HomeMy WebLinkAbout05-04-09 (2)INVENTORY
REGISTER OF W{LLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland }
Dale F Shughart, Jr. Esquire
Fife Number
Judy Andres
Personal Representative(s) of the Estate of U S, arty
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~~orandum at the end,~tl) is inventory.
I verify that the statements made in this inven- ~~
tort' are true and correct. I understand that false state- Judy A dyes
ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relating to unswom falsification to
authorities.
Attorney - (Name)
(Firm)
COUNTY, PENNSYLVANIA
21 - 09 - 0028
(Supreme Court i.D. No.) 19373
(Address) 10 West High Street
Carlisle, PA 17013
(Telephone) 717/241-4311
DATE OF DEATH i LAST RESIDENCE 1 Os "A~' Street DtGEDENTJ ScX:. stc;. rvv.
7/16/2007 Carlisle, PA 17013 397-66-5747
FIGURES MUST BE TOTALED
Personal Property
Household goods, furniture and furnishings
1993 Saturn stationwagon, value based upon actual private sale price.
State Farm, refund of auto insurance.
EXEL, final pay (162.49 + 319.96 + 169.40 + 162.49 )
Sovereign Bank, checking account #1691032859
Fidelity 401 K dividend checks (149.17 + 149.39 + 149.47)
so.oo
500.00
22.00
814.34
-~- O
i~
_ - ,
'_ ,
=c
411
448.03 < ;
-w:
.~-
_; - -a
~` _
_~ raa
i \.;
tv
(Attach additional sheets if necessary) Total Personal Property and Real Estate $3,512.48
CUMBERLAND
INVENTORY
(continued)
REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21 - 09 - 0028
DATE OF DEATH LAST RESIDENCE 106 '~A" Street DECEDENTS SOC. SEC. NO.
7/16/2007 Carlisle, PA 17013 397-66-5747
U. S. Treasury, 2007 Federal Income Tax refund 1,210.00
Total Personal Property 3,512,48
2