Fill and Sign the Chapter 6 Trial Courtsnebraska Judicial Branch Form

Page 1 of 3 Updated Inventory CC 16:2.45 Rev. 09/16 UPDATED INVENTORY TO THE GUARDIAN AND/OR CONSERVATOR: To protect personal information , only the last four digits of the account should be provided on this form . Complete account information is provided on the Personal and Financial Information for Guardianships and Conservatorships form . The inventory listed below is the inventory as of the ending date of this Annual Report, __ ____________________. 1. PERSONAL PROPERTY: Checking Accounts Bank Name ___________________________ Account no.XXX-_____ _____ _____ _______ $____________________ Bank Name ___________________________ Account no. XXX-_____ _____ _____ ______ $____________________ Bank Name ___________________________ Account no. XXX-_____ _____ _____ ______ $____________________ Savings Accounts Bank Name ___________________________ Account no.XXX-_____ _____ _____ _______ $____________________ Bank Name ___________________________ Account no. X XX-_____ _____ _____ ______ $____________________ Bank Name ___________________________ Account no. XXX-_____ _____ _____ ______ $____________________ Certificates of Deposit Bank Name ___________________________ Account no.XXX-_____ _____ _____ _______ $____________________ Bank Nam e ___________________________ Account no. XXX-_____ _____ _____ ______ $____________________ Bank Name ___________________________ Account no. XXX-_____ _____ _____ ______ $____________________ Stocks and Bonds $____________________ Vehicles $____________________ Household goods and furnishings $____________________ Other: _ _ _____________________________ $____________________ TOTAL: $____________________ Nebraska State Court Form REQUIRED CC 16:2.45 Rev. 09/16 IN THE COUNTY COURT OF _________________ COUNTY, NEBRASKA UPDATED INVENTORYIN THE MATTER OF THE GUARDIANSHIP/ CONSERVATORSHIP OF: ______________________________________ Ward/Incapacitated Person/Protected Person Case No. ____________________ Neb. Rev. Stat. §§ 30-2628, 30-2648, Neb. Ct. R. § 6-1442 2. JOINTLY HELD PROPERTY: W ith whom ________________________________ $__________________ __ W hat ________________________ ____________ $_________________ ___ W ith whom ____________________ ____________ $________________ ____ W hat _________________________ ___________$ ______________ ______ TOTAL : $_____________________ 3. INCOME (Monthly): W ages - Employer name: ________________________ $_____________________ Social Security $_____________________ Supplemental Security income $_____________________ Veterans Administration benefits $_____________________ Company pension $_____________________ Interest - From where : ___________________________ $_____________________ Divide n ds - From where: _________________________ $_____________________ Other: _ _________________ ______________________ $_____________________ TOTAL: $_____________________ 4. CREDIT CARD(S) belonging to ward/incapacitated person/protected person (If applicable) Card Name ___________________________ Account no.XXX-_____ _____ _____ _______ $_____________________ Card Name ___________________________ Account no. XXX-_____ _____ _____ ____ ___ $_____________________ TOTAL: $_____________________ _ Page 2 of 3Updated Inventory CC 16:2.45 Rev. 09/165. NOTICE: You must file your Letters of Guardianship and/ or Conservatorship with the Register of Deeds in any county where the ward/incapacitated person/protected person has real property or an interes t in real property. Location _________ ____________________________________ Legal description _______________________________________ _____________________________________________ Location _____________________________________________ Legal description _______________________________________ _____________________________________________ Location _____________________________________________ Legal description _______________________________________ _____________________________________________ Location _____________________________________________ Legal description _______________________________________ _____________________________________________ REAL PROPERTY (List location by address and value): Note: legal property descriptions may be obtained from the Register of Deeds in the county that the property is located. For longer descriptions, reference the location and legal description on a separate page. Value $________________ Value $________________ Value $________________ Value $________________ T O TAL: $________________ I swear or affirm, under the penalties of perjury, that I have examined the Updated Inventory and to the best of my knowledge and belief, they are true, correct and complete. Date Signature(s) of Guardian(s) and/or Conservator(s) Print or Type Name of Guardian(s) and/or Conservator(s) Bar Number and Firm Name (attorneys only) Street Address/P.O. Box of Guardian(s) and/or Conservator(s) mark if new address City/State/ZIP Code of Guardian(s) and/or Conservator(s) Phone E-mail AddressPage 3 of 3 Updated Inventory CC 16:2.45 Rev. 09/16