Personal Property Inventory (United States)
This is an inventory of personal property. The form provided here is simply a sample of what the actual form looks like.
PERSONAL PROPERTY INVENTORY
TANGIBLE
Personal Property
(Automobiles, boats, jewelry, furs, silverware, china, art work, books, stamp collections, coin collections, household furniture, etc.)
Description __________________________
Date Acquired __________________________
Location __________________________
Current Value __________________________
Insurance __________________________
Other Basic Information __________________________
Description __________________________
Date Acquired __________________________
Location __________________________
Current Value __________________________
Insurance __________________________
Other Basic Information __________________________
Description __________________________
Date Acquired __________________________
Location __________________________
Current Value __________________________
Insurance __________________________
Other Basic Information __________________________
INTANGIBLE PROPERTY
Bonds
Description (Issuer Series, Rate, Date Acquired)
__________________________
Registration of Bonds (Form and Names)
__________________________
Face Amount __________________________
Cost or Other Basis __________________________
Current Value __________________________
Description (Issuer Series, Rate, Date Acquired)
__________________________
Registration of Bonds (Form and Names)
__________________________
Face Amount __________________________
Cost or Other Basis __________________________
Current Value __________________________
Description (Issuer Series, Rate, Date Acquired)
__________________________
Registration of Bonds (Form and Names)
__________________________
Face Amount __________________________
Cost or Other Basis __________________________
Current Value __________________________
Total __________________________
Bond Total __________________________
Stocks
Name of Company and Type of Stock
_____________________________________
Number of Shares __________________________________
Registration of Stock
(Form and Names) ____________________________________________________
Date Acquired ___________________________________
Cost or Other Basis ____________________________
Current Value __________________________________
INSURANCE
Type of Insurance __________________________
Name of Company __________________________
Policy Number __________________________
Expiration Dates __________________________
Name of Broker __________________________
Type of Insurance __________________________
Name of Company __________________________
Policy Number __________________________
Expiration Dates __________________________
Name of Broker __________________________
Type of Insurance __________________________
Name of Company __________________________
Policy Number __________________________
Expiration Dates __________________________
Name of Broker __________________________
LIFE INSURANCE
List all policies under which you are the insured.
Name of Company __________________________
Type of Policy __________________________
Policy Number __________________________
Present Cash Value __________________________
Face Amount __________________________
Owner __________________________
How will Proceeds Be Paid __________________________
Beneficiary __________________________
Name of Company __________________________
Type of Policy __________________________
Policy Number __________________________
Present Cash Value __________________________
Face Amount __________________________
Owner __________________________
How will Proceeds Be Paid __________________________
Beneficiary __________________________
Name of Company __________________________
Type of Policy __________________________
Policy Number __________________________
Present Cash Value __________________________
Face Amount __________________________
Owner __________________________
How will Proceeds Be Paid __________________________
Beneficiary __________________________
Total Present Cash Value __________________________
Total Face Amount __________________________
EMPLOYEE AND RETIREMENT BENEFITS
Employers Pension, Profit-sharing or Stock Bonus Plans
Plan 1 Name of Plan __________________________
Trustee, Insurance Company, or Administrator
__________________________
Amount Contributed by Employee __________________________
Amount Contributed by Employer __________________________
Retirement Benefit __________________________
Death Benefit __________________________
Present Value of Total Contributions __________________________
Amount Vested __________________________
Plan 2 Name of Plan __________________________
Trustee, Insurance Company, or Administrator
__________________________
Amount Contributed by Employee __________________________
Amount Contributed by Employer __________________________
Retirement Benefit __________________________
Death Benefit __________________________
Present Value of Total Contributions __________________________
Amount Vested __________________________
Plan 3 Name of Plan __________________________
Trustee, Insurance Company, or Administrator
__________________________
Amount Contributed by Employee __________________________
Amount Contributed by Employer __________________________
Retirement Benefit __________________________
Death Benefit __________________________
Present Value of Total Contributions __________________________
Amount Vested __________________________
GROUP LIFE, ACCIDENT, HEALTH, DEATH BENEFIT, AND DISABILITY PLANS
Plan 1 Name of Plan __________________________
Insurer of Trustee __________________________
Policy Number __________________________
Benefits __________________________
Beneficiary __________________________
Options Elected __________________________
Plan 2 Name of Plan __________________________
Insurer of Trustee __________________________
Policy Number __________________________
Benefits __________________________
Beneficiary __________________________
Options Elected __________________________
Plan 3 Name of Plan __________________________
Insurer of Trustee __________________________
Policy Number __________________________
Benefits __________________________
Beneficiary __________________________
Options Elected __________________________
SPLIT-DOLLAR LIFE INSURANCE
Enter here all information relating to split-dollar life insurance, e.g., name of company, policy number, form of agreement, face amount, net amount payable to beneficiary.
__________________________
__________________________
STOCK OPTIONS
Enter her all pertinent information relating to stock options held by you, e.g., option price, number of shares to which options extends, number of shares already purchased, price at which purchased, present market value per share, etc.
__________________________
__________________________
TRUSTS
Type of trust: Inter vivos ______________
Testamentary ______________
Name of settlor: _____________________________________________________________
Name and address of trustee:
___________________________________________________
Date trust executed if inter vivos:
_______________________________________________
Date will probated if testamentary:
______________________________________________
Court having supervision of trust:
_______________________________________________
Duration of trust:
____________________________________________________________
Present market value of trust corpus:
_____________________________________________
Rights and interest held by you:
_________________________________________________
Is trust revocable?
___________________________________________________________
ASSETS
Bank Accounts ______________________________
Bonds (Total U.S. Savings Bonds) ___________________________
(and others)___________________________
Stocks ___________________________
Non business receivables ___________________________
Life Insurance on your life ___________________________
Life insurance on lives of others ___________________________
Business interests ___________________________
Death benefits 3/4 Employee and Retirement plans ___________________________
Rights under estates and trusts including powers of appointment ___________________________
Miscellaneous assets ___________________________
ESTIMATED GROSS TOTAL ____________________________