Fillable ANNUAL RETURN - PERSONAL REPRESENTATIVE (Fulton County Government)

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ANNUAL RETURN - PERSONAL REPRESENTATIVE (Fulton County Government)

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CASH ASSETS
This page is the portion of the
return where you will account for cash assets in the estate. On this page, only
assets held in checking accounts, savings accounts, money market accounts, and certificates of deposit should be
shown.
RECEIPTS: Include in this section all income received and interest earned by the estate during this reporting period.
DATE
SOURCE OF INCOME
AMOUNT RECEIVED
Balance from previous return or inventory
Interest earned during this reporting period
Other receipts:
T
OTAL OF O
THER RE
CEIPTS (not including previous balance or
i
nterest
)
T
OTAL
RECEIP
TS I
N
CLUDING PREVIOUS BALANCE AND INTEREST
ANNUAL RETURN - PERSONAL REPRESENTATIVE
Probate Court
136 Pryor Street SW, Suite C-230
Atlanta, Georgia, 30303
404-613-4070
ESTATE NO.
Decedent's Name:
Administrator or Executor:
TO:
ANNUAL RETURN
FINAL RETURN
PERIOD FROM:
ANNUAL RETURN - PERSONAL REPRESENTATIVE
PAGE 1 OF 4
DISBURSEMENTS: Show all funds spent during this reporting period.
Note: Yearly totals for monthly
expenses may be shown for the purposes of clarity and summarization.
DATE
PAYMENT (List to whom and purpose of payment)
AMOUNT PAID
TOTAL DISBURSEMENTS:
NET BALANCE ON HAND
(Deduct total disbursements from total receipts including previous balance
and interest):
Show where cash assets are deposited:
TYPE OF ACCOUNT (checking,
savings, money market, or
certificate of d
eposit)
Banking Institution
Account Number (Do not give
account numbers for certificates o
f
deposit.)
ANNUAL RETURN - PERSONAL REPRESENTATIVE
PAGE 2 OF 4
UPDATED LIST OF NON-CASH ASSETS
REAL ESTATE PROPERTY ADDRESS APPROXIMATE VALUE
Parcel One:
Parcel Two:
Parcel Three:
Parcel Four:
TOTAL APPROXIMATE VALUE OF REAL ESTATE
STOCKS (give number of shares), BONDS (give face value amount), AND OTHER
SECURITIES
S
T
OCK, BOND, OR
OTHER
SECURITY
APPROXIMATE VALUE
TOTAL APPROXIMATE VALUE OF SECURITIES
MISCELLANEOUS: List all other non-cash assets in this section.
COMMENTS/EXPLANATIONS ABOUT ANYTHING ON THIS RETURN:
Current Amount of Bond:
ANNUAL RETURN - PERSONAL REPRESENTATIVE
PAGE 3 OF 4
CERTIFICATE OF MAILING
A copy of this Return has been mailed by first class mail to each heir or beneficiary of the estate. If any heir
or beneficiary has waived the right to receive a copy of the Annual Return, as provided in Code Section
53-7-68(b), their name is as follows:
____________________________________
Signature of Attorney representing fiduciary, if any
It is ORDERED that the within Return be Allowed.
This _____ day of ____________, 20_____.
__________________________________________
Judge of the Probate Court
____________________________________
Personal Representative
Sworn to and subscribed before me
This_____ day of__________, 20_____.
_____________________________________
Notary Public or Clerk of Probate Court
ANNUAL RETURN - PERSONAL REPRESENTATIVE
PAGE 4 OF 4
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ANNUAL RETURN - PERSONAL REPRESENTATIVE (Fulton County Government)

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Completed 6 August 2020

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