Estate Inventory

The undersigned as the personal representative of the estate of , deceased, who died on , hereby submits this inventory of all the property of the estate, that has come into the hands, possession, control, or knowledge of this personal representative.

Note: Whether property is protected homestead and therefore exempt from the claims of creditors, is a judicial determination.

All real estate located outside the State of Florida owned by the decedent of which the personal representative is aware, if any, is described on a schedule attached hereto.

NOTICE: Each residuary beneficiary in a testate estate or heir in an intestate estate has the right to request a written explanation of how the inventory value of any asset was determined, including whether the personal representative obtained an independent appraisal for that asset and, if so, a copy of the appraisal. Any other beneficiary may request this information regarding all assets distributed to or proposed to be distributed to that beneficiary.

Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true to the best of my knowledge and belief.

Pursuant to Florida Probate Rule 5.330, the personal representative(s) must sign an estate's inventory form. Accordingly, please print and actually sign this page before scanning and submitting it alongside the Inventory Smart Form. The personal representative's attorney may sign this form in any manner authorized by Florida Judicial Administration Rule 2.515(c).

I CERTIFY that a true copy of the foregoing has been served on: