______________Judicial Circuit,
in and for_____________
County, Florida
Probate Division
Case No._______________
Judge:_________________
Amended Form? _____Yes* _____No
*If yes, version of the Amended
Form:
In Re: Guardianship of
__________________________
______________________________________________________________________________
INITIAL INVENTORY
Date of letters of guardianship:___________________________________________________
Property guardianship type:_____________________________________________________
___________________________________________________________________________
SUMMARY
Section A: Value of Real Property Assets | $________ |
Section B: Cash Assets/Cash Equivalent Assets | $________ |
Section C: Intangible Assets/Stocks/Bonds | $________ |
Section D: Tangible Personal Property | $________ |
Section E: Debts/Encumbrances/Liabilities/Liens | $________ |
Total | $________ |
______________________________________________________________________________
Section A: Real Property Assets
Do you have entries for Section A? _____Yes _____No
Number | Description and Address | Full Value | Is There Another Owner? Yes or No |
1. | |||
2. | |||
3. | |||
Total for Section A | $ |
Attach a copy of the property appraiser's information or a copy of the deed for all real property.
______________________________________________________________________________
Section B: Cash Assets/Cash Equivalent Assets (checking account, savings account, money market account, certificate of deposit (CD))
Do you have entries for Section B? _____Yes _____No
Are any of the entries held in a depository account? _____Yes _____No
Number | Institution Name | Last 4 Digits of Account Number | Type of Asset | Full Value | Is There Another Owner? Yes or No | Is this a Depository Account? Yes or No |
1. | ||||||
2. | ||||||
3. | ||||||
Total for Section B | $ |
Attach a copy of the institution's statement for each account from the creation date of the guardianship.
______________________________________________________________________________
Section C: Intangible Assets/Stocks/Bonds
Do you have entries for Section C? _____Yes _____No
Are any of the entries held in a depository account?_____Yes _____No
Number | Issuer Name and Address | Type of Asset | Full Value | Last 4 Digits of Account Number | Is There Another Owner? Yes or No |
1. | |||||
2. | |||||
3. | |||||
Total for Section C | $ |
Attach a copy of the institution's statement for each account from the creation date of the guardianship.
______________________________________________________________________________
Section D: Tangible Personal Property Assets (motor vehicles, jewelry, household furnishings, collectibles, fine art)
Do you have entries for Section D? _____Yes _____No
Number | Description and Location | Full Value | Is There Another Owner? Yes or No |
1. | |||
2. | |||
3. | |||
Total for Section D | $ |
Attach a copy of the title for any motor vehicle.
______________________________________________________________________________
Section E: Debts/Encumbrances/Liens/Liabilities
Do you have entries for Section E? _____Yes _____No
Instructions: List each liability equal to or greater than $1,000.
Number | Creditor | Full Amount of Liability | Last 4 Digits of Account Number | Is there Another Person who Owes on the Debt? Yes or No |
1. | ||||
2. | ||||
3. | ||||
Total for Section E | $ |
A copy of documents detailing each listed liability.
______________________________________________________________________________
Section F: Sources of Income
Do you have entries for Section F? _____Yes _____No
Number | Type | Payor | Estimated Monthly Amount |
1. | |||
2. | |||
3. | |||
Total for Section F | $ |
Is the guardian the representative payee of Social Security benefits? _____Yes _____No
If no, who is the representative payee for the Social Security benefits?_______________
______________________________________________________________________
Section G: Lawsuits Against the Ward
Do you have entries for Section G? _____Yes _____No
Number | Description of Lawsuit or Claim | Estimated Amount of Claim | Court Address | Plaintiff's Name and Address | Describe Cause of Action | Date of Debt Occurrence |
1. | ||||||
2. | ||||||
3. |
______________________________________________________________________________
Section H: Pending Litigation and/or Lawsuits the Ward May Bring if Court Approval Is Received
Do you have entries for Section H? _____Yes _____No
Number | Description of Lawsuit or Claims | Case Number and Court Address | Defendant Name and Address | Describe Cause of Action | Attorney for Ward |
1. | |||||
2. | |||||
3. |
______________________________________________________________________________
Section I: Assets the Ward, as of the Date of the Letters of Guardianship, Was Entitled to Receive, but Has Not Received
Do you have entries for Section I? _____Yes _____No
Instructions: If the guardian has knowledge of assets the ward was entitled to receive as of the date of letters, but were not received the assets should be listed here. Examples: insurance policies, benefits, inheritance, or settlements from litigation.
Number | Description | Estimated Date of Receipt | Estimated Amount |
1. | |||
2. | |||
3. |
______________________________________________________________________________
Section J: Trusts
Do you have entries for Section J? _____Yes _____No
Number | Name of Current Trustee and Address | Ward's Interest | Estimated Date Trust was Created | Value of the Ward's Interest in the Trust |
1. | ||||
2. | ||||
3. |
Section K. Safe-Deposit Box
Does the ward lease a safe-deposit box? _____Yes _____No
If yes, location and number of safe-deposit box:_________________________
Does the ward lease a safe-deposit box with another individual or individuals? _____Yes _____No
Who is the joint lessee with the ward?_______________________________
Was an inventory of the safe-deposit box filed with the court as required by section 744.365, Florida Statutes? _____Yes _____No
Has the safe-deposit box been opened? _____Yes _____No
[certificate of service as required by Florida Rule of Judicial Administration 2.516 must be included if the incapacitated person is not a minor under 14 years of age and is not totally incapacitated.]
I certify that the foregoing document has been furnished to .....(name, address used for service, mailing address, and e-mail address) by (e-mail) (delivery) (mail) (fax).....on .....(date)......
____________________
Guardian's Signature
Guardian's Printed Name:____________________
_________________________
Guardian's Address:________________________
_________________________
Guardian's Phone Number:____________________
Guardian's E-mail Address:____________
Fl. Prob. R. 5.910