Minnesota Legislature
Office of the Revisor of Statutes
MINNESOTA COURT RULES
GENERAL RULES OF PRACTICE
FORM 417.02 TRUSTEE'S ACCOUNTING
| State of Minnesota | District Court | |||
| COUNTY | JUDICIAL DISTRICT | |||
| COURT FILE NO. | ||||
| Case Type: _ | ||||
| In the Matter of the Trust Created under Article | ||||
| _ of the Last Will of_. | ||||
| ALTERNATIVE FOR INTER VIVOS TRUSTS: | ||||
| In the Matter of the Trust Created under | ||||
| Agreement By and Between _______________, | ||||
| Settlor, and ____________ and _____________, | ||||
| Trustees, dated _ | . | |||
| TRUSTEE'S ANNUAL ACCOUNT | ||||
| Principal | Income | |||
| Assets on Hand as of _________________ (Schedule 1) | $ | $ | ||
| Increases to Assets: | ||||
| Interest (Schedule 2) | $ | 0.00 | $ | |
| Dividends (Schedule 3) | $ | 0.00 | $ | |
| Capital gains distributions (Schedule 4) | $ | $ | 0.00 | |
| Gains on sales and other dispositions (Schedule 5) | $ | $ | 0.00 | |
| Return on capital (Schedule 6) | $ | $ | 0.00 | |
| Other increases (Schedule 7) | $ | $ | ||
| Decreases to Assets: | ||||
| Losses on sales and other dispositions (Schedule 8) | ($ | ) | ($ | .00) |
| Administration expenses (Schedule 9) | ($ | ) | ($ | ) |
| Taxes (Schedule 10) | ($ | ) | ($ | ) |
| Trustee fees | ($ | ) | ($ | ) |
| Attorney fees | ($ | ) | ($ | ) |
| Other decreases (Schedule 11) | ($ | ) | ($ | ) |
| Balance Before Distributions | $ | $ | ||
| Distributions to Beneficiaries (Schedule 12) | ($ | ) | ($ | ) |
| Principal and Income Balances | $ | 0.00 | $ | 0.00 |
| Total Assets on Hand as of _ | $ | |||
| (Income plus principal) (Schedule 13) |
[NAME OF TRUST]
ASSETS ON HAND
[Beginning DATE]
Schedule 1
| Values at Cost | Values at Cost | |||||
| Market Value | or Basis | or Basis | ||||
| as of [DATE] | Principal | Income | ||||
| Cash or Cash Equivalents | ||||||
| Checking account | $ | $ | $ | |||
| Savings account | $ | $ | $ | |||
| Money market account | $ | $ | $ | |||
| Stocks and Bonds | ||||||
| Stocks | $ | $ | $ | 0.00 | ||
| Corporate bonds | $ | $ | $ | 0.00 | ||
| Municipal bonds | $ | $ | $ | 0.00 | ||
| Real Estate | $ | $ | $ | 0.00 | ||
| Other Assets | $ | |||||
| Life insurance policies (cash | ||||||
| value) | $ | $ | $ | |||
| Other assets | $ | $ | $ | |||
| Total Assets on Hand as of | $ | 0.00 | $ | 0.00 | $ | 0.00 |
| [Date] ________________ . |
Note: This schedule reflects assets on hand at the beginning of the period. Identify each asset thoroughly. Provide the name of the bank and account number for each account holding cash or cash equivalents. Under Minn. Gen. R. Prac. 11, financial account numbers must be submitted on a separate Form 11.1 Confidential Information Form that is not accessible to the public. Provide the number of shares or par value of each security. Provide the address of each parcel of real estate.
[NAME OF TRUST]
INTEREST
Schedule 2
| Income | ||
| Checking account(s) | ||
| 1. | $ | |
| 2. | $ | |
| Savings account(s) | ||
| 1. | $ | |
| 2. | $ | |
| Corporate bonds | ||
| 1. | $ | |
| 2. | $ | |
| 3. | $ | |
| Municipal bonds | ||
| 1. | $ | |
| 2. | $ | |
| 3. | $ | |
| Other interest | ||
| 1. | $ | |
| 2. | $ | |
| 3. | $ | |
| Total Interest | $ | 0.00 |
Identify each interest-producing asset. List each bank account by name and account number. Under Minn. Gen. R. Prac. 11, financial account numbers must be submitted on a separate Form 11.1 Confidential Information Form that is not accessible to the public. Identify each bond or other asset that pays interest.
[NAME OF TRUST]
DIVIDENDS
Schedule 3
| Income | ||
| Stocks | ||
| 1 | $ | |
| 2 | $ | |
| 3 | $ | |
| 4 | $ | |
| 5 | $ | |
| 6 | $ | |
| 7 | $ | |
| 8 | $ | |
| 9 | $ | |
| 10 | $ | |
| 11 | $ | |
| 12 | $ | |
| 13 | $ | |
| 14 | $ | |
| 15 | $ | |
| Total Dividends | $ | 0.00 |
Identify each security that paid dividends.
[NAME OF TRUST]
CAPITAL GAINS DISTRIBUTIONS
Schedule 4
| Principal | ||
| Capital gains distributions: | ||
| 1 | $ | |
| 2 | $ | |
| 3 | $ | |
| 4 | $ | |
| 5 | $ | |
| 6 | $ | |
| 7 | $ | |
| 8 | $ | |
| 9 | $ | |
| 10 | $ | |
| 11 | $ | |
| 12 | $ | |
| 13 | $ | |
| 14 | $ | |
| Total Capital Gains Distributions | $ | 0.00 |
Identify each security that paid dividends.
[NAME OF TRUST]
GAINS ON SALES AND OTHER DISPOSITIONS
Schedule 5
| Principal | ||||
| Sale of ________ shares of __________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of _________ shares of __________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of ___________ : | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Total Gains | $ | 0.00 |
[NAME OF TRUST]
RETURN OF CAPITAL
Schedule 6
| Principal | ||
| Return of capital: | ||
| 1. | $ | |
| 2. | $ | |
| 3. | $ | |
| 4. | $ | |
| 5. | $ | |
| 6. | $ | |
| 7. | $ | |
| 8. | $ | |
| 9. | $ | |
| 10. | $ | |
| 11. | $ | |
| 12. | $ | |
| 13. | $ | |
| 14. | $ | |
| Total Return of Capital | $ | 0.00 |
Identify each security that paid a return of capital.
[NAME OF TRUST]
OTHER INCREASES
Schedule 7
| Principal | Income | |||
| Securities added to trust by Settlor | $ | 0.00 | ||
| 1 | $ | $ | ||
| 2 | $ | $ | ||
| 3 | $ | $ | ||
| 4 | $ | $ | ||
| 5 | $ | $ | ||
| 6 | $ | $ | ||
| 7 | $ | $ | ||
| 8 | $ | $ | ||
| 9 | $ | $ | ||
| Income transferred to principal | $ | $ | 0.00 | |
| Other increases: | ||||
| 1 | $ | $ | ||
| 2 | $ | $ | ||
| 3 | $ | $ | ||
| 4 | $ | $ | ||
| 5 | $ | $ | ||
| 6 | $ | $ | ||
| 7 | $ | $ | ||
| 8 | $ | $ | ||
| 9 | $ | $ | ||
| Total Other Increases | $ | 0.00 | $ | 0.00 |
[NAME OF TRUST]
LOSSES ON SALES AND OTHER DISPOSITIONS
Schedule 8
| Principal | ||||
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Sale of ________ shares of __________: | ||||
| Proceeds received | $ | |||
| Less cost or basis | ($ | ) | $ | 0.00 |
| Total Losses | $ | 0.00 |
[NAME OF TRUST]
ADMINISTRATIVE EXPENSES
Schedule 9
| Principal | Income | ||||
| Bank account fees | $ | $ | |||
| Check charges | $ | $ | |||
| Broker annual fees | $ | $ | |||
| Photocopies | $ | $ | |||
| Postage | $ | $ | |||
| Maintenance of real estate (schedule attached) | $ | $ | |||
| Other (schedule attached) | $ | $ | |||
| Total Administrative Expenses | $ | 0.00 | $ | 0.00 |
[NAME OF TRUST]
TAXES
Schedule 10
| Principal | Income | ||||
| Foreign dividend tax | $ | 0.00 | $ | ||
| U.S. fiduciary income tax | $ | $ | |||
| Minnesota fiduciary income tax | $ | $ | |||
| Total Taxes | $ | 0.00 | $ | 0.00 | |
| Note: The portion of fiduciary income tax allocated to capital gains is charged against principal. The portion of foreign dividend tax is allocated to income. | |||||
[NAME OF TRUST]
OTHER DECREASES
Schedule 11
| Principal | Income | |||
| Income transferred to principal | $ | $ | 0.00 | |
| Other decreases: | ||||
| 1. | $ | $ | ||
| 2. | $ | $ | ||
| 3. | $ | $ | ||
| 4. | $ | $ | ||
| 5. | $ | $ | ||
| 6. | $ | $ | ||
| 7. | $ | $ | ||
| 8. | $ | $ | ||
| 9. | $ | $ | ||
| 10. | $ | $ | ||
| Total Other decreases | $ | 0.00 | $ | 0.00 |
[NAME OF TRUST]
DISTRIBUTIONS TO BENEFICIARIES
Schedule 12
| Principal | Income | ||||
| Name of each beneficiary and date and description of distribution: | |||||
| 1. | $ | $ | |||
| 2. | $ | $ | |||
| 3. | $ | $ | |||
| 4. | $ | $ | |||
| 5. | $ | $ | |||
| 6. | $ | $ | |||
| 7. | $ | $ | |||
| 8. | $ | $ | |||
| 9. | $ | $ | |||
| 10. | $ | $ | |||
| 11. | $ | $ | |||
| 12. | $ | $ | |||
| 13. | $ | $ | |||
| 14. | $ | $ | |||
| 15. | $ | $ | |||
| Total Distributions to Beneficiaries | $ | 0.00 | $ | 0.00 | |
[NAME OF TRUST]
ASSETS ON HAND
[ending DATE]
Schedule 13
| Values at Cost | Values at Cost | ||||||
| Market Value | or Basis | or Basis | |||||
| as of [DATE] | Principal | Income | |||||
| Cash or Cash Equivalents | |||||||
| Checking account | $ | $ | $ | ||||
| Savings account | $ | $ | $ | ||||
| Money market account | $ | $ | $ | ||||
| Stocks and Bonds | |||||||
| Stocks | $ | $ | $ | 0.00 | |||
| Corporate bonds | $ | $ | $ | 0.00 | |||
| Municipal bonds | $ | $ | $ | 0.00 | |||
| Real Estate | $ | $ | $ | 0.00 | |||
| Other Assets | |||||||
| Life insurance policies (cash value) | $ | $ | $ | ||||
| Other assets | $ | $ | $ | ||||
| Total Assets on Hand as of | $ | 0.00 | $ | 0.00 | $ | 0.00 | |
| [Date] ______________. | |||||||
Note: This schedule reflects assets on hand at the end of the accounting period. Identify each asset thoroughly. Provide the name of the bank and account number for each account holding cash or cash equivalents. Under Minn. Gen. R. Prac. 11, financial account numbers must be submitted on a separate Form 11.1 Confidential Information Form that is not accessible to the public. Provide the number of shares or par value of each security. Provide the address of each parcel of real estate.
I declare under penalty of perjury that everything I have stated in this document is true and correct. Minnesota Statutes, section 358.116.
| Signed at: ______________________________County,________________________ |
| __________________________________________________State. |
| On___________________________, 20____. |
| Signature |
| ____________________________________________________ |
| Name_________________________________________ |
| Agency or Business Name, if applicable:________________________________ |
| Address________________________________________ |
| City/State/Zip____________________________________ |
| Telephone (_______)______________________________ |
| Notarial Stamp or Seal (or Other Title or Rank) | Signed and sworn to (or affirmed) before | ||
| me on (date) _ | |||
| by _ | |||
| and ________________ , | |||
| Trustees. | |||
| _ | |||
| Signature of Notary Public or Other | |||
| Official |
(Amended effective July 1, 2015; amended effective May 23, 2016.)