Settlement Form. This is a Missouri form and can be use in 22nd Circuit (St. Louis City) Local Circuit Courts.
Tags: Settlement, Missouri Local Circuit Courts, 22nd Circuit (St. Louis City)
MISSOURI CIRCUIT COURT, TWENTY-SECOND JUDICIAL CIRCUIT PROBATE DIVISION, CITY OF ST. LOUIS In the estate of ____________________________________________ No. _________________________ Deceased/Disabled/Minor SETTLEMENT Following is a settlement of the accounts of the undersigned Personal Representative/Conservator for the period commencing on the ______________________ day of __________________, ____, and ending on the _________________________ day of ____________________, ____. DATE VOUCHER NO. DETAILS OF TRANSACTION RECEIPTS BALANCE OF PERSONAL PROPERTY ONLY PER INVENTORY OR LAST SETTLEMENT: DISBURSEMENTS XXXXXX XX TOTALS BALANCE American LegalNet, Inc. www.FormsWorkflow.com RECAPITULATION Furniture, household goods, wearing apparel $_______________________________ Corporate stocks, per schedule attached $_______________________________ Mortgages, bonds, notes, other evidences of debt, Per schedule attached $_______________________________ Bank accounts, insurance policies payable to personal representative, per schedule attached $_______________________________ All personal property, including proportionate share In any partnership $_______________________________ Total Value Personal Property $_______________________________ NOTE: If any category does not remain exactly as inventoried, but is changed by any transaction reported herein, such category must be itemized on an attached schedule (i.e., bank accounts, corporate stocks sold, distributed or received by stock split, etc.) The personal representative(s)/conservator(s) of this estate state(s) 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. Signed this ________ day of ________________, ______. ________________________________________ Attorney’s Signature ________________________________________ Attorney’s Name (Typed) and MBE # ________________________________________ Street Address ________________________________________ City State Zip Code ________________________________________ Telephone No. ________________________________________ ________________________________________ Current Address of Protectee ________________________________________ City State Zip Code _____________________________________ Pers. Rep./Conservator’s Signature _____________________________________ Pers. Rep./Conservator’s Name (Typed) _____________________________________ Street Address _____________________________________ City State Zip Code _____________________________________ Pers. Rep./Conservator’s Signature ____________________________________ Pers. Rep./Conservator’s Name (Typed) _____________________________________ Street Address _____________________________________ City State Zip Code REQUIREMENTS Each settlement filed shall state period for which it is made, and among other things, shall contain a just and true account of all assts collected, the date when collected, from whom collected and on what account collected. Also, the date and amount of each expenditure or distribution must be supported by proper vouchers or receipts executed by the person to whom the disbursement was made. American LegalNet, Inc. www.FormsWorkflow.com