Part 1                                                                               Case # ________

5 East Pine    Street                                                                                 Phone:      (302) 855-7875
P.O. Box 743                                                                                          Fax:    (302)    853-5871 
Georgetown, DE 19947                                                                                  sussexcountyde.gov

                                               STATE OF DELAWARE 
                                                        INVENTORY
                                                   Register of Wills 

                                                                                         DateFiled     : _____    ______________

Decedent’s Name:
Residence at Time of Death:
                                                                         Number and Street
                                                                 Decedent’s  Social Security #: 
                City, State  and Zip Code 
Date of Death:                                                   Date Letters   Granted:
Testate:                 Intestate:                              County:  New     Castle         Kent               Sussex  
Name of Personal Representative:
Address of Personal       Representative:
Name of Personal Representative:
Address of Personal       Representative:

Name and Address of Attorney,   if any:

                                                   GENERAL INSTRUCTIONS 
      Everyone required to file this Inventory form shall do so within three (3) months after the estate is opened, or within
three (3) months of the date of death when an estate is not opened. Extensions may be granted for good cause at the
discretion of the Register.  Any Personal Representative may be subject, personally and individually, to a fine under
12 Del. C. §   1906 if the Inventory is not filed on time.  The Inventory shall be filed in the Office of the Register of Wills of
the county in which the estate has been opened, or when no estate is opened, in the county where the Decedent lived at
the date of death. The Inventory shall list all  personal    property the Decedent owned at the date of death. It must also list
allreal estate  the Decedent owned at the date of death and must provide the parcel/lot number of each piece of real estate,
the names/address(es) of the new owner(s) of the real estate, and his/her/their relationship to the Decedent (for example,
son). The Inventory must also be filed in every county of the state in which the Decedent owned real estate at the date of
death. The person who is responsible for preparing and filing the Inventory must swear or affirm that the information in it is
true and correct before the Inventory will be treated as legally filed. 
      If  the  Decedent      died  before  January  1,  1999,  the  person  responsible  for  filing  this  Inventory  must  file    a  similar
inventory with the Divisi on of Revenue using its form. This must be done within nine (9) months from the date of death, not
from the date when the estate was opened.
      The person who opens an estate for a deceased person is called the “personal representative.” That term includes
an executor, administrator, and any other person     responsible for filing an Inventory.
      If more   space    is needed   on any of the following schedules, additional sheets of paper    of the same  size may  be       
inserted following the appropriate schedule, provided the added sheet refers to the schedule          it supplements.
      The value to be used for any property listed on this Inventory is the fair market value as of the date of death of the
Decedent.
        If the Decedent owned no property of the kind described in any of the following schedules, the word 
“None” should    be written on the page. Pages left blank will result in the Inventory being rejected.

                                                                                                                       Revised 07/2021

                                       SCHEDULE A 
                                SOLELY OWNED REAL       ESTATE        

Include tax parcel number, deed record number and an adequate description and/or address to identify all real
estate and complete the names and addresses and relationship of persons entitled to each parcel and share of
each person. Jointly owned property must be disclosed on  Schedule D.

                                                                                         VALUE AT DATE 
ITEM NO.                               DESCRIPTION 
                                                                                            OF DEATH 

            Please specify the name, address and phone number to whom the tax bill 
            should be mailed: 

TOTAL of Schedule A - Also list on corresponding line of Recapitulation page.                        $ 0.00

ESTATE OF: 
                                                                                            Revised 07/2021 

          SCHEDULE B 
          STOCKS AND BONDS                               

Jointly owned property must be disclosed on Schedule D. 

                                                                              DIVIDENDS OF 
                                                                              RECORD PRIOR TO 
                                                                              DEATH AND 
                                                         FAIR MARKET VALUE 
ITEM NO.  DESCRIPTION                                                         PAYABLE AFTER 
                                                         AT DATE OF DEATH 
                                                                              DEATH OR 
                                                                              INTEREST ACCRUED 
                                                                              TO DATE OF DEATH 

                      Subtotals                          $ 0.00               $ 0.00
TOTAL of Schedule B - Also list on corresponding line of Recapitulation page. $ 0.00

ESTATE OF:

                                                                              Revised 07/2021 

                                               SCHEDULE C 
                                    MORTGAGES,            NOTES, AND     CASH 

Include  money  in  banks  and/or  mortgages  or  moneys owed     to  Decedent  at  time  of  death.  Mortgages  or
moneys payable by Decedent are      not  incl  udable on this schedule. Do not list bank account numbers. Jointly
owned property should be disclosed on Schedule D.

                                                                                              INTEREST OR OTHER 
                                                                        FAIR MARKET VALUE 
ITEM NO.                   DESCRIPTION                                                        INCOME ACCRUED TO 
                                                                         AT DATE OF DEATH 
                                                                                                 DATE OF DEATH 

                                                          Subtotals                 $ 0.00                $ 0.00
TOTAL of Schedule C - Also list on corresponding line of            Recapitulation page.                  $ 0.00

ESTATE OF: 
                                                                                                      Revised 07/2021 

                                               SCHEDULE D 
                                      JOINTLY OWNED PROPERTY 

Did the decedent, at the time of death, own any  property   (s)  with another person with right of survivorship; or     
(b) with his/her wife/husband?      Yes    No. If   “Yes”, state the      name, relationship and address of each 
surviving co-tenant. Do not list bank account numbers.

           NAME                         RELATIONSHIP              ADDRESS (Number and Street, City, State and Zip Code 

A. 
B. 
C. 

                                                                                                  INTEREST OR OTHER 
                                 DESCRIPTION                              FAIR MARKET VALUE 
ITEM NO.                                                                                          INCOME ACCRUED TO 
                  (Identify co-tenant by using appropriate letter, above) AT DATE OF DEATH 
                                                                                                   DATE OF DEATH 

                                                           Subtotals                 $ 0.00                      $ 0.00
     TOTAL of Schedule D - Also list on corresponding line of             Recapitulation page.                   $ 0.00

ESTATE OF:

                                                                                                          Revised 07/2021 

                                                SCHEDULE E 
                                      MISCELLANEOUS PROPERTY 

List all other personal property not listed on another schedule, including, if owned by or payable to the decedent
or the decedent’s estate. For example, life insurance proceeds, employee death benefits, individual retirement
accounts, annuities, or anything else that is   NOT      payable     living to a    person      or atrust.   Jointly  owned property
must be disclosed on Schedule D. 

                                                                                                              INTEREST OR OTHER 
                                                                        FAIR MARKET VALUE 
ITEM NO.                         DESCRIPTION                                                                  INCOME ACCRUED TO 
                                                                                   AT DATE OF DEATH 
                                                                                                                     DATE OF DEATH 

                                                         Subtotals                                     $ 0.00               $ 0.00
TOTAL of Schedule E - Also list on corresponding line of                Recapitulation page.                                $ 0.00

ESTATE OF: 

                                                                                                                       Revised 07/2021 

                                                      RECAPITULATION
         The total at the bottom from each schedule should be listed with the corresponding line below.

SCHEDULE 
B      Stocks and Bonds                                      $ 0.00

C      Mortgages, Notes and Cash                             $ 0.00

E      Miscellaneous Property                                $ 0.00

       TOTAL OF PROBATE ASSETS 
       (Sum of B, C, and E)                                                                                    $ 0.00

A       Real Estate                                                                                            $ 0.00

D        Jointly Owned Property                                                                                $ 0.00

         GRAND TOTAL
       (Sum of B, C, E, A and D)                                                                               $ 0.00

                            OATH OR AFFIRMATION OF PERSONAL REPRESENTATIVE 

________________________________________________________ make(s) solemn oath (or affirmation) that 
he/she/they has/have made due inquiry concerning the goods, chattels, money and credits due and belonging 
to  ____________________________________________________,  “the  deceased  person,”  and  that  this 
Inventory contains all the goods, chattels, money and credits due or belonging to the deceased person that has 
come to the knowledge of the deponent (or affiant) and that the information contained in the Schedule of Real 
Estate and the information pertaining to Entireties and Jointly Owned Real and Personal Property is true to the 
best of his/her/their knowledge and belief. 

_______________________________________________              _______________________________________________
Personal Representative   - Sign in the presence of a Notary.Personal Representative - Sign in the presence of a notary.

Signed and sworn (or affirmed),      before me,  on this __________________________________________ , A.D., __________. 

                                                             __________________________________________________              
                                                             Register of Wills, Notary Public, or other qualified person    
                                                                       (State your title)                                    

                                                                                                            Revised 07/2021