Fillable 841 (Administrative Office of the Courts)

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841 (Administrative Office of the Courts)

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BROWSE ADMINISTRATIVE OFFICE OF THE COURTS (KY) FORMS

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IN RE: Estate of ______________________________________________________________________________
Decedent’s Date of Death: ______________________ Decedent’s SSN: ______________________________
Description of Assets Estimated Value
AOC-841 Doc. Code: INV
Rev. 2-17
Page 1 of 2
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
KRS 395.250
INVENTORY AND APPRAISEMENT
OF ESTATE
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Case No. ____________________
Court ____________________
County ____________________
Division ____________________
Description of Assets Estimated Value
Total Estimated Value: $_______________________
I submit the foregoing as the Inventory of the above-named Decedent’s estate; which Inventory was made on
____________________________________, 2_______.
________________________________________________________
Signature of Executor/Executrix or Administrator/Administratrix
Subscribed and sworn before me on ______________, 2_____. My commission expires: ______________, 2_____.
______________________________________________
Name/Title
Attorney’s Signature: ______________________________________________ Phone No.: ____________________
Attorney Name (Printed): __________________________________________________________________________
Address: _______________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
CLERK’S CERTIFICATE
The foregoing Inventory having been returned to me in duplicate, the original is now led in my ofce and the
duplicate mailed to the Commissioner of Revenue, Commonwealth of Kentucky this on_____________, 2_____.
_________________________________________ Clerk
By: ______________________________________ D.C.
Distribution: Court File (original) Revenue Cabinet
AOC-841
Rev. 2-17
Page 2 of 2
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Completed 3 September 2020

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