Inventory and Valuation of Estate — G.S. 28A-20-1

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01ESTATE INFORMATION

Decedent Full Name *

County *

Estate File Number *

Date of Death *

Executor / Administrator Name *

Date of Qualification (Letters Issued) *

02REAL PROPERTY

Address / Description	Deed Book/Page	Date-of-Death Value

REAL PROPERTY TOTAL$0.00

03PERSONAL PROPERTY

BANK / FINANCIAL ACCOUNTS

Institution	Account Type	Balance at Death

INVESTMENT / BROKERAGE ACCOUNTS

Institution / Account	Account No. (last 4)	Value at Death

VEHICLES

Year / Make / Model	VIN (last 6)	Value at Death

LIFE INSURANCE PAYABLE TO ESTATE

Insurance Company	Policy Number	Face Value	Cash Value

RETIREMENT ACCOUNTS PAYABLE TO ESTATE

Institution / Account Type	Account No. (last 4)	Value at Death

BUSINESS INTERESTS

Business Name / Description	Ownership %	Value at Death

OTHER PERSONAL PROPERTY

Description	Value at Death

PERSONAL PROPERTY TOTAL$0.00

04TOTAL VALUES

GROSS ESTATE TOTAL $0.00

These totals auto-calculate from values entered above. Note: Assets passing outside the estate (joint tenancy, POD beneficiaries, trusts) should generally be excluded unless payable to the estate.

05CERTIFICATION UNDER PENALTY OF PERJURY

I, [Executor / Administrator Name], being duly sworn or affirmed, certify under penalty of perjury that the foregoing Inventory is a true and complete statement of all property belonging to the estate of the above-named decedent, including all property in my possession or control, as of the date of death, and that the values stated are, to the best of my knowledge and belief, the fair market values as of the date of death.

I acknowledge the certification above and affirm that all information provided is true and correct to the best of my knowledge. I understand this Inventory will be filed with the Clerk of Superior Court. *

DEADLINE & FILING

Due within 3 months of the date of qualification (Letters issued)
File with Clerk of Superior Court — no filing fee
A new inventory must be filed if substantial additional assets are discovered
Use fair market value as of the date of death for all assets
Assets passing outside the estate (POD accounts, joint tenancy, beneficiary designations) are generally excluded unless payable to the estate

STATUTORY REFERENCE

G.S. 28A-20-1Inventory requirement

G.S. 28A-20-2Failure to file inventory

G.S. 28A-20-3Amended inventory

G.S. 28A-21-1Accounts of administration

VALUATION TIPS

Real estate: use date-of-death appraisal or tax value as starting point
Bank accounts: use statement balance as of date of death
Stocks / mutual funds: use closing price on date of death
Vehicles: use NADA/KBB value as of date of death
Personal property: reasonable estimate; appraisal required for items over $5,000