STATE OF SOUTH CAROLINA	)
)	IN THE PROBATE COURT
COUNTY OF:	)
)	ANNUAL REPORT OF TANGIBLE AND REAL ESTATE
IN THE MATTER OF:	)
)	CASE NUMBER:

PLEASE ANSWER THE FOLLOWING QUESTIONS

1.	Are the items of tangible personal property shown on Schedule F of the inventory still in existence? If so, where are they located?

2.	Have any items shown on the original inventory been disposed of?

Have any items of tangible personal property been acquired during the accounting period?

4.	Where are these new items located?

5.	Is proper casualty insurance carried on these tangible items of personal property? If so, list company and

amount of coverage.

6.	Does the protected person still own the real estate listed on Schedule A of the Inventory?

7.	Has the protected person acquired an interest in real estate that was not shown on the Inventory?

8.	Is proper casualty Insurance maintained, if necessary, on any real or personal property owned by the Protected Person? If so, list company, amount of coverage and effective dates of policy.

Executed this day of , 20 .

SWORN to before me this	day of	Signature:
, 20
Name:
Address:
Notary Public for South Carolina	Telephone (O):
My Commission Expires:
(H):

Check here if address or phone number has changed from last report

FORM #564PC (2/2004)

STATE OF SOUTH CAROLINA

2004-02-10

HMcCaw

SC Judicial Dept.