Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Licensed Fiduciary Number: ____________________________________ Representing Self, without a Lawyer or Attorney for Petitioner FOR CLERK'S USE ONLY OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the Matter of: Case Number: PB A Deceased Person INVENTORY AND APPRAISEMENT AND PROOF OF MAILING I am the Personal Representative for the decedent, the person who died, and I state under oath or affirm as follows: 1. 2. 3. TRUE AND CORRECT STATEMENT. The following inventory of property is a true and correct statement of all the property known to me to be owned by the person who died at his or her death. TOTAL ESTIMATED VALUE. The total estimated value of all real and personal property in the estate, as supported by the following itemization of property, is $ DESCRIPTION OF PROPERTY AND DEBT. This document accurately describes each item of property, estimates the fair market value of the property as of the date of the decedent's death, describes the nature of the property as community or separate property, and itemizes the type and amount of all debts, mortgages, or liens relating to each item of property. 4. NOTICE TO OTHER PARTIES. A copy of this document was hand-delivered or mailed by first class mail, postage prepaid, to the following persons: (Attach additional paper if necessary.) Name Address Relationship to Person who Died Date Mailed or Delivered Date Signature STATE OF ____________________________________ COUNTY OF __________________________________ Subscribed and sworn to or affirmed before me this: _______________________________________________ by (date) __________________________________________________________. (notary seal) � Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED _______________________________ Deputy Clerk or Notary Public Page 1 of 3 PBIP46f 042916 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com IAA Case No. INVENTORY AND APPRAISEMENT OF PROPERTY IN ESTATE (use additional sheets of paper if necessary) Inventory date: REAL PROPERTY A. GENERAL INFORMATION: Property Description and Address 1. 2. 3. 4. 5. 6. 7. 8. Community OR Separate Property Estimated Value in Dollars Dollars of Debt Total estimated fair market value of real property: Total estimated debt on real property: B. $ $ INFORMATION ABOUT REAL PROPERTY ITEMS LISTED ABOVE THAT WERE APPRAISED: Name Address Item Number Above � Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 2 of 3 PBIP46f 042916 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com IAA Case No. PERSONAL PROPERTY A. GENERAL INFORMATION: Property Description Community OR Separate Property Estimated Value in Dollars Dollars of Debt 1. 2. 3. 4. 5. 6. 7. 8. 9. Total estimated fair market value of personal property: Total estimated debt on personal property: $ $ B. INFORMATION ABOUT PERSONAL PROPERTY ITEMS LISTED ABOVE THAT WERE APPRAISED: Name Address Item Number Above � Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED Page 3 of 3 PBIP46f 042916 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com IAA