IN THE CIRCUIT COURT OF THE TWENTY-SECOND JUDICIAL CIRCUIT McHENRY COUNTY, ILLINOIS Probate Division IN THE MATTER OF THE GUARDIANSHIP OF ______________________________________________ Disabled Person ) ) ) ) ) Case Number_______________________________ ACCOUNTING I, _______________________________, am the Guardian of the Estate of __________________________________, a disabled person, and the following is a true and complete Accounting of the Estate’s Cash Receipts and Disbursements covering the period from __________________, 20_____, to ______________________, 20_____, and an Inventory of the Ward’s Assets as of ________________________, 20________. CASH RECEIPTS Date Description Amount $ $ $ $ $ TOTAL CASH RECEIPTS $________________ CASH DISBURSEMENTS Date Recapitulation Description Amount $ $ $ $ $ $ $ $ TOTAL CASH DISBURSEMENTS $________________ Cash on Hand Beginning of Accounting Period $________________ Total Cash Receipts (Listed above) $________________ Total Cash Disbursements (Listed above) $________________ Cash on Hand Ending of Accounting Period $________________ PR-ACC1: revised 12/01/06 Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com INVENTORY Item Number Description Value $ $ $ $ $ $ $ $ $ $ TOTAL VALUE $___________________ I am the duly appointed and acting Guardian of the Estate of ______________________________________, a disabled person, and attest that the above Accounting signed by me is true and correct to the best of my knowledge and belief. Signed this ______________ day of _____________________________________, 20_______. ________________________________________________________ Guardian’s Signature I, _______________________________________, the duly appointed and acting Guardian of the Estate of ___________________________________________, a disabled person, provided the information for this Accounting to the person named below. PREPARED BY: Name:___________________________________________________________ Address__________________________________________________________ City, State Zip_____________________________________________________ Telephone:_______________________________________________________ RETURN TO: McHenry County Clerk of the Circuit Court Attn: Probate Division 2200 N. Seminary Avenue Woodstock, IL 60098 PR-ACC1: revised 12/01/06 Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com