Fill and Sign the Inventory Estate Form

IN THE CHANCERY COURT OF ____________ COUNTY, MISSISSIPPI IN THE MATTER OF THE CONSERVATORSHIP OF ___________ NO. ___________ INVENTORY The following represents a true and correct inventory of the cash and personal property which was owned by ______________________________________ as of __________________, _____, and which has come into the hands of ___________________________ as Conservatrix of _____________________ __________________________. DESCRIPTION VALUE Checking Account No. at _____________________ $______________ __ __________________________________________ Furniture, and miscellaneous household efects $______________ __ and personal property Annuity with Insurance $______________ _ Company Witness my signature, this the ______day of ______________, _____. _____________________________________, Conservatrix of _______________________ Of Counsel: ______________________ ______________________ ______________________ ______________________ Telephone Number: ___________ STATE OF MISSISSIPPI COUNTY OF ______________ Personally appeared before me, the undersigned authority in and for the aforesaid jurisdiction, the within-named ___________, who, after having been frst duly sworn, stated on oath that the matters and facts set forth in the above and foregoing Inventory are true and correct as therein stated. SWORN to and subscribed before me, this the _____ day of ________________, _____. _______________________________________ __ Notary Public My Commission Expires: ______________________ - 3 -/16985