Sworn Inventory Form

SWORN INVENTORY FORM

This Sworn Inventory Form is executed as of by and between Client Name: and Custodian Name: . Each of the foregoing is individually a "Party" and collectively the "Parties."

RECITALS

WHEREAS, Client Name represents that Client is the legal owner or lawful custodian of the tangible personal property listed in the Inventory Schedule attached hereto; and

WHEREAS, Custodian Name has agreed to take possession, safekeeping, or temporary custody of certain items and requires a sworn, itemized inventory to document condition, quantity, and estimated value; and

WHEREAS, the Parties desire to reduce to writing a complete and sworn inventory of the property transferred or held for the purposes set forth below.

NOW, THEREFORE, in consideration of the mutual covenants and agreements set forth herein, the Parties agree as follows:

1. DEFINITIONS

For purposes of this Form: (a) "Inventory Schedule" means the itemized list of tangible property described in Section 2 below; (b) "Affiant" means the individual who prepares and swears to the Inventory Schedule; and (c) "Estimated Value" means the fair market value as determined in good faith in accordance with the Valuation Methodology set forth in Section 3.

2. INVENTORY SCHEDULE

The Inventory Schedule below is a complete, itemized list of the tangible personal property that is the subject of this sworn inventory as of the Effective Date stated above. The Parties acknowledge that additional pages may be attached and are part of this sworn inventory if so indicated.

If additional pages are attached to this Inventory Schedule, indicate number of additional pages: and confirm attachment by checking: Attached

3. VALUATION METHODOLOGY

Estimated Value provided in the Inventory Schedule is the affiant's reasonable good faith estimate of the fair market value at the Effective Date. Unless otherwise stated in writing, valuation is based on comparable sales, purchase receipts, manufacturer suggested retail price less depreciation, or independent appraisal where available. Parties acknowledge that Estimated Value is an estimate only and does not constitute a guarantee of replacement cost or insurance valuation.

4. POSSESSION, CUSTODY AND ACCESS

Custodian Name shall take physical possession of the items listed in the Inventory Schedule to the extent identified in writing and shall exercise reasonable care in the custody and safekeeping of the items. Access to items shall be permitted to Client Name upon reasonable prior written notice to Custodian Name except where restricted by court order or law. Any change in possession shall be documented by an updated sworn inventory signed by the Parties.

5. AFFIANT'S OATH AND CERTIFICATION

I, , declare under penalty of perjury under the laws of the State of that the foregoing Inventory Schedule and statements contained herein are true, complete, and accurate to the best of my knowledge and belief as of the Effective Date.

Affiant further affirms that all known liens, encumbrances, or security interests affecting any listed item have been disclosed in the Remarks section below or attached schedules.

6. ATTACHMENTS AND EXHIBITS

All attachments, photographs, appraisal reports, receipts, or supplemental lists referenced in this Form are incorporated by reference and identified as Exhibits attached hereto. Specify Exhibit identifiers and brief descriptions:

7. NOTICES

Any notices, requests, or other communications required or permitted hereunder shall be in writing and shall be delivered to the address specified below for each Party. Notice shall be effective upon personal delivery, or three (3) days after deposit with a recognized postal carrier by certified mail, return receipt requested.

8. AMENDMENTS; WAIVER

This Form may be amended only by a written instrument signed by both Parties. No waiver of any provision of this Form will be effective unless in writing and signed by the Party waiving compliance, and no waiver will constitute a waiver of any other provision or continue thereafter.

9. GOVERNING LAW

This Form shall be governed by and construed in accordance with the laws of the State of , without regard to principles of conflicts of law.

10. ENTIRE AGREEMENT; SEVERABILITY

This Form, together with any Exhibits or attachments referenced herein, constitutes the entire agreement between the Parties with respect to the subject matter hereof. If any provision of this Form is held invalid or unenforceable by a court of competent jurisdiction, the remainder of this Form will remain in full force and effect.

11. COUNTERPARTS; ELECTRONIC SIGNATURES

This Form may be executed in counterparts, each of which will be deemed an original and all of which together will constitute one instrument. Signatures transmitted by electronic means that reproduce a handwritten signature are binding for all purposes.

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