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INVENTORY ~ +j. L~
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
Steven C. Koslov and Andrew M. Koslov
File Number 2007-00876 '
Personal Representative(s) of the Estate of Steven A. Koslov
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets whergver
situate and all of the real estate In the Commonwealth of Penns Ivania of said Decedent, that the valuation Rt~yced opposiit~;each -
item of said inventory represents its fair value as of the date oft decedent's deat and that Decedent owrlleb~q real es~5te
outside of the Commonwealth of Pennsylvania except that whi ppears in a m o dum at the end of thisil~pento c~
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. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (/Name)
(Firm)
(Address)
(Telephone)
Edward P. Seeber Esq.
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(Supreme Court l.D~. No.) 76084
James, Smith, Dietterick 8~ Connelly
134 Sipe Avenue, Hummelstown, PA 17036 _
717/533-3280
DATE OF DEATH I LAST RESIDENCE 7B Richland Lane DECEDENTS SOC. SEC. NO.
09/01/2006 Camp Hill, PA 17011 194-44-9016
FIGURES MUST BE TOTALED
Personal Property
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 .........................
1,108.75
100.00
1,208.75
C 1.,208.75
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include th~a 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 RW-09 Rey. ~o-rs-loos
REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland } File Number 2007-00$76
DATE OF DEATH LAST RESIDENCE 7B Richland Lane DECEDENTS SOC. SEC. NO.
09/01/2006 Camp Hill, PA 17011 194-44-9016
Cash
Prudential Financial -refund of premium
Total Cash
Personal Property
Personal Property -valued per executor
Total Personal Property
1,108.75
1,108.75
100.00
100.00
(Attach additional sheets if necessary) Total Personal Property and Real Estate 1,208.75