GC-400(A) (3) Schedule A, Receipts, Pensions, Annuities, and Other Regular Periodic Payments—Standard Account

Source: https://www.courts.ca.gov/documents/gc400a3.pdf

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GC-400(A)(3)

CONSERVATORSHIP GUARDIANSHIP OF CASE NUMBER:

(Name): Conservatee Minor Schedule A, Receipts, Pensions, Annuities, and Other Regular Periodic Payments—Standard Account*

• (Report veterans' pensions on form GC-400(A)(5), Schedule A, Receipts, Social Security, Veterans' Benefits, Other Public Benefits.)

Pensions, annuities, and other regular periodic payments

Date of Receipt Description* Amounts (mm/dd/yyyy) * (Report receipts from each source separately.)

$

Subtotal, Pensions, Annuities, Other Regular or Periodic Payments: $

(Add pages as required. Check the box at the bottom of the last page of this receipt category and total the amount of the category. Include that sum in the total of receipts on line 3 of the Summary of Account (form GC-400(SUM)/GC-405(SUM)). The page total to the right is the number of pages in Schedule A.) Page A of pages

Form Approved for Optional Use SCHEDULE A, RECEIPTS, PENSIONS, ANNUITIES, AND OTHER REGULAR Probate Code, §§ 1060–1064, 2620; Judicial Council of California Cal. Rules of Court, rule 7.575 GC-400(A)(3) [New January 1, 2008] PERIODIC PAYMENTS—STANDARD ACCOUNT www.courtinfo.ca.gov (Probate—Guardianships and Conservatorships)

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