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STATE OF MICHIGAN

CASE NO. and JUDGE

PROBATE COURT
COUNTY

INVENTORY (CONSERVATORSHIP)
AMENDED

Court address

Court telephone no.

USE NOTE: The conservator must serve this completed inventory on all interested persons as required by Michigan Court
Rules 5.105 and 5.125. Then the conservator must complete a proof of service (form PC 564) and file it and this inventory
with the court.

In the matter of

First, middle, and last name

Name (type or print)

, am the conservator and submit the following as a complete

and accurate inventory of all the assets of the estate, including the fair market valuations as of the date of qualification as
conservator. I have listed on this inventory any property the protected individual owns jointly or in common with others,
including the type of ownership.

PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by
both the protected individual and others, specify the type of ownership in the description and
check the box in the column “Total Value of Property.” If the property has been used to secure
a loan, show the nature and amount of the lien. Definitions and instructions for completing the
inventory are on the next page.

LIEN
AMOUNT

TOTAL VALUE OF
PROPERTY
(without reduction
for lien)

TOTAL ASSETS

I declare under the penalties of perjury that this inventory has been examined by me and that its contents are true to the
best of my information, knowledge, and belief.

Attorney signature

Address

Attorney name (type or print) Bar no.

Name (type or print)

Date

Signature

Address

City, state, zip Telephone no.

JIS Code: INVApproved, SCAOForm PC 674, Rev. 1/21MCL 700.5417, MCR 5.409(B)Page 1 of 1DEFINITIONS:

• Real property means land, including a building or house that is built on the land.

• Personal property means everything that a person owns except real property. Personal property includes bank accounts
and checking accounts.

INSTRUCTIONS TO COMPLETE THE INVENTORY:

1. List all real and personal property in the column “Personal Property and Real Property Description.”

2. When listing real property, provide the legal description of the property and the name of any other owner.

a. If real property has been used to secure a loan (including an equity line of credit), show the nature and amount of the lien.

b. If the value of real property is determined by an appraisal, include the appraiser’s name and address and a description of

the property appraised.

c. Property that the protected individual owns jointly or in common with others must be listed along with the type of ownership.

The court may require additional information to support the value of property that is stated in the inventory.

3. When listing personal property, provide enough detail to adequately determine the value. Some items should be listed
separately and some items should be combined under one category. Provide the name and address of each financial

used most frequently by the conservator.

institution listed. The address of a financial institution shall be either that of the institution’s main headquarters or the branch

Do not provide financial account numbers on this form. If an account number is necessary to distinguish between accounts,
put it on form MC 97.

a. Examples of items that should be listed and valued separately are:

• Automobiles
• Jewelry
• Bank accounts
• Antiques
• Furniture
• Any other individual item of high value (such as a fur coat)

• Prepaid burial contracts
• Life insurance (cash value)
• Annuities
• Mutual funds
• Stocks and bonds

b. Examples of items that can be listed in categories are:

• Household items such as dishes, flatware, curtains, linens, utensils, clothing, furnishings, etc. can be grouped into
several categories or combined into one category.
• Multiple copies or pieces of a specific item that have the same value such as stocks and bonds.

c. If personal property has been used to secure a loan, show the nature and amount of the lien.

d. If the value of personal property is determined by an appraisal, include the appraiser’s name and address and a description

of the property appraised.

e. Property that the protected individual owns jointly or in common with others must be listed along with the type of ownership.

The court may require additional information to support the value of property that is stated in the inventory.

PC 674, Inventory (Conservatorship)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/conservatorship-protected-individuals (2023-03)
Page(s): 2
Fields(s): 53
Average fields per page: 26
Reading Level: Grade 11
LIST Grouping(s): HO-00-00-00-00, ES-00-00-00-00, ES-02-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

stat_e_f_michiga_n_probat_cour_county was STATE OF MICHIGAN PROBATE COURT COUNTY (0.62 conf)
amended was AMENDED (0.35 conf)
first_middle_last_name was First middle and last name (0.37 conf)
name_type_print__1 was Name type or print (0.45 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__1 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow1 (0.41 conf)
lie_n_amount_row__1 was LIEN AMOUNTRow1 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__2 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow2 (0.41 conf)
lie_n_amount_row__2 was LIEN AMOUNTRow2 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__3 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow3 (0.41 conf)
lie_n_amount_row__3 was LIEN AMOUNTRow3 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__4 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow4 (0.41 conf)
lie_n_amount_row__4 was LIEN AMOUNTRow4 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__5 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow5 (0.41 conf)
lie_n_amount_row__5 was LIEN AMOUNTRow5 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__6 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow6 (0.41 conf)
lie_n_amount_row__6 was LIEN AMOUNTRow6 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__7 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow7 (0.41 conf)
lie_n_amount_row__7 was LIEN AMOUNTRow7 (0.41 conf)
persona_l_propert_rea_descriptio_n_property_owned_protected_individual_others_specify_type_ownership_description_check_box_column_total_value_used_secure_loan_show_nature_amount_lien_definitions_instructions_completing_inventory_side_row__8 was PERSONAL PROPERTY AND REAL PROPERTY DESCRIPTION If the property is owned by both the protected individual and others specify the type of ownership in the description and check the box in the column Total Value of Property If the property has been used to secure a loan show the nature and amount of the lien Definitions and instructions for completing the inventory are on the other sideRow8 (0.41 conf)
lie_n_amount_row__8 was LIEN AMOUNTRow8 (0.41 conf)
tota_l_assets was TOTAL ASSETS (0.46 conf)
signature_date was Date (1.00 conf)
attorney_name_type_print was Attorney name type or print (0.50 conf)
bar was Bar no (0.41 conf)
name_type_print__2 was Name type or print_2 (0.40 conf)
users1_address_line_one was Address (1.00 conf)
address was Address_2 (0.35 conf)
users1_address_line_two was City state zip (1.00 conf)
telephone__1 was Telephone no (0.44 conf)
city_state_zip was City state zip_2 (0.35 conf)
telephone__2 was Telephone no_2 (0.45 conf)
cas_e was CASE NO (0.47 conf)
judge was Judge (0.39 conf)
text__1 was Text2 (0.35 conf)
text__2 was Text3 (0.35 conf)
text__3 was Text400 (0.35 conf)
text__4 was Text401 (0.35 conf)
text__5 was Text402 (0.35 conf)
text__6 was Text403 (0.35 conf)
text__7 was Text404 (0.35 conf)
text__8 was Text405 (0.35 conf)
text__9 was Text406 (0.35 conf)
text__10 was Text407 (0.35 conf)
text__11 was Text5 (0.35 conf)
text__12 was Text6 (0.35 conf)
check_box__1 was Check Box100 (0.37 conf)
check_box__2 was Check Box102 (0.37 conf)
check_box__3 was Check Box103 (0.37 conf)
check_box__4 was Check Box105 (0.37 conf)
check_box__5 was Check Box106 (0.37 conf)
check_box__6 was Check Box107 (0.37 conf)
check_box__7 was Check Box101 (0.37 conf)
check_box__8 was Check Box108 (0.37 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

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lie_n_amount_row__2
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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

PC 674, Inventory (Conservatorship)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02