Fillable Mpc853a Combined Account Without Schedules Fill (Commonwealth of Massachusetts)

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Mpc853a Combined Account Without Schedules Fill (Commonwealth of Massachusetts)

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BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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MPC 853a (4/8/13) ACC
of
page
ACCOUNT
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
Division
Estate of:
Other:
This is the
(1
st
, 2
nd
, etc.)
ANNUAL
AMENDED
FINAL ACCOUNT
FOR THE REPORTING PERIOD FROM
(MM/DD/YYYY)
TO
(MM/DD/YYYY)
If Final Account, indicate why:
Appointment terminated
Estate closed
Judicial Order
Summarize the financial activity below after completing the detailed accounting information in Schedules A, B and C. Attach
additional sheets if necessary.
Notice to Interested Persons. Interested persons have the responsibility to protect their own rights and interests within the
time and in the manner provided by the Massachusetts Uniform Probate Code, including the appropriateness of disbursements,
the compensation of fiduciaries, attorneys, and others, and the distribution of estate assets. The Court will not review or
adjudicate these or other matters unless specifically requested to do so by an interested person, the Personal Representative,
or the Conservator.
Personal Representative's/Conservator's Information
Name:
Last Name
First Name
MI
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Address
SUMMARY OF SCHEDULES
SCHEDULE A - Receipts and income:
SCHEDULE B - Payment and debts, administration expenses, taxes and distributions:
SCHEDULE C - Balance of assets on hand:
(If you are completing this on-line, the totals will auto-fill.)
TOTAL
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MPC 853a (4/8/13) ACC
of
page
CONSERVATORSHIPS ONLY
Protected Person's Information
Name:
Last Name
First Name
MI
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
Current Address: (Include Name of Nursing Facility, if applicable)
Age:
(Name of Facility if applicable)
Is there a continued need for the Conservatorship?
Yes
No
1.
If No, describe why and what steps should be taken. If you would like the Court to take action, you must file the
appropriate pleadings with the Court.
Are the remaining assets in the estate sufficient to provide for the present and future care of the protected person?
2.
If No, describe why and what steps should be taken. If you would like the Court to take action, you must file a motion
with the Court.
Yes
No
List the services provided to the protected person.
3.
Recommended changes to the Conservator's Plan, if any:
4.
The Conservator's Account pursuant to G.L. c. 190B §5-418 must be filed annually and served on all interested persons
and on the Protected Person (if over 14) andto any parent or guardian who lives with the Protected Person.
I state under penalty of perjury that this is a true and complete report of the administration of this estate,
during the period shown, both dates inclusive, to the best of my knowledge, information and belief. I understand
that this Account is subject to audit and verification.
I understand that I am required to maintain supporting documentation for all receipts and disbursements
including detailed billing statements from any professional. The Court or any Interested Persons may request
copies at any time.
All Fiduciaries
SIGNATURE OF FIDUCIARY
Date
(Address)
(Apt, Unit, No. etc.)
(City/Town)
(State)
(Zip)
Print Name
BBO No.:
Primary Phone #:
Attorney for Fiduciary:
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Mpc853a Combined Account Without Schedules Fill (Commonwealth of Massachusetts)

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Completed 27 July 2020

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