AOC-846 Rev. 3-00 Page 1 of 2 Doc. Code: SET Case No.______________________ Court_________________________ County_______________________ Division_______________________ Commonwealth of Kentucky Court of Justice KRS 395.600 - .657 _________________SETTLEMENT of________________________________________________as________________ of the_____________________________________________________________________________________________ Date Voucher No. Receipts Disbursements American LegalNet, Inc. www.FormsWorkFlow.com AOC-846 Rev. 3-00 Page 2 of 2 Date Doc. Code: SET Voucher No. Receipts Disbursements Total Receipts and Disbursements To The Judge of The________________________District Court: I hereby certify that the foregoing is a true and correct statement of the amounts received and paid out by me as _____________________________________Judge ________________________of the__________________ Noted of record, and filed therein, this____________ ________________from__________________to this date. __________________________________ __________________________________________ Subscribed in my presence, and sworn to before me by the said______________________this the________day of ____________________________in the year _________. __________________________________________ Notary Public, _______________________________ County, ________________________. My commission as Notary Public will expire___________________________ _____________________________________Judge ______________________________________________ Attorney Name & Address (If any) American LegalNet, Inc. www.FormsWorkFlow.com It is now ordered that this Settlement be filed in the Clerk's office; advertised in accordance with statutory regulations; and continued for exceptions. _____________________________________Clerk By___________________________________, D.C. Having been appropriately advertised on__________ _____________________________, and no exceptions having been filed, this Settlement is now approved; ordered recorded; the estate now closed; the personal representative discharged; and the surety relieved effective this date.