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OPG Inventory Form 1 /7
Inventory Form
PUBLIC GUARDIAN’S REF PG/
DATE OF APPOINTMENT
Note: You can save this form on your computer at any time during completion, to do so, click on the logo
representing a floppy disk on the toolbar in acrobat reader, or click in “File” then “Save as” in the acrobat
reader’s menu.
Adult
TITLE
SURNAME
FORENAME
Guardian
TITLE
SURNAME
FORENAME
CURRENT ADDRESS
TELEPHONE NUMBER
EMAIL
(As per Court Order. If you had
interim financial powers, give
the date of the Interim Order)
ARE YOU THE PRIMARY
POINT OF CONTACT?
YES NO
If more than one Financial Guardian has been appointed, please tell us who will be the primary point of
contact. This will be helpful, particularly if clarification or further information is needed by this office.
B/1/2011/1
12/12/2011
Mr
Beech
Michael
Mr
Beech
Tom
✔
OPG Inventory Form 2 /7
DETAILS ESTIMATED
VALUATION
TOTAL VALUE HERITABLE ASSETS £
Joint Guardian (If Applicable)
TITLE:
SURNAME:
FORENAME:
EMAIL:
TELEPHONE NUMBER:
Joint Guardian (If Applicable)
TITLE:
SURNAME:
FORENAME:
EMAIL:
TELEPHONE NUMBER:
Section 1 - Heritable Property
(Please read Guidance Note 2.1)
(Include share of any property owned by the adult)
YES NO
ARE YOU THE PRIMARY
POINT OF CONTACT?
YES NO
ARE YOU THE PRIMARY
POINT OF CONTACT?
Select...
1 Treetops Avenue, Dundee
130,000.00
130,000.00
OPG Inventory Form 3 /7
Section 2 - Moveable Assets
SECTION 2A - CASH, BANK AND BUILDING SOCIETY ACCOUNTS
FUND HOLDER SORT ACCOUNT TYPE ACCOUNT BALANCE
CODE NUMBER
TOTAL CASH, BANK AND BUILDING SOCIETY ACCOUNTS £
SECTION 2B - STOCKS/SHARES
DETAILS (DESCRIPTION OF ITEM) HOLDING VALUE
TOTAL STOCKS/SHARES £
(
Please read Guidance Note 2.2)
Please note the balance/value of each asset should be entered as at the date of appointment and
documentary evidence provided for each item. (The date of appointment is the date on which the Sheriff
appointed you as financial guardian.)
If an account is overdrawn, please add a minus sign before the balance e.g. –1000.00
Bank of Scotland
Current Account
12345678
12,000.00
Nationwide
ISA Account
910111213
8,000.00
20,000.00
0.00
OPG Inventory Form 4 /7
SECTION 2C - PROPERTY OTHER THAN HERITABLE
e.g. separately insured valuable items, paintings, antiques, jewellery etc.
DETAILS VALUE
TOTAL PROPERTY OTHER THAN HERITABLE £
SECTION 2D - VEHICLES (INCLUDING CARAVANS)
only include vehicles which the adult owns, do not include motability vehicles.
DETAILS VALUE
TOTAL VALUE OF VEHICLES £
SECTION 2E - BUSINESS ASSETS & INTERESTS
DETAILS VALUE
TOTAL BUSINESS ASSETS & INTERESTS £
TOTAL INSURANCE/ASSURANCE POLICIES £
SECTION 2F - INSURANCE/ASSURANCE POLICIES
Surrender value if cash return expected, do not include if cash return only payable on death.
DETAILS VALUE
TOTAL VALUE MOVEABLE ASSETS
£
0.00
0.00
0.00
0.00
20,000.00
OPG Inventory Form 5 /7
TOTAL ANNUAL INCOME £
Section 3 - Adult’s Income
(Please read Guidance Note 2.3)
(include all of the Adult's income, Pensions, Benefits and Allowances etc.
Please provide documentary evidence.)
DETAILS AMOUNT FREQUENCY ANNUAL
AMOUNT
TOTAL EXISTING DEBTS £
Section 4 - Any existing debts due by the adult as
at date of your appointment by the court
(Please read Guidance Note 2.4)
Please provide evidence for all debts listed, e.g. care home charges, utility bills, council tax,
rent arrears, credit card debt, mortgage etc.
DETAILS AMOUNT
DWP Disability Living Allowance
135.00
Weekly
7,020.00
Employment and Support Allowance
105.00
Weekly
5,460.00
DWP pension
104.70
Weekly
5,444.40
Works private pension
221.30
Monthly
2,655.60
Select
0.00
Select
0.00
Select
0.00
Select
0.00
20,580.00
0.00
OPG Inventory Form 6 /7
Section 5 - Other relevant information
(Please read Guidance Note 2.5)
(please include any other financial interest the adult has, or may be due in the future, which has not been
identified in the previous sections of the inventory.)
Section 6 - Summary of Inventory
Based on the information you have entered in Sections 1 – 4, the following totals have been calculated
automatically. Please check that the totals are correct and then complete the declaration in Section 7 and
the checklist in Section 8.
TOTAL HERITABLE ASSETS (1) £
TOTAL MOVEABLE ASSETS (2) £
TOTAL ANNUAL INCOME (3) £
TOTAL OF EXISTING DEBTS (4) £
Section 7 - Declaration
I/We hereby certify that, to the best of my/our knowledge, this inventory is a fair and full reflection of the
adult’s estate, as at the date of the court order.
FINANCIAL GUARDIAN DATE
FINANCIAL GUARDIAN DATE
FINANCIAL GUARDIAN DATE
Dad is in hospital just now and will be moving to a suitable care home in the next few weeks. Once all the
arrangements have been made I will contact the office to advise the change of address.
130,000.00
20,000.00
20,580.00
0.00
OPG Inventory Form 7 /7
Section 8 - Checklist
The form is now complete, please print it and send it to:
The Office of the Public Guardian
Hadrian House
Callendar Business Park
Callendar Road
Falkirk
FK1 1XR
DX: 550360 Falkirk 3
LP: LP-17 Falkirk
Telephone: 01324 678300
Fax: 01324 678301
E-mail: opg@scotcourts.gov.uk
Website: www.publicguardian-scotland.gov.uk
Have you completed all of the relevant sections, with due regard to the date of your appointment?
(This is the date when the Sheriff granted your appointment. Not the date on the certifcate issued by
the Public Guardian.)
Has/have all financial guardians signed and dated the inventory?
Have you enclosed all of the necessary supporting documentation?
Have you enclosed the relevant fee? (please note the fee is based on the value shown in box 2 of
Section 6 and your cheque should be made payable to the “Scottish Court Service”).
Have you retained a copy of this inventory for your own records? It may be required by you for future
reference.
Version 3
August 2011
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