STATE OF WISCONSIN, CIRCUIT COURT
[COUNTY] COUNTY
IN THE MATTER OF THE ESTATE OF: Sample, John Q.
ESTATE ACCOUNT (Form PR-1814 structure)
Accounting Period: January 1, 2025 through December 31, 2025
Format: Wisconsin Court System Form PR-1814: Estate Account (Informal and Formal Administration), Wis. Stat. §§862.01, 862.05, 862.07, 862.11, 865.16(1)(c). The official form "shall not be modified" but "may be supplemented"; this exhibit supplies the supporting schedules the form requires. Amounts are illustrative sample data.
SUMMARY (PR-1814 page 1)
| Amount | |
|---|---|
| 1. Inventory value of assets (or balance from prior account) | $1,010,650.00 |
| 2. Receipts (Schedule A) | $35,055.50 |
| 3. Gains on sale (Schedule B) | $1,250.00 |
| 4. Total to be accounted for | $1,046,955.50 |
| 5. Disbursements (Schedule C) | $28,885.00 |
| 6. Distributions to beneficiaries (Schedule D) | $30,000.00 |
| 7. Losses on sale | $0.00 |
| 8. Assets on hand at close (Schedule E) | $988,070.50 |
| 9. Total accounted for | $1,046,955.50 |
SCHEDULE A – Receipts
| Date | Source | Nature / Purpose | Amount |
|---|---|---|---|
| 01/01/2025 | Tenant – 123 Sample Ln | Rent – January | $2,000.00 |
| 01/15/2025 | Sample Securities | Dividends – Q4 2024 (various) | $2,460.00 |
| 02/01/2025 | Tenant – 123 Sample Ln | Rent – February | $2,000.00 |
| 03/01/2025 | Tenant – 123 Sample Ln | Rent – March | $2,000.00 |
| 04/01/2025 | Tenant – 123 Sample Ln | Rent – April | $2,000.00 |
| 04/15/2025 | Sample Securities | Dividends – Q1 2025 (various) | $2,460.00 |
| 05/01/2025 | Tenant – 123 Sample Ln | Rent – May | $2,000.00 |
| 06/01/2025 | Tenant – 123 Sample Ln | Rent – June | $2,000.00 |
| 06/30/2025 | First Sample Bank | Interest – Jan–Jun | $607.75 |
| 07/01/2025 | Tenant – 123 Sample Ln | Rent – July | $2,000.00 |
| 07/15/2025 | Sample Securities | Dividends – Q2 2025 (various) | $2,460.00 |
| 08/01/2025 | Tenant – 123 Sample Ln | Rent – August | $2,000.00 |
| 09/01/2025 | Tenant – 123 Sample Ln | Rent – September | $2,000.00 |
| 10/01/2025 | Tenant – 123 Sample Ln | Rent – October | $2,000.00 |
| 10/15/2025 | Sample Securities | Dividends – Q3 2025 (various) | $2,460.00 |
| 11/01/2025 | Tenant – 123 Sample Ln | Rent – November | $2,000.00 |
| 12/01/2025 | Tenant – 123 Sample Ln | Rent – December | $2,000.00 |
| 12/31/2025 | First Sample Bank | Interest – Jul–Dec | $607.75 |
| Total Receipts | $35,055.50 |
SCHEDULE B – Gains / Losses on Sale
| Date | Asset Sold | Carry Value | Proceeds | Gain / (Loss) |
|---|---|---|---|---|
| 09/12/2025 | 200 sh XYZ Corp | $8,400.00 | $9,650.00 | $1,250.00 |
| Net Gain on Sale | $1,250.00 |
SCHEDULE C – Disbursements
| Date | Payee | Nature / Purpose | Amount |
|---|---|---|---|
| 03/10/2025 | Anytown Property Mgmt | Repairs – roof leak, 123 Sample Ln | $3,675.00 |
| 04/10/2025 | Anytown County Tax Collector | Property tax – 1st installment | $3,910.00 |
| 04/15/2025 | Franchise Tax / IRS | Fiduciary income tax – 2024 | $1,950.00 |
| 05/20/2025 | Sample Mutual Insurance | Homeowner's insurance – annual | $2,140.00 |
| 06/30/2025 | Jane Q. Sample | Trustee compensation – 1st half (per trust §7.2) | $3,000.00 |
| 08/05/2025 | Doe & Roe LLP | Attorney fees – trust administration | $4,500.00 |
| 11/15/2025 | Autonomi Books | Accounting & bookkeeping services | $2,800.00 |
| 12/10/2025 | Anytown County Tax Collector | Property tax – 2nd installment | $3,910.00 |
| 12/31/2025 | Jane Q. Sample | Trustee compensation – 2nd half (per trust §7.2) | $3,000.00 |
| Total Disbursements | $28,885.00 |
SCHEDULE D – Distributions to Beneficiaries
| Date | Beneficiary | Description | Amount (at carry value) |
|---|---|---|---|
| 06/30/2025 | Beneficiary A (Sample, Robert) | Discretionary distribution – cash | $15,000.00 |
| 06/30/2025 | Beneficiary B (Sample, Maria) | Discretionary distribution – cash | $15,000.00 |
| Total Distributions | $30,000.00 |
SCHEDULE E – Assets on Hand at Close
| Description of Asset | Inventory / Carry Value | Est. Current Value |
|---|---|---|
| Checking – First Sample Bank (…4417) | $34,070.50 | $34,070.50 |
| Brokerage – Sample Securities (…8821) | $304,000.00 | $338,750.00 |
| Residence – 123 Sample Lane, Anytown | $650,000.00 | $728,000.00 |
| Total | $988,070.50 | $1,100,820.50 |
Liabilities at Close of Period
| Creditor | Description | Amount |
|---|---|---|
| Anytown County Tax Collector | Property tax accrued (due 04/2026) | $3,910.00 |
Verification
I, Jane Q. Sample, declare under penalty of perjury that I am the Personal Representative of The Sample Family Revocable Trust dated March 15, 2011; that I have read the foregoing account and the schedules attached; and that the same is true and correct to the best of my knowledge.
Dated: ____________________ ______________________________________
Jane Q. Sample, Successor Trustee