File No. (TYPE OR PRINT IN BLACK INK) STATE OF NORTH CAROLINA In The General Court Of Justice Superior Court Division Before The Clerk County IN THE MATTER OF THE TRUST UNDER THE WILL OF: Name Of Decedent INVENTORY FOR TRUST UNDER WILL G.S. 36C-2-209 IMPORTANT: File within three (3) months after qualifying as trustee. Give values as of date of qualifying and continue on additional sheet if necessary. I, the trustee, 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 trust named above, which have come into my hands. PART I. PERSONAL PROPERTY OF THE TRUST Value 1. Accounts (List bank, etc., each account no. and balance.) $ 2. Stocks And Bonds (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.) 3. Cash And Undeposited Checks On Hand 4. All Other Personal Property TOTAL FROM ATTACHMENT, IF ANY TOTAL PART I. AOC-E-511, Rev. 7/06 © 2006 Administrative Office of the Courts $ $ (Over) American LegalNet, Inc. www.FormsWorkflow.com PART II. REAL PROPERTY Interests In Real Estate (List all real estate including entireties property and life estate; give legal description of Value each parcel, and give fair market value of beneficiary's interest.) $ TOTAL PART II. Signature Of Trustee $ Signature Of Co-trustee, If Any SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME SWORN/AFFIRMED 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 Date My Commission Expires Assistant CSC Deputy CSC Date My Commission Expires Notary Clerk Of Superior Court Notary County Where Notarized SEAL County Where Notarized SEAL AOC-E-511, Side Two, Rev. 7/06 © 2006 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkflow.com