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HomeMy WebLinkAbout04-16-07 (3) INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } David M Stauffer and Evan E Stauffer Jr Personal Representative(s) of the Estate of Sara B Stauffer File Number 21-06-0781 deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in trie Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. 0 -0 ".~,. ::::J ~- I verify that the statements made in this Inven- } tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. ~ 4904 relating to unsworn falsification to } authorities. " Attorney -- (Name) (Firm) (Address) (Telephone) EDMUND G. MYERS Johnson Duffie 301 MARKET STREET (717) 761-4540 N o (Supreme Court I.D. No.) - 20558 DATE OF DEATH 07/29/2006 LAST RESIDENCE 325 Wesley Drive Mechanicsburg, PA 17055 FIGURES MUST BE TOTALED DECEDENT'S SOC. SEC. NO. 171-42-1130 Personal Property Cash............................................................................................... Personal Property......................................................................... Stocks/Listed................................................................................. Stocks/Closely Held...................................................................... Bonds............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property......................................................................... 76,103.05 11,894.99 5,000.00 Total Personal Property......................................... 92,998.04 Total Real Property................................................ Total Personal and Real Property......................... 92,998.04.1 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ~ 3301 (b)) Fann RW-09 Rev. 10-13-2006 0b .~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-06-0781 DATE OF DEATH 07/29/2006 LAST RESIDENCE 325 Wesley Drive Mechanicsburg, PA 17055 DECEDENT'S SOC. SEC. NO. 171-42-1130 Cash Asbury Communities (Bethany Village) - Refund for Nursing Home Care 974.70 Central PA MRI Center - Refund of Payment 96.56 Magazine Subscription Refund 21.07 Medicare Supplemental Insurance Refund 170.75 PNC Bank Certificate of Deposit Account No. 31200268702 10,010.19 PNC Bank Certificate of Deposit Account No. 31300252431 30,053.47 PNC Bank Certificate of Deposit Account No. 31400252653 10,023.98 PNC Bank Certificate of Deposit Account No. 31600283828 7,659.75 PNC Bank Checking Account 5070075799 11,585.07 PNC Bank Money Market Account No. 5080034288 254.92 Prudential Life Insurance Policy 5,252.59 Total Cash 76.103.05 Stock I Listed 219.0000 shares Praxair Inc - Com 11.894.99 Total Stock / Listed 11,894.99 (Attach additional sheets if necessary) Total Personal Property and Real Estate 92,998.04 . INVENTORY o-~ REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-06-0781 DATE OF DEATH 07/29/2006 LAST RESIDENCE 325 Wesley Drive Mechanlcsburg, PA 17055 DECEDENrs soc. SEC. NO. 171-42-1130 Bond U.S. Treasury Note/ Maturity Date 12/31/2006 5.000.00 Total Bond 5.000.00 -2-