THE DEATON LAW FIRM INVENTORY, APPRAISEMENT, LIST OF CLAIMS, DEBTS AND CREDITOR INFORMATION NAME OF DECEDENT: DATE OF DEATH: 1.

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1 THE DEATON LAW FIRM RUTH A. HUGHES-DEATON TEL: MCCRACKEN CIRCLE FAX: SUITE C rhd@ruthdeaton.com CYPRESS, TEXAS INVENTORY, APPRAISEMENT, LIST OF CLAIMS, DEBTS AND CREDITOR INFORMATION NAME OF DECEDENT: DATE OF DEATH: 1. Real Property: 1 st Tract: Street Address: Legal Description: Fair Market Value (at date of death): $ Copy of Deed. Copy of deeds of trust if lien on property. If debt, include outstanding balance at date of death. Address of Real Estate with Mortgage: Name of Mortgage Company: Address of Mortgage Company: Copy of Amortization Schedule. Copy of leases, if any. Copy of tax statement showing value. Most recent appraisal, if any. Separate / Community (circle one) 2nd Tract: Street Address: Legal Description: Fair Market Value (at date of death): $ Copy of Deed. Copy of deeds of trust if lien on property. If debt, include outstanding balance at date of death. Address of Real Estate with Mortgage: Name of Mortgage Company: Address of Mortgage Company: Copy of Amortization Schedule.

2 Copy of leases, if any. Copy of tax statement showing value. Most recent appraisal, if any. Separate / Community (circle one) 2

3 3rd Tract: Street Address: Legal Description: Fair Market Value (at date of death): $ Copy of Deed. Copy of deeds of trust if lien on property. If debt, include outstanding balance at date of death. Address of Real Estate with Mortgage: Name of Mortgage Company: Address of Mortgage Company: Copy of Amortization Schedule. Copy of leases, if any. Copy of tax statement showing value. Most recent appraisal, if any. Separate / Community (circle one) LIST INFORMATION FOR ADDITIONAL TRACTS ON SEPARATE SHEET 2. A. Personal Property: A.1 Household goods, appliances, furniture, tools Total Fair Market Value at Date of Death: $ (Circle One) Community / Separate property? A.2 Jewelry, clothing, and personal items Total Fair Market Value at Date of Death: $ List significant individual items and estimated value below: Item Fair Market Value At Date of Death Community/Separate LIST INFORMATION FOR ADDITIONAL ITEMS ON SEPARATE SHEET B. Automobiles, Trailers, Boats, Motorcycles, Etc.: B.1 Description: Date of Death Fair Market Value $ Community / Separate (circle one) B.2 Description: Date of Death Fair Market Value $ Community / Separate (circle one) 3

4 B.3 Description: Date of Death Fair Market Value $ Community / Separate (circle one) LIST INFORMATION FOR ADDITIONAL VEHICLES ON SEPARATE SHEET Need copy of title to all above. If lien on vehicle, name and address of lienholder with outstanding balance at date of death. C. Cash, Notes, Mortgages Held, Etc.: (Cash in financial institutions) Institution: Address: Name(s) on account: Acct. No: Balance at death: $ Institution: Address: Name(s) on account: Acct. No: Balance at death: $ Institution: Address: Name(s) on account: Acct. No: Balance at death: $ LIST INFORMATION FOR ADDITIONAL INSTITUTIONS ON SEPARATE SHEET Provide the following documents: Copy of last statement immediately after death Copy of Note or Mortgage held D. Stocks And Bonds D.1. Certificates and bonds held by Decedent Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ 4

5 Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ 5

6 Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ LIST INFORMATION FOR ADDITIONAL BONDS ON SEPARATE SHEET Provide the following documents: Copy of last statement immediately after death. Stocks or bonds not held by a broker. Copy of stock certificates. D.2. Certificates and Bonds Held by Broker Name of Brokerage Company: Name of Broker: Address of Brokerage Company: Phone Number of Brokerage Company: Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ LIST INFORMATION FOR ADDITIONAL BONDS ON SEPARATE SHEET Provide the following documents: Copy of last statement immediately after death. Stocks or bonds held by a broker. 6

7 Copy of stock certificates. 7

8 D.3 Certificates and Bonds Held By Company Name of Company: Name of Individual Agent: Address of Company: Phone Number of Company: Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ Description: No. Of Shares/Bonds held at death Value per share/bond at death $ Total value of shares at death $ LIST INFORMATION FOR ADDITIONAL BONDS ON SEPARATE SHEET Provide the following documents: Copy of last statement immediately after death. Stocks or bonds not held by a broker. Copy of stock certificates. E. Ownership in Closely Held Business List business entities of which Decedent was a shareholder, member, owner, or partner. Name of Entity: Type of Entity (for example, C corporation, S corporation, limited liability company, general partnership, limited partnership, sole proprietorship): Names, addresses, and phone numbers of other persons who are shareholders, partners, members, etc.: 8

9 Name of Entity: Type of Entity (for example, C corporation, S corporation, limited liability company, general partnership, limited partnership, sole proprietorship): Names, addresses, and phone numbers of other persons who are shareholders, partners, members, etc.: Name of Entity: Type of Entity (for example, C corporation, S corporation, limited liability company, general partnership, limited partnership, sole proprietorship): Names, addresses, and phone numbers of other persons who are shareholders, partners, members, etc.: LIST INFORMATION FOR ADDITIONAL ENTITIES ON SEPARATE SHEET Provide the following documents for each entity: Copy of corporate or record book. Balance Sheet as of date of death. Real estate owned by business: Copy of deed. Copy of deeds of trust if lien on property. Copy of leases, if any. Copy of tax statement showing value. Fair market value if you think tax statement is not accurate. Most recent appraisal, if any. 9

10 Copy of last statements for all Business financial institution accounts, including banks, brokers. 10

11 F. Miscellaneous Property 1. Item Fair Market Value At Date of Death Community/Separate LIST INFORMATION FOR ADDITIONAL PROPERTY ON SEPARATE SHEET 3. Life Insurance: (INCLUDING CREDIT LIFE POLICIES) A. Polices Insuring the Life of the Decedent: Provide copy of each life insurance policy. A.1 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Owner of Policy: Name(s) of Beneficiary(ies): Face Amount of Policy: $ Outstanding Loans Against Policy: $ Net of Policy Benefits Payable: $ A.2 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Owner of Policy: Name(s) of Beneficiary(ies): 11

12 Face Amount of Policy: $ Outstanding Loans Against Policy: $ Net of Policy Benefits Payable: $ A.3 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Owner of Policy: Name(s) of Beneficiary(ies): Face Amount of Policy: $ Outstanding Loans Against Policy: $ Net of Policy Benefits Payable: $ LIST INFORMATION FOR ADDITIONAL POLICIES ON SEPARATE SHEET B. Polices Insuring the Life of the Persons Other Than the Decedent of which the Decedent Had an ownership interest, such as surviving spouse or children: Provide copy of each life insurance policy. B.1 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Insured: Owner of Policy: Name(s) of Beneficiary(ies): Cash Value of Policy: $ Face Value of Policy: $ Annual Premiums: $ Are premiums paid up? Yes No When does policy expire, if applicable? 12

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14 B.2 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Insured: Owner of Policy: Name(s) of Beneficiary(ies): Cash Value of Policy: $ Face Value of Policy: $ Annual Premiums: $ Are premiums paid up? Yes No When does policy expire, if applicable? B.3 Insurance Co. Agent s Name: Agent s Address: Policy No.: Type of Policy (i.e., whole-life, term, etc.): Insured: Owner of Policy: Name(s) of Beneficiary(ies): Cash Value of Policy: $ Face Value of Policy: $ Annual Premiums: $ Are premiums paid up? Yes No When does policy expire, if applicable? LIST INFORMATION FOR ADDITIONAL POLICIES ON SEPARATE SHEET 4. IRA s, 401-K s, Pension Plans, Profit Sharing: Type of Plan: Owner of Plan: Beneficiary: Name of Plan Administrator: Address of Plan Administrator: 14

15 Phone Number of Plan Administrator: Value at Date of Death: $ Provide copy of last statement immediately after date of death Type of Plan: Owner of Plan: Beneficiary: Name of Plan Administrator: Address of Plan Administrator: Phone Number of Plan Administrator: Value at Date of Death: $ Provide copy of last statement immediately after date of death Type of Plan: Owner of Plan: Beneficiary: Name of Plan Administrator: Address of Plan Administrator: Phone Number of Plan Administrator: Value at Date of Death: $ Provide copy of last statement immediately after date of death 5. Safe Deposit Box: List of items in safe deposit box 6. Debts and Creditor Information: Funeral Costs $ Flowers $ Headstone $ Minister Fee $ Probate Costs $ Probate Attorney Fees $ Medical Expenses $ 15

16 Utility Bills $ Credit Cards $ Miscellaneous $ $ $ 16

17 CREDITOR INFORMATION Creditor Address Debt Amount Community/Separate **Include copy of last statement immediately after date of death. To expedite the probate process, please provide this information to our office within 60 days from the date the Will is admitting to probate. If you need more room, please attach additional sheets. 7. List of Claims: A. List of claims Owed to Decedent (i.e. IRS Refunds, Deposit Refunds, Medical Overpayments, etc.) B. The following claims have been filed against the estate: C. Check if applicable. There are no claims due or owing to the Estate other than those shown on the foregoing Inventory and Appraisement, except for unpaid claims due the estate from medical insurance policies, which should be close to the amount of medical bills. 17

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