BPC §6561: (a) A licensee shall initially, and annually thereafter, file with the bureau a statement under penalty of perjury containing the following: (1) The licensee’s business address, telephone number, and

(a) A licensee shall initially, and annually thereafter, file with the bureau a statement under penalty of perjury containing the following: (1) The licensee’s business address, telephone number, and facsimile number. (2) Whether or not the licensee has been removed for cause as a conservator, guardian, trustee, personal representative of a decedent’s estate, agent under a durable power of attorney for health care, agent under a durable power of attorney for finances, or a position arising from appointment as a professional fiduciary practice administrator. The licensee may file an additional statement of the issues and facts pertaining to the case. (3) The names of the licensee’s current conservatees, wards, principals under a durable power of attorney for health care, or principals under a durable power of attorney for finances, and the names of trusts and decedent’s estates currently administered by the licensee, whether the cases are court supervised or non-court supervised, and including court names, court locations, and case numbers where applicable. (4) The case names, court locations, and case numbers of all conservatorship, guardianship, trust and other estate administration cases that are closed for which the licensee served as the conservator, guardian, trustee, agent under a durable power of attorney for finance or health care, and personal representative of a decedent’s estate, whether the case is court supervised or non-court supervised. (5) Whether the licensee has been found by a court to have breached a fiduciary duty. (6) Whether the licensee has resigned or settled a matter in which a complaint against the licensee has been filed with the court, along with the case number and a statement of the issues and facts pertaining to the allegations. (7) Any licenses or professional certificates held by the licensee. (8) Any ownership or beneficial interests in businesses or other enterprises held by the licensee or by a family member that receives or has received payments from a client of the licensee. (9) Whether the licensee has filed for bankruptcy or held a controlling financial interest in a business that filed for bankruptcy in the last ten years. (10) The name of any persons or entities that have an interest in the licensee’s professional fiduciary business. (11) Whether the licensee has been convicted of a crime. (b) The statement by the licensee required by this section may be filed electronically with the bureau, in a form approved by the bureau. However, any additional statement filed under paragraph (2) of subdivision (a) shall be filed in writing.