SCHEDULE IDEBTS OF DECEDENT,MORTGAGE LIABILITIES & LIENSESTATE OFFILE NUMBER Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEMVALUE AT DATE NUMBERDESCRIPTIONOF DEATH TOTAL (Also enter on Line 10, Recapitulation)$ If more space is needed, insert additional sheets of the same size.1.REV-1512 EX+ (02-15)INHERITANCE TAX RETURNRESIDENT DECEDENT American LegalNet, Inc. www.FormsWorkFlow.com