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AUG-07-0i
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F-641
INVENTORY
Estate of JO ANN SARRETT
No. 2007-00061
also known as JO ANN F. BARREIT
Date of Death 10/05/06
, Deceased
Social Security No. 267-78-8509
Timothy C_ Barrett
Personal Representalive(S) of the above Estate, deceased, I19rify that the items appearing in the follovving invelltOlY lndude all of the
persotlal aS$e~ wherever situate and all of the real estate in the Commonwealth of PennSYlvania of said Dececlent. ttlat the valuation
plClced opposite each Item of 50id Inventory represents its fClir valLIe as of the data of the Decedent's death, and thai Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that whiCh appears In a mernornndum allhe end of this Inventory.
IflNe verify that the statements made in thiS Inventory are true and correct. rflNe understilnd that false statements herein are made
SUbject to the penalties of 18 Pa C.S. Section 4904 relaling to unsworn falsifICation to aulh(l~ities;-' ,,/7
Personal-Re .....-., / -' " _
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Name of
Attorney: Heather D. Rover E~1J.!!re
x
I.D. No.: 76327
Executor
Address: 4431 North Front Street
Dated
y- 10- 0 '7
Harrisbur9. Pennsylvania 17110
Telephone: (717) 234-2401
Description
Value
2000 Stock Appreciation Rights-McDonald's Corporation
$ 31,220.00
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(Attach Additional Sheets if necessary)
Total: $31,220.00
NOTE; The Memorandum of (eal estate outside the Commcnwe~lth of ~ennsylvania may, at the election or tile pe~onal rllpresen~tlve, lnclulle the
value of e3cll il0m, but such flgUL'e$ should not be $l<\endcd into the to~1 cf the Inventory.
AUG-07-2007 15:57
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