Verified Inventory {B}

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Code: Your name Address Telephone __________________________ __________________________ __________________________ __________________________ In Proper Person IN THE _______ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF ______________________ ) ) ) ) ____________________________, ) A(n) Adult / Minor. ) ____________________________________) In the Matter of the Guardianship of the estate, the person and the estate, CASE NO._______________________ DEPT. NO._______________________ VERIFIED INVENTORY I. RECORD OF VALUE Note: There are two parts to this verified inventory. Assets should only be listed once, either in the Record of Value section or the Appraised Inventory section. The asset may not appear in both sections. **Designate Nature of Ward's Interest & % of Ownership; (C) Community; (S) Separate; I.E. 50 % (C) or (S) a) Asset Value b) Amount Owed (mortgage, lien, loan) c) Net Asset Value [a-b=c] d) Ward's** Interest e) Value of Ward's Interest [cxd=e] A. REAL PROPERTY Description 1 Item 1._______________________ 2._______________________ 3._______________________ $_______ $_______ $_______ $_______ $_______ $_______ $______ $______ $______ _____% ( ) _____% ( ) _____% ( ) $______ $______ $______ 1 Real property is real estate, whether it is undeveloped land or developed commercial, industrial, or residential land. The County assessed value is acceptable until the property is to be sold. For All Guardianship Packets Inventory 1 of 6 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B. PERSONAL PROPERTY Cash, Checking and Savings Accounts, other Accounts (List) 4.________________________ 5.________________________ 6.________________________ Other Interest, Etc. (Describe)2 7.________________________ 8.________________________ Notes, Bonds, Securities, Debts, Etc., (List Name & Address of Debtor, Date Debt Originated, Endorsement W/Date, Estimate As to Amount Collectible)3 9._______________________ 10.______________________ 11.______________________ 12.______________________ Vehicles (Describe) 13.______________________ 14.______________________ 15.______________________ Miscellaneous Personal Property (Describe)4 16.______________________ 17.______________________ 18.______________________ 19.______________________ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $______ $______ $______ $______ $______ _____% ( ) _____% ( ) _____% ( ) _____% ( ) _____% ( ) $______ $______ $______ $______ $______ $________ $________ $________ $________ $________ $________ $________ $________ $________ $________ $________ $________ $________ $________ $______ $______ $______ $______ $______ $______ $______ ____ %( ____ %( ____ %( ____ %( ) ) ) ) $________ $________ $________ $________ $________ $________ $________ ____ %( ) ____ %( ) ____ %( ) $________ $________ $________ $________ $________ $________ $________ $________ $______ $______ $______ $______ ____ %( ____ %( ____ %( ____ %( ) ) ) ) $________ $________ $________ $________ Interests in partnerships, LLCs, corporations, joint ventures, trusts, etc. Book value may be acceptable to the court until the interest is to be sold, disposed or transferred. The Guardian may need to request instructions from the court on how the value of the Ward's interest is to be listed on this document. 3 Additional items to be listed in this category are: deeds of trust, rents, royalties, life insurance policies with cash values. 4 This category includes household items, collectibles and antiques. If the aggregate(total) replacement value exceeds $5,000.00 an appraisal is required. 2 For All Guardianship Packets Inventory 2 of 6 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 VERIFIED RECORD OF VALUE (IN LIEU OF APPRAISEMENT) I, the undersigned, solemnly affirm that Items listed above in section "I. Record of Value" of this Verified Inventory of the Estate have been examined by me and that I have written the value of these items on the Verified Inventory at the value shown opposite thereof. I report that the total value of the times listed in this section of this Verified Inventory have a value of $________________________ dollars and cents. ________________________________ Guardian ________________________________ Co-Guardian II. APPRAISED INVENTORY a) Asset Value A. REAL PROPERTY Description 1._____________________ 2._____________________ 3._____________________ B. PERSONAL PROPERTY 4.________________________ 5.________________________ 6.________________________ 7.________________________ 8.________________________ 9.________________________ b) Amount Owed (Mortgage, lien, loan) c) Net Asset Value (a-b=c) $________ $________ $________ $________ $________ $________ $________ $________ $________ d) Ward's** Interest e) Value of Ward's Interest [cxd=e] $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $______ $______ $______ $______ $______ $______ $______ $______ $______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ $_______ ____ %( ) ____ %( ) ____ %( ) ____ %( ____ %( ____ %( ____ %( ____ %( ____ %( ) ) ) ) ) ) **Designate Nature of Ward's Interest & % of Ownership; (C) Community; (S) Separate; I.E. 50 % (C) or (S) For All Guardianship Packets Inventory 3 of 6 ©2006 Nevada Supreme Court Revised December 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 OATH OF APPRAISER, CPA OR EXPERT IN VALUATIONS STATE OF NEVADA ) ) COUNTY OF ____________) I, the undersigned, appraiser of the estate of the above-named ward, solemnly affirm that I will truly, honestly, and impartially appraise the inventory of the Estate to the best of my knowledge and ability, and the appraisal was completed in compliance with NRS 159.0865. EXECUTED this __________ day of _________, 20____. SIGNED and SWORN to before me by (Appraiser's name) ____________________ on the _____ day of ________________, _____. _______________________________ NOTARY PUBLIC _____________________________ Appraiser's name (print) _____________________________ Appraiser's address ___________