District Court Denver Probate Court _________________________________________ County, Colorado Court Address: IN THE MATTER OF THE ESTATE OF: Deceased Protected Person Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg.#: Courtroom INVENTORY Being sworn, I verify that the attached schedules contain a complete and accurate inventory of the real and personal property of this estate to the best of my knowledge, information and belief. ___________________________________________ Signature of Personal Representative Conservator Subscribed and sworn to before me on ____________________. My commission expires ________________________________. ___________________________________________ Notary public/(Deputy) Clerk of Court INSTRUCTIONS Both decedent’s estates and conservatorship: Within three months after appointment, a personal representative or conservator shall list and value the estate’s assets and liabilities, clearly identifying each item and the decedent’s or protected person’s interest in the item. If additional space is needed, separate sheets may be used. If additional items are discovered after the initial inventory has been completed, a supplemental inventory listing those additional item(s) shall be completed. Decedent’s estates: Assets shall be listed and the fair market value given as of the date of the decedent’s death. The inventory shall be sent to interested persons who request it or the original inventory may be filed with the Court. (Sections 15-12-706, 15-12-707 & 15-12-708, C.R.S., and Rules 28 & 30, C.R.P.P.) Conservatorship: Assets shall be listed and the fair market value given as of the date of the conservator’s appointment. The inventory must be filed with the Court. A copy must also be provided to the protected person, if 14 years of age or older, and to any parent or guardian with whom the protected person resides. (Section 15-14-418, C.R.S. and Rule 28, C.R.P.P.) Schedule A SUMMARY Real Estate…………………………………………………………………………..$________________________ Schedule B Stocks and Bonds…………………………………………………………………….________________________ Schedule C Mortgages and Notes……………………………._____________________ Cash……………………………………………….._____________________ Total Mortgages, Notes and Cash………………………………………………….________________________ Schedule D Insurance, Annuities, Pension & Profit Sharing Plans……………………………________________________ Schedule E (Conservatorship only) Property Held In Joint Tenancy…………………………….________________________ Schedule F Miscellaneous Property………………………………………………………………________________________ Total Gross Value………………………………………………………………………………………...$________________________ Encumbrances on Inventoried Assets………………………………………………………………..(_______________________) Total Net Value……………………………………………………………………………………………$________________________ CPC 20 R7/00 INVENTORY 1 2001 © American LegalNet, Inc. Schedule A Real Estate (State Name in which Title is Held) Value Schedule B Total Schedule A Stocks and Bonds (State Name in which Title is Held) $____________________ Value Total Schedule B Schedule C Mortgages, Notes and Cash (State Name in which Title is Held) Mortgages and Notes $____________________ Value Mortgages and Notes CPC 20 R7/00 INVENTORY $____________________ 2 2001 © American LegalNet, Inc. Cash Cash $____________________ Total Schedule C $____________________ Schedule D Insurance, Annuities, Pension and Profit Sharing Plans Value (Decedent’s estate should include only those items payable to the estate. Conservatorship should include all items in which the protected person has an ownership or beneficial interest.) CPC 20 R7/00 Total Schedule D (Conservatorship only) Property Held in Joint Tenancy $____________________ Value Total Schedule E Schedule E $____________________ INVENTORY 3 2001 © American LegalNet, Inc. Schedule F Miscellaneous Property (If Titled, State Name in which Title is Held) Total Schedule F Encumbrances on Inventoried Assets Schedule and Item Number Description R7/00 INVENTORY $____________________ Amount Total Encumbrances CPC 20 Value $____________________ 4 2001 © American LegalNet, Inc.