HomeMy WebLinkAbout03-13-07
GUARDIAN'S INVENTORY
COURT OF COMMON PLEAS OF C_U m b{> rl (l VY'A COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
Estate of DCA \f l~c\ L. V\A~-3
No. ~ (- ()~- (Jq~o
1. Real Estate: (Location, by whom occupied and rental
terms, if applicable)
-* \~'" cP:f;tf<- R 01,,-,, Net.kJ\J I '-L6' , ]:>A 11 ~ 'f I
ItJ WM.)b:A A/~A~ t-JA-vv..e. 6CCUPI6-D B~
$AAJf::. ~Mt:> [N' f:-u LL-
Sub-Totalfor Real Estate:
.~
-*
-*
'-K
3. Jointly Held Property:
(Set forth real and personal property owned by the Incapacitated Person JOINTLY with any
other person(s). State whether held as tenants by the entireties; if not, whether the right of
survivorship exists.)
Form G-04 rev. 10.13.06
} 13 an Incapacitated Person
, Oa Minor
Estimated Value:
~ 1'1~cx~ 0
---.1b I 75' oeo.oo
Estimated Value:
f 23,90001
1\ _"" G()
'fb 3 i CO 0.....
..!t> 31.9 0 0"-';
~ <'. "'i
Estimated Value:
l_.~_.l
t , 5'0 QOO
I
Page 1 of2
0,
;j
Estate of --Do. \f I ~ L. M Qjj-S
} 181 an Incapacitated Person
, [J a Minor
4. Anticipated Assets:
(Set forth property of any kind expected to be acquired hereafter, together with
anticipated date of acquisition.)
Estimated Value:
Property
Anticipated Date
of Acquisition
NONe
k f'Jo \,"J tV
Sub-Total for Personal Estate:
(Attach additional sheets if necessar;~
TOTAL OF ITEMS 1, 2, 3, and 4: ............. '" .......... ....
3~lo 500.00.
-t:t 3(0 b 5' () 0.00
Commonwealth of Pennsylvania
County of 0-11mbe, la.V\a : ss.
'w 0.. riel ~ ~"v\tLtj~ , says that the foregoing is a full,
Guardian . L
true and complete Inventory of the Estate of DiAVI d . Ma~s
the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is
true and correct to the best ofthe Guardian's knowledge and belief.
I verifY that the statements made in this )
Inventory are true and correct. I under- )
stand that false statements herein are )
made subject to the penalties of )
18 Pa.C.S. S 4904 relating to unsworn )
falsification to authorities. )
Attorney for Guardian:
Supreme Court J.D. No.:
Address: '84~ Slr Ih(;yy\f.l s: Co~ ,SLu:dUL..
--=i::lGLnn','\;~ l 'fA I i[loq
1)elephone: (11,) SL/,I -5:/ 5 ()
, ,.
C~~ ;~~
r"
'.... /..}.; (~.. '....
Form G-04 rev, 10.13.06
Page 2 of2