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This question already has an answer here:

Ethereum uses Accounts instead of UTXO (Bitcoin). I would like to know how does the ledger keep the account state (technical details if possible)?

  1. Does it modify the ledger (accounts) by incrementing or decrementing the balances?
  2. Or does it use the cumulative (sum) of received amounts and send to verify users have a proper balance?
  3. Where does the Patricia-Tree used stand in all of this?

marked as duplicate by Ismael, Vignesh Karthikeyan, Achala Dissanayake, Richard Horrocks, Badr Bellaj Jun 29 '18 at 14:37

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You can find answers to all your questions in the official White Paper, but essentially:

  1. Yes
  2. No
  3. It is used to store information about transactions, transaction's receipts and contract's state.

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