Instructions
Clear Form
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name: Case Name: Case Number:
(if known)
INVENTORY OF FIDUCIARY
Executor/Administrator Original 1. Fiduciary Name Fiduciary Name 2. 3. 4.
5.
Guardian/Conservator
Trustee
Amended (Attach written explanation)
Attorney name Appraiser named by fiduciary on petition (if applicable) BOND AMOUNT ORDERED BY THE COURT $
Bar ID #
Answer the following questions only if processing the estate of a deceased person.
If you have an attorney, have attorney fee arrangements been discussed? Have fiduciary fee arrangements been considered? 6. A. ESTATE SUMMARY TOTAL VALUE OF REAL ESTATE ............... ................................... $
On a sheet of paper (Attachment A), list each piece of real estate including its street address, city/town where real estate is located, county where deed is recorded, book and page of deed, and the value of each piece of real estate.
Yes Yes
No No
B. C.
TOTAL VALUE OF PERSONAL ESTATE (from total on second page) ....... $ TOTAL VALUE OF ENTIRE ESTATE (Add A and B above) ......................... $
Examined and accepted by court,
Date Judge
7.
PERSONAL ESTATE DETAIL
Enter the total value of the personal property for each category below, and list the specific items and their value for each category on the appropriate attachment. For decedent estates, all values should be as of the date of death. For all other case types, values should be as of the date of the fiduciary's appointment.
A. B.
Cash On Hand (No attachment is required.) ...................................... $ Attachment B Household Furnishings and Effects ........................... $
On a sheet of paper (Attachment B), list the contents of the household and their values. Do not list wearing apparel, Bibles, family pictures, photographs, or other personal trinkets of sentimental rather than intrinsic value. If items have been appraised by a professional appraiser, enter the total value and attach a copy of the appraisal to Attachment B.
NHJB-2125-P (12/01/2008) (formerly AOC 044-003)
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Case Name: Case Number: INVENTORY OF FIDUCIARY
C.
Attachment C Other Tangible Personal Property ............................. $
On a sheet of paper (Attachment C), list all other tangible personal property including motor or recreational vehicles, farmers' utensils, mechanics tools and livestock. For each motor or recreational vehicle, list the year, make, model and vehicle identification number (VIN). If items have been appraised by a professional appraiser, enter the total value and attach a copy of the appraisal to Attachment C.
D.
Attachment D Stocks and Bonds
...................................... $
On a sheet of paper (Attachment D), list stock or bond name, number of shares and value per share. See additional information in the `Personal Estate Detail' box above.
E.
Attachment E Deposited in Banks/Financial Institutions .................. $
On a sheet of paper (Attachment E), list the name and address of the bank or financial institution, the account or certificate number, the date of the last interest/dividend paid and the account balance.
F. G.
Attachment F BUSINESS ASSETS
...................................... $
On a sheet of paper (Attachment F), list all business assets and their values.
Attachment G Notes Receivable and Other Written Evidence of Debt Owed to the Deceased or Ward.......................................................... $
On a sheet of paper (Attachment G), list debtor and/or payor, the amount owed, the date of the note and terms of payment.
H.
Attachment H Other Miscellaneous Personal Property ..................... $
On a sheet of paper (Attachment H), list any personal property not listed above and the individual values.)
TOTAL VALUE OF PERSONAL ESTATE ................................................................ $
Add amounts on lines 7A through 7H (Cash on Hand plus Attachments B through H). Copy the `total value of personal estate' amount to page 1, line 6B of the Estate Summary.
8. This section must be completed by the appraiser named in #3 of this form. If no appraiser was named, proceed to #9 below. I, , the appraiser of the estate of , swear that I have acted faithfully, impartially and according to my best judgment.
Date Appraiser
State of This instrument was acknowledged before me on
Date
, County of by
Appraiser Name
My Commission Expires Affix Seal, if any
Signature of Notarial Officer / Title
NHJB-2125-P (12/01/2008) (formerly AOC 044-003)
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Case Name: Case Number: INVENTORY OF FIDUCIARY
9.
This section must be completed by the fiduciary completing the form.
I/We, estate of
,
the fiduciary, of the , swear that if an
appraiser was appointed by the court (the person named in #3 on page 1 of this form), I have shown the appraiser the total estate of the ward or deceased of which I have knowledge or possession. If there was no court appointed appraiser, I swear I have acted faithfully, impartially and according to my best judgment. I further swear that if I have knowledge or possession of any further estate of the ward or deceased, I will immediately amend my inventory. I certify that a copy of this document has been provided to the parties who have filed an appearance for this case or who are otherwise interested parties.
Date
Fiduciary Signature
Date
Fiduciary Signature
State of This instrument was acknowledged before me on
Date
, County of by
Fiduciary
My Commission Expires Affix Seal, if any
Signature of Notarial Officer / Title
ATTENTION BENEFICIALLY INTERESTED PARTIES
This Inventory may be accepted by the probate court unless a written objection, containing the specific factual or legal basis for the objection, is filed within 10 days after the date the Inventory is filed in the probate court. Failure to file an objection may forfeit your right to a hearing concerning the Inventory or your objection, and the probate court may then act without a hearing or any further notice to you.
NHJB-2125-P (12/01/2008) (formerly AOC 044-003)
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