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MATHEWS & ASSOCIATES
Attorneys at Law
INVENTORY AND APPRAISEMENT
COMMUNITY ESTATE OF THE PARTIES
1. Real Property (include all property purchased by contract for deed, such as Texas Veterans Land Board property, property purchased in recreational developments, and time-shares)
1.1. Street address:_______________________________________________________
County of location:___________________________________________________
Date when purchased:________________________________________________
Description of improvements, if any:_____________________________________
Legal description:____________________________________________________
Current fair market value (as of ___________): $_____________
Name of mortgage company and account number, if any:______________________
Address of mortgage company:__________________________________________
Current balance of mortgage (as of _________): $_____________
Other liens against property:____________________________________________
Current net equity in property: $____________
1.2. Street address:_______________________________________________________
County of location:___________________________________________________
Date when purchased:________________________________________________
Description of improvements, if any:_____________________________________
Legal description:____________________________________________________
Current fair market value (as of ___________): $_____________
Name of mortgage company and account number, if any:_____________________
Address of mortgage company:__________________________________________
Current balance of mortgage (as of _________): $_____________
Other liens against property:____________________________________________
Current net equity in property: $____________
2. Mineral Interests (include any property in which the parties own the mineral estate, separate and apart from the surface estate, such as oil and gas leases; also include royalty interests, working interests, and producing and nonproducing oil and gas wells)
2.1. Name of mineral interest/lease/well:_______________________________________
Date purchased:______________________________________________________
Type of interest:______________________________________________________
County of location:____________________________________________________
Legal description:_____________________________________________________
Name of producer/operator:_____________________________________________
Current value (as of ________________): $___________
2.2. Name of mineral interest/lease/well:_____________________________________
Date purchased:______________________________________________________
Inventory & Appraisement CONFIDENTIAL Page 2
Type of interest:______________________________________________________
County of location:____________________________________________________
Legal description:_____________________________________________________
Name of producer/operator:_____________________________________________
Current value (as of ________________):$_____________
3. Cash and Accounts with Financial Institutions (include cash, Traveler’s checks, money orders, and accounts with commercial banks, savings banks, credit unions, and funds on deposit with attorneys and other third parties; exclude accounts with brokerage houses and all retirement accounts)
3.1. Name of financial institution:____________________________________________Account
name:________________________________________________________Account
number:_______________________________________________________Type of account: [checking/savings/money market/certificate of
deposit]:__________Name(s) on withdrawal
cards:___________________________________________Current account balance (as of _______________): $_________________
3.2. Name of financial institution:____________________________________________Account
name:_______________________________________________________Account
number:_______________________________________________________Type of account: [checking/savings/money market/certificate of
deposit]:__________Name(s) on withdrawal
cards:___________________________________________Current account balance (as of _______________): $_________________
3.3. Name of financial institution:____________________________________________Account
name:_______________________________________________________Account
number:______________________________________________________
Inventory & Appraisement CONFIDENTIAL Page 3
Type of account: [checking/savings/money market/certificate of deposit]:_________
Name(s) on withdrawal cards:___________________________________________
Current account balance (as of _______________): $___________________
4. Brokerage/Mutual Fund Accounts
4.1. Name of brokerage firm/mutual fund:______________________________________
Address of brokerage firm/mutual fund:_____________________________________
Name account held in:_________________________________________________
Name of account (and subaccounts if any):_________________________________
Account number (and numbers of subaccounts if any):Date Account
Opened:________________________________________________Source of Account
Funds:______________________________________________Margin loan balance (as of _________):
$___________________
4.2. Name of brokerage firm/mutual fund:______________________________________
Address of brokerage firm/mutual fund:_____________________________________
Name account held in:_________________________________________________
Name of account (and subaccounts if any):_________________________________
Account number (and numbers of subaccounts if any):Date Account
Opened:________________________________________________Source of Account
Funds:______________________________________________Margin loan balance (as of _________):
$___________________
4.3. Name of brokerage firm/mutual fund:______________________________________
Address of brokerage firm/mutual fund:_____________________________________
Name account held
Inventory & Appraisement CONFIDENTIAL Page 4
in:_________________________________________________Name of account (and subaccounts if
any):_________________________________Account number (and numbers of subaccounts if any):Date Account
Opened:________________________________________________Source of Account
Funds:______________________________________________Margin loan balance (as of _________):
$___________________
5. Publicly Traded Stocks, Bonds, and Other Securities (include securities not in a brokerage account, mutual fund, or retirement fund)
5.1. Name of security:______________________________________________________
Number of shares:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Type of security: [common stock/preferred stock/bond/[other security]]:___________
Certificate numbers:___________________________________________________
In possession of:_______________________________________________________
Name of exchange on which listed:________________________________________
Pledged as collateral? [Yes/No]___________________________________________
Current market value (as of ___________):$___________________
5.2. Name of security:______________________________________________________
Number of shares:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Type of security: [common stock/preferred stock/bond/[other security]]:___________
Certificate
Inventory & Appraisement CONFIDENTIAL Page 5
numbers:___________________________________________________In possession
of:_______________________________________________________Name of exchange on which
listed:________________________________________Pledged as collateral?
[Yes/No]___________________________________________Current market value (as of ___________):
$___________________
5.3. Name of security:______________________________________________________
Number of shares:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Type of security: [common stock/preferred stock/bond/[other security]]:___________
Certificate numbers:___________________________________________________
In possession of:_______________________________________________________
Name of exchange on which listed:________________________________________
Pledged as collateral? [Yes/No]___________________________________________
Current market value (as of ___________):$___________________
5.4. Name of security:______________________________________________________
Number of shares:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Type of security: [common stock/preferred stock/bond/[other security]]:___________
Certificate numbers:___________________________________________________
In possession of:_______________________________________________________
Name of exchange on which
Inventory & Appraisement CONFIDENTIAL Page 6
listed:________________________________________Pledged as collateral?
[Yes/No]___________________________________________Current market value (as of ___________):
$___________________
6. Stock Options (include all exercisable, nonexercisable, vested, and nonvested stock options regardless of any restrictions on transfer)
6.1. Name of company:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Date of option/grant:__________________________________________________
Vesting schedule:______________________________________________________
Number of options:____________________________________________________
Are the options exercisable? [Yes/No]_____________________________________
Are the options registered? [Yes/No]_______________________________________
Current stock price (as of ________):_______________________________________
Strike price:__________________________________________________________
Current net market value (as of __________):$___________________
6.2. Name of company:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Date of option/grant:__________________________________________________
Vesting schedule:______________________________________________________
Number of options:____________________________________________________
Are the options exercisable? [Yes/No]_____________________________________
Inventory & Appraisement CONFIDENTIAL Page 7
Are the options registered? [Yes/No]_______________________________________
Current stock price (as of ________):_______________________________________
Strike price:__________________________________________________________
Current net market value (as of __________):$___________________
6.3. Name of company:_____________________________________________________
Date Purchased/Acquired:_____________________________________________
Source of Funding to purchase/acquire:___________________________________
Date of option/grant:__________________________________________________
Vesting schedule:______________________________________________________
Number of options:____________________________________________________
Are the options exercisable? [Yes/No]_____________________________________
Are the options registered? [Yes/No]_______________________________________
Current stock price (as of ________):_______________________________________
Strike price:__________________________________________________________
Current net market value (as of __________):$___________________
7. Bonuses
7.1. Name of company:____________________________________________________
Date bonus expected to be paid:_________________________________________
Anticipated amount of bonus:$___________________
7.2. Name of company:____________________________________________________
Date bonus expected to be paid:_________________________________________
Anticipated amount of bonus:
Inventory & Appraisement CONFIDENTIAL Page 8
$___________________
8. Closely Held Business Interests (include sole proprietorships, professional practices, corporations, partnerships, limited liability companies and partnerships, joint ventures, and other nonpublicly traded business entities)
8.1. Name of business:_____________________________________________________
Address:___________________________________________________________
Date Started/Purchased/Acquired:_________________________________________
Source of Funding to start/purchase/acquire:_________________________________
Type of business organization:__________________________________________
Percentage of ownership:______________________________________________
Number of shares owned (if applicable):__________________________________
Value (as of ______________):$___________________
Balance of accounts receivable if on cash basis accounting: $___________________
Balance of liabilities if on cash basis accounting:<$_________________>
8.2. Name of business:_____________________________________________________
Address:___________________________________________________________
Date Started/Purchased/Acquired:_________________________________________
Source of Funding to start/purchase/acquire:_________________________________
Type of business organization:__________________________________________
Percentage of ownership:______________________________________________
Number of shares owned (if applicable):__________________________________
Value (as of ______________):$___________________
Balance of accounts receivable if on cash basis accounting: $___________________
Balance of liabilities if on cash basis accounting:
Inventory & Appraisement CONFIDENTIAL Page 9
<$_________________>
8.3. Name of business:_____________________________________________________
Address:___________________________________________________________
Date Started/Purchased/Acquired:_________________________________________
Source of Funding to start/purchase/acquire:_________________________________
Type of business organization:__________________________________________
Percentage of ownership:______________________________________________
Number of shares owned (if applicable):__________________________________
Value (as of ______________):$___________________
Balance of accounts receivable if on cash basis accounting: $___________________
Balance of liabilities if on cash basis accounting:<$_________________>
9. Retirement Benefits
9.A. Defined Contribution Plans (a plan that provides for an individual account for a participant and for benefits based solely on the amount contributed to the participant’s account; IRC §§ 401(k), 403(b))
9.A.1. Exact name of plan:_______________________________________________
Name and address of plan administrator:____________________________
Employee:____________________________________________________
Employer:______________________________________________________
Starting date of creditable service:___________________________________
Percentage employee is vested:____________________________________
Account name:________________________________________________
Account number:_______________________________________________
Account balance as of date of
Inventory & Appraisement CONFIDENTIAL Page 10
marriage:_____________________________Payee of survivor
benefits:________________________________________Designated
beneficiary:_________________________________________Current account balance (as of ___________):
$___________________Balance of loan against plan:
$___________________
9.A.2. Exact name of plan:_______________________________________________
Name and address of plan administrator:____________________________
Employee:____________________________________________________
Employer:______________________________________________________
Starting date of creditable service:___________________________________
Percentage employee is vested:____________________________________
Account name:________________________________________________
Account number:_______________________________________________
Account balance as of date of marriage:_____________________________
Payee of survivor benefits:________________________________________
Designated beneficiary:_________________________________________
Current account balance (as of ___________):$___________________
Balance of loan against plan: $___________________
9.A.3. Exact name of plan:_______________________________________________
Name and address of plan administrator:____________________________
Employee:____________________________________________________
Employer:______________________________________________________
Starting date of creditable
Inventory & Appraisement CONFIDENTIAL Page 11
service:___________________________________Percentage employee is
vested:____________________________________Account
name:________________________________________________Account
number:_______________________________________________Account balance as of date of
marriage:_____________________________Payee of survivor
benefits:________________________________________Designated
beneficiary:_________________________________________Current account balance (as of ___________):
$___________________Balance of loan against plan:
$___________________
9.B. Defined Benefit Plan (any plan that is not a defined contribution plan and that usually involves payment of benefits according to a formula)
9.B.1. Exact name of plan:______________________________________________
Name and address of plan administrator:______________________________
Employee:____________________________________________________
Employer:____________________________________________________
Starting date of creditable service:__________________________________
Percentage employee is vested:_____________________________________
Designated beneficiary:___________________________________________
Payee of survivor benefits:_______________________________________
Description of benefits:____________________________________________
9.B.2. Exact name of plan:______________________________________________
Name and address of plan administrator:______________________________
Employee:____________________________________________________
Inventory & Appraisement CONFIDENTIAL Page 12
Employer:____________________________________________________
Starting date of creditable service:__________________________________
Percentage employee is vested:_____________________________________
Designated beneficiary:___________________________________________
Payee of survivor benefits:_______________________________________
Description of benefits:____________________________________________
9.C. IRA/SEP
9.C.1. Name of financial institution:_______________________________________
Account name:________________________________________________
Account number:_______________________________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:__________________________________________
Current account balance (as of ___________): $______________
9.C.2. Name of financial institution:_______________________________________
Account name:________________________________________________
Account number:_______________________________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:__________________________________________
Current account balance (as of ___________): $______________
9.C.3. Name of financial institution:_______________________________________
Account name:________________________________________________
Account
Inventory & Appraisement CONFIDENTIAL Page 13
number:_______________________________________________Payee of survivor
benefits:_______________________________________Designated
beneficiary:__________________________________________Current account balance (as of ___________):
$______________
9.D. Military Benefits
9.D.1. Branch of service:________________________________________________
Name of service member:________________________________________
Rank/pay grade of service member:________________________________
Starting date of creditable service:_________________________________
Status of service member: [active/reserve/retired]_____________________
Payee of survivor benefits:_______________________________________
Description of benefits:__________________________________________
Monthly benefit payable: $______________
Current account balance (as of ___________): $______________
9.D.2. Branch of service:________________________________________________
Name of service member:________________________________________
Rank/pay grade of service member:________________________________
Starting date of creditable service:_________________________________
Status of service member: [active/reserve/retired]_____________________
Payee of survivor benefits:_______________________________________
Description of benefits:__________________________________________
Monthly benefit payable: $______________
Current account balance (as of ___________):
Inventory & Appraisement CONFIDENTIAL Page 14
$______________
9.E. Nonqualified Plans
9.E.1. Name of financial institution:_______________________________________
Account name:__________________________________________________
Account number:_________________________________________________
Account balance as of date of marriage:_____________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:____________________________________________
Current account balance (as of ___________): $______________
9.E.2. Name of financial institution:_______________________________________
Account name:__________________________________________________
Account number:_________________________________________________
Account balance as of date of marriage:_____________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:____________________________________________
Value of community interest in plan (as of __________):$______________
Current account balance (as of ___________): $______________
9.F. Government Benefits (civil service, teacher, railroad, state, and local)
9.F.1. Name of plan:__________________________________________________
Name of government employee:___________________________________
Account name:_________________________________________________
Account number:________________________________________________
Inventory & Appraisement CONFIDENTIAL Page 15
Account balance as of date of marriage:_______________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:__________________________________________
Current account balance (as of ___________): $______________
9.F.2. Name of plan:__________________________________________________
Name of government employee:___________________________________
Account name:_________________________________________________
Account number:________________________________________________
Account balance as of date of marriage:_______________________________
Payee of survivor benefits:_______________________________________
Designated beneficiary:__________________________________________
Current account balance (as of ___________): $______________
10. Other Deferred Compensation Benefits (e.g., worker’s compensation, disability benefits, other special payments, and other forms of compensation)
10.1. Husband’s description of assets:_________________________________________Value:
$______________
10.2. Wife’s description of assets:____________________________________________
Value: $______________
11. Insurance and Annuities
11.A.Life Insurance
Inventory & Appraisement CONFIDENTIAL Page 16
11.A.1. Name of insurance company:______________________________________
Policy number:_________________________________________________
Name of insured:______________________________________________
Name of owner:_______________________________________________
Type of insurance: [term/whole/universal]:_________________________
Amount of premiums [monthly/quarterly/semiannually]: $______________
Date of issue:________________________________________________
Face amount:________________________________________________
Cash surrender value on date of marriage:__________________________
Current cash surrender value:$______________
Designated beneficiary:________________________________________
Balance of loan against policy: $______________
11.A.2. Name of insurance company:______________________________________
Policy number:_________________________________________________
Name of insured:______________________________________________
Name of owner:_______________________________________________
Type of insurance: [term/whole/universal]:_________________________
Amount of premiums [monthly/quarterly/semiannually]: $______________
Date of issue:________________________________________________
Face amount:________________________________________________
Cash surrender value on date of marriage:__________________________
Current cash surrender value:$______________
Designated
Inventory & Appraisement CONFIDENTIAL Page 17
beneficiary:________________________________________Balance of loan against policy:
$______________
11.B.Annuities
11.B.1.Name of company:_______________________________________________
Policy number:_______________________________________________
Name of annuitant:______________________________________________
Name of owner:________________________________________________
Type of annuity:______________________________________________
Amount of premiums [monthly/quarterly/semiannually]: $______________
Date of issue:__________________________________________________
Face amount:__________________________________________________
Designated beneficiary:__________________________________________
Value on date of marriage:______________________________________
Current value (as of ____________):$______________
Balance of loan against policy: $______________
11.B.2.Name of company:_______________________________________________
Policy number:_______________________________________________
Name of annuitant:______________________________________________
Name of owner:________________________________________________
Type of annuity:______________________________________________
Amount of premiums [monthly/quarterly/semiannually]: $______________
Date of issue:__________________________________________________
Face
Inventory & Appraisement CONFIDENTIAL Page 18
amount:__________________________________________________Designated
beneficiary:__________________________________________Value on date of
marriage:______________________________________Current value (as of ____________):
$______________Balance of loan against policy:
$______________
12. Motor Vehicles, Boats, Airplanes, Cycles, etc. (including mobile homes, trailers, and recreational vehicles; exclude company-owned vehicles)
12.1.Year:_____________________________________________________________
Make:__________________________________________________________
Model:___________________________________________________________
Name on certificate of title:___________________________________________
In possession of:__________________________________________________
Vehicle identification number:_________________________________________
Name of creditor if loan against vehicle:_________________________________
Current balance (as of ___________): $______________
Current net equity in vehicle:$______________
12.2.Year:_____________________________________________________________
Make:__________________________________________________________
Model:___________________________________________________________
Name on certificate of title:___________________________________________
In possession of:__________________________________________________
Vehicle identification number:_________________________________________
Name of creditor if loan against vehicle:_________________________________
Inventory & Appraisement CONFIDENTIAL Page 19
Current balance (as of ___________): $______________
Current net equity in vehicle:$______________
12.3.Year:_____________________________________________________________
Make:__________________________________________________________
Model:___________________________________________________________
Name on certificate of title:___________________________________________
In possession of:__________________________________________________
Vehicle identification number:_________________________________________
Name of creditor if loan against vehicle:_________________________________
Current balance (as of ___________): $______________
Current net equity in vehicle:$______________
13. Money Owed to Me or My Spouse (include any expected federal or state income tax refund but do not include receivables connected with a business)
13.1. Name of debtor:____________________________________________________
Debtor’s relationship to you:_________________________________________
Is debt evidenced in writing? [Yes/No]________________________________
Is debt secured? [Yes/No]____________________________________________
Current loan amount owed (as of ___________):$______________
13.2. Name of debtor:____________________________________________________
Debtor’s relationship to you:_________________________________________
Is debt evidenced in writing? [Yes/No]________________________________
Is debt secured? [Yes/No]____________________________________________
Inventory & Appraisement CONFIDENTIAL Page 20
Current loan amount owed (as of ___________):$______________
14. Household Furniture, Furnishings, and Fixtures
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Inventory & Appraisement CONFIDENTIAL Page 21
20.
21.
22.
23.
24.
25.
26.
27.
28.
30.
(Please attach additional pages if necessary)
15. Electronics and Computers
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
6.
7.
8.
Inventory & Appraisement CONFIDENTIAL Page 22
9.
10.
16. Antiques, Artwork, and Collections (include any works of art, such as paintings, tapestry, rugs, and coin or stamp collections)
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
6.
7.
(Please attach additional pages if necessary)17. Miscellaneous Sporting Goods and Firearms
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
18. Jewelry and Other Personal Items
Item Description/Identification
Location Value
Inventory & Appraisement CONFIDENTIAL Page 23
1.
2.
3.
4.
5.
6.
19. Livestock (include cattle, horses, and so forth)
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
(Please attach additional pages if necessary)
20. Club Memberships
20.1. Name of club:______________________________________________________
Name membership held in:__________________________________________
Account number:___________________________________________________
Current value (as of ___________):$______________
Method of valuation:______________________________________________
20.2. Name of club:______________________________________________________
Inventory & Appraisement CONFIDENTIAL Page 24
Name membership held in:__________________________________________
Account number:___________________________________________________
Current value (as of ___________):$______________
Method of valuation:______________________________________________
20.3. Name of club:______________________________________________________
Name membership held in:__________________________________________
Account number:___________________________________________________
Current value (as of ___________):$______________
Method of valuation:______________________________________________
21. Travel Award Benefits (include frequent-flyer mileage accounts)
21.1. Name of airline:____________________________________________________Name of account holder:_____________________________________________Account
number:____________________________________________________Current number of miles (as of
____________):_________________________Current value (if any):
$______________
21.2. Name of airline:____________________________________________________
Name of account holder:_____________________________________________
Account number:____________________________________________________
Current number of miles (as of ____________):_________________________
Current value (if any):$______________
21.3. Name of airline:____________________________________________________
Name of account
Inventory & Appraisement CONFIDENTIAL Page 25
holder:____________________________________________Account
number:____________________________________________________Current number of miles (as of
____________):_________________________Current value (if any):
$______________
22. Miscellaneous Assets (intellectual property, licenses, crops, farm equipment, construction equipment, tools, leases, cemetery lots, gold/silver/coins not part of a collection described elsewhere in this inventory, estimated tax payments, tax overpayments, loss carry-forward deductions, lottery tickets/winnings, stadium bonds, stadium seat licenses, seat options, and season tickets)
Item Description/Identification
Location Value
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
23. Safe-Deposit Boxes
23.1. Name of financial institution or other depository:__________________________
Box
Inventory & Appraisement CONFIDENTIAL Page 26
number:_____________________________________________________Names of persons with access to
contents:_______________________________Items in safe-deposit
box:____________________________________________
23.2. Name of financial institution or other depository:__________________________
Box number:_____________________________________________________
Names of persons with access to contents:_______________________________
Items in safe-deposit box:____________________________________________
24. Storage Facilities
24.1. Name and location: Unit #:
Terms and length of lease:___________________________________________
Names of persons with access to contents:_______________________________
Items in storage unit:_________________________________________________
25. Community Claim for Reimbursement
25.1. Reimbursement claim against husband’s separate estate:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
25.2. Reimbursement claim against husband’s separate estate:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
25.3. Reimbursement claim against wife’s separate estate:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
Inventory & Appraisement CONFIDENTIAL Page 27
25.4. Rimbursement claim against wife’s separate estate:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
26. Equitable Interest(s) of Community Estate
26.1. Equitable interest due to financial contribution of community property to husband’s separate estate:Basis of
claim:_____________________________________________________Amount claimed (as of _________):
$______________
26.2. Equitable interest due to financial contribution of community property to wife’s separate estate:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
26.3. Equitable interest resulting from use of community property to pay debts on husband’s separate property:Basis of
claim:____________________________________________________Amount claimed (as of _________):
$______________
26.4. Equitable interest resulting from use of community property to pay debts on wife’s separate property:Basis of
claim:______________________________________________________Amount claimed (as of _________):
$______________
27. Contingent Assets (e.g., lawsuits by either party against a third party)
27.1. Nature of claim:____________________________________________________
Amount of claim$______________
27.2. Nature of
Inventory & Appraisement CONFIDENTIAL Page 28
claim:____________________________________________________Amount of claim
$______________
28. Community Liabilities
28.A.Credit Cards and Charge Accounts
28.A.1. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.A.2. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.A.3. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.A.4. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.A.5. Name of
Inventory & Appraisement CONFIDENTIAL Page 29
creditor:____________________________________________Account
number:____________________________________________Name(s) on
account:________________________________________Current balance (as of _________):
<$___________>
28.A.6. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.A.7. Name of creditor:____________________________________________
Account number:____________________________________________
Name(s) on account:________________________________________
Current balance (as of _________):<$___________>
28.B.Federal, State, and Local Tax Liability
28.B.1. Amount owed in any previous tax year: <$___________>
[describe liability, e.g., federal income tax/property taxes]
Amount owed for current year _________: <$___________>
28.B.2. Amount owed in any previous tax year: <$___________>
[describe liability, e.g., federal income tax/property taxes]
Amount owed for current year _________: <$___________>
28.B.3. Amount owed in any previous tax year: <$___________>
Inventory & Appraisement CONFIDENTIAL Page 30
[describe liability, e.g., federal income tax/property taxes]
Amount owed for current year _________: <$___________>
28.C.Attorney’s Fees in This Case
28.C.1. Husband (as of ________):<$___________>
28.C.2. Wife (as of __________):<$___________>
28.D.Other Professional Fees in This Case
28.D.1. Husband (as of ________):<$___________>
28.D.2. Wife (as of __________):<$___________>
28.E.Other Liabilities Not Otherwise Listed in This Inventory (e.g., loans, margin accounts, if not previously disclosed)
28.E.1. Name of creditor:___________________________________________
Account number:__________________________________________
Party incurring liability:_____________________________________
Is loan evidenced in writing? [Yes/No]__________________________
Current balance (as of _________):<$___________>
Security, if any:_____________________________________________
28.E.2. Name of creditor:___________________________________________
Account number:__________________________________________
Party incurring liability:_____________________________________
Is loan evidenced in writing? [Yes/No]__________________________
Current balance (as of _________):<$___________>
Security, if
Inventory & Appraisement CONFIDENTIAL Page 31
any:_____________________________________________
28.E.3. Name of creditor:___________________________________________
Account number:__________________________________________
Party incurring liability:_____________________________________
Is loan evidenced in writing? [Yes/No]__________________________
Current balance (as of _________):<$___________>
Security, if any:_____________________________________________
28.F.Reimbursement Claims against Community Estate
28.F.1. Reimbursement claim by husband’s separate estate:________________
Basis of claim:_____________________________________________
Amount of claim (as of _________):<$___________>
28.F.2. Reimbursement claim by wife’s separate estate:__________________
Basis of claim:_____________________________________________
Amount of claim (as of _________):<$___________>
28.G.Equitable Interest Claims against Community Estate
28.G.1. Equitable interest due to financial contribution of husband’s separate property to community estate: Basis of
claim:______________________________________________Amount of claim (as of _________):
<$___________>
28.G.2. Equitable interest due to financial contribution of wife’s separate property to community estate:Basis of
claim:______________________________________________Amount of claim (as of _________):
<$___________>
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28.G.3. Equitable interest resulting from use of husband’s separate property to pay community property debts:Basis of
claim:_____________________________________________Amount of claim (as of _________):
<$___________>
28.G.4. Equitable interest resulting from use of wife’s separate property to pay community property debts:Basis of
claim:______________________________________________Amount of claim (as of _________):
<$___________>
28.H. Pledges (include charitable, church, and school related)
28.H.1. Name and address of recipient:_________________________________
Date of pledge:____________________________________________
Total amount of pledge:<$___________>
Is pledge payable in installments? [Yes/No]_____________________
Date each installment payment is due:__________________________
Amount of each installment:_________________________________
28.I. Contingent Liabilities (e.g., lawsuit against either party, guaranty either party may have signed)
28.I.1. Name of creditor:__________________________________________
Name of person primarily liable:______________________________
Amount of contingent liability:<$___________>
Nature of contingency:_______________________________________
SEPARATE ESTATES OF THE PARTIES
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29. Separate Assets of Husband (generally defined as assets owned before marriage or assets acquired during marriage by gift or inheritance or as a result of personal injury)
29.1. Description of asset:_________________________________________________
Date property acquired:______________________________________________
How acquired(e.g., gift, devise, descent, or owned before marriage): Value (as of ________):
$____________
29.2. Description of asset:_________________________________________________
Date property acquired:______________________________________________
How acquired(e.g., gift, devise, descent, or owned before marriage): Value (as of ________):
$____________
29.3. Husband’s separate reimbursement claim against community estate:Amount of Claim (as of ________):
$____________
29.4. Husband’s separate reimbursement claim against wife’s separate estate:Amount of Claim (as of ________):
$____________
29.5. Equitable interest claim due to financial contribution of husband’s separate estate to community estate:Basis of
claim:____________________________________________________Amount of Claim (as of ________):
$____________
29.6. Equitable interest claim due to financial contribution of husband’s separate estate to wife’s separate estate:Basis of
claim:____________________________________________________Amount of claim (as of ________):
$____________29.7. Equitable interest claim resulting from use of husband’s separate property to
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pay debts on community property:Basis of
claim:____________________________________________________Amount of claim (as of ________):
$____________
29.8. Equitable interest claim resulting from use of husband’s separate property to pay debts on wife’s separate property:Basis of
claim:____________________________________________________Amount of claim (as of ________):
$____________
30. Liabilities of Husband’s Separate Estate
30.1. Description of liability:_______________________________________________
Date of liability:____________________________________________________
How liability acquired:______________________________________________
Amount of liability (as of __________): <$___________>
30.2. Wife’s separate property reimbursement claim against husband’s separate estate:
Value (as of ___________): <$___________>
30.3. Community estate’s reimbursement claim against husband’s separate estate:Value (as of ___________):
<$___________>
30.4. Equitable interest claim due to financial contribution of community property to husband’s separate estate:Basis of
claim:_____________________________________________________Amount of claim (as of _________):
<$___________>
30.5. Equitable interest claim due to financial contribution of wife’s separate property to husband’s separate estate:Basis of
claim:____________________________________________________Amount of claim (as of _________):
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<$___________>
30.6. Equitable interest claim resulting from use of community property to pay debts on husband’s separate property:Basis of
claim:______________________________________________________Amount of claim (as of _________):
<$___________>
30.7. Equitable interest claim resulting from use of wife’s separate property to pay debts on husband’s separate property:Basis of
claim:____________________________________________________Amount of claim (as of _________):
<$___________>
31. Separate Assets of Wife (generally defined as assets owned before marriage or assets acquired during marriage by gift or inheritance or as a result of personal injury)
31.1. Description of asset:_________________________________________________
Date property acquired:______________________________________________
How acquired(e.g., gift, devise, descent, or owned before marriage): Value (as of ________):
$____________
31.2. Description of asset:_________________________________________________
Date property acquired:______________________________________________
How acquired(e.g., gift, devise, descent, or owned before marriage): Value (as of ________):
$____________
31.3. Wife’s separate reimbursement claim against community estate:
Value (as of ________):$____________
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31.4. Wife’s separate reimbursement claim against husband’s separate estate:
Value (as of ________):$____________
31.5. Equitable interest claim due to financial contribution of wife’s separate estate to community estate:Basis of
claim:____________________________________________________Amount of claim (as of _________):
$_____________
31.6. Equitable interest claim due to financial contribution of wife’s separate estate to husband’s separate estate:Basis of
claim:_____________________________________________________Amount of claim (as of _________):
$_____________
31.7. Equitable interest claim resulting from use of wife’s separate property to pay debts on community property:Basis of
claim:____________________________________________________Amount of claim (as of _________):
$_____________
31.8. Equitable interest claim resulting from use of wife’s separate property to pay debts on husband’s separate property:Basis of
claim:____________________________________________________Amount of claim (as of _________):
$_____________
32. Liabilities of Wife’s Separate Estate
32.1. Description of liability:_______________________________________________
Date of liability:___________________________________________________
How liability acquired:_______________________________________________
Amount of liability (as of ___________):
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<$___________>
32.2. Husband’s separate property reimbursement claim against wife’s separate estate:
Value (as of ________):
<$___________>
32.3. Community estate’s reimbursement claim against wife’s separate estate: Value (as of ________):
<$___________>
32.4. Equitable interest claim due to financial contribution of community property to wife’s separate estate: Basis of
claim:____________________________________________________Amount of claim (as of _________):
<$___________>32.5. Equitable interest claim due to financial contribution of husband’s separate
property to wife’s separate estate: Basis of
claim:____________________________________________________Amount of claim (as of _________):
<$___________>
32.6. Equitable interest claim resulting from use of husband’s separate property to pay debts on wife’s separate estate: Basis of
claim:_____________________________________________________Amount of claim (as of _________):
<$___________>
32.7. Equitable interest claim resulting from use of community property to pay debts on wife’s separate property: Basis of
claim:____________________________________________________Amount of claim (as of _________):
<$___________>
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CHILD/CHILDREN’S PROPERTY
33. Child/Children’s Property (e.g., custodial accounts under the Texas Uniform Gifts to Minors Act or Uniform Transfers to Minors Act)
33.1. Name of financial institution:_________________________________________
Address of financial institution:________________________________________
Name of account:__________________________________________________
Account number:____________________________________________________
Amount on deposit (as of _____________): $______________
Name of minor for whom funds were deposited:__________________________
33.2. Name of financial institution:_________________________________________
Address of financial institution:________________________________________
Name of account:__________________________________________________
Account number:____________________________________________________
Amount on deposit (as of _____________): $______________
Name of minor for whom funds were deposited:__________________________
33.3. Name of financial institution:_________________________________________
Address of financial institution:________________________________________
Name of account:__________________________________________________
Account number:____________________________________________________
Amount on deposit (as of _____________): $______________
Name of minor for whom funds were deposited:__________________________
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33.4. Name of financial institution:_________________________________________
Address of financial institution:________________________________________
Name of account:__________________________________________________
Account number:____________________________________________________
Amount on deposit (as of _____________): $______________
Name of minor for whom funds were deposited:__________________________
TRUST AND ESTATE ASSETS
34. Assets Held by Either Party for the Benefit of Another (include formal/ informal trusts)
34.1. Name(s) of person(s) holding assets:____________________________________
Description of assets:_______________________________________________
Name and title of fiduciary (e.g., executor, trustee):________________________
Name of owner of beneficial interest:____________________________________
Value of assets (as of _________): $______________
35. Assets Held for the Benefit of Either Party as a Beneficiary (include formal/informal trusts)
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35.1. Name(s) of person(s) holding assets:___________________________________
Description of assets:______________________________________________
Name and title of fiduciary (e.g., executor, trustee):_______________________
Name of owner of beneficial interest:__________________________________
Value of assets (as of _________): $______________
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Verification
"I have read these instructions and I state that all the community- and separate-property
assets and liabilities are fully disclosed on the attached Preparation of Inventory and Appraisement."
Signature
Printed Name
Date:______________________________________
STATE OF TEXAS §
COUNTY OF TRAVIS §
This instrument was acknowledged before me on
by ____________________________.
Notary Public, State of Texas
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