Florida Probate Rule 5.910
RULE 5.910. INVENTORY
Judicial Circuit,
in and for
County, Florida
Probate Division
Case No.
Judge:
Amended Form? Yes* No
*If yes, version of the Amended
Form:
In Re: Guardianship of
INITIAL INVENTORY
Date of letters of guardianship:
Property guardianship type:
SUMMARY
Section A: Value of Real Property Assets $
Section B: Cash Assets/Cash Equivalent Assets $
Section C: Intangible Assets/Stocks/Bonds $
Section D: Tangible Personal Property $
Section E: Debts/Encumbrances/Liabilities/Liens $
Total $
Section A: Real Property Assets
Do you have entries for Section A? Yes No
Number Description and Full Value Is There Another
Address Owner? Yes or No
1.
2.
3.
Total for Section A $
Attach a copy of the property appraiser’s information or a copy of the deed for
all real property.
Section B: Cash Assets/Cash Equivalent Assets (checking account, savings
account, money market account, certificate of deposit (CD))
Do you have entries for Section B? Yes No
Are any of the entries held in a depository account? Yes No
Number Institution Last 4 Type of Full Is There Is this a
Name Digits of Asset Value Another Depository
Account Owner? Account?
Number Yes or Yes or No
No
1.
2.
3.
Total for Section B $
Attach a copy of the institution’s statement for each account from the creation
date of the guardianship.
Section C: Intangible Assets/Stocks/Bonds
Do you have entries for Section C? Yes No
Are any of the entries held in a depository account? Yes No
Number Issuer Type of Full Value Last 4 Is There
Name and Asset Digits of Another
Address Account Owner?
Number Yes or No
1.
2.
3.
Total for Section C $
Attach a copy of the institution’s statement for each account from the creation
date of the guardianship.
Section D: Tangible Personal Property Assets (motor vehicles, jewelry,
household furnishings, collectibles, fine art)
Do you have entries for Section D? Yes No
Number Description and Full Value Is There Another
Location Owner? Yes or No
1.
2.
3.
Total for Section D $
Attach a copy of the title for any motor vehicle.
Section E: Debts/Encumbrances/Liens/Liabilities
Do you have entries for Section E? Yes No
Instructions: List each liability equal to or greater than $1,000.
Number Creditor Full Amount Last 4 Digits Is there
of Liability of Account Another
Number Person who
Owes on the
Debt? Yes or
No
1.
2.
3.
Total for Section E $
A copy of documents detailing each listed liability.
Section F: Sources of Income
Do you have entries for Section F? Yes No
Number Type Payor Estimated
Monthly Amount
1.
2.
3.
Total for Section F $
Is the guardian the representative payee of Social Security benefits? Yes
No
If no, who is the representative payee for the Social Security benefits?
Section G: Lawsuits Against the Ward
Do you have entries for Section G? Yes No
Number Description Estimated Court Plaintiff’s Describe Date of
of Lawsuit Amount Address Name Cause of Debt
or Claim of Claim and Action Occurrence
Address
1.
2.
3.
Section H: Pending Litigation and/or Lawsuits the Ward May Bring if
Court Approval Is Received
Do you have entries for Section H? Yes No
Number Descriptio Case Defendant Describe Attorney
n of Number Name and Cause of for Ward
Lawsuit or and Court Address Action
Claims Address
1.
2.
3.
Section I: Assets the Ward, as of the Date of the Letters of Guardianship,
Was Entitled to Receive, but Has Not Received
Do you have entries for Section I? Yes No
Instructions: If the guardian has knowledge of assets the ward was entitled to
receive as of the date of letters, but were not received the assets should be
listed here. Examples: insurance policies, benefits, inheritance, or settlements
from litigation.
Number Description Estimated Date of Estimated
Receipt Amount
1.
2.
3.
Section J: Trusts
Do you have entries for Section J? Yes No
Number Name of Ward’s Estimated Date Value of
Current Interest Trust was the Ward’s
Trustee and Created Interest in
Address the Trust
1.
2.
3.
Section K. Safe-Deposit Box
Does the ward lease a safe-deposit box? Yes No
If yes, location and number of safe-deposit box:
Does the ward lease a safe-deposit box with another individual or individuals?
Yes No
Who is the joint lessee with the ward?
Was an inventory of the safe-deposit box filed with the court as required by
section 744.365, Florida Statutes? Yes No
Has the safe-deposit box been opened? Yes No
[A certificate of service as required by Florida Rule of Judicial
Administration 2.516 must be included if the incapacitated person is not a minor
under 14 years of age and is not totally incapacitated.]
I certify that the foregoing document has been furnished to .....(name,
address used for service, mailing address, and e-mail address)..... by .....(e-
mail) (delivery) (mail) (fax)..... on .....(date)…...
Guardian’s Signature
Guardian’s Printed Name:
Guardian’s Address:
Guardian’s Phone Number:
Guardian’s E-mail Address:
Judicial Circuit,
in and for
County, Florida
Probate Division
Case No.
Judge:
Amended Form? Yes* No
*If yes, version of the Amended
Form:
In Re: Guardianship of
INITIAL INVENTORY
Date of letters of guardianship:
Property guardianship type:
SUMMARY
Section A: Value of Real Property Assets $
Section B: Cash Assets/Cash Equivalent Assets $
Section C: Intangible Assets/Stocks/Bonds $
Section D: Tangible Personal Property $
Section E: Debts/Encumbrances/Liabilities/Liens $
Total $
Section A: Real Property Assets
Do you have entries for Section A? Yes No
Number Description and Full Value Is There Another
Address Owner? Yes or No
1.
2.
3.
Total for Section A $
Attach a copy of the property appraiser’s information or a copy of the deed for
all real property.
Section B: Cash Assets/Cash Equivalent Assets (checking account, savings
account, money market account, certificate of deposit (CD))
Do you have entries for Section B? Yes No
Are any of the entries held in a depository account? Yes No
Number Institution Last 4 Type of Full Is There Is this a
Name Digits of Asset Value Another Depository
Account Owner? Account?
Number Yes or Yes or No
No
1.
2.
3.
Total for Section B $
Attach a copy of the institution’s statement for each account from the creation
date of the guardianship.
Section C: Intangible Assets/Stocks/Bonds
Do you have entries for Section C? Yes No
Are any of the entries held in a depository account? Yes No
Number Issuer Type of Full Value Last 4 Is There
Name and Asset Digits of Another
Address Account Owner?
Number Yes or No
1.
2.
3.
Total for Section C $
Attach a copy of the institution’s statement for each account from the creation
date of the guardianship.
Section D: Tangible Personal Property Assets (motor vehicles, jewelry,
household furnishings, collectibles, fine art)
Do you have entries for Section D? Yes No
Number Description and Full Value Is There Another
Location Owner? Yes or No
1.
2.
3.
Total for Section D $
Attach a copy of the title for any motor vehicle.
Section E: Debts/Encumbrances/Liens/Liabilities
Do you have entries for Section E? Yes No
Instructions: List each liability equal to or greater than $1,000.
Number Creditor Full Amount Last 4 Digits Is there
of Liability of Account Another
Number Person who
Owes on the
Debt? Yes or
No
1.
2.
3.
Total for Section E $
A copy of documents detailing each listed liability.
Section F: Sources of Income
Do you have entries for Section F? Yes No
Number Type Payor Estimated
Monthly Amount
1.
2.
3.
Total for Section F $
Is the guardian the representative payee of Social Security benefits? Yes
No
If no, who is the representative payee for the Social Security benefits?
Section G: Lawsuits Against the Ward
Do you have entries for Section G? Yes No
Number Description Estimated Court Plaintiff’s Describe Date of
of Lawsuit Amount Address Name Cause of Debt
or Claim of Claim and Action Occurrence
Address
1.
2.
3.
Section H: Pending Litigation and/or Lawsuits the Ward May Bring if
Court Approval Is Received
Do you have entries for Section H? Yes No
Number Descriptio Case Defendant Describe Attorney
n of Number Name and Cause of for Ward
Lawsuit or and Court Address Action
Claims Address
1.
2.
3.
Section I: Assets the Ward, as of the Date of the Letters of Guardianship,
Was Entitled to Receive, but Has Not Received
Do you have entries for Section I? Yes No
Instructions: If the guardian has knowledge of assets the ward was entitled to
receive as of the date of letters, but were not received the assets should be
listed here. Examples: insurance policies, benefits, inheritance, or settlements
from litigation.
Number Description Estimated Date of Estimated
Receipt Amount
1.
2.
3.
Section J: Trusts
Do you have entries for Section J? Yes No
Number Name of Ward’s Estimated Date Value of
Current Interest Trust was the Ward’s
Trustee and Created Interest in
Address the Trust
1.
2.
3.
Section K. Safe-Deposit Box
Does the ward lease a safe-deposit box? Yes No
If yes, location and number of safe-deposit box:
Does the ward lease a safe-deposit box with another individual or individuals?
Yes No
Who is the joint lessee with the ward?
Was an inventory of the safe-deposit box filed with the court as required by
section 744.365, Florida Statutes? Yes No
Has the safe-deposit box been opened? Yes No
[A certificate of service as required by Florida Rule of Judicial
Administration 2.516 must be included if the incapacitated person is not a minor
under 14 years of age and is not totally incapacitated.]
I certify that the foregoing document has been furnished to .....(name,
address used for service, mailing address, and e-mail address)..... by .....(e-
mail) (delivery) (mail) (fax)..... on .....(date)…...
Guardian’s Signature
Guardian’s Printed Name:
Guardian’s Address:
Guardian’s Phone Number:
Guardian’s E-mail Address: