700-00152 – Fiduciary’s Closing Report (04/2018) Page 1 of 1

STATE OF VERMONT

SUPERIOR COURT PROBATE DIVISION Unit Docket No.:

In re:

FIDUCIARY’S CLOSING REPORT

I hereby state under oath: 1. This report is filed within one year after the final decree in this proceeding.2. I have paid and delivered the money and/or other property to the persons entitled to receive it.3. I have filed a receipt for each payment and delivery or such other proof as required by the Court.

I have attached an affidavit explaining the omission if I was unable to obtain the proof required.I hereby swear or affirm that the information in this report is true to the best of my knowledge and belief.

Date Signature

Printed Name

Signed and sworn to before me:

_____________________________________________________________________________

ORDER OF APPROVAL AND DISCHARGE

The Fiduciary’s report is approved, and the proceeding closed. The Fiduciary is discharged.

__________________________ _______________________________________ Dated Judge’s Signature

Date Signature of Notary Public Expiration Date

_______________________________________ Printed Name