Initial Report - County Of Nassau Supreme Court Page 5
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5ASSETS NOT YET MARSHALLED
(Set forth all bank accounts, stocks, securities and/or security accounts not yet marshalled)
STATE OF NEW YORK )
) ss.:
COUNTY OF NASSAU )
I, ___________________________________, being duly sworn, say I am the Guardian
for the above-named Incapacitated Person, the foregoing account and inventory contain, to the best of
my knowledge and belief, a full and true statement of all my receipts and disbursements on account of
said Incapacitated Person; and of all money and other personal property of said Incapacitated Person
which have come to my hands or have been received by any other persons by my order or authority or
for my use since my appointment, and of the value of all property. I do not know of any error or
omission in the report to the prejudice of said Incapacitated Person.
_________________________________________
Guardian
Sworn to before me this _________
day of __________________, 20
.
________________________________________________
Notary Public-Commissioner of Deeds
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