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Here is the text we could read:

CONSERVATORSHIP 

GUARDIANSHIP     OF 

CASE NUMBER:

GC-400(A)(1)

Schedule A, Receipts, Dividends—Standard Account*

Conservatee

Minor

(Note returns of principal with the items listed below, but do not include their dollar amounts in the amounts or the total.  Report returns 
of principal on Schedule A1, Return of Principal (there is no form for that schedule), add their dollar amounts to cash assets on hand, 
and subtract their dollar amounts from the carry values of the securities involved.) 

(Name):

*Noncapital items

Dividends

Date of Receipt
(mm/dd/yyyy)

Description*
* (Report dividends from each security separately.)

Amounts

$

(Add pages as required.  Check the box at the bottom of the last page of this receipt category and total the amount of the category. 
Include that sum in the total of receipts on line 3 of the Summary of Account (form GC-400(SUM)/GC-405(SUM)).   
The page total to the right is the number of pages in Schedule A.)

Page  A

of

pages

Form Approved for Optional Use 
Judicial Council of California
GC-400(A)(1) [New January 1, 2008]

SCHEDULE A, RECEIPTS, DIVIDENDS—STANDARD ACCOUNT
(Probate—Guardianships and Conservatorships)

Probate Code, §§ 1060–1064, 2620;
Cal. Rules  of Court, rule 7.575 
www.courtinfo.ca.gov

Subtotal, Dividends:

$

Schedule A, Receipts, Dividends—Standard Account

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 90
Average fields per page: 90
Reading Level: Grade 9
LIST Grouping(s): Unknown

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Schedule A, Receipts, Dividends—Standard Account

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02