STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF: (Decedent) ) ) ) ) ) ) ) ) ) IN THE PROBATE COURT INVENTORY AND APPRAISEMENT ORIGINAL AMENDED # (must restate the unchanged information from the original Inventory) CASE NUMBER: File the original Inventory and Appraisement with the Probate Court within ninety (90) days following the fiduciary appointment. A copy shall be sent to each interested person who has demanded it. A Proof of Delivery must be filed with the Court. The gross fair market value of all probate assets, regardless of location (whether in this state or elsewhere), should be listed as of the date of death. Continue on additional sheets if necessary. An Amended Inventory should be utilized for correcting, adjusting or adding to an original inventory, and must restate the unchanged information from the original Inventory. A qualified and disinterested appraiser may be employed to ascertain the value of any asset. If an appraiser is employed, his/her name and address must be indicated with the item or items he/she appraised. RECAPITULATION Non-Probate Probate (OPTIONAL) Schedule A - Real Estate ...................................................................................................... ....................... $ Schedule B - Stocks and Bonds ............................................................................................ ....................... $ Schedule C - Notes Due Decedent and Cash ....................................................................... ....................... $ Schedule D - Insurance on Decedent's Life - Part 1 - Payable to Estate .............................. ....................... $ Part 2 - Payable to Beneficiary ..................... $ Schedule E - Jointly Owned Property .................................................................................... $ Schedule F - Other Miscellaneous Assets Payable to Estate ................................................ ....................... $ Schedule G - Transfers During Decedent's Life .................................................................... $ Schedule H - Powers of Appointment .................................................................................... $ Schedule I - Annuities and Retirement Accounts ................................................................ $ $ $ $ GROSS VALUE OF PROBATE ESTATE ............................................................................. ....................... $ The undersigned, being sworn, states: That the following schedules contain a complete and accurate inventory and appraisement of all probate real and personal property of this estate so far as the undersigned is informed; that he/she has estimated and/or appraised all listed property at its fair market value, according to the best of his/her knowledge and ability. Personal Representative Signature: Print Name: Address: Telephone (Work): (Home): (Cell): (Email): SWORN to before me this , 20 day of Notary Public for South Carolina My Commission Expires: Attorney: Address: Telephone: Email: Co-Personal Representative Signature (if applicable) Name: Address: Telephone (Work): Telephone (Home): (Cell): (Email): FORM #350ES LF (04/2017) 62-2-805, 62-3-704, 62-3-706, 62-3-707, 62-3-708, 62-3-1203, 62-3-1204 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com WHEN COMPLETING THE FOLLOWING SCHEDULES LIST ALL PROBATE ASSETS, REGARDLESS OF LOCATION. OF-STATE PROBATE ASSETS MUST BE DISCLOSED. NON-PROBATE PROPERTY NEED NOT BE DISCLOSED. ALL OUT- ____________________________________________________________________________________________________________________________________________ SCHEDULE A ­ REAL ESTATE. List below any real estate in Decedent's name alone or tenants in common (not as joint with right of survivorship or tenants in the entirety). Describe each property by listing its full address, tax map number, deed book and page, and description consistently (for example: house, lot, buildings, acreage). Also list oil/mineral rights and time shares if it is real property. If none, so state. If the property is encumbered, list the full fair market value of the property here and the encumbrance on the Encumbrance Schedule below. (For jointly owned property with right of survivorship, you may list in Schedule E.) Item No. Description % owned Fair Market Value Value of Decedent's by Decedent interest 1. Tax Map Number: 2. Tax Map Number: 3. Tax Map Number: TOTAL SCHEDULE A (also enter under recapitulation, page 1) $ SCHEDULE B ­ STOCKS AND BONDS. List below all stocks and bonds in the Decedent's name alone or tenants in common (not as joint with right of survivorship). Identify each type of security and the number of shares. If none, so state. (For jointly owned property with right of survivorship, you may list in Schedule E. Item No. 1. 2. 3. 4. Description Face Value Appraised Value TOTAL SCHEDULE B (also enter under recapitulation, page 1) $ _____________________________________________________________________________________________________________ SCHEDULE C ­ CASH, BANK ACCOUNTS, NOTES RECEIVABLES. List all bank accounts owned by Decedent alone or as tenants in common (checking, savings, CDs, money market, brokerage, employment bonus, cash award, final paycheck, etc.), cash on hand, notes payable to Decedent, and survival action proceeds. If none, so state. List each separate account type and institution and last two digits of the account. (For jointly owned property with right of survivorship, you may list in Schedule E.) Item No. 1. 2. 3. TOTAL SCHEDULE C Description Value $ (also enter under recapitulation, page 1) SCHEDULE D - LIFE INSURANCE (If none, so state.) Part 1 - Life Insurance ­ List the insurance on the life of the Decedent which is payable to the Estate. Item No. 1. 2. 3. Description Value TOTAL PART 1 (also enter under recapitulation, page 1) $ (If more space is required, insert additional sheets of same size.) Part 2 (OPTIONAL) - You may list here the insurance on the life of the Decedent which is payable to beneficiaries. FORM #350ES LF (04/2017) 62-2-805, 62-3-704, 62-3-706, 62-3-707, 62-3-708, 62-3-1203, 62-3-1204 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Item No. 1. 2. 3. Description Beneficiary Value TOTAL PART 2 (also enter under recapitulation, page 1) $ ______________________________________________________________________________ SCHEDULE E - (OPTIONAL) JOINT WITH RIGHT OF SURVIVORSHIP­ You may list below