CONNECTICUT PROBATE COURTS Landlord222s Inventory of Possessions of Deceased Tenant PC - 24 06 NEW 1/18 Landlord222s Inventory of Possessions of Deceased Tenant PC - 2 406 RECEIVED : Instructions: 1) A landlord may use this form to file an inventory of a deceased occupant222s possessions and personal effects in the deceased occupant222s dwelling unit. 2)The inventory may be filed onProbate Court Name District Number In the Matter of (Name and address of the deceased occupant.) Hereinafter referred to as the deceased occupant . THE LANDLORD REPRESENTS that: The landlord filed an affidavit with the court at least 30 days ago pursuant to C.G.S. section 47a-11d. The following is a complete inventory of the deceased occupant222s possessions and personal effects in the dwelling unit: The representations made in this petition are made under the penalty of false statement. Signature of Landlord Date American LegalNet, Inc. www.FormsWorkFlow.com