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INVENTORY
Estate of D. Richard Akers
No.21
05
0999
, Deceased
Date of Death 11/3/2005
Social Security No. 192017250
also known as
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
I.D. No.:
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Silvio ~
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Dated
Name of
Attorney: PETER R. WILSON
Address: 2331 MARKET STREET
CAMP HILL
PA 17011
Telephone: 7177631383
Description
THE FIDELITY MUTUAL LIFE INSURANCE COMPANY (DISTRIBUTION
OF DISTRIBUTABLE EQUITY)
Value
1,284.99
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Total
(Attach Additional Sheets if necessary)
1,284.99
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.
RW-4