COUNTY STATE OF WISCONSIN, CIRCUIT COURT, For Official Use Amended IN THE MATTER OF THE ESTATE OF Trustee's Account Annual Interim Final Informal Administration Formal Administration Case No. For the following trust: This is an accurate account of the administration of the trust for the period from (Date) . through (Date) Summary Description (Attach Schedules) Line Balance 1. Beginning Balance. Do not change any pre-printed amount. (Inventory total value or ending 2. Total assets and income received from Schedule A (Page 1). 3. Subtotal 4. Total expenses, distributions and losses incurred from Schedule B (Page 2.) 5. Total assets on hand from Schedule C (Page 3.) $ balance from prior account.) (Add) $ $ (Subtract) $ TOTAL $ STOP! YOU MUST SIGN THIS FORM IN FRONT OF A NOTARY. State of County of Subscribed and sworn to before me on Trustee Name Printed or Typed Notary Public/Court Official Address Name Printed or Typed Telephone Number My commission/term expires: Date State of County of Subscribed and sworn to before me on Trustee Name Printed or Typed Address Notary Public/Court Official Name Printed or Typed My commission/term expires: Telephone Number Date Form completed by: (Name) Address Telephone Number Bar Number (If any) PR-1937, 10/10 Trustee's Account (Informal Administration and Formal Administration) §701.16(4) and (5), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Trustee's Account (Informal Administration and Formal Administration) Page 2 of 3 Case No. See attached (If the space given is insufficient for any item, attach additional sheets.) Schedule A – Assets and Income Received Description (Example: Interest, dividends, rental and other income, gains from assets sold for more than inventory value, or purchase price if acquired after the initial inventory.) Amount $ TOTAL: $ (Enter in Summary on Line 2 on page 1) See attached Schedule B – Expenses, Distributions and Losses Incurred Description (Example: Distributions to or for beneficiary, expenses of the trust, assets sold for less than inventory value, or purchase price if acquired after the initial inventory.) Amount $ TOTAL: (Enter in Summary on Line 4 on page 1) PR-1937, 10/10 Trustee's Account (Informal Administration and Formal Administration) $ §701.16(4) and (5), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Trustee's Account (Informal Administration and Formal Administration) Page 3 of 3 Case No. See attached Schedule C – Assets on Hand (at end of accounting period) Description (Example: Cash, Checking Accounts, Savings Accounts, Certificates of Deposit, including Names and Account Amount Numbers; Investments; Real Estate, Including Encumbrances) (List balance at end of accounting period; inventory value, or purchase price if acquired after the initial inventory.) $ TOTAL: (Enter in Summary on Line 5 on page 1) $ For Authorized Persons Only: Display and Verification of Assets I am not the trustee and I am authorized by the court to verify assets. I have examined all securities, evidences of deposit and investments; and such assets correspond with the account, except as indicated. Signature (Not Trustee) Date of verification: Name Printed or Typed and Title Telephone Number Date PR-1937, 10/10 Trustee's Account (Informal Administration and Formal Administration) §701.16(4) and (5), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com