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Minor Conservatorship Inventory And Asset Management Plan Short Form. This is a Georgia form and can be use in Probate Court Statewide.
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Tags: Minor Conservatorship Inventory And Asset Management Plan Short Form, GPCSF 59, Georgia Statewide, Probate Court
Minor Conservator Inventory and Asset Management Program
GEORGIA PROBATE COURT
STANDARD FORM
PROBATE COURT OF ____________________ COUNTY
STATE OF GEORGIA
ESTATE NO.
MINOR:
CONSERVATOR(S):
MINOR CONSERVATORSHIP INVENTORY
AND ASSET MANAGEMENT PLAN SHORT FORM
Approximate Current Value
A.
INVENTORY
1. Checking/Savings/Money Market/Certificates of Deposit/Liquid Accounts:
Bank/Financial Institution/Broker
Acct. No.
$
$
$
2. Stocks/Bonds/Investments (including retirement and profit-sharing accounts):
Brokerage Firm or Institution
Acct. No.
$
$
3. Real Estate:
Brief Description
Minor's Interest
Co-Owner(s)
$
$
4. Personal Property (Vehicles, furniture, etc.):
Description
$
$
TOTAL ASSET VALUE:
B.
$
ESTIMATED MONTHLY INCOME FROM ALL SOURCES
Interest, dividend, or investment income
Social Security
Other (describe) _______________________________
TOTAL AVERAGE MONTHLY INCOME:
The minor:
Effective 8/10
-1-
$
$
$
$
GPCSF59
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I. is not a beneficiary of a Trust
II. is a beneficiary of a Trust, and the following is the name of the Trust, the Trustee,
his/her address, and telephone number; state when and how payments are required to made under
the Trust and the criteria for payment (attach outline if necessary):
.
C.
BUDGET
I/We plan during the following reporting year (initial one)
a.
not to expend any of the minor’s funds but to allow it to accumulate; OR
b.
to expend the interest earned on the minor’s estate for the following purposes:
; OR
c.
regardless of interest earned, to expend from the minor’s estate the sum of
$
per month for the following purposes:
; and
If b. or c. above is selected, the following is the monthly estimated expenses for the care, support,
health and education of the minor:
Room and board allowance:
$
Child care:
$
School Tuition/Supplies/Expenses/Lunches:
$
Clothing/Diapers/Grooming/Hygiene:
$
Medical/Dental/Prescription:
$
Health/Life/Disability Insurance:
$
Entertainment/Activities:
$
Personal Caretakers/Home Health Care:
$
Transportation
$
Miscellaneous:
$
Average Monthly Expenses
$
Effective 8/10
-2-
GPCSF59
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SUMMARY
1. Average Monthly Income
2. Monthly support provided by parent(s)
$
Subtotal
$
3. Less Average Monthly Expenses
-
Requested spending amount
D.
$
$
ASSET MANAGEMENT PLAN
I/We plan to: (initial one)
a.
maintain the investment plan for the minor’s assets as indicated in the above Inventory,
OR
b.
expend the amount requested above and maintain and invest the remaining funds as
authorized by law or in accordance with an investment plan approved by the court.
E.
AFFIDAVIT
I/We,
, Conservator(s) of the
above minor, do swear that the foregoing Inventory and Asset Management Plan contains a just, true, and
complete inventory and budget of all property belonging to said minor within my/our possession, control,
or knowledge, in addition to the financial information of the parent(s), if provided. This Inventory and
Asset Management Plan has been provided to the Guardian of the ward, if any, by first class mail.
Sworn to and subscribed before
day of
me this
, 20
.
Conservator
NOTARY/CLERK OF PROBATE COURT
Printed Name
My Commission Expires: __________________
-----------------------------------------------------------------------------------------------------------------------------Sworn to and subscribed before
day of
me this
, 20
.
Co-Conservator, if any
NOTARY/CLERK OF PROBATE COURT
My Commission Expires: ___________________
Effective 8/10
Printed Name
-3-
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IN THE PROBATE COURT OF _______________ COUNTY
STATE OF GEORGIA
IN RE:
,
MINOR
,
CONSERVATOR(S)
)
)
)
)
)
)
)
ESTATE NO.
ASSET MANAGEMENT PLAN
ORDER
The Conservator(s) having filed an Inventory/Asset Management Plan for the above estate on
, 20
,
IT IS HEREBY ORDERED that said Inventory/Asset Management Plan is hereby
APPROVED.
(initial if applicable)
IT IS FURTHER ORDERED that Conservator(s) is/are authorized to disburse from the
minor’s estate
a. the sum of $
per month for the support of the minor.
b. the income for the support of the minor.
c. a one time lump sum distribution of $
for the following
purpose:
.
IT IS FURTHER ORDERED that said Conservator(s) shall show in the annual return how such
funds actually were spent.
SO ORDERED this
day of
, 20
.
Probate Judge
FILED: ____________________________
DATE
____________________________
DEPUTY CLERK
Effective 8/10
-4-
GPCSF59
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