HomeMy WebLinkAbout03-26-09 (2)INVENTORY
REGISTER OF WILLS OF -CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF Cumberland J SS
Cvnthia A Gorski Executri:
COUNTY, PENNSYLVANIA
File Number 21-07-1128
Personal Representative(s) of the Estate of PAUL M. MORROW
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.
1 verify that the statements made in this Inven- ~` / '
tory are true and correct. I understand that false state- - ~ ~ "~` ~~ ` ~~ ~~ `'~ ~-'"~~ ~~' 'J ~~ ~- ~ ~`~---
ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relating to unsworn falsification to Cynthia A. Gorski, Executrix
authorities.
Carlisle, PA 17015
Attorney -- (Name) Richard C. Snelbaker, Esquire
(Supreme Court I.D. No.) 6355
(Address) Snelbaker & Brenneman, P.C., 44 West Main Street, Mechanicsburg, PA 17055
(Telephone) 717-697-8528
DATE OF DEATH
11 /30/2007
LAST RESIDENCE
4833 East Trindle Road, Apt. 554, Ham den T DECEDENT'S SOC. SEC. NO.
p wp, Mechanicsburg PA 242-12-0275
FIGURES MUST BE TOTALED
1. AARP, membership refund
2. Bank of America, checking account #1428744541
3. Blue Cross Insurance, refund unused medical premium
4. Brooksville Healthcare, refund from nursing home in Florida
5. Commerce Bank, savings account #627017742
6. Commerce Bank, checking account #537670580
7. Commerce Bank, checking account #537669624
8. Conseco, refund unused premium on long term care insurance
9. Economic Stimulus Refund
10. Household goods retained by family $3,452.00 and household goods sold $475.00
11. Internal Revenue Service, refund on decedent's 2007 Final Individual Tax Return
12. Lincoln Financial Group, annuity payment due the decedent
13. Social Security Administration, social security benefit
14. Terminix, refund due the decedent on terminated contract
I5. West Shore EMS, refund on ambulance service
(Attach additional sheets as needed)
rC~
~r~
_L~ ~ >
t--
. t-t,
~ ~.' ==t
_ "` i
16.11
2,969.40
66.80
290.00
~5
] 9, l 62.54--
1,124:48 '
11,580.03
t'' 2,310.00 '
r
~ 60QD0 `
~ 3,927.00
N 3,714.00 ~ ~~
609.23
1,273.OU
99.50
986.64
~t4 ~~o ~~
TnTar
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, bu[ such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ,¢ 3301(6))
Form RW-09 rev. /0)3.06
V