Annual Report Of Tangible And Real Estate {564PC}

STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF: ) ) ) ) ) ) ) IN THE PROBATE COURT ANNUAL REPORT OF TANGIBLE AND REAL ESTATE CASE NUMBER: PLEASE ANSWER THE FOLLOWING QUESTIONS 1. Are the items of tangible personal property shown on Schedule F of the inventory still in existence? If so, where are they located? 2. Have any items shown on the original inventory been disposed of? 3. Have any items of tangible personal property been acquired during the accounting period? 4. Where are these new items located? 5. Is proper casualty insurance carried on these tangible items of personal property? If so, list company and amount of coverage. 6. Does the protected person still own the real estate listed on Schedule A of the Inventory? 7. Has the protected person acquired an interest in real estate that was not shown on the Inventory? FORM #564PC (2/2004) Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com 8. Is proper casualty Insurance maintained, if necessary, on any real or personal property owned by the Protected Person? If so, list company, amount of coverage and effective dates of policy. Executed this SWORN to before me this , 20 day of day of Signature: Name: Address: Telephone (O): (H): , 20 . Notary Public for South Carolina My Commission Expires: Check here if address or phone number has changed from last report FORM #564PC (2/2004) Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com