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If the inventory is filed, include the following notice if a minor is named in the caption or if the inventory contains other unredacted sensitive data. See § 6 of the Introduction in volume 1 of this manual concerning protection of sensitive data in filed documents. |
NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA
[Caption. See § 3 of the Introduction in volume 1 of this manual.]
Inventory and Appraisement of [name of party]
[Name], [Petitioner/Respondent], submits this inventory and appraisement of all assets and liabilities, community and separate estates, as follows:
Community Estate of the Parties
1.Real Property (include any property purchased by contract for deed, such as Texas Veterans Land Board property, property purchased in recreational developments, and time-shares)
1.1.Street address:
County of location:
Description of improvements, if any:
Legal description:
Current fair market value (as of [date]): $[amount]
Name of mortgage company and account number, if any:
Current balance of mortgage (as of [date]): $[amount]
Other liens against property (as of [date]): $[amount]
Current net equity in property: $[amount]
Source(s) of value:
|
Repeat for each piece of real estate. |
2.Mineral Interests (include any property in which the parties own the mineral estate, separate and apart from the surface estate, such as oil and gas leases; also include royalty interests, working interests, and producing and nonproducing oil and gas wells)
2.1.Name of mineral interest/lease/well:
Type of interest:
County of location:
Legal description:
Name of producer/operator:
Current value (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
3.Cash and Accounts with Financial Institutions (include cash, traveler’s checks, money orders, and accounts with commercial banks, savings banks, credit unions, and funds on deposit with attorneys and other third parties; exclude accounts with brokerage houses and all retirement accounts)
3.1.Name of financial institution:
Account name:
Account number:
Type of account: [checking/savings/money market/certificate of deposit]
Name(s) on withdrawal cards:
Current account balance (as of [date]): $[amount]
Source(s) of value/balance:
|
Repeat for each such item of property. |
4.Brokerage and Mutual Fund Accounts
4.1.Name of brokerage firm or mutual fund:
Address of brokerage firm or mutual fund:
Name(s) account held in:
Name of account (and subaccounts if any):
Account number (and numbers of subaccounts if any):
Margin loan balance (as of [date]): $[amount]
Value of community interest in each account (and
subaccounts if any) (as of [date]): $[amount]
Tax basis of each security held: $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
5.Publicly Traded Stocks, Bonds, and Other Securities (include securities not in a brokerage account, mutual fund, or retirement fund)
5.A.Stocks
5.A.1.Name of security:
Number of shares:
Type of security: [common stock/preferred stock/[other security]]:
Certificate number(s):
Location of certificate(s):
Name of exchange on which listed:
Pledged as collateral? [Yes/No]
Date acquired:
Tax basis: $[amount]
Current market value (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
5.B.Bonds
5.B.1.Name of issuer:
Address:
Serial number of bond: Denomination:
Date acquired:
Cost: $[amount]
Registered owner:
Source of funds:
Interest rate: Interest payable:
Convertible: Due date:
Pledged: [Yes/No]
Value (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
6.Employee Stock Benefit Plans (include all stock options (qualified and nonqualified), restricted stock awards (RSAs), restricted stock units (RSUs), and Employee Stock Purchase Plans)
6.A.Stock Options (include all stock options, whether exercisable, nonexercisable, vested, nonvested, transferable, or nontransferable, regardless of any restrictions on transfer, but if the stock was once an option and is currently owned without restrictions, list that stock under section 5.)
6.A.1.Name of company:
Date of option/grant:
Number of options:
Vesting schedule:
Are the options exercisable? [Yes/No]
Are the options registered? [Yes/No]
Current stock price:
Strike price:
If purchased, total purchase price of option contract (including commissions): $[amount]
Current net market value (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
6.B.Restricted Stock (include all restricted stock awards and restricted stock units regardless of any restrictions on transfer, but if the stock was once restricted and is currently owned without restrictions, list that stock under section 5.)
6.B.1.Name of company:
Date of award/grant:
Number of shares/units:
Vesting schedule:
Current stock price:
Current net market value (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
6.C.Employee Stock Purchase Plan
6.C.1.Name of company:
Number of shares/units:
Current stock price:
Current net market value (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
7.Bonuses
7.1.Name of company:
Spouse earning bonus:
Date bonus expected to be paid:
Time period covered by bonus:
Anticipated amount of bonus: $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
8.Closely Held Business Interests (include sole proprietorships, professional practices, corporations, partnerships, limited liability companies and partnerships, joint ventures, and other nonpublicly traded business entities)
8.1.Name of business:
Address:
Type of business organization:
Percentage of ownership (if partnership or LLC):
Number of shares owned (if corporation):
Value (as of [date]): $[amount]
Balance of accounts receivable if on cash basis accounting: $[amount]
Balance of liabilities if on cash basis accounting: <$[amount]>
Source(s) of value:
Assets owned by business (include financial accounts, real property, vehicles, equipment, etc. owned by the business):
|
Repeat for each such item of property. |
9.Retirement Benefits
9.A.Defined Contribution Plans (a plan that provides for an individual account for a participant and for benefits based solely on the amount contributed to the participant’s account; IRC §§ 401(k), 403(b))
9.A.1.Exact name of plan:
Name and address of plan administrator:
Employee spouse:
Employer:
Starting date of creditable service:
Account name:
Account number:
Account balance as of date of marriage:
Payee of survivor benefits:
Designated beneficiary(ies):
Current account balance (as of [date]): $[amount]
Balance of loan against plan: $[amount]
Value of community interest in plan (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
9.B.Defined Benefit Plan (any plan that is not a defined contribution plan and that usually involves payment of benefits according to a formula)
9.B.1. Exact name of plan:
Name and address of plan administrator:
Employee spouse:
Employer:
Starting date of creditable service:
Designated beneficiary(ies):
Payee of survivor benefits:
Description of benefits:
Value of community interest in plan (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
9.C.IRA/SEP
9.C.1. Name of financial institution:
Account name:
Account number:
Payee of survivor benefits:
Designated beneficiary(ies):
Current account balance (as of [date]): $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
9.D.Military Benefits
9.D.1. Branch of service:
Name of servicemember:
Rank/pay grade of servicemember:
Starting date of creditable service:
Status of servicemember: [active/reserve/retired]
Payee of survivor benefits:
Description of benefits:
Monthly benefit payable: $[amount]
Value of community interest in plan (as of [date]): $[amount]
Percentage of plan that is community: [percent]%
Source(s) of value:
|
Repeat for each such item of property. |
9.E.Nonqualified Plans (Not under ERISA)
9.E.1. Name of financial institution:
Account name:
Account number:
Account balance as of date of marriage:
Payee of survivor benefits:
Designated beneficiary(ies):
Value of community interest in plan (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
9.F.Government Benefits (civil service, teacher, railroad, state, and local)
9.F.1. Name of plan:
Account name:
Account number:
Account balance as of date of marriage:
Payee of survivor benefits:
Designated beneficiary(ies):
Value of community interest in plan (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
10.Other Deferred Compensation Benefits (e.g., worker’s compensation, disability benefits, other “special payments,” and any other forms of compensation)
10.1.[Name of party A]—description of assets:
Value: $[amount]
Source(s) of value:
10.2.[Name of party B]—description of assets:
Value: $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
11.Insurance and Annuities
11.A.Life Insurance
11.A.1.Name of insurance company:
Policy number:
Name of insured:
Name of owner:
Type of insurance: [term/whole/universal]
Amount of premiums [monthly/quarterly/
semiannually]: $[amount]
Date of issue:
Face amount:
Cash surrender value on date of marriage:
Current cash surrender value: $[amount]
Designated beneficiary(ies):
Balance of loan against policy: $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
11.B.Annuities
11.B.1.Name of company:
Policy number:
Name of annuitant:
Name of owner:
Type of annuity:
Amount of premiums [monthly/quarterly/
semiannually]: $[amount]
Date of issue:
Face amount:
Designated beneficiary(ies):
Value on date of marriage:
Current value (as of [date]): $[amount]
Balance of loan against policy: $[amount]
Value of community interest (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
11.C.Health Savings Accounts
11.C.1.Institution holding account:
Account number:
Name of high-deductible health plan with which the HSA is coupled:
Value of assets in account (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
11.D.Medical Savings Accounts
11.D.1.Institution holding account:
Account number:
Name of high-deductible health plan with which the MSA is coupled:
Value of assets in account (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
12.Motor Vehicles, Boats, Airplanes, Cycles, Etc. (include mobile homes, trailers, and recreational vehicles, but do not include vehicles owned by a business entity)
12.1.Year:
Make:
Model:
Name on title:
In possession of:
Vehicle identification number:
Name of creditor if loan against vehicle:
Current balance (as of [date]): $[amount]
Current fair market value (as of [date]): $[amount]
Current net equity in vehicle: $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
13.Money Owed to Me or My Spouse (include any expected federal or state income tax refund, but do not include receivables connected with a business entity)
13.1.Name of debtor:
Debtor’s relationship to you:
Is debt evidenced in writing? [Yes/No]
Is debt secured? [Yes/No]
Current loan amount owed (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
14.Household Furniture, Furnishings, and Fixtures
14.1.In possession of [name of party A] (attach separate sheet by room if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
14.2.In possession of [name of party B] (attach separate sheet by room if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
15.Electronics and Computers
15.1.In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
15.2.In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
16.Antiques, Artwork, and Collections (include any works of art, such as paintings, tapestry, rugs, and coin or stamp collections)
16.1.In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
16.2.In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
17.Miscellaneous Sporting Goods and Firearms
17.1.In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
17.2.In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
18.Jewelry and Other Personal Items
18.1.In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
18.2.In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
19.Livestock and Pets (include cattle, horses, frozen semen or embryos, dogs, cats, and so forth)
19.1.In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
19.2.In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
20.Club Memberships
20.1.Name of club:
Name membership held in:
Account number:
Current value (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
21.Travel Award Benefits (include frequent-flyer mileage accounts)
21.1.Name of airline:
Account number and name on account:
Current number of miles or points (as of [date]):
Current value (if any): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
22.Other Assets
22.A.Miscellaneous Assets (include intellectual property (such as musical, literary, and artistic/creative works; discoveries and inventions; copyright, trademarks, patents, and so forth), licenses, crops, farm equipment, construction equipment, tools, leases, cemetery lots, gold or silver coins not part of a collection described elsewhere in this inventory, estimated tax payments, tax overpayments, loss carry-forward deductions, lottery tickets/winnings, stadium bonds, stadium seat licenses, seat options, season tickets, ranch brands, and business names)
22.A.1. In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
22.A.2. In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
22.B.Digital Assets (identify assets—anything that exists in digital form, i.e., data in the form of binary digits, including such things as Bitcoin or other forms of cryptocurrency, e-mail addresses, social network accounts, websites, domain names, digital media such as pictures, music, e-books, movies, and videos, blogs, reward points, digital storefronts, artwork, and data storage accounts)
22.B.1. In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
22.B.2. In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
22.C.Virtual Assets (identify assets—intangibles used in virtual worlds or MMORPGs (massively multiplayer online role playing games), virtual pets, avatars, accessories for characters, prizes, virtual real estate, and virtual currency)
22.C.1. In possession of [name of party A] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party A]: $[amount]
Source(s) of value:
22.C.2. In possession of [name of party B] (attach separate sheet if necessary):
Description and value of each item in possession of [name of party B]: $[amount]
Source(s) of value:
22.D.Tax Assets (tax refunds, estimated tax payments, carryovers, carryforwards, etc.)
22.D.1. Income tax refunds
Income tax year for the refund:
Amount of income tax refund: $[amount]
22.D.2. Estimated tax payments
Applicable income tax year:
Amount of estimated payments made: $[amount]
22.D.3. Income tax carryover/carryforward
Applicable income tax year:
Amount of income tax carryover/carryforward: $[amount]
23.Safe-Deposit Boxes
23.1.Name of financial institution or other depository:
Box number:
Names of persons with access to contents:
Items in safe-deposit box:
Value(s) of items in safe-deposit box:
Source(s) of value:
|
Repeat for each safe-deposit box. |
24.Storage Facilities
24.1.Name and location:
Unit number:
Terms and length of lease:
Names of persons with access to contents:
Items in storage unit:
Value(s) of items in storage unit:
Source(s) of value:
|
Repeat for each storage facility. |
25.Community Claim for Reimbursement
25.1.Reimbursement claim against [name of party A]’s separate estate:
Basis of claim:
Amount claimed (as of [date]): $[amount]
Source(s) of value:
25.2.Reimbursement claim against [name of party B]’s separate estate:
Basis of claim:
Amount claimed (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such claim. |
26.Reconstitution of the Community Estate for Fraud or Waste
26.1.[Name of party A]’s claim for reconstitution of the community estate
Value: $[amount]
Source(s) of value:
26.2.[Name of party B]’s claim for reconstitution of the community estate
Value: $[amount]
Source(s) of value:
27.Contingent Assets (e.g., lawsuits by either party against a third party)
27.1.Nature of claim:
Amount of claim: $[amount]
Source(s) of value:
|
Repeat for each such asset. |
28.Sole and Joint Liabilities
28.A.Credit Cards and Charge Accounts
28.A.1.Name of creditor:
Account number:
Name(s) on account:
Current balance (as of [date]): <$[amount]>
Balance on date of marriage: <$[amount]>
Balance as of [date of separation]: <$[amount]>
Source(s) of balance:
28.B.Federal, State, and Local Tax Liability
28.B.1. Amount owed in any previous tax year: [year] <$[amount]>
[describe liability, e.g., federal income tax/property
taxes]
Source(s) of amount owed:
28.B.2. Amount owed for current year [year]: <$[amount]>
Source(s) of amount owed:
28.C.Attorney’s Fees in This Case
28.C.1. [Name of party A] (as of [date]): <$[amount]>
28.C.2. [Name of party B] (as of [date]): <$[amount]>
28.D.Other Professional Fees in This Case
28.D.1. [Name of party A] (as of [date]): <$[amount]>
28.D.2. [Name of party B] (as of [date]): <$[amount]>
28.E.Other Liabilities Not Otherwise Listed in This Inventory (e.g., loans and margin accounts, if not previously disclosed)
28.E.1.Name of creditor:
Account number:
Party incurring liability:
Is loan evidenced in writing? [Yes/No]
Current balance (as of [date]): <$[amount]>
Security, if any:
Source(s) of balance:
28.F.Reimbursement Claims against Community Estate
28.F.1. Reimbursement claim by [name of party A]’s separate estate:
Basis of claim:
Amount of claim (as of [date]): <$[amount]>
Source(s) of amount:
28.F.2. Reimbursement claim by [name of party B]’s separate estate:
Basis of claim:
Amount of claim (as of [date]): <$[amount]>
Source(s) of amount:
28.G.Pledges (include charitable, church, and school related)
28.G.1.Name and address of recipient:
Date of pledge:
Total amount of pledge: <$[amount]>
Is pledge payable in installments? [Yes/No]
Date each installment payment is due:
Amount of each installment:
28.H.Contingent Liabilities (e.g., lawsuit against either party, guaranty either party may have signed)
28.H.1.Name of creditor:
Name of person primarily liable:
Amount of contingent liability: <$[amount]>
Nature of contingency:
Source(s) of amount:
|
Repeat for each such sole or joint liability. |
Separate Estates of the Parties
(generally defined as assets owned before marriage or assets acquired during marriage by gift or inheritance or as a result of personal injury; may include real property, mineral interests, cash and financial accounts, brokerage and mutual fund accounts, stocks, bonds, other securities, stock options, bonuses, closely held business interests, retirement benefits, deferred compensation benefits, insurance and annuities, vehicles, boats, airplanes, cycles, notes receivable, household furnishings, electronics, antiques, art, miscellaneous sporting goods and firearms, jewelry and other personal items, livestock, club memberships, travel awards, miscellaneous assets, digital assets, virtual assets, and contingent assets)
29.Separate Assets of [name of party A]
29.1.Description of asset:
Date property acquired:
How acquired (e.g., by gift, by devise, by descent, or owned before marriage):
Current value (as of [date]): $[amount]
Source(s) of value:
29.2.[Name of party A]’s separate reimbursement claim against community estate:
Value (as of [date]): $[amount]
Source(s) of value:
29.3.[Name of party A]’s separate reimbursement claim against [name of party B]’s separate estate:
Value (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such asset or claim. |
30.Liabilities of [name of party A]’s Separate Estate
30.1.Description of liability:
Date of liability:
How liability acquired:
Amount of liability (as of [date]): <$[amount]>
Source(s) of amount:
30.2.[Name of party B]’s separate property reimbursement claim against [name of party A]’s separate estate:
Value (as of [date]): <$[amount]>
Source(s) of value:
30.3.Community estate’s reimbursement claim against [name of party A]’s separate estate:
Value (as of [date]): <$[amount]>
Source(s) of value:
|
Repeat for each such liability. |
31.Separate Assets of [name of party B]
31.1.Description of asset:
Date property acquired:
How acquired (e.g., by gift, by devise, by descent, or owned before marriage):
Value (as of [date]): $[amount]
Source(s) of value:
31.2.[Name of party B]’s separate reimbursement claim against community estate:
Value (as of [date]): $[amount]
Source(s) of value:
31.3.[Name of party B]’s separate reimbursement claim against [name of party A]’s separate estate:
Value (as of [date]): $[amount]
Source(s) of value:
32.Liabilities of [name of party B]’s Separate Estate
32.1.Description of liability:
Date of liability:
How liability acquired:
Amount of liability (as of [date]): <$[amount]>
Source(s) of amount:
32.2.[Name of party A]’s separate property reimbursement claim against [name of party B]’s separate estate:
Value (as of [date]): <$[amount]>
Source(s) of value:
32.3.Community estate’s reimbursement claim against [name of party B]’s separate estate:
Value (as of [date]): <$[amount]>
Source(s) of value:
|
Repeat for each such liability. |
Child[ren]’s Property
33.Child[ren]’s Property (e.g., custodial accounts under the Texas Uniform Gifts to Minors Act or Uniform Transfers to Minors Act, 529 plans)
33.A.Custodial Account under Texas Uniform Transfers to Minors Act
33.A.1.Name of financial institution:
Address of financial institution:
Name of account:
Account number:
Amount on deposit (as of [date]): $[amount]
Name of minor for whom funds were deposited:
Source(s) of value:
|
Repeat for each such item of property. |
33.B.529 Plans/Other College Savings Plans
33.B.1.Financial institution or entity administering plan:
Name on account:
Account number:
Type of plan: [529/prepaid/savings]
Value of assets in plan (as of [date]): $[amount]
Name of child for whom funds were deposited:
Custodian of account:
Source(s) of funds:
Source(s) of value:
|
Repeat for each such item of property. |
Trust and Estate Assets
34.Trusts
34.1.Name of trust:
Type of trust:
Name and address of trustee:
Beneficiary(ies):
Description of assets held in trust:
Date trust was created:
Value of assets held in trust (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
35.Assets Held by Either Party for the Benefit of Another (Other than Trusts)
35.1.Name(s) of person(s) holding assets:
Description of assets:
Name and title of fiduciary (e.g., executor, trustee):
Name of owner of beneficial interest:
Value of assets (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
36.Assets Held for the Benefit of Either Party as a Beneficiary (Other than Trusts)
36.1.Name(s) of person(s) holding assets:
Description of assets:
Name and title of fiduciary (e.g., executor, trustee):
Name of owner of beneficial interest:
Value of assets (as of [date]): $[amount]
Source(s) of value:
|
Repeat for each such item of property. |
|
See the practice notes at section 7.4 regarding whether to include the following verification. |
Verification
I, [name of party filing inventory and appraisement], state on oath that, to the best of my knowledge, this inventory and appraisement contains—
1.a full and complete list of all properties that I claim belong to the community estate of me and my spouse, with the values thereof;
2.a full and complete list of all properties in my possession or subject to my control that I claim or admit are my or my spouse’s separate property and estate, with the values thereof; and
3.a full and complete list of the debts that I claim are community indebtedness.
There may be other assets and liabilities in the control of my spouse of which I am not aware as of this date, and the omission of those items from this inventory should not be construed as a waiver of my interest in them.
[Name]
|
An unsworn declaration may be used in place of a verification. See form 8-27. |
SIGNED under oath before me on ______________________________.
Notary Public, State of Texas