GN-3440, 05/18 Guardianship or Conservatorship Inventory 24724754.60 and 54.76, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF Name Date of Birth Amended Guardianship or Conservatorship Inventory Case No. I CERTIFY: As guardian or conservator, 1. this inventory with schedules includes all of or individualinterest regardless of how the asset is titled. 2. upon diligent inquiry, I have not been able to discover any other property or interest in property of my ward or individual. SUMMARY OF PROPERTY (Value of War d or Individual Estate as of d ate Letters of Guardianship or Conservatorship w ere i ssued . ) Date Letters Issued or individualproperty at its fair market value on date Letters of Guardianship or Conservatorship were issued. (a) individual an d any marital property interest regardless of how the asset is titled. $ (b) Minus total value of encumbrances, liens or other charges upon each item - $ (c) Net value of property subject to this guardianship or conservatorship $ Schedules showing details are attached. Note: This form with the statutory filing fee shall be filed within 60 days of appointment. Guardian/Conservator Co - G uardian / Co - Conservator State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: State of County of Subscribed and sworn to before me on Notary Public/Court Official N ame Printed or Typed My commission/term expires: American LegalNet, Inc. www.FormsWorkFlow.com GN-3440, 05/18 Guardianship or Conservatorship Inventory 24724754.60 and 54.76, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 Supporting Inventory Schedules ASSETS: List all of the ward / individual assets including interests in property , including digital property as defined under 247 711.03(10), Wis. Stats., and any marital property interest , regardles s of how the asset is titled. For each asset, indicate how the asset is held or titled; the name and relationship to the ward/ individual of any co - owner; the marital property classification of the property and, for any property that is marital property, the spouse who has management and control rights with respect to the property. Also indicate related encumbrances, liens or other charges upon each item , any beneficiary or payable on death designations , jointly owned property, and any interest in a life estate . Carry these totals to line (a) and line (b) in the summary of property on page 1. INCOME: In addition, separately list all of t he ward/ individual sources of income. Do not include income in the totals in the summary of property on page 1. Value of Ward's or Individual Interest on Date Letters Issued: American LegalNet, Inc. www.FormsWorkFlow.com