IN THE COURT OF COMMON PLEAS OF CHESTER COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In the Matter of __________________________________________________________, an Incapacitated Person File Number: ________________________________________ GUARDIAN INVENTORY (1) Real Estate: (Location, by whom occupied and rental) Estimated Value (2) Personal Property: (Continue on reverse side. Attach additional sheets if necessary) American LegalNet, Inc. www.USCourtForms.com Matter of ______________________________________________________, an Incapacitated Person (3) Jointly Held Property: Estimated Value (Set forth real and personal property owned by the Incapacitated person JOINTLY with any other person(s). State whether held as tenants by the entireties; if not, whether the right of survivorship exists.) (4) Anticipated Assets: (Set forth property of any kind expected to be acquired hereafter, together with anticipated date of acquisition.) TOTAL OF ITEMS 1,2,3 & 4 ════════════════ The Guardian certifies that a testamentary writing of the aforesaid Incapacitated Person has/has not been found and if found said writing has been submitted to the Clerk of the Orphans’ Court, on ________________________, __________ to be impounded until further Order of the Court. Commonwealth of Pennsylvania County of Chester } ss. } _____________________________________________ being duly sworn says that the foregoing is a full, true and complete Inventory of the Estate of ______________________________________, the aforesaid Incapacitated Person; and that all of the information set forth herein is true and correct to the best of the affiant's knowledge and belief. Sworn and subscribed before me this ____________ day of _______________________________, _________ __________________________________________ Attorney for Guardian ________________________________________ Guardian __________________________________________ Attorney's Address American LegalNet, Inc. www.USCourtForms.com