CAUSE NO. IN THE MATTER OF § IN THE DISTRICT COURT …

CAUSE NO. ________________________

IN THE MATTER OF THE MARRIAGE OF

__________________________ and

__________________________

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IN THE DISTRICT COURT

?

?

? ______ JUDICIAL DISTRICT

?

?

COLLIN COUNTY, TEXAS

SWORN INVENTORY AND APPRAISEMENT

______________________, the Petitioner / Respondent, files this sworn inventory and appraisement of all assets and liabilities, community and separate estates, as follows:

COMMUNITY ESTATE OF THE PARTIES

1. REAL PROPERTY 1.1. Street address: ________________________________________________ City/County/State: _____________________________________________ Description of improvements, if any: ______________________________ ____________________________________________________________ Current fair market value: $_________________Appraised / Estimated Mortgage or Lien owed: $________________ as of __________________ Name(s) on mortgage: __________________________________________ Bank/Mortgage Company Name: _________________________________ Account No. _______________________ Is this a VA loan? Yes / No

1.2. Street address: ________________________________________________ City/County/State: _____________________________________________ Description of improvements, if any: ______________________________ ____________________________________________________________ Current fair market value: $_________________Appraised / Estimated Mortgage or Lien owed: $________________ as of __________________ Name(s) on mortgage: __________________________________________ Bank/Mortgage Company Name: _________________________________ Account No. _______________________ Is this a VA loan? Yes / No

Sworn Inventory of ________________________________

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2. CASH AND ACCOUNTS WITH FINANCIAL INSTITUTIONS 2.1. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: Checking / Savings / IRA / Money Market Trust / Stock Trading / Certificate of Deposit Name(s) on account: ___________________________________________ Balance: $____________________ as of ___________________________

2.2. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: Checking / Savings / IRA / Money Market Trust / Stock Trading / Certificate of Deposit Name(s) on account: ___________________________________________ Balance: $____________________ as of ___________________________

2.3. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: Checking / Savings / IRA / Money Market Trust / Stock Trading / Certificate of Deposit Name(s) on account: ___________________________________________ Balance: $____________________ as of ___________________________

2.4. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: Checking / Savings / IRA / Money Market Trust / Stock Trading / Certificate of Deposit Name(s) on account: ___________________________________________ Balance: $____________________ as of ___________________________

2.5. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: Checking / Savings / IRA / Money Market Trust / Stock Trading / Certificate of Deposit Name(s) on account: ___________________________________________ Balance: $____________________ as of ___________________________

Sworn Inventory of ________________________________

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3. ACCOUNTS RECEIVABLE

3.1. Name of Debtor: ______________________________________________ Debtor's Relationship to you: ____________________________________ Purpose of Loan: ______________________________________________ Is the debt evidenced in writing? Yes / No - If "Yes" attach a copy Is the debt secured? Yes / No - If "Yes" describe: ________________ ____________________________________________________________ Current loan balance: $________________ as of _____________________

3.2. Name of Debtor: ______________________________________________ Debtor's Relationship to you: ____________________________________ Purpose of Loan: ______________________________________________ Is the debt evidenced in writing? Yes / No - If "Yes" attach a copy Is the debt secured? Yes / No - If "Yes" describe: ________________ ____________________________________________________________ Current loan balance: $________________ as of _____________________

3.3. Name of Debtor: ______________________________________________ Debtor's Relationship to you: ____________________________________ Purpose of Loan: ______________________________________________ Is the debt evidenced in writing? Yes / No - If "Yes" attach a copy Is the debt secured? Yes / No - If "Yes" describe: ________________ ____________________________________________________________ Current loan balance: $________________ as of _____________________

3.4. Name of Debtor: ______________________________________________ Debtor's Relationship to you: ____________________________________ Purpose of Loan: ______________________________________________ Is the debt evidenced in writing? Yes / No - If "Yes" attach a copy Is the debt secured? Yes / No - If "Yes" describe: ________________ ____________________________________________________________ Current loan balance: $________________ as of _____________________

Sworn Inventory of ________________________________

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4. RETIREMENT ACCOUNTS

4.1. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: 401K / KEOGH / Defined Benefits Name(s) on account: ___________________________________________ Payee of survivor benefits: ______________________________________ Current Balance: $_____________________ (attach most recent statement) Value on date married: $_________________ (if more than $0 attach proof)

4.2. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: 401K / KEOGH / Defined Benefits Name(s) on account: ___________________________________________ Payee of survivor benefits: ______________________________________ Current Balance: $_____________________ (attach most recent statement) Value on date married: $_________________ (if more than $0 attach proof)

4.3. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: 401K / KEOGH / Defined Benefits Name(s) on account: ___________________________________________ Payee of survivor benefits: ______________________________________ Current Balance: $_____________________ (attach most recent statement) Value on date married: $_________________ (if more than $0 attach proof)

4.4. Name of Financial Institution: ____________________________________ Account Number: _____________________________________________ Type of Account: 401K / KEOGH / Defined Benefits Name(s) on account: ___________________________________________ Payee of survivor benefits: ______________________________________ Current Balance: $_____________________ (attach most recent statement) Value on date married: $_________________ (if more than $0 attach proof)

Sworn Inventory of ________________________________

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5. COMPANY AND/OR GOVERNMENT RETIREMENT BENEFITS

5.1 Employer/Sponsor: ____________________________________________ Plan Administrator: ____________________________________________ Plan type: Company Government Military Rail Road Other Employee Starting Date: ________________________________________ Years / Months credible service - current: _______________________ Years / Months credible service - on date of marriage: _____________ Percentage employee is vested: ________________ Is there a loan against this plan? Yes / No; If "Yes" balance$________ Current value of plan: $__________________ attach most recent statement

5.2 Employer/Sponsor: ____________________________________________ Plan Administrator: ____________________________________________ Plan type: Company Government Military Rail Road Other Employee Starting Date: ________________________________________ Years / Months credible service - current: _______________________ Years / Months credible service - on date of marriage: _____________ Percentage employee is vested: ________________ Is there a loan against this plan? Yes / No; If "Yes" balance$________ Current value of plan: $__________________ attach most recent statement

5.3 Employer/Sponsor: ____________________________________________ Plan Administrator: ____________________________________________ Plan type: Company Government Military Rail Road Other Employee Starting Date: ________________________________________ Years / Months credible service - current: _______________________ Years / Months credible service - on date of marriage: _____________ Percentage employee is vested: ________________ Is there a loan against this plan? Yes / No; If "Yes" balance$________ Current value of plan: $__________________ attach most recent statement

Sworn Inventory of ________________________________

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6. HUSBAND'S OTHER DEFERRED COMPENSATION BENEFITS

6.1 Description of benefits:: ________________________________________ Value: _________________________ Vesting date:_________________ Is Husband vested? Yes No; If "No" what event triggers vestment? ____________________________________________________________

6.2 Description of benefits:: ________________________________________ Value: _________________________ Vesting date:_________________ Is Husband vested? Yes No; If "No" what event triggers vestment? ____________________________________________________________

7. WIFE'S OTHER DEFERRED COMPENSATION BENEFITS

7.1 Description of benefits:: ________________________________________ Value: _________________________ Vesting date:_________________ Is Wife vested? Yes No; If "No" what event triggers vestment? ____________________________________________________________

7.2 Description of benefits:: ________________________________________ Value: _________________________ Vesting date:_________________ Is Wife vested? Yes No; If "No" what event triggers vestment? ____________________________________________________________

8. LIFE INSURANCE AND ANNUITIES

8.1 Company Name: ______________________________________________ Policy type: Term Whole Life Universal Annuity Other Name of Insured: _____________________________Owner: Yes No Beneficiary: _________________________________Owner: Yes No Monthly Premium $______________ Next payment due:______________ Date issued: _________________ Face Value: $____________________ Cash surrender value on date of marriage: $_________________________ Current cash surrender value: $___________________________________ Is there a loan against? Yes No If "Yes" what is owed: $___________

Sworn Inventory of ________________________________

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8.2 Company Name: ______________________________________________ Policy type: Term Whole Life Universal Annuity Other Name of Insured: _____________________________Owner: Yes No Beneficiary: _________________________________Owner: Yes No Monthly Premium $______________ Next payment due:______________ Date issued: _________________ Face Value: $____________________ Cash surrender value on date of marriage: $_________________________ Current cash surrender value: $___________________________________ Is there a loan against? Yes No If "Yes" what is owed: $___________

8.3 Company Name: ______________________________________________ Policy type: Term Whole Life Universal Annuity Other Name of Insured: _____________________________Owner: Yes No Beneficiary: _________________________________Owner: Yes No Monthly Premium $______________ Next payment due:______________ Date issued: _________________ Face Value: $____________________ Cash surrender value on date of marriage: $_________________________ Current cash surrender value: $___________________________________ Is there a loan against? Yes No If "Yes" what is owed: $___________

8.4 Company Name: ______________________________________________ Policy type: Term Whole Life Universal Annuity Other Name of Insured: _____________________________Owner: Yes No Beneficiary: _________________________________Owner: Yes No Monthly Premium $______________ Next payment due:______________ Date issued: _________________ Face Value: $____________________ Cash surrender value on date of marriage: $_________________________ Current cash surrender value: $___________________________________ Is there a loan against? Yes No If "Yes" what is owed: $___________

Sworn Inventory of ________________________________

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9. PUBLICLY TRADED STOCKS, BONDS, AND OTHER SECURITIES 9. Security Name: ______________________________________________ Security type: Stock Futures Treasury Bills Bonds Options Certificate numbers: ___________________________________________ Current Market Value of all shares /contracts controlled: $______________ Who has possession: ___________________ Exchange listed: __________ Pledged?: Yes No If "Yes", give details:________________________ ____________________________________________________________

9.2 Security Name: ______________________________________________ Security type: Stock Futures Treasury Bills Bonds Options Certificate numbers: ___________________________________________ Current Market Value of all shares /contracts controlled: $______________ Who has possession: ___________________ Exchange listed: __________ Pledged?: Yes No If "Yes", give details:________________________ ____________________________________________________________

9.3 Security Name: ______________________________________________ Security type: Stock Futures Treasury Bills Bonds Options Certificate numbers: ___________________________________________ Current Market Value of all shares /contracts controlled: $______________ Who has possession: ___________________ Exchange listed: __________ Pledged?: Yes No If "Yes", give details:________________________ ____________________________________________________________

9.4 Security Name: ______________________________________________ Security type: Stock Futures Treasury Bills Bonds Options Certificate numbers: ___________________________________________ Current Market Value of all shares /contracts controlled: $______________ Who has possession: ___________________ Exchange listed: __________ Pledged?: Yes No If "Yes", give details:________________________ ____________________________________________________________

Sworn Inventory of ________________________________

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