Basic Instructions For Conservators

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Basic Instructions For Conservators is a commonly used form within Kansas. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

These basic instructions for conservators were prepared by the Guardianship and Conservatorship Advisory Committee of the Kansas Judicial Council. After their original publication in January 2009, the instructions were revised and updated in June 2015 and agin in 2017. The instructions constitute the basic instructional program concerning the duties and responsibilities of a conservator required by K.S.A. 59-3069(j). After reading these instructions, a proposed conservator should sign the affidavit of completion at the end of this booklet and file it with the court as evidence of completion of the basic instructional program.

Atticus Fast Facts About Basic Instructions For Conservators

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Basic Instructions For Conservators:

• This form pertains to the State of Kansas

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Kansas’s Form Basic Instructions For Conservators up to date, certain details can change from time-to-time with little or no communication.

Step 1 - Download the correct Kansas form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Kansas probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form Basic Instructions For Conservators, take a break, and then review. Probate and estate settlement processes in KS are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form Basic Instructions For Conservators online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Basic Instructions For Conservators to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

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Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Kansas.

5 reasons you should submit this form as quickly as possible:

1. The sooner you begin, the faster Kansas can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.
   
   Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Kansas. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

5. If a house in the State of Kansas is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Kansas probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Kansas probate clerk or court for exact answers regarding Form Basic Instructions For Conservators, and when in doubt— consult a qualified trust & estates lawyer for that area.

Basic Instructions For Conservators is one of the many probate court forms available for download through Atticus.

It may also be available through some Kansas probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Kansas.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form Basic Instructions For Conservators f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Kansas probate court office.

Basic Instructions For Conservators is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Kansas-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

Here’s the text, verbatim, that is found on Kansas Form Basic Instructions For Conservators. You can use this to get an idea of the context of the form and what type of information is needed.

Kansas Probate Forms 3d BASIC INSTRUCTIONS FOR CONSERVATORS January 1, 2009 Revised and Updated - 2017 Kansas Judicial Council 2017 Kansas Probate Forms 3d Preface These basic instructions for conservators were prepared by the Guardianship and Conservatorship Advisory Committee of the Kansas Judicial Council. After their original publication in January 2009, the instructions were revised and updated in June 2015 and agin in 2017. The instructions constitute the basic instructional program concerning the duties and responsibilities of a conservator required by K.S.A. 59-3069(j). After reading these instructions, a proposed conservator should sign the affidavit of completion at the end of this booklet and file it with the court as evidence of completion of the basic instructional program. Table of Contents Definitions .........................................................................................................................1 Conservator's Powers and Duties ......................................................................................1 Responsibilities to the Court Required Training .................................................................................................3 Oath .......................................................................................................................4 Bond ......................................................................................................................4 Letters ...................................................................................................................4 Conservatorship Plan ............................................................................................4 Inventory and Valuation ........................................................................................4 Annual Accounting ...............................................................................................5 Special Reports and Accountings ..........................................................................5 Reimbursement for Time and Expenses ...............................................................5 How a Conservatorship Ends ............................................................................................5 Conflicts of Interest ...........................................................................................................6 Additional Resources ........................................................................................................6 Sample Forms Inventory and Valuation - Instructions for Completing ........................................7 Sample Inventory and Valuation ...........................................................................8 Annual Accounting - Instructions for Completing ..............................................11 Sample Annual Accounting .................................................................................13 Affidavit of Completion of Basic Instructional Program ......................................last page 2017 Kansas Probate Forms 3d BASIC INSTRUCTIONS FOR CONSERVATORS Definitions of Words You Need to Know: Conservator - A conservator is a person appointed by a court to act on behalf of a minor or impaired person, who is called a conservatee. A conservator manages a conservatee's property or estate, such as money, personal and real property. Conservatee - A conservatee is a person for whom a conservator has been appointed. A conservatee may be a minor, an adult person with an impairment, or a person who has voluntarily requested a conservatorship. Guardian - A guardian is a person appointed by a court to act on behalf of a minor or impaired person, who is called a ward. A guardian manages a ward's personal health, safety, and welfare. Ward - A ward is a person for whom a guardian has been appointed. A ward may be either a minor or an adult person with an impairment. Accounting - A detailed written summary of all financial actions done by the conservator on behalf of the conservatee. Bond - A bond is similar to an insurance policy and is usually purchased from an insurance company. It is intended to protect the conservatee's property should the conservator mismanage the person's estate. NOTE: Sometimes, a person is appointed as both a guardian and conservator. In that case, the person they are helping may be called either a ward or conservatee, or both. What Are a Conservator's Powers and Duties? THESE DUTIES APPLY TO BOTH VOLUNTARY AND INVOLUNTARY CONSERVATORSHIPS The basic duties, responsibilities, powers and authorities of conservators are defined by statute and can be found at K.S.A. 59-3078. The following is a general overview. A conservatorship is a lawsuit filed to protect the property of an impaired person, who is called a conservatee. After a hearing to determine whether a conservatorship is necessary, a court order will be issued. Your attorney should provide you with a copy of that court order. Before the court will issue you Letters of Conservatorship, you must 1 2015 Kansas Probate Forms 3d be bonded unless the court waives the bond. If the court appoints you as conservator, your responsibilities are separate from the duties of a guardian and your job is to manage the conservatee's property. The conservatee's property is called his or her estate. As conservator, you are always subject to court control and direction. State law and the court define your power, as conservator, and set the rules you must follow when managing the conservatee's property. As conservator, you must always act in the best interest of the conservatee. Your first duty, as conservator, is to open a bank account under the conservatee's social security number, titled in your name as conservator for the conservatee. You will then need to file an inventory (a detailed list) of all assets in the conservatee's estate within 30 days of issuance of the Letters of Conservatorship. NEVER combine the conservatee's assets with those of another person, including your own. THE CONSERVATOR MUST FILE AN ACCOUNTING WITH THE COURT EACH YEAR. You must know the conservatee's needs, and you must also support and involve the conservatee in decision-making regarding his or her property. You should consider the conservatee's stated desires and personal values when making decisions for him or her. You must try to avoid conflicts of interest and protect the conservatee's personal, civil, and human rights. The law does NOT require you as conservator to use your own personal money or other assets for support of the conservatee solely because you have been appointed as conservatee. However, if you are the parent or spouse of the conservatee, you may have a personal duty to support the conservatee. For example, each parent has a legal duty to support his or her minor child by paying the ordinary expenses of the child's care, treatment, housing and education. You are not liable to other persons for the acts of the conservatee solely because you have been appointed as conservator. This means you are not responsible to anyone else for something that the conservatee has done simply because you are the conservator. A conservator has the following general duties, responsibilities, powers and authorities, which may be exercised without getting additional court approval: 1. To pay reasonable charges for the support, care, clothing, housing, and education of the conservatee in a reasonable manner, unless the conservatee's parent or spouse is required by law to pay those charges; 2. To pay all lawful debts of the conservatee; 3. To control and manage all the conservatee's property and collect debts and assert claims in favor of the conservatee (for example, if the conservatee is owed money); 4. To insure property against theft or other loss in a reasonable amount; 2 2015 Kansas Probate Forms 3d 5. To pay the premium for your conservator's bond; and 6. To revoke a durable power of attorney for financial decisions. The following actions ALWAYS require WRITTEN court approval. As conservator, you may NOT take any of the following actions unless the supervising court issues a written order approving the action(s): 1. Pay, or reimburse a parent of a minor conservatee for paying, any obligation imposed by law upon the parent for the ordinary expenses of the minor conservatee's care, treatment, housing or education. 2. Settle any claim of the conservatee for less than full value; 3. Sell or transfer the property of any ongoing businesses; 4. Sell, convey, lease, or mortgage the conservatee's homestead or other real estate; 5. Lease or convey possession in any real estate for more than 3 years; 6. Sell, convey, or mortgage any oil, gas, or other mineral interests; 7. Sell, convey, lease, or mortgage any interest the conservatee may have in real estate belonging to the conservatee's spouse; 8. Extend an existing mortgage for more than 5 years, which includes both mortgages where the conservatee is the borrower or the lender; 9. Make a gift on behalf of the conservatee; 10. Access digital assets of the conservatee, such as online accounts, pictures and music stored electronically, social media accounts, etc.; or 11. Pay the guardian, the conservator, or the guardian's or conservator's attorney a fee. The following actions MAY require court approval. As conservator, you should get court approval before taking any of the following actions: 1. Sell the conservatee's personal property as necessary; 2. Manage any ongoing business; 3. Invest funds in a conservative and reasonable manner, including purchasing an insurance policy or annuity, reserving to the conservatee the right to change the beneficiary on termination of the conservatorship; 4. Prosecute and defend all actions in the name of the conservatee; or 5. Dispose of property after the death of the conservatee. What are a Conservator's Responsibilities to the Court? Required Training Before you are appointed as conservator, you must complete a basic training program about the duties and responsibilities of a conservator. Reading this booklet meets that requirement. At the end of this booklet, you will find an affidavit of completion of the basic training program (a form stating you have read the booklet). When you 3 2017 Kansas Probate Forms 3d finish reading this booklet, you should sign the affidavit and file it with the court to prove that you have completed the program. You should also keep this booklet for future reference. Oath When you are appointed as conservator, the court will require that you file an oath or affirmation stating that you will faithfully, impartially and to the best of your ability fulfill all duties assigned by the court. The oath must be in writing and signed before a notary or the judge. Bond When you are appointed as conservator, you must be bonded unless the court waives the bond. A bond is intended to protect the conservatee's property should the conservator mismanage the person's estate. The court will determine the amount of the bond and whether sureties are necessary. Bonds are usually purchased from an insurance company with the assistance of an insurance agent. To keep the bond in effect, you must pay a yearly premium (fee). You will be released from the bond only after the court has approved your actions and final accounting and has ended the conservatorship. Letters After you have filed your oath and affidavit of completion of the basic training program, the court will issue Letters of Conservatorship. This document gives you the authority to carry out your legal duties. You should ask for a certified (legal) copy of the original document, which is on file with the court. You should keep the certified copy in a safe place and provide copies of the Letters of Conservatorship to anyone you deal with who provides services to the conservatee. Conservatorship Plan In some cases, the court may require, or your attorney may suggest, that you file a conservatorship plan. A conservatorship plan might include provisions about how much money a conservatee will be allowed to control and how the conservator plans to protect the eligibility of the conservatee for public benefits. Conservatorship plans are most useful in situations where the conservatee is capable of making some decisions independently. Inventory and Valuation As conservator, you are required to file with the court an inventory and valuation (statement of worth) of the property and assets of the conservatee's estate, including any sources of regular income. This must be done within 30 days of issuance of the Letters of Conservatorship. The inventory and valuation describes the conservatee's estate 4 2017 Kansas Probate Forms 3d at the time the conservatorship begins. You must list and describe each property and asset separately and give its full and fair value. You may need to obtain an independent appraisal of some assets. A sample of the inventory and valuation is included at the end of this booklet. Annual Accounting A conservator is required to file a detailed accounting every year of both income and payments made on behalf of the conservatee. The reporting period usually starts when the conservator is appointed and covers a 12-month period of time, unless the judge orders a different reporting time period. If a conservator fails to file the required accounting, the court may compel the conservator to appear and take actions to remove that person as conservator. A sample of the annual accounting is included at the end of this booklet. Special Reports and Accountings A conservator must file a special report or accounting with the court if any of the following occurs: 1) a change of address of the conservator; 2) a change of residence or placement of the conservatee; 3) a significant change in the health or impairment of the conservatee; 4) a change in the circumstances of the conservator or conservatee that may constitute a conflict of interest; or 5) the death of the conservatee. You should also inform the court if your telephone number or email address changes. If the conservatee dies, you will need to complete a final accounting of the conservatee's assets and have that accounting approved by the court so that the court can close the case. Reimbursement for Time and Expenses The court must approve in advance any reimbursement to the conservator for expenses and time spent on official duties. If you want to be paid back for your time and expenses, you must keep a detailed timesheet of time spent and a detailed record of expenses incurred. Many conservators do not claim such expenses, especially if the conservatee is a family member, and perform their duties out of love and affection. If you want to receive reimbursement, you should talk to your attorney and bring this up preferably at the first court hearing. 5 2017 Kansas Probate Forms 3d How Does a Conservatorship End? A conservatorship never ends automatically. The court may end a conservatorship for a number of different reasons, including when the need for it no longer exists, when the conservatee has turned 18 (and was not determined to be a minor with an impairment) unless the court has extended the conservatorship beyond the conservatee's 18th birthday, or when the conservatee has died. At any time, any person including the conservatee may file a petition asking the court to end the conservatorship for any of the reasons listed above. The court may also end a conservatorship because the conservatee is no longer impaired. At any time, the conservatee may file a petition asking the court to find that he or she is no longer impaired and requesting to be restored to capacity. If the court ends a conservatorship, the court will enter appropriate orders to close the case. What are Conflicts of Interest? A conflict of interest happens when your personal or financial interests as conservator go against those of the conservatee or where your actions appear to be self- serving (for your own benefit). For example, it would be a conflict of interest for a conservator to get a loan from or buy property belonging to the conservatee's estate. It could also be a conflict of interest for a conservator to work in the same facility where the conservatee lives. Whenever you think you might have a conflict of interest, even if you are not sure, report it to the court. Just because you may have a conflict of interest does not mean you cannot serve as guardian and conservator, as long as you keep the court informed. Additional resources: If you have questions about any of your duties as a conservator, ask your attorney. Additional resources, including blank forms for inventories and accountings can be found on the Kansas Judicial Council's webpage at: www.kansasjudicialcouncil.org 6 2017 Kansas Probate Forms 3d CONSERVATOR INVENTORY AND VALUATION Instructions for Completing Definition A detailed list or inventory of the conservatee's estate (property and financial resources) at the time of appointment of a conservator. Filing Procedures The inventory is filed with the court within 30 days of the appointment date. Preparing Documents for the Court This document is a permanent legal record. The information should be typed or written legibly. Use black or dark blue ink when reports are handwritten. Supplementary Inventory and Valuation may be filed to change or add information. ASSESSING VALUES Jointly Owned Property For both real and personal property, indicate if the property is jointly owned and give the name of the co-owner(s) and the form of ownership. Report the full value of the property, not just the portion owned by the conservatee. Real Estate Provide an address and description and the appraised value of the property. The property description is available from the local Register of Deeds office. The appraised value is available from the County Treasurer or Appraiser's office. Furniture / Household Goods / Wearing Apparel / Jewelry Furniture, household goods, and wearing apparel may be listed as a combined value. However, individually valuable items such as antiques, jewelry, coins, electronics, etc. should be listed separately. For assistance with appraisals on items of value, contact a credible antique dealer or auctioneer. Insurance Provide the cash value of all insurance policies. Add additional lines or pages as needed to provide complete documentation. 2015 7 Kansas Probate Forms 3d S A M P L E IN THE 32nd JUDICIAL DISTRICT DISTRICT COURT OF APACHE COUNTY, KANSAS In the Matter ) of the Conservatorship ) of Samuel G. Crown ) Case No. _________ ) ) Proceeding Pursuant to K.S.A. Chapter 59 INVENTORY AND VALUATION REAL ESTATE (Indicate if property is jointly owned and with whom) Address and Description Value 1. 39 Solar Haven Rd, Lot 59, Solar Haven Addition, $ 45,489.00 Sanesville, KS 66666 (joint tenancy with Mrs. Betty Crown) Total Real Estate ........................................................................................$ 45,489.00 PERSONAL PROPERTY (Indicate if property is jointly owned and with whom) Cash / Checking and Savings Accounts / Certificates of Deposit Description Amount 1. Checking Account, Savers Union Bank, Sanesville, KS $ 1,178.00 2. Savings Account, Savers Union Bank, Sanesville, KS $ 8,978.00 3. CD, Savers Union Bank $ 4,329.00 Stocks / Bonds / Investments / Retirement Accounts / Annuities Description Value 1. N/A $ 0 8 2015 Kansas Probate Forms 3d S A M P L E Vehicles / RVs / Boats / Trailers Description Value 1. 2006 Toyota Camry $ 6,000.00 Furniture / Household Goods / Wearing Apparel / Jewelry Description Value 1. Household furnishings $ 4,500.00 2. Wearing Apparel $ 500.00 Other Assets (For example: interest in a business entity; oil & gas lease or interest; agricultural lease interest and accounts in cooperatives; livestock; equipment; debts owed to the conservatee; interest in a trust; life insurance; long term care insurance; funeral or burial plan; burial plot) Description Value 1. Red Shield life insurance (cash value) $ 10,000.00 2. Funeral & burial trust, Timberline Mortuary, Sanesville, KS $ 4,250.00 3. Antique gun collection $ 1,500.00 4. Lawn mower and tools $ 300.00 Total Personal Property .............................................................................$ 41,535.00 DEBTS AND LIABILITIES Mortgages / Liens / Loans / Credit Card Debt Description Amount 1. Mortgage on 39 Solar Haven Rd. (The conservatee and his wife, Betty Crown, are jointly liable on the mortgage.) $ 20,000.00 2. Bank of America Visa credit card (The conservatee's wife, Betty Crown, has possession of the card and pays the bill.) $ 2,000.00 Total Debts and Liabilities ........................................................................ $ 22,000.00 9 2015 Kansas Probate Forms 3d S A M P L E RECAPITULATION Total Real Estate ............................................................................................$ 45,489.00 Total Personal Property ..................................................................................$ 41,535.00 Less Total Debts and Liabilities ..................................................................$ (22,000.00) Total Estate $ 65,024.00 SOURCES OF REGULAR INCOME (For example: social security benefits, supplemental security income; pension or retirement income; trust or annuity payments; veterans benefits; farm or rental income; oil and gas income; child support or alimony; interest) Description Amount How Often Received 1. Social Security disability insurance $ 415 per month 2. KPERS retirement $ 685 per month 3. Veterans benefit $ 380 per month 4. Bank account interest amount varies I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on June 30, 2013. Conservator 10 2015 Kansas Probate Forms 3d ANNUAL CONSERVATOR ACCOUNTING Instructions for Completing This is a report of all income (receipts) and disbursements (expenses) of the estate transacted during the accounting period. It also updates the inventory and valuation. The accounting is submitted to the court once a year either on the anniversary date of the appointment of the conservator, or, on a calendar year basis. This varies by county. File the accounting within 30 days of the end of the accounting period. Record Keeping Keep the following financial information to prepare an accurate accounting: • Bank statements, check book register, copies of cancelled checks • Receipts of items purchased • Financial reports from trust accounts COMPLETING THE ACCOUNTING 1. The accounting is a permanent legal record. The form should be typed OR written legibly. Use black or dark blue ink when reports are handwritten. 2. Work from bank statements to prepare the accounting using the check register for support information. 3. Attachments - Financial Statements from a Provider If the person lives in a facility, or the provider is the payee for the conservatee's benefits, some courts will accept an attachment of the monthly or quarterly financial statements from the provider. Check the math accuracy before attaching to the accounting. Computer Generated Financial Spread Sheets Some courts will accept an accounting generated by a computer program. Courts may have a format preference for how information is presented. Generally, there are two acceptable formats: Format 1 - Spread Sheet Set up looks like the check book register and includes a running balance of cash on hand. Advantage: The accounting may be easily prepared from the bank statements. Format 2 - Spread Sheet Columns totaling income, disbursements and a final balance of cash on hand. 11 2015 Kansas Probate Forms 3d I. STATEMENT OF RECEIPTS (INCOME) AND DISBURSEMENTS (EXPENSES) Balance Carried Forward If an accounting was filed for the previous year - The balance carried forward should be the same amount as the balance on hand from the previous year accounting. If no accounting was filed for the previous year - The balance carried forward is the cash balance on the initial Inventory and Valuation. Receipts (Income) Itemize receipts from all sources received in the accounting period. Add additional pages if needed. Fill in all the information required on the form. Income for the same amount may be documented in lump sums. Refer to Sample Accounting. Disbursements (Expenditures) Itemize all money spent during the accounting period. Add pages if needed. Fill in all the information required on the form. Expenses for the same amount (i.e. cable, or phone) may be documented in lump sums. Refer to Sample Accounting. Summary List the total receipts and the total disbursements. The cash balance is the difference between the total receipts and total disbursements. II. INVENTORY Real Estate - List any real estate including the appraised value. Personal Property List account balances as of the end of the accounting reporting period, and value of all other assets. Document any newly purchased assets such as a TV, bicycle or furniture. Total the personal property. Add the Total Personal Property and Total Real Estate, and put the amount on the Total Real Estate and Total Personal Property line. Debts and Liabilities Total all debts and liabilities, and subtract that number from the Total Real Estate and Total Personal Property to find the Total Estate value. 2015 12 Kansas Probate Forms 3d S A M P L E IN THE 32nd JUDICIAL DISTRICT DISTRICT COURT OF APACHE COUNTY, KANSAS In the Matter ) of the Conservatorship ) of Samuel G. Crown ) Case No. _________ ) ) Proceeding Pursuant to K.S.A. Chapter 59 X ANNUAL FINAL ACCOUNTING Marjorie Crestone 3299 Smithville Road, Apt #4 Name Address Sanesville, KS 66666 (785) 999-7100 mcrestone@gmail.com City & Zip Code Telephone Number Email Address conservator in the above-entitled estate submits the following annual accounting in the conservatorship of Samuel G. Crown 39 Solar Haven Rd., Sanesville, KS 66666 1942 Name Address, City & Zip Code Year of Birth for the period from July 1, 2013 to June 30, 2014. I. Statement of Receipts and Disbursements RECEIPTS (Income) DATERECEIVED FROMEXPLANATIONAMOUNT Balance Carried ForwardChecking Account $ 1,050.00 July - Dec 2013Social Security Admin.$ 415 X 6 mos 2,490.00 Jan - June 2014Social Security Admin.$ 425 X 6 mos 2,550.00 July - June 2014 Veterans Affairs$ 380 x 12 mos 4,560.00 July - June 2014 KPERS Retirement $ 685 x 12 mos 8,220.00 July - June 2014 Savers Union Bank Yearly Checking Account Interest 16.98 July - June 2014 US Treasury IRS Tax Refund - Earned Income Credit 75.00 May 28, 2014Crown Savings AccountTransfer of Funds 1,000.00 June 15, 2014Savers Union Bank Cashed Certificate of Deposit 2,000.00 Total Receipts (Including balance carried forward) $ 21,961.98 13 2015 Kansas Probate Forms 3d S A M P L E DISBURSEMENTS (Expenses) from Checking Account DATE Check #PAID TOPURPOSEAMOUNT 07/13-06/14 Savers Union Bank Monthly Mortgage - Incls Insurance ($568 x 12 mos) $6,816.00 07/13-06/14 Westar Energy Electrical Utility (Average Payment Plan $55 x 12) 660.00 07/13-06/14 City Water DeptWater and Sewage ($35 x 12 mos) 420.00 07/13-06/14 KS Gas ServiceGas Utility (Equal Payments Plan $70 x 12) 840.00 07/13-06/14 Ripple City Cable Cable Bill ($38.50 x 12 mos)462.00 07/13-06/14 Birch Telephone Phone ($41.89 per month X 12 mos)502.68 07/13-06/14 Sanesville Life Line Medical Alert ($19.99 x 12 mos)239.88 07/13-06/14 BCBS Insurance Supplemental Insurance ($97.45 x 12 mos) 1,169.40 07/13-06/14 Pelley Pharmacy Prescription Co-pay 168.00 07/13-06/14 Tuppence Foods Groceries $65 x 52 wks (Per Conservator Plan) 3,380.00 07/13-06/14 Samuel Crown Spending Money ($100/mo x 12) (Conservator Plan) 1,200.00 07/14/13 #2498K-Mart Socks, personal hygiene produces, video 130.00 07/13-06/14 Barber of Saville Haircuts ($10 x 12 mos) 120.00 07/14/13#2501Seniors Travel Public Transportation (12 books x $25 x 12 mos) 300.00 08/19/13#2543Sanesville Library Audio Reader Rental ($10 x 12 mos)120.00 09/20/13#2559Walmart Jeans, shirts, under wear 124.00 10/10/13#2561Sanesville Bowl Senior Bowling; Senior Olympics - Yrly Fee150.00 11/28/13#2584SearsWinter Jacket; Christmas gifts220.00 12/12/13#2598Orville Furniture Lift Chair for Samuel Crown 1,200.00 02/24/14 #2677Walmart Clothing; personal care items; TV 456.78 04/28/14#2792Penney's Towels, bath set, shower curtain; (Dresser $400) 687.92 05/24/14 #2812County TreasurerYearly Property Taxes 725.67 06/17/14#2822Walmart Hygiene items; household cleaners85.00 06/18/14#2823 Sears & Applebees Birthday Gift and Dinner for Samuel Crown50.00 06/18/14#2824Dr. Long Tooth Dentist - cleaning and two fillings 298.00 06/22/14#2825Eye Magic New Glasses220.00 06/22/14 #2826 Savers Union Bank Ordered Checks 36.25 06/22/14#2827Sanesville Times Newspaper Subscription ($11.95 x 12 mos) 143.30 06/24/14#2828 US Post Office Stamps for paying bills ($7.80 x 4 books) 31.20 TOTAL$ 20,956.08 14 2015 Kansas Probate Forms 3d S A M P L E Savings Account Transactions DATEPAID TOPURPOSEAMOUNT 07/01/13Beginning Balance $8,245.95 08/30/13Samuel Crown Quarterly Interest (+ 3.45) 12/31/13Samuel Crown Quarterly Interest (+3.79) 03/31/14Samuel Crown Quarterly Interest (+3.57) 05/28/14Samuel Crown Transfer to Checking Account(-1,000.00) 06/30/14Samuel Crown Quarterly Interest (+3.02) Ending Balance $7,259.78 SUMMARY Total Receipts ............................................................................ $ 21,961.98 Total Disbursements .................................................................. $ 20,956.08 Cash Balance on Hand ............................................................... $ 1,005.90 II. INVENTORY REAL ESTATE Address and Description Value 1. 39 Solar Haven Rd, Lot 59, Solar Haven Addition, $ 45,489.00 Sanesville, KS 66666 (joint tenancy with Betty Crown) Total Real Estate $ 45,489.00 PERSONAL PROPERTY Cash / Checking and Savings Accounts / Certificates of Deposit Description Amount 1. Checking Account, Savers Union Bank, Sanesville, KS $ 1,005.90 2. Savings Account, Savers Union Bank, Sanesville, KS $ 7,259.78 3. CD, Savers Union Bank $ 2,350.00 Stocks / Bonds / Investments / Retirement Accounts / Annuities Description Value 1. N/A $ 0 2015 15 Kansas Probate Forms 3d S A M P L E Vehicles / RVs / Boats / Trailers Description Value 1. 2006 Toyota Camry $ 5,700.00 Furniture / Household Goods / Wearing Apparel / Jewelry Description Value 1. Household furnishings $ 4,500.00 Lift Chair ($1200) Dresser ($400) $ 1,600.00 2. Wearing Apparel $ 500.00 Other Assets Description Value 1. Red Shield life insurance (cash value) $ 10,000.00 2. Funeral & burial trust, Timberline Mortuary, Sanesville, KS $ 4,250.00 3. Antique gun collection $ 1,500.00 4. Lawn mower and tools $ 300.00 Total Personal Property $ 38,060.68 Total Real Estate and Personal Property $ 83,549.68 DEBTS AND LIABILITIES Mortgages / Liens / Loans / Credit Card Debt Description Amount 1. Mortgage on 39 Solar Haven Rd. $ 17,000.00 2. Bank of America Visa credit card $ 1,000.00 Total Debts and Liabilities $ 18,000.00 RECAPITULATION Total Real Estate and Personal Property $ 83,549.68 Less Total Debts and Liabilities $ (18,000.00) Total Estate $ 65,549.68 2015 16 Kansas Probate Forms 3d S A M P L E I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on June 30, 2014. Conservator 2015 17 Kansas Probate Forms 3d IN THE JUDICIAL DISTRICT DISTRICT COURT OF COUNTY, KANSAS In the Matter of the Conservatorship of Case No. _________ Proceeding Pursuant to K.S.A. Chapter 59 AFFIDAVIT OF COMPLETION OF BASIC INSTRUCTIONAL PROGRAM I declare that I have received and reviewed the Basic Instructions for Conservators and kept a copy of those Instructions. I acknowledge that, as conservator, I have the duties and responsibilities described in the Instructions. I declare under penalty of perjury that this is true and correct. Executed on this day of , . Signature Please Print Your Name Address Telephone Number Email Address 2015