(TYPE OR PRINT IN BLACK INK) File No. STATE OF NORTH CAROLINA In The General Court Of Justice County Superior Court Division Before The Clerk IN THE MATTER OF THE ESTATE OF: Name Of Minor/Incompetent INVENTORY FOR GUARDIANSHIP ESTATE G.S. 35A-1261 IMPORTANT: File within three (3) months after qualifying as guardian. Give values as of date of qualifying. Continue on additional sheet if necessary. I, the undersigned guardian, being duly sworn, say that to the best of my knowledge the following is a just, true and perfect inventory of all the real and personal property of the minor/incompetent named above, which have come into my hands. PART I. PERSONAL PROPERTY OF THE ESTATE 1. Accounts In Sole Name Of Minor/Incompetent (List bank, etc., each account no. and balance.) Value $ 2. Joint Accounts Administered By Guardian (List bank, etc., each account no., and balance.) 3. Stocks And Bonds In Sole Name Of Minor/Incompetent Or Jointly Owned With Right Of Survivorship (Identify each type of security and give market value of all securities of that type, e.g., 100 shares of XYZ Corp. common stock @ 37-1/4...$3,725.) % Owned % Owned % Owned % Owned % Owned 4. Cash And Undeposited Checks On Hand 5. Annuity, Pension Or Retirement Benefits, Social Security, Disability, Injury Settlement Or Other Periodic Payment (Identify each payor, date received and amount.) 6. All Other Personal Property TOTAL FROM ATTACHMENT, IF ANY $ TOTAL PART I. (Costs apply to this total) $ AOC-E-510, Rev. 7/01 (Over) 2001 Administrative Office of the Courts >>>> 2 PART II. REAL PROPERTY Interests In Real Estate (List all real estate including entireties property and life estate; give fair market value of minors/incompetents interest.) Value $ TOTAL PART II. $ Signature Of Guardian Signature Of Co-guardian, If Any SWORN AND SUBSCRIBED TO BEFORE ME SWORN AND SUBSCRIBED TO BEFORE ME Date Date Signature Of Person Authorized To Administer Oaths Signature Of Person Authorized To Administer Oaths Deputy CSC Assistant CSC Clerk Of Superior Court Deputy CSC Assistant CSC Clerk Of Superior Court Date My Commission Expires Date My Commission Expires SEAL Notary Notary SEAL AOC-E-510, Side Two, Rev. 7/01 2001 Administrative Office of the Courts