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HomeMy WebLinkAbout07-21-08 (3)INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } J. Craig Jurgensen CUMBERLAND COUNTY, PENNSYLVANIA File Number 21-08-0272 Personal Representative(s) of the Estate of Charles Andrew Jurgensen 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 emorandum at the end of this inventory. ~~ I verify that the statements made in this Inven- ~ ~ '~ % 1 ~ ~ n ~O tory are true and correct. I understand that false state- ~ ~u-u~'~~-_=~-- ~--- _ ments herein are made subject to the penalties of . Craig J r e sen ~ _° c~ 18 Pa.C.S. § 4904 relating to unsworn falsification to } _ r ' ~ n rv authorities. -_~ i, -~.~ ~'= ~3 N --f _ ~~ Attorney -- (Name) James D. Flower, Jr. Esq (Supreme Court I.D. No.) .~' 27742 (Firm) _Sa1dIS, Flower & Lindsay (Address) 26 West High Street, Carlisle, PA 17013 -- - -- -. ----- -__ - _- etephone) 717-243-6222 DATE OF DEATH LAST RESIDENCE 210 Big Spring Road DECEDENTS SOC. SEC. NO. 03/05!2008 Newville, PA 17241 142-03-3386 FIGURES MUST BE TOTALED Personal Progertv Cash ............................................................................................... Personal Property ......................................................................... Stocks/Listed ................................................................................, Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... Total Real Property ................................................ Total Personal and Real Property ......................... 185,490.06 88,186.60 87.40 273,764.06 273,764.06 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)) Form RIN-~9 Rev. 10.13-2006 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-08-0272 DATE OF DEATH LAST RESIDENCE 210 Big Spring Road DECEDENTS SOC. SEC. NO. 03/05/2008 Newville, PA 17241 142-03-3386 Cash Adams County National Bank CD Account #169097 79,022.93 Cash -Reimbursement for overpayment of costs from J. Craig Jurgensen 1,282.00 M & T Bank Certificate of Deposit Account #031003910979821 7,124.56 Accrued income on above item through date of death 1fi6.51 M & T Bank Certificate of Deposit Account #031003911001194 27,811.37 Accrued income on above item through date of death 369.73 M & T Bank Certificate of Deposit Account #031003913122279 12,623.23 Accrued income on above item through date of death 350.23 M 8 T Bank Certificate of Deposit Account #031003916445173 44,209.99 Accrued income on above item through date of death 338.37 M $ T Bank Checking Account #1188151 11,306.95 Accrued interest on above item through date of death 0.19 Northern Trust Company -Pension 54.00 Redemption of Traveler's Checks 110.00 Rutgers University Foundation - Fnd Gift Annuity-Replacement check 720.00 Total Cash 185,490.06 (Attach additional sheets if necessary) Total Personal Property and Real Estate 273,764.06 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-08-0272 DATE OF DEATH LAST RESIDENCE 210 Big Spring Road DECEDENTS SOC. SEC. NO. 03/05/2008 Newville, PA 17241 142-03-3386 Stock /Listed 800.0000 shares Exxon Mobile -Common Stock 120.0000 shares International Business Machines Corporation -Common Stock 100.0000 shares Public Service Enterprise Group Incorprated -Common Stock Total Stock /Listed Bond U. S. Savings Bond -Serial Number L202620274EE Accrued interest on above item through date of death Total Bond 69,752.00 13,839.60 4,595.00 88,186.60 25.00 62.40 87.40 -2-