IN THE CIRCUIT COURT FOR LEE COUNTY, STATE OF FLORIDA, GUARDIANSHIP, PROBATE AND MENTAL HEALTH DIVISION IN RE: THE GUARDIANSHIP OF CASE NO.: _________________ (Name) SIMPLIFIED ACCOUNTING (GUARDIANSHIP REPORT) OF GUARDIAN OF PROPERTY FROM: _________________ THROUGH: _________________ ____________________________________________________, the guardian of the property of ____________________________________________________ (the ward), submits the following Simplified Accounting as the annual accounting of this guardian for the abovereferenced period: 1. Pursuant to order of this Court, all assets of the Ward are in the following designated depositories under Sec. 69.031, Florida Statutes: a.) __________________________________________________ (Name of institution) Account Number: ___________________________ (Must provide at least the last 4 digits) Balance at end of period $ ____________ b.) ________________________________________________ (Name of institution) Account Number: ___________________________ (Must provide at least the last 4 digits) Balance at end of period $ ____________ c.) _____________________________________________ (Name of institution) Account Number: ___________________________ (Must provide at least the last 4 digits) Balance at end of period $ ____________ CASH TOTAL $ ___________ American LegalNet, Inc. www.FormsWorkFlow.com 2. The original or certified copies of the end-of-period statement(s) of the Ward's account(s) from the financial institution(s) are attached to this accounting*. *Important Note: Please attach a copy of the bank statement that covers/shows the account balance as of the last date of the reporting period covered by this Simplified Accounting, for each account. In the alternative, a letter from the bank with a bank official's signature and business card attached, which states the asset amount as of that date, may be provided for each account. 3. The only transactions that have occurred in the account(s) are interest accrual, deposits pursuant to 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 end-of-accounting-period statement(s). Signed on _____________________________ , 20______. Guardian Print Name: Address: ________________________________________ Phone Number: An attorney's signature is not required on a Simplified Accounting. 2 American LegalNet, Inc. www.FormsWorkFlow.com