INSTRUCTIONS FOR FILING ANNUAL ACCOUNTING 1. Your Annual Account as Conservator of the person is due each year on the anniversary date of your appointment. Idaho Code Section 15-5-419. 2. Your Annual Account should be as complete and accurate as possible. Failure to make a correct and timely report would be sufficient ground for your removal as Conservator. Your report should be filed with the Clerk of the Court (see address below) and a copy sent to any other parties who are specified in your order. 3. Please read over your accounting carefully and make sure that it is fully completed with the case number and your ward’s name. Please type your report if possible otherwise, complete it in black ink. 4. For additional information, consult your attorney and check the Idaho Code for Conservators of Persons at I.C. Sec. 15-5-401 et seq. 5. If you would like a conformed copy of your report for your records, please send a copy along with the original report and a self addressed stamped envelope. 6. IMMEDIATELY notify the court if you relocate and change address and/or phone number so that the court has the most current contact information. 7. Please make copies of this form for your use on a yearly basis. 8. Extra reports can be obtained on the Internet by visiting the Guardianship Monitoring home page at www.adaweb.net. (4th District Court, Ada County 208287-7651) 9. There is a new $50.00 court-filing fee to submit the Annual Accounting of Wards Estate for the next three years beginning 7/1/05; the fees will be reduced after the three-year period. 10. Make check or money orders payable to the Clerk of the Court and mail your check and accounting to the Ada County Courthouse, Clerk of the Court, 200 W. Front Street, Boise, ID. 83702 Please find the Annual Accounting form on the next page. American LegalNet, Inc. www.USCourtForms.com Form 119A Option 1 - Annual Account of Ward’s Estate (I.C. 15-5-419) IN THE DISTRICT COURT OF THE FOURTH JUDICIAL DISTRICT OF THE STATE OF IDAHO, IN AND FOR THE COUNTY OF ADA MAGISTRATE DIVISION In The Interest Of : ___ A Protected Person. ___ A Minor. ) ) ) ) ) ) ) Case No. Annual Account of Ward’s Estate I.C. 15-5-419 The undersigned, , as: Guardian of the person of the above-named incapacitated person, Conservator of the estate of the above-named incapacitated person, hereby renders the following financial accounting for the twelve month period beginning , 200 , and ending ,200 : , 200 Balance forward as of : $ . BEGINNING ASSET INVENTORY Real property (attach legal description and describe any encumbrances) Checking accounts (bank and account numbers) Savings accounts (bank and account numbers) Mutual Funds (describe) American LegalNet, Inc. www.USCourtForms.com Stocks (describe) Certificates of Deposit (location, account numbers) Life Insurance (describe cash value) Cash Miscellaneous assets (describe) Other encumbrances (describe) TOTAL ASSETS: $ American LegalNet, Inc. www.USCourtForms.com INCOME Interest (describe) Investment income (describe) Social Security Retirement/pension Medicare benefits Tax refunds Capital gains/losses Auction proceeds American LegalNet, Inc. www.USCourtForms.com Rentals Insurance payments Miscellaneous TOTAL INCOME: $ EXPENSES Medical: Prescriptions Hospital American LegalNet, Inc. www.USCourtForms.com Doctors Insurance Premiums Glasses Misc. Medical Taxes: State Federal Property Preparation American LegalNet, Inc. www.USCourtForms.com Other: Attorneys Fees Homeowners insurance Bank fees Appraisal fees Bus Pass Hair Cut Travel Expenses Misc. Items, i.e., furniture Clothing American LegalNet, Inc. www.USCourtForms.com Court Expenses Court visitor Living Expenses Moving Expenses Remittance from trust account Room and board Utilities Personal Care svc/msg Household repairs Yard Maintenance American LegalNet, Inc. www.USCourtForms.com Miscellaneous: Total Expenses: $ Net Income: $ Ending Balance of Asset Inventory: $ Date last Annual Account file with Court: . I have mailed copies of this report to the following persons: Name Address Relationship to Ward Dated: Typed or printed name, address and telephone number of Conservator or Guardian, and signature of Conservator or Guardian or duly authorized officer if conservator or or guardian an entity. American LegalNet, Inc. www.USCourtForms.com