Form 350es-Sf - Inventory And Appraisement: Probate Property Page 2
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1
2(If none, so state)
% owned
Fair Market Value of
A.
REAL ESTATE
by Decedent Decedent’s Interest
in Decedent’s name alone or as tenants in common (not as joint with
right of survivorship). Describe each property by listing its full street/city/state address, tax map
number, deed book and page and description consistently (house, lot, buildings, acreage). List any
oil/mineral rights and time shares, if it is real property. If the property is encumbered, list the full fair
market value of the property here and show the encumbrance in Encumbrance section at bottom.
1. __________________________________________________________________
__________
________________
2. __________________________________________________________________
__________
________________
3. __________________________________________________________________
__________
________________
B.
STOCKS, BONDS
in Decedent’s name alone or tenants in common (not as joint with right of
survivorship). List each name of security(ies) and number of shares.
1. __________________________________________________________________
__________
________________
2. __________________________________________________________________
__________
________________
3. __________________________________________________________________
__________
________________
C. CASH, BANK ACCOUNTS, NOTES RECEIVABLES
in Decedent’s name alone or as
tenants in common. List each separate account type and institution and the last two digits of each
account. List all bank accounts owned by Decedent alone or as tenants in common (checking,
savings, CDs, money market, brokerage, employment bonus, cash award, final paycheck etc.),
cash on hand, notes payable to Decedent, and survival action proceeds.
1. __________________________________________________________________
__________
________________
2. __________________________________________________________________
__________
________________
3. __________________________________________________________________
__________
________________
D. LIFE INSURANCE
payable to the Decedent’s estate.
1. __________________________________________________________________
________________
2. __________________________________________________________________
________________
E.
JOINTLY OWNED PROPERTY – REPORTING IS NOT REQUIRED
N/A_____________
F.
ALL OTHER MISCELLANEOUS PERSONAL PROPERTY
in Decedent’s name alone or
as tenants in common. List below any tangible personal property, including household goods &
furnishings, vehicles, boats/motors/trailers, mobile homes that are not de-titled (include year/make/
model/VIN, if applicable), airplanes, equipment, interest in a partnership or unincorporated
business, articles or collections having either artistic or intrinsic value, including coins, guns,
artwork, jewelry, etc., and any other miscellaneous probate items not listed elsewhere, including
any digital assets.
1. __________________________________________________________________
__________
________________
2. __________________________________________________________________
__________
________________
3. __________________________________________________________________
__________
________________
4. __________________________________________________________________
__________
________________
G. TRANSFERS DURING DECEDENT’S LIFE PAYABLE TO ESTATE ONLY
Any transfers
intended to take effect at death if payable to the Estate shall be reported. A trust created by
Decedent in which income for life was retained by the Decedent, power to revoke or other incidents
of ownership retained by the Decedent, lifetime transfers of real property in which Decedent retained
life estate, etc.
1. __________________________________________________________________
________________
2. __________________________________________________________________
________________
H. POWERS OF APPOINTMENT PAYABLE TO THE ESTATE ONLY
List property, both
real and personal, over which Decedent possessed a Power of Appointment whether testamentary
or otherwise, if such property is payable to the Estate.
1. __________________________________________________________________
________________
I.
ANNUITIES AND IRA, ETC. PAYABLE TO THE ESTATE ONLY
List any annuities or
retirement accounts owned by the Decedent that are payable to the Estate.
1. __________________________________________________________________
________________
2. __________________________________________________________________
________________
TOTAL PROBATE ESTATE VALUE:
$
================
ENCUMBRANCES
(e.g., mortgages, liens, judgments, etc., but not general debts of the estate). List debts
of the Decedent secured by assets on the above schedule and describe the debt and the specific asset encumbered.
1. __________________________________________________________________
________________
2. __________________________________________________________________
________________
TOTAL ENCUMBRANCES:
$
================
Page 2 of 2
FORM #350ES SF (1/2016)
62-2-805, 62-3-704, 62-3-706, 62-3-707, 62-3-708, 62-3-1203
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