Form 12. Inventory of Property and Debts

Name: Mailing Address: City, State, Zip Code: Daytime Phone Number: Evening Phone Number: Representing: [ ] Self [ ] Petitioner [ ] Respondent State Bar Number: ARIZONA SUPERIOR COURT, COUNTY OF __________ Case No. Petitioner ATLAS No. INVENTORY OF PROPERTY AND DEBTS Respondent [ ] HUSBAND [ ] WIFE I. PROPERTY List all property acquired during your marriage in which you or your spouse claims to have a community interest. If there is a dispute as to whether there is a community interest or obligation, indicate under “Contested Position.” Value of the property is its current fair market value, minus any encumbrances. Use additional paper if necessary. Description Date Acquired Value Contested Position Proposed allocation [H or W] A. Cash and Financial Institution Accounts: savings, checking, money market, etc. Include financial institution's name, branch and account number. 1. 2. 3. 4. 5. B. Investments: stocks, bonds, notes, certificates of deposit, mortgages, deeds of trust, etc. 6. 7. 8. C. Life Insurance: company name, owner, policy number, insured, beneficiary, death benefits and cash surrender value (if any) 9. 10. 11. 12. 13. D. Retirement Plans: pension, profit-sharing, 401(k), deferred compensation 14. 15. 16. 17. 18. 19. E. Real Property: 20. 21. 22. 23. F. Business Interests: corporations, partnerships, limited liability corporations, joint ventures, proprietorships 24. 25. 26. 27. G. Vehicles: cars, motorcycles, motor homes, boats, trailers, etc. 28. 29. 30. 31. 32. 33. H. Personal Property over $100 in Value: household goods, personal effects, antiques, objects of intrinsic value 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. I. Miscellaneous Assets: 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. II. DEBTS List all debts and installment payments you currently owe. Use additional paper if necessary. Creditor Name Purpose of Debt Unpaid Balance Min. Monthly Payment Date of last Payment Contested Position Proposed Allocation [H or W] 1. 2. 3. 4 . 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. I. Miscellaneous Assets: 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. II. DEBTS List all debts and installment payments you currently owe. Use additional paper if necessary. Creditor Name Purpose of Debt Unpaid Balance Min. Monthly Payment Date of last Payment Contested Position Proposed Allocation [H or W] 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. _________________________ Date Signature of [ ] Husband [ ] Wife [ ] Attorney for [ ] Husband [ ] Wife