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HomeMy WebLinkAbout01-23-09 (4)INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 2 SS COUNTY OF Cumberland s File Number 21 OS 0342 Personal Representative(s) of the Estate of _Eatl L. Swauger 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 [he end of this inventory. I verify [hat the statements made in this Inven- tory are tme and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating ro unsworn falsification to authorities. Attorney -- (Name) Theresa L Shade Wix (Supreme Court LD. No.) 43089 (Address) 4705 Duke Street Harrisburg PA 17109 (Telephone) (717) 652-8455 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. N0. West Main Street FIGURES MUST BE TOTALED Proceeds of settlement of claim asserted under the Pennsylvania Wrongful Death Survival Act I 100,000.00 N 0 ') C) L _~ ~~) ~ ,~' - ~ N r-:. -'. ' it Ca ._:} n~ - _ - r-; ... '9 t~i ~C~ :~ Z ~i c ~: (Attach ndditianal sheets as needed) TOTAL: 100,000.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of [he personal representative include the value of each 1 item, but such figures should no[ be extended into the total of the Inventory. (See 20 Pa. C.S. § 330!(b)) \n\~ ~~ P'orm RW-09 rev. 10.13.06 ~VJ