Fla. Prob. R. 5.910

As amended through March 26, 2024
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 Address

Full Value

Is There Another 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 Name

Last 4 Digits of Account Number

Type of Asset

Full Value

Is There Another Owner? Yes or No

Is this a Depository Account? Yes or 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 Name and Address

Type of Asset

Full Value

Last 4 Digits of Account Number

Is There Another Owner? 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 Location

Full Value

Is There Another 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 of Liability

Last 4 Digits of Account Number

Is there Another 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 of Lawsuit or Claim

Estimated

Amount of Claim

Court

Address

Plaintiff's Name and Address

Describe Cause of Action

Date of

Debt

Occurrence

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

Description of Lawsuit or Claims

Case Number and Court Address

Defendant Name and Address

Describe Cause of Action

Attorney for Ward

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 Receipt

Estimated Amount

1.

2.

3.

______________________________________________________________________________

Section J: Trusts

Do you have entries for Section J? _____Yes _____No

Number

Name of Current Trustee and Address

Ward's Interest

Estimated Date Trust was Created

Value of the Ward's Interest in 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

[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:____________

FL. Prob. R. 5.910

Adopted by 301 So.3d 859, effective 9/3/2020.