THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of EXECUTOR'S/ADMINISTRATOR'S ACCOUNTING Original Amended 1. The and ending 2. Executor/administrator name Mailing address Co-executor/administrator name Mailing address 3. Attorney name Firm name Mailing Address 4. Account Summary (totals taken from the following page) TOTAL RECEIPTS TOTAL DISBURSEMENTS (expenses) BALANCE HELD BY EXECUTOR / ADMINISTRATOR 5. Total Value of Estate from the Accounting Worksheet ORDER Account allowed. Account allowed pending filing of Account disallowed for the following reasons If this is a final account, receipts for the balance must be filed within 30 days. account for the period beginning Check if final account Telephone Telephone Telephone Bar ID # $ $ $ $ 0.00 0.00 0.00 0.00 Date NHJB-2117-P (12/01/2008) (formerly AOC 001-003) Page 1 of 4 Judge American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Estate of Case Number: EXECUTOR'S/ADMINISTRATOR'S ACCOUNTING 6. RECEIPTS Schedule A � Inventory Total of Personal Estate or Balance held at Prior Accounting ................................. On a separate sheet of paper, list all the personal estate (but not real estate) that was listed on the Inventory form. For accounts other than the first account, list each item included in Schedule 9 of the prior accounting. $ Schedule B � Net Gains (or losses) on Sales/Other Dispositions On a separate sheet of paper, list the Inventory value and sale price for any asset sold (other than real estate), and show the difference between the two amounts. Also list the date of the sale. $ Schedule C � Income on all personal property, including dividends, during accounting period ...................................... $ On a separate sheet of paper, list all income including dividends and interest received during this accounting period. List the individual amounts and date each was received. Schedule D � Cash received from sale of real estate ................. If real estate was listed on the Inventory, and has been sold during this accounting period, on a separate sheet of paper list the address of the real estate, sale price, amounts deducted from sale price, amount received by the estate, and the date of sale. (May also attach a copy of the HUD settlement statement.) $ Schedule E � Cash collected on rents of real estate ................... If real estate was listed on the Inventory, and was not sold but rent was collected during this account period, on a separate sheet of paper, list the amount collected and the months for which the rent was collected. $ Schedule F � Personal estate not listed on the Inventory ........... On a separate sheet of paper, list each asset that was not listed on the Inventory with an explanation as to why it was not listed. Also list the description and value for each asset. $ Schedule G � Money advanced or contributed to estate ............. On a separate sheet of paper, list the name of the person who gave money to the estate, the amount and date given. $ TOTAL RECEIPTS (Schedules A - G) Add the amounts in Schedules A through G. Also enter this amount on Page 1, #4. $ 0.00 NHJB-2117-P (12/01/2008) (formerly AOC 001-003) Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Estate of Case Number: EXECUTOR'S/ADMINISTRATOR'S ACCOUNTING 7. DISBURSEMENTS (expenses) Schedule 1 � Administrative expenses including taxes................ Administrative expenses are all expenses incurred in administering the estate, such as filing fees, publication fees, bond premiums, etc. On a separate sheet of paper, list the date paid, each expense and the amount. $ Schedule 2� Attorney and Fiduciary Fees Total Fees (show breakdown below) ........................................... Attorney fees $ Prior fees allowed to date: Attorney fees $ Exec / Admin fees $ Exec / Admin fees $ $ 0.00 Probate rules require fees to be shown in summary form. This summary is sufficient unless the Court requires further detail. Schedule 3� Funeral and burial expenses................................... List all funeral and burial expenses, the amount and the date paid. $ $ Schedule 4� Paid spouse's allowance out of personal estate ..... If a Motion for Spousal Allowance has been filed and granted by the court, on a separate sheet of paper, list the name of the spouse, amount disbursed and the date Motion was granted by the court. If Receipt (Form NHJB-2139-P) was not filed, you must file it at this time. Schedule 5� Debts, including expenses of last sickness ............. On a separate sheet of paper, list all debts and/or claims paid during this accounting period that existed prior to death. List the last sickness expenses individually. List the amount paid, the date of payment and to whom the payment was made. $ Schedule 6 � Distribution to legatees, not residuary legatees .... On a separate sheet of paper, list each person who received specific bequests under the will. List name, amount received or item received and its value. If Receipts (Form NHJB-2139-P) were not filed for each person, you must file them at this time. $ Schedule 7 � Interim distributions made with prior court approval $ If a Motion for Distribution was filed and granted by the court during this accounting period, you must list the names that were on the Motion, the amounts distributed, and date the Motion was granted by the court. If Receipts (Form NHJB-2139-P) were not filed for each person, you must file them at this time. Schedule 8 � Other Disbursements ............................................ On a separate sheet of paper, list any other disbursements not listed in Schedules 1 through 7 above. List the amount disbursed, date it was disbursed and the name of the person receiving the disbursement. $ TOTAL DISBURSEMENTS (Schedules 1 - 8) Add the amounts in Schedules 1 through 8. Also enter this amount on Page 1, #4. NHJB-2117-P (12/01/2008) (formerly AOC 001-003) Page 3 of 4 $ 0.00 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Estate of Case Number: EXECUTOR'S/ADMINISTRATOR'S ACCOUNTING 8. Schedule 9� BALANCE HELD BY EXECUTOR / ADMINISTRATOR (Total Receipts minus Total Disbursements) $ On a separate sheet of paper, list all the assets, except real estate, remaining in the estate and the value of each asset. If there is no will, a Motion for Final Distribution must be filed at the same time as this account. After the Motion is granted by the cou