s) of the Ward's account(s) from the financial institution(s) are attached to this accounting. 4. The only transactions that have occurred in the account(s) are interest accrual, deposits from a settlement, or financial institution service charges. Under penalties of perjury, I declare that, to the best of my knowledge and belief, this accounting is true and correct, and that I have custody and control of the Ward's property as set forth in the attached yearend statements. Signed on this day of , . Guardian [Print or Type Names Under All Signature Lines] Bar Form No. G-4.028 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com