CONNECTICUT Inventory PC-440 REV. /1 Inventory PC - 440 Page 1 of 3 RECEIVED: Instructions: ) DECEDENT222S ESTATES: List all solely owned assets, including fractional shares; use market value as ofdate of death. Do not include real property located outside the state of Connecticut, jointly ownedproperty or property passing by beneficiary designation. 4) 5) 6) The fiduciary must send a copy of the inventory to each party and attorney and certify to the court that t. ) For more information, see C.G.S. section 45a-340 et seq. ) Type or print the form in ink. Use an additional sheet, or PC-180, if more space is needed. Estate of Date of Death, if Decedent222s Estate Fiduciary () Date of Appointment as Fiduciary INITIAL INVENTORY SUBSTITUTE OR CORRECTED SUPPLEMENTAL Net Value Description (a) REAL PROPERTY , 1. Real Property 3) ) ) American LegalNet, Inc. www.FormsWorkFlow.com PROBATE COURTS Inventory PC-440 REV. /1 Inventory PC - 440 Page 2 of 3 Description Net Value 2. Bank Accounts () 3. Stocks and Bonds () 4. Other Personal Property (.) 5. Total from Additional Sheets Attached, if any TOTAL For Use in Conservatorship Matters (Voluntary or Involuntary) 1. Real Property Located Outside Connecticut Description Total Market Value Conserved Person222s Interest (b) PERSONAL PROPERTY 1.Motor Vehicle(s) () American LegalNet, Inc. www.FormsWorkFlow.com CONNECTICUT Inventory PC-440 REV. /1 Inventory PC - 440 Page 3 of 3 The representations contained herein are made under penalty of false statement. Signature of Fiduciary Type or Print Name Date Signature of Fiduciary Type or Print Name Date CERTIFICATION I hereby certify that I sent a copy of this inventory to the following people as required by Probate Court Rules of Procedure, section 30.12: Signature of fiduciary or attorney Jointly Owned Personal Property Description 2. Conserved Person222s Interest American LegalNet, Inc. www.FormsWorkFlow.com