IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. __________________ Division __________________ INVENTORY OF SAFE DEPOSIT BOX , the guardian of the property of (the Ward), files this inventory of the contents of safe deposit box number (address of institution) , on of CASH (U.S. Currency) , , conducted in the presence located at (name of institution) , , an employee of the above-named institution. $ COINS, ETC. OTHER THAN STANDARD U.S. CURRENCY Description: JEWELRY (itemize and describe each item): Bar Form No. G-4.065 - 1 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com OTHER TANGIBLE PROPERTY (Itemize and describe): DOCUMENTS Will of Social Security Card of Birth Certificate of Passport of Marriage License of Living Will of Health Care Surrogate Document of Deeds to real property (legal description or address of real property) Life insurance policy _______________________________ (company, face amount and owner) Trust documents__________________________________ Stock Certificates_________________________________ (Company, class and number of shares) Bonds__________________________________________ (Entity and face amount) Financial account records __________________________ (Name of institution, type and account number) OTHER DOCUMENTS (itemize and describe): Dated Bar Form No. G-4.065 - 2 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com The above-described safe deposit box contained no other items of any kind. Under penalties of perjury, I declare that I have read and examined this Inventory of Safe Deposit Box, and the facts alleged are true, correct and complete to the best of my knowledge and belief. Signed on this day of , . Guardian I verify that I, , an employee of , was present during the opening of the above-described safe deposit box and that I witnessed the inventory of its contents on _______________, _______, and I verify that the above inventory is accurate and complete. Witness Address: Business Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. G-4.065 - 3 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com