STATE OF SOUTH CAROLINA	)	IN THE PROBATE COURT
)
COUNTY OF GREENVILLE	)	STATEMENT OF VALUE AND INCOME
)	FOR PURPOSES OF BOND
IN THE MATTER OF:	)
)	CASE NUMBER: ________________________
(Decedent)	)

The undersigned, after being duly sworn, states that:

1.	His/her/their best estimate of the value of the personal property of the Estate in this matter is $_________________.
2.	The income expected during the next year from the personal property in this matter is $________________.
3.	The total of this value and income is $____________________.
4.	Of the above amount, $_______________ has been placed in a bank or other financial institution with the appropriate restriction that the funds may not be withdrawn, disbursed, or otherwise distributed without the prior approval of the Probate Court.
5.	Should further assets be located at a later date, Personal Representative shall immediately report such finding to the
Probate Court and complete an Application to Alter Bond (FORM 343ES).

SWORN to before me this	day of	Signature:
, 20	Print Name:
Address:
Notary Public for South Carolina	Telephone (Work):
My Commission Expires:	(Home):
(Cell):
Email:

ORDER

IT IS HEREBY ORDERED that bond be set at $___________________.

Executed this _____ day of ___________________________, 20_____.

Chadwicke L. Groover, Probate Court Judge Caroline M. Horlbeck, Associate Probate Court Judge Elizabeth Wiygul, Associate Probate Court Judge Christie Martin-Kelley, Deputy Probate Court Judge