New York Codes, Rules and Regulations › Title 22 - JUDICIARY › Subtitle D - Forms › Chapter VII - Surrogate's Court Forms › Subchapter A - Forms Authorized By Section 207.52 › Surrogate's Forms › Form I-1 - Inventory of assets

Current through Register Vol. 46, No. 28, July
					 10, 2024
SURROGATE'S COURT OF THE STATE OF NEW
						YORK
COUNTY OF ________
________x
IN THE MATTER OF THE ESTATE OF LIST OF
						ASSETS - INVENTORY
[RULE §
											207.20(c)
						]
Deceased. File No. ________
________x
The undersigned, a fiduciary or an
						attorney for the above estate, certifies that the following recapitulation
						constitutes the gross estate (for tax purposes) of the above decedent. The
						following documents are attached: [ ] a detailed list of assets; or a copy of
						one of the following: [ ] Form ET-90; [ ] Form TT-385; [ ] Form 706; or, Form
						706NA.
IF FORM ET-90 IS ATTACHED, ALL RIGHTS TO
						SECRECY UNDER TAX LAW § 994 ARE WAIVED
Date of Death: ____________ Date of
						Letters: ____________ Type of Letters: ____________
Name of Each Fiduciary:
						____________
(I) [FN3] ( ____________ and I jointly and
						severally) undertake that defendant will appear in
RECAPITULATION OF Non-probate, Joint
						Individually owned
ATTACHED SCHEDULES: or Trust Property by
						Decedent or
Payable to Estate
A. Real Estate $ ________ $
						________
B. Stocks and Bonds ________
						________
C. Mortgages, Notes, Cash, etc. ________
						________
D. Insurance on Decedent's Life ________
						________
E. Jointly Owned Property ________
						________
F. Miscellaneous & Trust Property
						________ ________
G. Transfers During Decedent's Life
						________ ________
H. Powers of Appointment ________
						________
I. Annuities ________ ________
TOTALS $ ________ $ ________
Cause of Action Pending for Filing Fee
						under § 2402 (8) ________
Wrongful Death or Conscious Filing Fee
						Initially Paid ________
Pain and Suffering: Balance (Refund) Due
						________
Amount Claimed $________
ATTORNEY Certified to be true on
						____________, 19 ________
Name ________
Address ________
_______________
Signature
________
Telephone ________
_______________
Print Name
1-1 (12/91)
GROSS ASSETS
(Attach Additional Sheets If
						Necessary)
A. REAL ESTATE (Individually owned
						property)
Description Date of Death Value
________ ________
________ ________
________ ________
B. STOCKS AND BONDS (Individually
						owned)
Description, Including Face
Amount of Bonds and
Number of Shares Date of Death
						Value
________ ________
________ ________
________ ________
C. MORTGAGES, NOTES AND CASH (Including
						Bank Deposits)
(Jointly owned property should be reported
						at E and trust property at F)
Description Date of Death Value
________ ________
________ ________
________ ________
D. INSURANCE ON DECEDENT'S LIFE
(1) Payable to Estate
Description Date of Death Value
________ ________
________ ________
________ ________
(2) Payable to Named Beneficiary
Description Date of Death Value
________ ________
________ ________
________ ________
E. JOINTLY OWNED PROPERTY (Real and
						Personal Property)
(1) Real Estate
Description Joint Tenant Date of Death
						Value
________ ________ ________
________ ________ ________
________ ________ ________
(2) Stocks and Bonds
Description Joint Tenant Date of Death
						Value
________ ________ ________
________ ________ ________
________ ________ ________
(3) Mortgages, Notes and Cash
Description Joint Tenant Date of Death
						Value
________ ________ ________
________ ________ ________
________ ________ ________
F. OTHER MISCELLANEOUS PROPERTY
(1) Individually Owned
Description Date of Death Value
________ ________
________ ________
________ ________
(2) Assets Passing to the Estate from
						Employment
Description Date of Death Value
________ ________
________ ________
________ ________
(3) Trust Property
Description Date of Death Value
________ ________
________ ________
________ ________
G. TRANSFERS DURING DECEDENT'S LIFE
Description Date of Death Value
________ ________
________ ________
________ ________
H. POWERS OF APPOINTMENT
Description Date of Death Value
________ ________
________ ________
________ ________
I. ANNUITIES
Description Date of Death Value
________ ________
________ ________
________ ________
CAUSE OF ACTION for decedent's wrongful
						death and for conscious pain and suffering, as well as any other type of
						action.
Court in which Index Amount
Description Action Pending Number
						Demanded
________ ________ ________ ________
________ ________ ________ ________
________ ________ ________
						________