Merced — MSC-PR-006A

Source: https://www.merced.courts.ca.gov/system/files/msc-pr-006a-attachment-final-accounts-eff-712020.pdf

MSC-PR-006A IN THE MATTER OF: CASE NUMBER:

ATTACHMENT FOR FINAL ACCOUNTS

1. This is a final account for the following reason:

   a. The ward has reached the age of 18. The remaining assets of the estate should be distributed to

   the ward.

   b. The court terminated the conservatorship/guardianship/trust estate on (date):

   ___________________. The Petitioner has turned over all remaining assets to the parties

   indicated in the court order as

   shown in the receipt(s) provided in Attachment 19.

   c. Petitioner is no longer serving as conservator/guardian/trustee and successor was appointed per
   Court order on (date): _______________. Petitioner has turned over all remaining assets to the
   successor as indicated in the receipt(s) provided in Attachment 19.

   d. The estate has been entirely exhausted through disbursements as indicated in the attached

   schedules.

   e. The conservatee/minor/beneficiary died on (date): at (place): .

   (1) A separate Summary of Account and set of schedules for transactions after the death is attached.

   (Attach Judicial Council Forms GC-400, et seq. or GC-405, et seq.)

   (2) (i) The notice required by Probate Code 215/19202 was served on the California Director of

   Health Care Services on (date): with a copy of Decedent’s death

   certificate.

   A copy of the death certificate of the Decedent’s pre-deceased spouse or registered domestic

   partner (name): _________________________________________________ was also

   served the notice above.

   Or

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MSC-PR-006A IN THE MATTER OF: CASE NUMBER:

ATTACHMENT FOR FINAL ACCOUNTS

1. e. (2) (ii) The decedent did not receive, and was not the surviving spouse or registered domestic partner

   of a person who received, Medi-Cal benefits. Therefore, no notice to the California Director of

   Health Care Services is required.

   (3) (i) Petitioner knows of no heir or beneficiary of the estate that is or has previously been confined

   in a prison or facility under the jurisdiction of the Department of Corrections, or the Department

   of Youth and Community Restoration, or confined in any county jail, road camp, industrial farm

   or local correctional facility. Therefore, no notice to the California Victim Compensation Board

   is required;

   Or

   (ii) Notice was given as required under Probate Code Section 216 on (date): ________________.

   (4) (i) (For trusts only) Other than taxes or creditor claims otherwise addressed in this petition,

   Petitioner has no reason to believe that a any public entity listed in Probate Code 19201 has

   any basis for making a claim.

   Or

   (ii) Notice was sent as follows:

   Date Mailed

   Employment Development Department ________________

   State Board of Equalization ________________

   Department of State Hospitals ________________

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MSC-PR-006A IN THE MATTER OF: CASE NUMBER:

ATTACHMENT FOR FINAL ACCOUNTS

1. e. (5) (For special needs trusts only) The notice required by Probate Code 3605 for the trust was served

   as follows:

   California Department of Health Care Services (date):

   California Department of Mental Health (date):

   California Department of Developmental Services (date):

   The County or City and County of (name):

   that made a written request to the trustee for notice (date):

   (6) No claims have been received in response to the notices in items (2) through (5) above.

   Or

   Copies of all claims received are provided in Attachment 19.

   (7) Petitioner is informed, believes and therefore alleges that the following persons are beneficiaries

   and/or heirs of the Decedent as indicated in Attachment 19 as follows:

   Name Relationship Age Share of Estate

   Information regarding additional beneficiaries is contained on Attachment 19.

   (8) (i) After payment of requested compensation, the assets of the estate will be entirely exhausted.

   Or

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MSC-PR-006A IN THE MATTER OF: CASE NUMBER:

ATTACHMENT FOR FINAL ACCOUNTS

1. e. (8) (ii) The remaining assets of estate should be distributed as follows:

   (a) to the personal representative of the Decedent’s estate who has been appointed in the

   following case number: has not yet been appointed.

   (b) to the following successor(s) in interest of the decedent who have signed declarations

   under Probate Code 13100 which are attached as Attachment 19:

   Name Relationship Age Share of Estate

   Continued in Attachment 19.

   (c) to the beneficiaries of the trust as follows:

   Name Relationship Age Share of Estate

   Continued in Attachment 19.

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