Fillable Form 395.990: IF YOU ARE THE GUARDIAN FOR (Administrative Office of the Courts)

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Form 395.990: IF YOU ARE THE GUARDIAN FOR (Administrative Office of the Courts)

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NOTICE TO GUARDIAN OR CONSERVATOR FOR MINOR AND TO CONSERVATOR FOR DISABLED PERSON:
File this Settlement one (1) year after appointment and annually thereafter. If the net estate is $5,000 or less, le this
Settlement every two (2) years after the original report. (NOTE: YOU ARE NOT REQUIRED TO FILE THIS INVENTORY
IF YOU ARE THE GUARDIAN FOR A DISABLED PERSON.)
IN RE: Estate of ______________________________________________, a q Minor under 18 q Disabled Person.
Comes ____________________________________________, appointed as q Guardian q Conservator of the
above estate on ________________________, 2_____. This q Periodic q Final Settlement indicates, by itemized
statement and supported by receipts and vouchers, the assets received and disbursements made since the Inventory or
last Settlement was led. It is submitted pursuant to:
q KRS 387.710 OR q KRS 387.175, 395.610 - 395.657 and 395.990
ASSETS & INVESTMENTS
(Include anything of value to the estate including government benets, Social Security and SSI pension plan benets,
savings and checking accounts, certicates of deposit, all personal property, rents from real estate, and proceeds from
the sale of real estate and personal property. Attach additional sheets of paper if necessary).
ITEM AMOUNT
_______________________________________________________________________ $ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
TOTAL ASSETS RECEIVED: $ ____________
DISBURSEMENTS AMOUNT
_______________________________________________________________________ $ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
_______________________________________________________________________ ____________
TOTAL DISBURSEMENTS MADE: $ ____________
BALANCE ASSETS LESS DISBURSEMENTS: $ _________________
For Periodic Settlements - carry balance forward to next report.
For Final Settlements - indicate to whom balance was paid and attach receipt.
AOC-856 Doc. Code: SET or
Rev. 7-18 SETF
Page 1 of 2
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
KRS 387.175; 387.710; 395.610-.657;
395.990
PERIODIC/FINAL SETTLEMENT
q GUARDIAN OR CONSERVATOR FOR MINOR
q CONSERVATOR FOR DISABLED PERSON
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Case No. ____________________
Court ________________________
County ______________________
Division ______________________
District
IN PERIODIC SETTLEMENTS:
PLAN FOR PRESERVING AND MAINTAINING ESTATE (not to be lled out if estate has net value of $5,000 or less)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
IN FINAL SETTLEMENTS:
UNPAID CREDITORS - ALLOWED CLAIMS AMOUNT
___________________________________________________________________________ $ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
TOTAL $ ____________
CREDITORS - DISALLOWED CLAIMS AMOUNT
___________________________________________________________________________ $ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
___________________________________________________________________________ ____________
TOTAL $ ____________
Above-named Guardian/Conservator submits this Settlement to the Court, and if a Final Settlement, asks that the
Surety be discharged.
________________________________ ____________________________________________
Date Guardian/Conservator Signature
__________________________________ ____________________________________________
____________________________________________
Address
Subscribed and sworn before me on ________________________, 2_____. My commission expires: ______________________,
2_____.
_____________________________________________________
Name/Title
AOC 856
Rev. 7-18 Case No. ____________________________
Page 2 of 2
Guardian's/Conservator's Phone Number
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Form 395.990: IF YOU ARE THE GUARDIAN FOR (Administrative Office of the Courts)

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Completed 19 November 2020

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