Annual Report Of Guardian - New York Supreme Court Page 12
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12SCHEDULE O - Resume of any other pertinent facts relative to the care and maintenance of the
Incapacitated Person, including the frequency of the visits; whether the Incapacitated Person has
made a will or executed a Power of Attorney; and any other information necessary for the proper
administration of this matter.
STATE OF NEW YORK
)
: ss.:
COUNTY OF
)
I, ____________________________________________________, being duly sworn, say
that I am the Guardian for the above-named Incapacitated Person, the forgoing Annual Report of
Guardian contains, 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 all money and other personal
property of said Incapacitated Person which have come into my hands or have been received by any
other person in my order or authority or for my use since my appointment or since filing my last
Annual Report, and of the value of all such property; together with a full and true statement and
account of the manner in which I have disposed of the same and all property remaining in my hands
at the time of the filing of this Annual Report; also a full and true description of the amount and
nature of each investment made by me since my appointment or since the filing of my last Annual
Report. I do not know of any error or omission in this Annual Report to the prejudice of said
Incapacitated person.
____________________________________
Guardian
Sworn to before me this __________________
day of ________________________, 20_____
___________________________________
Notary Public
Page 12
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