HomeMy WebLinkAbout11-05-08 (2)INVENTORY
REGISTER OF WILLS OF Cumberland
PA 17055
COMMONWEALTH OF PENNSYLVANIA
COiJNTY OF Cumberland SS File Number 21-08-0394
Personal Representative(s) of the Estate of Donald H. Peterson
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.
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) John M. Eakin
(Address) Market Square Building, Mechanics
(Telephone) 717-766-3172
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
April 1, 2008 106 S. Frederick Street, Mechanicsburg, PA 17055 472-16-5591
FIGURES MUST BE TOTALED
106 S. Frederick Street, Mechanicsburg, P A17055
PNC Bank Account # 50-0311-4727
Cumberland County Burial Refund
Stimulus Check
110,000.00
22,656.65
100.00
1,200.00
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(Attach additional sheets as needed)
TOTAL: ~ 133,956.65
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))
COUNTY, PENNSYLVANIA
(Supreme Court I.D. No.) 6351
Form RW-09 rev. 10.13.06