Conservator'S Implementation Report And Inventory Page 4

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Wages:
Dividends/Interest:
Rental Income:
Pension:
Annuities:
Other: (describe)
$0.00
Total Monthly Income:
9.
Protected Person’s Monthly Expenses. (Money paid to anyone on behalf of the
protected person or the protected person’s legal dependents. Divide yearly amounts by
12. Attach extra pages if necessary.)
Monthly
Expense
Description
Amount
Nursing/Assisted Living Home:
Rent Payment:
Mortgage Payment:
Utilities:
Transportation:
Medical Treatment Costs:
Medications:
Credit Card Payments:
Food:
Clothing:
Recreation or Entertainment:
Personal Expenses (include allowance):
Income Tax & Property Tax:
Home/Property Maintenance Costs:
Insurance:
Home Insurance
Auto Insurance
Medical Insurance
Life Insurance
Gifts:
Child/Spousal Support:
Fees/Costs Paid to Conservator:
Other (list all other payments made):
$0.00
Total Monthly Expenses:
Page 4 of 9
Probate Rule 17(e)
PG-220 (2/05)(cs)
AS 13.26.250 & 13.06.100
CONSERVATOR’S IMPLEMENTATION REPORT & INVENTORY

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