HomeMy WebLinkAbout06-03-08 (2)
SUPPLEMENTAL
INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYL VANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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File Nwnber
Charlotte H. Griffiths
Personal Representative(s) of the Estate of Charlotte Y. Offley
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 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 of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
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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. 9 4904 relating to unsworn falsification to
authorities.
Keith O. Brenneman
(Address)
(Telephone)
44 W. Main Street, Mechanicsburg, PA
(717) 697-8528
(Supreme Court J.D. No.)
17055
47077
Attorney -- (Name)
DATE OF DEATH LAST RESIDENCE DECEDENT'S soc. SEC. NO
December 18, 2007 355 S. Sporting Hill Road, Mechanicsburg, P 208-42-2656
FIGURES MUST BE TOTALED
PERSONALTY.
A. IRS refund, 2007 federal tax return: $1,240.00
B. Capital Blue Cross premium refund 115.40
C. Refund for return of purchased skin products 42.35
Total Personalty:
$1,397.75
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(Attach additional sheets as needed)
TOTAL:
1,397.75
NOTE The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of eacr.
item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ~ 330J(b))
Form RW-09 rev. 10.13.06
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