File No. (TYPE OR PRINT IN BLACK INK) STATE OF NORTH CAROLINA In The General Court Of Justice County Superior Court Division Before The Clerk IN THE MATTER OF THE TRUST UNDER THE WILL OF:Name Of Decedent INVENTORY FOR TRUST UNDER WILL G.S. 36A-107 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 1. Accounts (List bank, etc., each account no. and balance.) Value $ 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. 7/01 2001 Administrative Office of the Courts (Over) >>>> 2 PART II. REAL PROPERTY Interests In Real Estate (List all real estate including entireties property and life estate; give fair market value of beneficiarys interest.) Value $ TOTAL PART II. $ Signature Of Trustee Signature Of Co-trustee, 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-511, Side Two, Rev. 7/01 2001 Administrative Office of the Courts