IN THE CIRCUIT COURT FOR FLORIDA IN RE: GUARDIANSHIP OF COUNTY, PROBATE DIVISION File No. Division VERIFIED INVENTORY OF GUARDIAN (Initial Guardianship Report of Guardian of the Property) , the guardian of the property of (the Ward), files, as the Initial Guardianship Report of the Guardian of the Property, this inventory of all the property of the Ward that has come into the guardian's possession or knowledge, including identification of any trust of which the Ward is a beneficiary and specifying all encumbrances, liens and other secured claims on any item. All property not in the guardian's possession as of the date of this inventory is identified by an asterisk (*) in the right margin. REAL PROPERTY: Description and Location of Property and of Encumbrances, Liens or Security Interests on any Item Estimated Amount of Encumbrances, Liens or Security Interests Estimated Fair Market Value Total Estimated Value of Real Estate Less: Encumbrances, Liens and Security Interests Estimated Net Value of Real Estate $ $ $ Bar Form No. G-4.060 - 1 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com PERSONAL PROPERTY: Description and Location of Property Estimated Fair Market Value Estimated Amount of Encumbrances, Liens or Security Interests (Note: Attached to this Inventory are copies of the most current statements of all of the Ward's cash assets from all institutions where the cash is on deposit.) Total Estimated Value of Personal Property Less: Encumbrances, Liens and Security Interests Estimated Net Value of Personal Property TOTAL ESTIMATED NET VALUE OF ALL PROPERTY $ $ $ $ LOCATION OF SAFE DEPOSIT BOX (if any): CLAIMS: Name and Address of Potential Claimant Basis for Claim Estimated Amount of Claim Bar Form No. G-4.060 - 2 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com INCOME: Description of All Income of Ward, Including Name and Address of Payor Frequency of Payment Amount of Payment CAUSES OF ACTION: The Ward has the right to sue on the following causes of action: Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Signed on this day of , . Guardian Attorney for Guardian Email Addresses: Florida Bar No. (address) Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. G-4.060 - 3 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com