INVENTORY AND APPRAISAL — WORKING DRAFT
Judicial Council Form DE-160
SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE — PROBATE DIVISION
| Estate of: | Dolores Maria Mendoza, Deceased |
| Case Number: | 30-2026-00123481-PR-PW-CJC (FICTIONAL) |
| Date of Death: | October 31, 2025 |
| Personal Representative: | Ana Mendoza (Executor — Letters Testamentary Pending) |
| Attorney for Petitioner: | [ATTORNEY NAME — STATE BAR NO. ######] |
| Date of Preparation: | April 28, 2026 (WORKING DRAFT — NOT FILED) |
DRAFT STATUS: This document is a working draft prepared by the paralegal in advance of probate referee assignment. Values marked [REFEREE APPRAISAL PENDING] will be updated upon receipt of the probate referee’s formal appraisal. This draft should not be filed or distributed without attorney review and referee completion.
SCHEDULE A — REAL PROPERTY
Assets subject to formal appraisal by court-appointed probate referee
Item A-1
| Field | Detail |
|---|---|
| Description | Single-family residential property |
| Address | 4817 Willow Creek Drive, Santa Ana, California 92704 (FICTIONAL ADDRESS) |
| Assessor’s Parcel No. (APN) | 197-342-08 (FICTIONAL) |
| Legal Description | Lot 22, Block 14, Willow Creek Tract, as per Map Book 188, Pages 41–42, Official Records of Orange County, California (FICTIONAL) |
| Title Vested In | Dolores Maria Mendoza, an unmarried woman |
| Mortgage/Lien | None — mortgage fully satisfied 2018 per client representation; title search pending |
| Informal Estimate (Broker Opinion, Dec. 2025) | $720,000 |
| Probate Referee Appraised Value | [REFEREE APPRAISAL PENDING — Referee not yet appointed] |
Schedule A Subtotal: $720,000 (estimated) | [PENDING formal appraisal]
SCHEDULE B — PERSONAL PROPERTY
Assets appraised at date-of-death fair market value using account statements or standard valuation
Item B-1 — Brokerage Account
| Field | Detail |
|---|---|
| Description | Individual brokerage account — diversified equities |
| Institution | Westside Investment Group (FICTIONAL) |
| Account Number | Ending XXXX-4471 |
| Title | Dolores Maria Mendoza — TOD beneficiary: none designated |
| Date-of-Death Value (Statement 10/31/2025) | $85,000 (approximate) |
| Probate Referee Review | Referee will confirm; publicly traded securities typically valued at mean of high/low on date of death |
| Appraised Value | [REFEREE CONFIRMATION PENDING] |
Item B-2 — Motor Vehicle
| Field | Detail |
|---|---|
| Description | 2019 Toyota Camry LE, 4-door sedan |
| VIN | [PENDING — pink slip not yet located; client searching] |
| License Plate | [PENDING] |
| Odometer (approx.) | 44,200 miles |
| Title | Dolores Maria Mendoza |
| Valuation Method | Kelley Blue Book private party value as of date of death |
| Estimated Value | $14,000 |
| Appraised Value | [REFEREE CONFIRMATION PENDING] |
Item B-3 — Checking Account
| Field | Detail |
|---|---|
| Description | Personal checking account |
| Institution | Orange County Community Bank (FICTIONAL) |
| Account Number | Ending XXXX-8803 |
| Title | Dolores Maria Mendoza |
| Date-of-Death Balance (Statement 10/31/2025) | $3,200.47 |
| Appraised Value | $3,200 |
| Note | Cash/deposits appraised at face value; no referee appraisal required per Probate Code § 8904 |
Item B-4 — Household Goods and Personal Effects
| Field | Detail |
|---|---|
| Description | Household furniture, furnishings, appliances, clothing, and general personal effects located at 4817 Willow Creek Drive, Santa Ana |
| Excludes | Jewelry and heirlooms designated as specific bequests to Rafael Mendoza per will (to be listed separately if appraised) |
| Estimated Value | $8,500 |
| Valuation Method | Estate sale comparable; furniture and effects presumed used/depreciated |
| Appraised Value | [REFEREE CONFIRMATION PENDING] |
Schedule B Subtotal (estimated): $110,700 | [Pending referee confirmation on B-1, B-2, B-4]
SUMMARY
| Schedule | Description | Estimated Value | Appraised Value |
|---|---|---|---|
| A | Real Property | $720,000 | PENDING |
| B | Personal Property | $110,700 | PENDING |
| TOTAL GROSS ESTATE | ~$830,700 | PENDING |
PROBATE REFEREE SECTION
Referee Name: [PENDING — Referee not yet appointed as of April 28, 2026]
Referee Certificate (to be completed by court-appointed referee):
I, the undersigned, am a probate referee appointed by the State Controller pursuant to California Probate Code § 8920. I certify under penalty of perjury under the laws of the State of California that the foregoing appraisal is true and correct to the best of my knowledge, information, and belief, and that the fair market values set out above are, in my opinion, the fair market values of the property described, as of the date of death of the decedent.
[PROBATE REFEREE NAME] Probate Referee No.: [_____] Date: ___________________
PERSONAL REPRESENTATIVE DECLARATION
I, Ana Mendoza, declare under penalty of perjury under the laws of the State of California that the foregoing Inventory and Appraisal, including all schedules, contains a true statement of all assets of the estate of Dolores Maria Mendoza that have come to my knowledge or possession.
Ana Mendoza, Executor Date: ___________________
OPEN ITEMS BEFORE FILING:
- Await probate referee assignment from Orange County Superior Court.
- Obtain vehicle VIN from client (pink slip search in progress).
- Confirm date-of-death brokerage statement from Westside Investment Group.
- Attorney to review Schedule A legal description against title report.
This document is a fictional representation created for portfolio purposes only. All names, case numbers, and factual details are invented.