IN THE CIRCUIT COURT FOR IN RE: ESTATE OF COUNTY, FLORIDA PROBATE DIVISION File Number Deceased. Division ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , The purpose of this accounting is to acquaint all interested persons with the transactions that have occurred during the period covered by the accounting and the assets that remain on hand. It consists of a SUMMARY sheet and Schedule A showing all Receipts, Schedule B showing all Disbursements, Schedule C showing all Distributions, Schedule D showing all Capital Transactions and Adjustments (the effect of which are also reflected in other schedules, if appropriate), and Schedule E showing assets on hand at the end of the accounting period. It is important that this accounting be carefully examined. Requests for additional information and any questions should be addressed to the personal representative(s) or the attorneys for the personal representative(s), the names and addresses of whom are set forth below. Under penalties of perjury, the undersigned personal representative(s) declare(s) that I (we) have read and examined this accounting and that the facts and figures set forth in the Summary and the attached Schedules are true, to the best of my (our) knowledge and belief, and that it is a complete report of all cash and property transactions and of all receipts and disbursements by me (us) as personal representative(s) of the estate of deceased, from . Signed on this ________ day of _________________________, ________. , , through , Attorney for Personal Representative: Personal Representative: Attorney Email Addresses: ___________________________________ ___________________________________ Florida Bar No. Name ____________________________________________ ____________________________________________ ____________________________________________ (address) (address) Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. P-5.0340 - Page 1 of 7 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , SUMMARY Income I. Starting Balance Assets per Inventory or on Hand at Close of Last Accounting Period Principal Totals $ $ $ II. Receipts Schedule A: $ $ $ III. Disbursements Schedule B: $ $ $ IV. Distributions Schedule C: $ $ $ V. Capital Transactions and Adjustments Schedule D: Net Gain or (Loss) $ $ VI. Assets on Hand at Close of Accounting Period Schedule E: Cash and Other Assets $ $ $ NOTE: Refer to Florida Probate Rules 5.330(b), 5.345, 5.346, and 5.400. Also see Accountings, Chapter 12 of Practice Under Florida Probate Code (Fla. Bar CLE). Entries on Summary are to be taken from totals on Schedules A, B, C, D and E. The Summary and Schedules A, B, C, D and E are to constitute the full accounting. Every transaction occurring during the accounting period should be reflected on the Schedules. All purchases and sales, all adjustments to the inventory or carrying value of any asset, and any other changes in the assets (such as stock splits) should be described on Schedule D. The amount in the "Total" column for Item VI must agree with the total inventory or adjusted carrying value of all assets on hand at the close of the accounting period on Schedule E. Bar Form No. P-5.0340 - Page 2 of 7 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , SCHEDULE A Receipts Date Brief Description of Items Income Principal NOTE: Schedule A should reflect only those items received during administration that are not shown on the inventory. Classification of items as income or principal is to be in accordance with the provisions of the Florida Uniform Principal and Income Act, Florida Statutes Chapter 738. Entries involving the sale of assets or other adjustments to the carrying values of assets are to be shown on Schedule D, and not on Schedule A. Bar Form No. P-5.0340 - Page 3 of 7 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , SCHEDULE B Disbursements Date Brief Description of Items Income Principal NOTE: Schedule B should reflect only those items paid out during the accounting period. Classification of disbursements as income or principal is to be in accordance with the provisions of the Florida Uniform Principal and Income Act, Florida Statutes Chapter 738. Entries involving the purchase of assets or adjustments to the carrying values of assets are to be shown on Schedule D, and not on Schedule B. Bar Form No. P-5.0340 - Page 4 of 7 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , SCHEDULE C Distributions Date Brief Description of Items Income Principal NOTE: Schedule C should reflect only those items or amounts distributed to beneficiaries during the accounting period. Assets distributed should be shown at their inventory or adjusted carrying values. Classification of distributions as income or principal is to be in accordance with the provisions of the Florida Uniform Principal and Income Act, Florida Statutes Chapter 738. Entries involving adjustments to the carrying values of assets are to be shown on Schedule D, and not on Schedule C. Bar Form No. P-5.0340 - Page 5 of 7 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCOUNTING OF PERSONAL REPRESENTATIVE(S) From: , , Through: , SCHEDULE D Capital Transactions and Adjustments (Does not include distributions. Distributions are shown on Schedule C.) Date Brief Description of Transactions Net Gain Net Loss TOTAL NET GAINS AND (LOSSES) NET GAIN OR (LOSS) $ $ $ $ NOTE: Schedule D should reflect all purchases and sales of assets and any adjustments to the carrying values of any assets. Entries reflecting sales should show the inventory or adjusted carrying values, the costs and expenses of the sale, and the net proceeds received. The net gain or loss should be extended in the appropriate column on the right side of Schedule D. Entries reflecting purchases should reflect the purchase price, any expenses of purchase or other adjustments to the purchase price, and the total amount paid. Presumably no gain or loss would be shown for purchases. Entries reflecting a