Fillable Self-Represented DISTRICT COURT Estate (Family Law Self Help Center)

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Self-Represented DISTRICT COURT Estate (Family Law Self Help Center)

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© 2018 Nevada Supreme Court
Page 1 of 5 – Inventory
COURT CODE: _____________________
Your Name:
Address:
City, State, Zip:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
_______________ COUNTY, NEVADA
In the Matter of the Guardianship of the:
Estate
Person and Estate
of:
_
___________________________________
(name of person who has a guardian)
A Protected Person.
CASE NO.: ____________________
DEPT: ____________________
INVENTORY, APPRAISAL AND RECORD OF VALUE
FINANCIAL ACCOUNTS: List all checking/savings accounts, investment/brokerage accounts,
retirement/pensions, cash value life insurance policies, interests in trusts, etc.
Financial Institution Name
and Last 4 Digits of Account Number
Current
Balance
Estate’s
Interest (%
owned)*
Name of Co-Owner
(if applicable)
Value of
Estate’s
Interest
$ % $
$ % $
$ % $
$ % $
$ % $
*Add additional pages if there are more accounts
REAL ESTATE: List all houses / real estate, land, and commercial/industrial properties.
Address
Current
Value
Mortgage
/ Loan
Balance
Name of Co-
Owner (if
applicable)
Net Value
(Value –
Loans)
Estate’s
Interest*
(% owned)
Value of
Estate’s
Interest
□ Good □Fair □Poor
$ $ $ % $
□ Good □Fair □Poor
$ $ $ % $
□ Good □Fair □Poor
$ $ $ % $
*Describe the nature of the Estate’s interest and percent of ownership; use (C) for Community Property and (S) for Separate
Property. For example, 50% (C) or (S).
IARV
CLARK
© 2018 Nevada Supreme Court
Page 2 of 5 – Inventory
VEHICLES
List all automobiles, motorcycles, motor homes, boats, etc.
Year, Make, Model
Current
Value
Loan
Balance
Name of Co-
Owner (if
applicable)
Net Value
(Value –
Loans)
Estate’s
Interest*
(% owned)
Value of
Estate’s
Interest
$ $ $ % $
$ $ $ % $
$ $ $ % $
$ $ $ % $
*Describe the nature of the Estate’s interest and percent of ownership; use (C) for Community Property and (S) for Separate
Property. For example, 50% (C) or (S).
MISCELLANEOUS PERSONAL PROPERTY
List valuable household goods, artwork, jewelry, safe deposit boxes, storage unit contents, etc.
Description
Current
Value
Loan
Balance
Name of Co-
Owner (if
applicable)
Net Value
(Value –
Loans)
Estate’s
Interest*
(% owned)
Value of
Estate’s
Interest
$ $ $ % $
$ $ $ % $
$ $ $ % $
$ $ $ % $
*Describe the nature of the Estate’s interest and percent of ownership; use (C) for Community Property and (S) for Separate
Property. For example, 50% (C) or (S).
*If personal property exceeds $5000 in value, an appraisal is required.
TRUSTS
Is the Protected Person a current beneficiary or entitled to receive benefits from a trust?
No
Yes
I don’t know
Is the Guardian requesting the Court to take jurisdiction over the trust?
No
Yes
Not applicable
© 2018 Nevada Supreme Court
Page 3 of 5 – Inventory
DEBTS/CLAIMS
Can the Protected Person assert any claims against you?
No
Yes: (describe) ___________________________________________________________
________________________________________________________________________
Does anyone legally owe money to the protected person but is not paying?
No
Yes: (describe who owes money and how much)
________________________________________________________________________
________________________________________________________________________
TOTAL ESTATE VALUE
$
*add the sums of all the values
© 2018 Nevada Supreme Court
Page 4 of 5 – Inventory
VERIFIED RECORD OF VALUE IN LIEU OF APPRAISEMENT
I, (guardian’s name) _____________________________________, solemnly affirm the
items listed in this Inventory, Appraisal and Record of Value of the Estate has been examined
by me and I have written the value of these items on the Inventory, Appraisal and Record of
Value at the value shown opposite thereof. I report that the total value of the items listed in this
section of this Inventory, Appraisal and Record of value of $_______________.
__________________________________________
GUARDIAN’S SIGNATURE
OATH OF GUARDIAN
I, (guardian’s name) _________________________________, the Guardian of the
Estate of the above-named Protected Person, solemnly affirm that the foregoing Inventory,
Appraisal and Record of Value is a true statement of all assets of the Estate having come into
my possession or for which I have knowledge, and includes all money and claims of the
Protected Person, including claims, if any, the Protected Person has against me.
__________________________________________
GUARDIAN’S SIGNATURE
VERIFICATION OF GUARDIAN
I state that I am the Guardian of the Estate of the above-named protected person, have
read the foregoing Inventory, Appraisement and Record of Value, know the contents thereof,
and it is true to my own knowledge, except for those matters therein stated on information and
belief, and as for those matters I believe them to be true.
I declare under penalty of perjury under the law of the State of Nevada that the
foregoing is true and correct.
__________________________________________
GUARDIAN’S SIGNATURE
© 2018 Nevada Supreme Court
Page 5 of 5 – Inventory
CERTIFICATE OF SERVICE
BY MAIL: I deposited copies of the Inventory in the U.S. mail in (write the name of
the city you mailed from) ______________________, Nevada, addressed to the persons
listed below on (date you mailed) _______________.
Protected Person:
Name: ____________________________
Address: __________________________
____________________________
Protected Person’s Attorney:
Name: ____________________________
Address: __________________________
____________________________
Protected Person’s Guardian Ad Litem:
Name: ____________________________
Address: __________________________
____________________________
ELECTRONIC: I served the following persons pursuant to the court’s electronic
service rules on (date) ____________________:
Protected Person:
Name: _________________________________
Email Address: __________________________
Protected Person’s Attorney:
Name: _________________________________
Email Address: __________________________
Protected Person’s Guardian Ad Litem:
Name: _________________________________
Email Address: __________________________
I declare under penalty of perjury under the law of the State of Nevada that the
foregoing is true and correct.
DATED (month) ________________________ (day) _______, 20___.
Submitted By: (your signature) _______________________________
(print your name) _______________________________
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Self-Represented DISTRICT COURT Estate (Family Law Self Help Center)

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Completed 15 January 2021

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