Report of Distribution of Assets - Fairfield County Probate

In the matter of Case number Deposited in a financial institution in the name of the minor Amount deposited in financial institution Form 22.3 is attached Delivered to the minor's parent/legal custodian Amount delivered to parent/legal custodian Delivered to the person by whom the minor is maintained Name of person by whom minor is maintained Amount delivered to person by whom minor is maintained Delivered to the minor Amount delivered to the minor Other distribution Other distribution amount Distribution notes or supporting details Date