State of Minnesota County of _____________________ District Court Probate Division Judicial District: _______________ Court File No. __________________ Case Type: 14, Conservatorship In Re: Conservatorship of _________________________________, Protected Person Order Allowing ________ Annual Account Final Account and Order Discharging Conservator This matter came before the Court on ________________, 20_____, and the conservator has accounted for every part of the estate according to law. The conservator having appeared personally and with the conservator's attorney, _________________________, a summary _______________ Annual Account / Final Account being as follows: statement of the Debits: Credits: $ __________________ $ __________________ Balance: $ __________________ consisting of ____________________ in (cash); and_____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ and the Court having considered the petition and being fully advised in the premises, and the conservator having filed the receipt for assets with the Court; IT IS ORDERED that: the _____________ Annual Account is settled and allowed. the Final Account is settled and allowed, the conservator and its sureties are discharged. Order Recommended by: _____________________________ Referee of District Court Date ________________________________ Date Judge of the District Court GAC 16-U State ENG Rev 12/03 www.mncourts.gov/forms Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com