Form CC 16:2.24 Certificate of Mailing Annual Reporting Form(S) - Nebraska

Form CC16:2.24 or the "Certificate Of Mailing Annual Reporting Form(s)" is a form issued by the Nebraska Judicial Branch.

Download a PDF version of the Form CC16:2.24 down below or find it on the Nebraska Judicial Branch Forms website.

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Nebraska State Court Form
REQUIRED
CERTIFICATE OF
CC 16:2.24 Rev. 12/16
MAILING ANNUAL
Neb. Rev. Stat. § 30-2601(10),
Neb. Ct. R. §§ 6-1443(D),
REPORTING FORM(S)
6-1433(D)(2)
TO THE GUARDIAN AND/OR CONSERVATOR OR THEIR ATTORNEY: This form can be used when
filing supplemental reporting forms. Complete the certificate and mark the forms you are mailing.
IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA
Case No. ____________________
IN THE MATTER OF
_____________________________________
CERTIFICATE OF MAILING ANNUAL
Ward/Incapacitated Person/Protected Person
REPORTING FORM(S)
I,
, swear or affirm, under the penalties of perjury, that I have filed
the required forms marked below with the court and that on ________________________, I mailed
copies of the forms marked below to all interested persons* and bonding company, if any, at the
addresses set forth below:
Annual Report of Guardian on Condition of Ward (CC 16:2.14)
Updated Inventory (CC 16:2.45)
Annual Accounting (CC 16:2.44)
Certificate of Proof of Possession (CC 16:2.13) (with proof of restricted account if any funds
are restricted)
Bank statements and/or brokerage statements for accounting period with personal information
(social security number, date of birth, etc.) blacked out
Notice of Right to Object (CC 16:2.16)
Certificate of Mailing
NAME(S) OF INTERESTED PERSON(S)
ADDRESS(ES)
See attached (more names and addresses than above)
Date
Signature(s) of Guardian(s) and/or Conservator(s) or Their Attorney
Print or Type Name of Guardian(s) and/or Conservator(s) or Their Attorney
Bar Number and Firm Name (attorneys only)
Street Address/P.O. Box of Guardian(s) and/or Conservator(s) or Their Attorney
City/State/ZIP Code of Guardian(s) and/or Conservator(s) or Their Attorney
Phone
E-mail Address
Page 1 of 2
Certificate of Mailing Annual Report and Accounting
CC 16:2.24 Rev 12/16
Nebraska State Court Form
REQUIRED
CERTIFICATE OF
CC 16:2.24 Rev. 12/16
MAILING ANNUAL
Neb. Rev. Stat. § 30-2601(10),
Neb. Ct. R. §§ 6-1443(D),
REPORTING FORM(S)
6-1433(D)(2)
TO THE GUARDIAN AND/OR CONSERVATOR OR THEIR ATTORNEY: This form can be used when
filing supplemental reporting forms. Complete the certificate and mark the forms you are mailing.
IN THE COUNTY COURT OF ________________COUNTY, NEBRASKA
Case No. ____________________
IN THE MATTER OF
_____________________________________
CERTIFICATE OF MAILING ANNUAL
Ward/Incapacitated Person/Protected Person
REPORTING FORM(S)
I,
, swear or affirm, under the penalties of perjury, that I have filed
the required forms marked below with the court and that on ________________________, I mailed
copies of the forms marked below to all interested persons* and bonding company, if any, at the
addresses set forth below:
Annual Report of Guardian on Condition of Ward (CC 16:2.14)
Updated Inventory (CC 16:2.45)
Annual Accounting (CC 16:2.44)
Certificate of Proof of Possession (CC 16:2.13) (with proof of restricted account if any funds
are restricted)
Bank statements and/or brokerage statements for accounting period with personal information
(social security number, date of birth, etc.) blacked out
Notice of Right to Object (CC 16:2.16)
Certificate of Mailing
NAME(S) OF INTERESTED PERSON(S)
ADDRESS(ES)
See attached (more names and addresses than above)
Date
Signature(s) of Guardian(s) and/or Conservator(s) or Their Attorney
Print or Type Name of Guardian(s) and/or Conservator(s) or Their Attorney
Bar Number and Firm Name (attorneys only)
Street Address/P.O. Box of Guardian(s) and/or Conservator(s) or Their Attorney
City/State/ZIP Code of Guardian(s) and/or Conservator(s) or Their Attorney
Phone
E-mail Address
Page 1 of 2
Certificate of Mailing Annual Report and Accounting
CC 16:2.24 Rev 12/16
*Interested persons are defined as:
 children and spouses;
 future heirs if the ward/incapacitated person/protected person would die without leaving a valid
will (brothers and sisters who are adults, grandparents, etc.);
 a trustee of any trust executed by the ward/incapacitated person/protected person;
 if there are no individuals defined as “interested persons” above, include any person or
organization named as a “devisee” in the ward’s/incapacitated person’s/protected person’s
most recent will;
 after death of the ward/incapacitated person/protected person, interested person also includes
the personal representative of a deceased ward’s/incapacitated person’s/protected person’s
estate, the deceased ward’s/incapacitated person’s/protected person’s heirs in an intestate
estate, and the deceased ward’s/incapacitated person’s/protected person’s devisees in a
testate estate.
 any governmental agency paying benefits on behalf of the ward/incapacitated person/protected
person; and
 any person designated by order of the court to be an interested person.
If there are no interested persons identified for a ward/incapacitated person/protected person, the court
shall appoint a guardian ad litem (Nebraska Supreme Court Rule § 6-1449(B)). The cost of the guardian ad
litem may be taken from the assets of the ward/incapacitated person/protected person.
Page 2 of 2
Certificate of Mailing Annual Report and Accounting
CC 16:2.24 Rev 12/16

Download Form CC 16:2.24 Certificate of Mailing Annual Reporting Form(S) - Nebraska

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