Probate inventory

Name of executor(s) Allan Mattsson

Contact information 4567 Main St, Buffalo, NY 98052

Decedent's name August Bergquist

Street address 6789 Main St

City Buffalo State NY Zip 98052

SSN AAA-GG-SSSS Occupation Dentist

Date of birth Wednesday, December 8, 1965 Place of birth NY

Date of death Monday, June 19, 2023 Place of death NY
Additional information

Spouse, children and other dependents

Name Relationship Dependent Age Address Phone number Email

Mirjam Nilsson Personal representative No 30

Victoria Lindqvist Spouse Yes 35
Alexander Martensson Child Yes 12

Professional advisors
Advisor type Contact person Company Address Phone number Email

Accountant
Lawyer/Notary

Other

Probate checklist Probate inventories

 Checklist items Probate assets Value ($) Probate liabilities Value ($)

✔ Last will, testament or any other documents Bank accounts $0.00 Mortgages $0.00

✔ Safe deposit rental agreement and keys Personal investments $0.00 Personal loans and lines of credit $0.00

✖ Passwords for computers and online accounts Business interests $0.00 Business interests $0.00

✔ Living trust agreements Real estate $0.00 Credit cards $0.00

✔ Life insurance, health/accident and insurance policies Pension plans $0.00 Other liabilities $0.00

✔ Financial statements Insurance $0.00

✔ Income tax returns for the past three years Private loans and mortgages $0.00

✔ Birth and death certificates Interest in other estates and trusts $0.00

✖ Deeds, mortgages and lease statements Personal effects and other assets $0.00

☐ Unpaid bills and notes Assets total $0.00 Liabilities total $0.00
 Probate assets
Use this worksheet to create an inventory of the probate assets. You will need to determine the market value of each estate asset at date of death. Review all records, including financial statements, insurance policies and tax
returns to obtain market values. You may also need to get an appraisal of personal items (i.e., art work, collections, antiques, etc.). Be sure to include any foreign assets in the inventory as well, such as real estate, securities or
overseas business interests. You may wish to get professional assistance to obtain an accurate market value for foreign assets.

Total assets $0.00

Bank accounts
List all bank accounts including cash, traveler’s checks, money orders, and accounts with commercial banks, savings banks, credit unions, etc. Include all names listed on the account and actual cash value which refers to the
exact dollar and change amount at the time of death.

Financial institution Address Phone Account number Account type Balance Notes

Total $0.00

Personal investments
List cash accounts, margin accounts, tax free savings accounts, registered retirement savings plans (RRSPs), registered retirement income funds (RRIFs), locked-in RRIFs, locked-in RRSPs, life income funds, prescribed retirement
income funds, registered education savings plans, annuities, etc.

Company Address Phone Account number Beneficiary Market value Notes

Total $0.00

Business interests
List all business interests including sole proprietorships, professional practices, corporations, partnerships, limited liability companies and partnerships, joint ventures, and other non-publicly traded business entities.

Business name Address Phone Contact Type Value Notes

Total $0.00

Real estate
List any real property on which decedent and/or decedent’s surviving spouse/partner are an owner, joint owner or have an interest in any manner, including property purchased in recreational developments and time-shares.
Obtain copies of the deeds. Provide a description of the real estate with its physical address. List the fair market value of the property, based on the most recent assessment by the tax assessor.

Address Title held by Phone Contact Purchase price Market price Notes

Total $0.00 $0.00

Pension plans
List defined benefits, money purchases or defined contributions, DPSP or group RRSP, etc.

Company Phone Plan type Beneficiary Email Value Notes

Total $0.00

Insurance
Include living trusts, life insurance policies with named beneficiaries and investment accounts that transferred on death, as non-probate assets. If the court inquires about these assets, the executor can easily reference the list
of non-probate assets and explain their absence from the probate inventory.

Issuer Policy number Phone Beneficiary Face value Cash value Notes

Total $0.00 $0.00

Private loans and mortgages

List private loans and mortgages where the deceased person was the lender.

Name of borrower Address Phone Type Original amount Balance owed Notes

Total $0.00 $0.00

Interest in other estates and trusts

List assets registered in the deceased person’s name held on behalf of others (e.g. assets held by the deceased person as a trustee or assets held under a power of attorney).

Name of estate/trust Name of executor/trustee Phone Address Email Distribution amount Notes

Total $0.00

Personal effects and other assets

List all personal items for example; cars, jewelry, art, antiques, furniture. Include items that may have been held in a safety deposit box or safekeeping.

Item description Location Phone Contact Beneficiary Value Notes

Total $0.00
 `
Probate liabilities
Use this worksheet to capture the details of the estate's liabilities, both domestic and foreign. You will require a valuation of each liability as at the date of death.

Total Assets $0.00

Mortgages
Financial institution Address Phone Title held by Account number Balance Notes

Total $0.00

Personal loans and lines of credit

Financial institution Address Phone Account number Type Balance Notes

Total $0.00

Business interests
Business name Address Phone Contact Type Value Notes

Total $0.00

Credit cards
Credit card company Company address Phone Card number Expiry date Balance Notes

Total $0.00 $0.00

Other liabilities
Item description Location Phone Contact Beneficiary Value Notes

Total $0.00