Estate Inventory And Statement
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1
2MASHANTUCKET PEQUOT PROBATE COURT
INVENTORY
[Type or Print in Black Ink]
RECORDED:
PC-440 REV. 06/2015
To: Mashantucket Pequot Probate Court, Mashantucket, Connecticut
DATE OF APPOINTMENT
ESTATE OF:
AS FIDUCIARY:
Hereinafter referred to as the Decedent/Ward.
DATE OF DEATH, IF
FIDUCIARY: [Include position of trust]
DECEDENT'S ESTATE:
INITIAL INVENTORY
SUBSTITUTE OR CORRECTED
SUPPLEMENTAL
PAGE
OF
INSTRUCTIONS: LIST ASSETS IN THE FOLLOWING CATEGORIES IN THE ORDER GIVEN AND THE MANNER
DESCRIBED: (1) REAL PROPERTY: Give complete LEGAL DESCRIPTION (copy from deed), show fair market value,
balance of unpaid mortgages and net value of interest. (2) STOCKS AND BONDS: Show number of shares, description, value
per share and total value; (3) ALL OTHER PERSONAL PROPERTY: Show account number for all bank accounts; for other
personal property use best description available. DECEDENTS' ESTATES: List non-survivorship assets only; use date of
death values. ALL OTHER ESTATES: Use date of appointment values.
ITEM NO.
$
GRAND TOTAL
$
_________________________________
Fiduciary’s Signature
SUBSCRIBED AND
DATE
SWORN TO BEFORE ME
_________________________________
Judge, Court Clerk
INVENTORY
Page 1 of 2
PB-440
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