HomeMy WebLinkAbout01-30-09INVENTORY
REGISTER OF WILLS OF _/ ~)M ~r~ ,n~~ COi]NT'y, pENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~~ . } SS
File Number ~ UC7 ~ - U / ~ ~. ~`
Personal Representative(s) of the Estate of c ~r.,/r ~ ~ ~ /~ ~ ~ ~-{-i,~ ~
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.
verify that the statements made in this Inven- '" C_..
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 ~~~~r .....~
authorities.
Attorney -- (Name)
(Address)
(Telephone),
DATE OF DEATH
1/-a3-ohs
(Supreme Court 1. D. No.).
LAST RESIDENCE
~ l~ ~o G1.ka-(n c.>-1- ~~~-~-~,~-1 /~, Via,--/I ~ fie,
FIGURES MUST BE TOTALED
y
DECEDENT'S SOC. SEC. NO.
add- ~~_
t ~.
~~
_. o
„~
^~
_~_
_ W
.~
~-
c_
--t N
C~
(Attach additional sheets as needed)
AL:
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 RW-09 rev. 10.!3.06
0.00
~:1J
XNVENTURX
REGISTER OP WILLS G)F.,. t~u~t3F12.t_.iAaJ~ CC7UNTY, PENNSYLVANIA
COM ~~~ I\VE.ILTH OF PENNSYLVANUI ~ SS
COU]r7'~ JF
File Nttmbsr
Pers. mal [iepreseruative(s} of flee Estate of 5~--1~-T ~ .
dace tsei depose(s) end say(s) that the items appearing in the following lrtventory urekude all of the personal assets wherever situate
and ~ It c. the real estate In the Gorx~monweahh of l't*nnsvlvania of saidDeoedetrt, that the valuation placed opposite each item of said
invei lu>° , represents its fair value as of [he datr of the dceedent's death, a[td the[ Decedent ownaf no rral estate outside of the
Cone me iwealth of Pent[sylvania except that which appears in a rnttnorandult- at the end of [his inventory.
verify ttxat file statcrnents made in this toven-
rory ate ;rue and correct. t understand that false sWte-
men s +;rein are made subject m the penalties of
$ F a. C 5. § 4904 relatiulg to unswom falsification to
auth xi~ +n
Att<r+r, !~ -- (Name) (Ss-preme Court I,D. No,)
(~ ddress) _
pg1(N ~FJTN W1RE810~,NCl`. l7EClOENT`6.SC1C.9EC.Nt).
~~ •a~ ;
a NC a CCT' F1GUftES MUST BE TOTAL13b
# 5 r-~to~{3- 85-7(, $ l ~ 3 ~ 9 8 y
ACCT## 50•d385-IZQR 2~LZ2•l4
Cyr ~ DrcPoStt' 3l5 000 ~o2Q'8 (c 5o t~5.2~
ZGOI ~a~6E STt2A-avS very=p3E3~#~XO~t~53g2Z3 ~ 315a.oo
5 O 7, C]c,rnex5~ ap ~EA~. ~'d~e GTCF~~~. cr~- x(03 t~ f ~ ~a l vw'~"
d
~, ~L~ Ala, P~
f~~
Va~lre. l7s;a~
,Q-
t- 8'i , 5 bc~ . CJG
fi
.
- -
Fi de~tf~ ~ ~°Y° '
Ir`t~s - kwtntut,~ugt, ~GGT aB1C - 83 ~~~o
z~ o, i q o . `~`~
lR~+--~tdetc~ - Acct- ~61~-$3~~fZa 4Z5y•71
Rnw~i~ie5
~~.,~oo~s7-~4 W/~~,~.E.~a~•( wctoQ,~n>~ f~a,~. ss(~v.8~ 45to6.85
4~e1+c v~ p015'7 S In$ ~~0 Q er-~t,ct a,rrt,~ ~+p~i~h ~'~. ~ 100 7, p (o
/ ~ 1 O 6 ~ . D lp
t.+ a. ~,, , a~rdreio>ur ski a,; needed!
~..~, ~ ror~.• '~' 55'-1 a9D.-79
N01 F..'. I'hc MemOreLdYm of real e3itte outside d+e Commonwealth of t+ertlvsylvania mq, at the clkpMn pr tfit perwe~l tepteaentacivt include die valus or X11
gym, but eucb figut~7 Should not bo e><natc9~rd into the tofatl oCthe lmeheorv (Sre 10 Fa. C S. ,i 330! /b),+
Fors i Y. +l 09 ;Yro. 10.13. !'16