IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI In the estate of _________________________________________ No. _______________________________ REPORT IN LIEU OF SETTLEMENT Comes now ___________________________________________ __________________________ , ________________________ __ of the above estate, and files this report in lieu of ________________________ settlement as an accounting for the period from ________________ to ________________ and states that no estate (date) (date) moneys, property or assets of any kind have been disbursed or distributed during this period; that other than interest in the amount of $_________________ _____ no assets have come into the estate during this time; and that the total current balance now due the estate is $_________ ________________. THEREFORE, the ______________ __ ____________ prays that this report be accepted and approved in lieu of a settlement. The ________________________ _____ states that the foregoing is made under oath or affirmation and its representations are true and correct to the best of _________ knowledge and belief, subject to the penalties of making a false affidavit or declaration, on this ______ day of ______________, 20_____. _________________________ ___________________ _____ __________________ __________________ Attorneys Signature Pers. Rep. / Consvr. Signature ____________________________________________ _______________ __________________________ Attorneys Name (Typed) Pers. Rep. / Consvr. Name (Typed) ____________________________________________ _________________________________________ Street Address Street Address _______________________ ____________________ _________________________________________ City State Zip Code City State Zip Code _________________________________ _________ Pers. Rep. / Consvr. Signature __________________________________________ Pers. Rep. / Consvr. Name (Typed) __________________________________________ Street Address __________________________________________ City State Zip Code