Name of Person Filing: ________________________________________ Mailing Address: ________________________________________ City, State, and Zip Code: ________________________________________ Day/Evening Phone Number: ________________________________________ ATLAS Number (if applicable):________________________________________ State Bar Number (if applicable):______________________________________ Self Representing: Petitioner Respondent For Clerk’s Use Only SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number: ________________________ In the Matter of the Estate of INVENTORY AND APPRAISEMENT AND PROOF OF MAILING ________________________________ an Adult or a Minor, deceased I am the Personal Representative for the person who died and I state under oath as follows: 1. 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. 2. 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 $______________________________. 3. 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 my appointment, 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 Date Mailed Person who Died or Delivered __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ STATE OF ARIZONA ) COUNTY OF MOHAVE ) ss. Signature: _____________________________________________ Date:__________________________ SUBSCRIBED AND SWORN TO before me this _____________, day of _________________, 20________ By:_______________________________________ My Commission Expires:______________________ 3/10/09 _____________________________________ Deputy Clerk/Notary Public Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 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 Community OR Separate Property Estimated Value In dollars Dollars of Debt 1. 2. 3. 4. 5. 6. 7. 8. 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 3/10/09 Address Item Number Above Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 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 3/10/09 Address Item Number Above Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com