HomeMy WebLinkAbout06-09-08i'
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Register of WiAs of Cumberland County
INVENTORY
Estate of j i2U Y /-~ ~// 1~ / S ~~o t~
Also known as
Deceased
Personal Representative:
the above Estate, deceased, verify that the items appearing on the following inventory include all of the personal assets wherever situate and al] 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 (PEF § 3301). UWe verify that the statements made in this inventory are true and correct.
1/We understand that false statements herein made ace subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to
authorities.
Name of Attorney:
I.D. Na.:
Address:
Telephone:
~1 ~ {~ ~ ~ ~ j ~ j ~% _ ,Personal Representative{s) of
,,~~,~ r~ G 5 ~T~ i~
Address: ~C'U ~~ ~.h~r /~ /~rl
Estate No. ~'~~~~ d ~- C~ JG /%
Date of Death C ~ /%1;~cr:>l
Social Security No. _`'~3 ~'._ ~j~' /~'.~ ~3
~~~~ n ~ % ~ ~g i ~U ~i
_~ ___
Signature: r; ~ _~ x ~~
Date: / ~ i7~Ny ~ce~P,
RW-4
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the persona] representative, include the
value of each item, but such f gures should not be extended into the total of the Inventory.