MARK J. BARTOLOTTA, JUDGE PROBATE COURT OF LAKE COUNTY, OHIO IN THE MATTER OF THE GUARDIANSHIP OF_______________________________________ CASE NO._____________________________ GUARDIAN'S ACCOUNT [R.C. 2109.30] ____________________________ACCOUNT FROM_______________TO______________ __________________________________________________________________________________ ___________ (year) (Balance from previous account) Voucher No. $ $ 15.8 GUARDIAN'S ACCOUNT 3/1/96 American LegalNet, Inc. www.FormsWorkFlow.com [Side 2 of 2] RECAPITULATION Total Receipts________________________________________ Total Disbursements___________________________________ Balance Remaining____________________________________ $___________________ $___________________ $___________________ ITEMIZED STATEMENT OF ALL FUNDS, ASSETS AND INVESTMENTS ITEM $ ____________________________ Attorney ____________________________ Attorney Registration No. ____________________________ Guardian ____________________________ Typed or Printed Name __________________________________ Address of Guardian __________________________________ ENTRY SETTING HEARING The Court sets_____________________________at_____________o'clock_______.M., as the date And time for hearing the above account. __________________________________ Date __________________________________ Probate Magistrate American LegalNet, Inc. www.FormsWorkFlow.com