This form contains 60 fields organized into 18 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Appraisal Values
Total Appraisal by Representative Number
Enter the total appraisal value by the representative, guardian, or conservator, as detailed in Attachment 1.
Total Appraisal by Referee Number
Enter the total appraisal value by the referee, as detailed in Attachment 2.
Total Appraisal Sum Number
Enter the total sum of all appraisals.
Attorney or Party Information
Attorney or Party Information Text
Provide the name, State Bar number, and address for the attorney or party without an attorney.
Telephone Number Text
Enter the telephone number of the attorney or party.
Fax Number (Optional) Text
Provide the optional fax number of the attorney or party.
Email Address (Optional) Text
Enter the optional email address of the attorney or party.
Attorney For Name Text
State the name of the party for whom the attorney is acting.
Bond Statement Signature
Bond Statement Date Date
Enter the date the bond statement is signed.
Bond Statement Signer Printed Name Text
Enter the typed or printed name and title of the corporate officer signing the bond statement.
Case Information
Case Number Text
Enter the case number for this legal proceeding.
Date of Death or Appointment Date
Enter the date of death of the decedent or the date of appointment of the guardian or conservator.
Case Number
Case Number Text
Enter the case number for this form.
Commission and Expenses
Statutory Commission Number
Enter the amount of the statutory commission.
Expenses Number
Enter the amount of the expenses incurred.
Total Commission and Expenses Number
Enter the total amount of commission and expenses.
Court Information
County Text
Enter the name of the county for the Superior Court of California.
Street Address Text
Enter the street address of the court.
Mailing Address Text
Enter the mailing address of the court.
Branch Name Text
Enter the specific branch name of the court.
City and Zip Code Text
Enter the city and zip code of the court.
Declaration Signature
Declaration Date Date
Enter the date of the declaration.
Declarant Printed Name and Title Text
Enter the printed name and title of the person making the declaration.
Declaration Statement
All Estate Checkbox
Check this box if the attached inventories, along with all prior inventories, constitute a true statement of the entirety of the estate.
A Portion of Estate Checkbox
Check this box if the attached inventories, along with all prior inventories, constitute a true statement of only a portion of the estate.
Number of Attachments/Inventories in Statement Text
Enter the number of attachments and prior inventories that together form a true statement of the estate.
Estate Information
Estate Name Text
Enter the full name of the estate.
Decedent Checkbox
Check this box if the estate information pertains to a deceased person.
Conservatee Checkbox
Check this box if the estate information pertains to a conservatee.
Minor Checkbox
Check this box if the estate information pertains to a minor.
Estate Name
Estate Name Text
Enter the full name of the estate.
Estate Type
Decedent Estate Type Checkbox
Check this box if the estate type is for a decedent.
Conservatee Estate Type Checkbox
Check this box if the estate type is for a conservatee.
Minor Estate Type Checkbox
Check this box if the estate type is for a minor.
General
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Inventory and Appraisal Type
Partial No. Checkbox
Check this box if the inventory and appraisal is a partial filing, indicating that not all assets are included in this appraisal.
Partial Inventory Number Text
Enter the partial inventory number.
Final Checkbox
Check this box if this is the final inventory and appraisal for the estate.
Supplemental Checkbox
Check this box if this inventory and appraisal is an addition to a previously filed one.
Corrected Checkbox
Check this box if this inventory and appraisal is a corrected version of a previously filed one.
Reappraisal for Sale Checkbox
Check this box if this inventory and appraisal is specifically for the purpose of reappraising assets prior to their sale.
Property Tax Certificate Checkbox
Check this box if this inventory and appraisal is being submitted as a property tax certificate.
Probate Referee Requirement
No probate referee is required Checkbox
Check this box if no probate referee is required for the inventory and appraisal.
By order of the court dated Checkbox
Check this box if no probate referee is required specifically by an order of the court, and then specify the date of that order.
Probate Referee Requirement Date Date
Enter the date of the court order specifying that no probate referee is required.
Property Tax Certificate Certification
Property Tax Certificate a. Not Applicable Checkbox
Check this box if the property tax certificate requirements are not applicable because the decedent owned no real property in California at the time of death.
Property Tax Certificate b. Requirements Satisfied Checkbox
Check this box if the property tax certificate requirements have been satisfied by filing a change of ownership statement with the county recorder or assessor for each county in California where the decedent owned property at the time of death.
Referee Declaration
Declaration Date Date
Enter the date of the declaration.
Referee's Printed Name Text
Enter the typed or printed name of the referee.
Statement About The Bond
6. Bond Waived or Sole Fiduciary Is Corporate/Exempt Checkbox
Check this box if the bond is waived, or if the sole fiduciary is a corporate fiduciary or an exempt government agency.
7. Bond Filed In Amount Checkbox
Check this box if a bond has been filed and specify the amount in the adjacent field.
Bond Amount Number
Enter the monetary amount of the bond filed.
7. Bond Amount Sufficient Checkbox
Check this box if the filed bond amount is sufficient.
7. Bond Amount Insufficient Checkbox
Check this box if the filed bond amount is insufficient.
8. Receipts For Deposits Filed Checkbox
Check this box if receipts for deposits have been filed with the court for a blocked account and specify the institution and location.
Receipts Amount Number
Enter the monetary amount for which receipts have been filed.
Blocked Account Institution and Location Text
Provide the name and location of the institution where deposits for the blocked account have been filed.