Fill and Sign the Pursuant to Rule 110 of the Rules of the Court of Chancery the Following Form

IN THE COURT OF CHANCERY OF THE STATE OF DELAWARE IN THE MATTER OF: C.M. #a disabled person INVENTORY Pursuant to Rule 110 of the Rules of the Court of Chancery, the following Inventory is submitted by _______________________________ in his/her capacity as Guardian/Trustee of the property. Please identify all assets* (including all bank accounts & real property) found to be owned by the disabled person: *Are any of the above mentioned assets jointly held? If so, please list and identify the co-owner(s) of the asset(s), note if there is a right of survivorship by the co-owner(s), and describe the percent interest owned by the disabled person. I certify that to the best of my knowledge and belief the foregoing is a complete Inventory as of ______________________, the date of my appointment as Guardian/Trustee of __________________________. ______________________ Guardian/Trustee Sworn To and Subscribed before the undersigned Notary Public this______day of ____________________,200___. ______________________ Notary Public Submit to the Register in Chancery Office within 30 days of appointment. Please note that your first accounting is due one year from the date of your appointment as Guardian/Trustee. Rule 110(c) If, after filing an inventory, a guardian or trustee receives additional assets not described therein, he or she shall file a verified supplemental inventory of all such assets.