Free GN-3440 - Wisconsin

For Official Use

STATE OF WISCONSIN, CIRCUIT COURT, Amended IN THE MATTER OF

COUNTY

Ward's Name

Guardianship or Conservatorship Inventory
Case No.

As guardian or conservator, I certify that: 1. This inventory with schedules includes all of the ward's or conservatee's interests in property and any marital property interest 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 conservatee. Date Letters Issued SUMMARY OF PROPERTY (Value of Ward's or Conservatee's Estate as of date Letters of Guardianship or Conservatorship were issued.) The following is a listing of all the ward's or conservatee's property at its fair market value on date Letters of Guardianship or Conservatorship were issued. (a) The ward's or conservatee's interests in property and any marital property interests 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.

Signature of Guardian/Conservator

Signature of Co-Guardian

Subscribed and sworn to before me on

Subscribed and sworn to before me on

Notary Public/Court Official

Notary Public/Court Official

My commission expires:

My commission expires:

Name of Attorney

Address

Telephone Number

Bar Number

GN-3440, 01/07 Guardianship or Conservatorship Inventory Page 1 of 2

§§54.60 and 54.76, Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.

Guardianship or Conservatorship Inventory Page 2 of 2 Case No.

Supporting Inventory Schedules
ASSETS: List all of the ward's assets including interests in property and any marital property interest, regardless of how the asset is titled. For each asset, indicate how the asset is held or titled; the name and relationship to the ward 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 the ward's sources of income. Do not include income in the totals in the summary of property on page 1.

Value of Ward's or Conservatee's Interest on Date Letters Issued:

GN-3440, 01/07 Guardianship or Conservatorship Inventory Page 2 of 2

§§54.60 and 54.76, Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.