HomeMy WebLinkAbout07-14-09 (3)
INVENTORY
REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY OF Cumberland }
Tracy L. Olson
Personal Representative(s) of the Estate of Pearl E. 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 m 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)
(Firm) .
(Address)
(Telephone)
James D. Hughes Esq.
SALZMANN HUGHES PC
(Supreme Court I.D. No.) 58884
354 Alexander Spring Road, Suite 1, Carlisle, PA 17015
717-249-6333
DATE OF DEATH LAST RESIDENCE Bethany Village, 325 W@Sley Drlve DECEDENTS SOC. SEC: NO. '
11/1112008 Mechanicsburg, PA 10755
File Number 21-08-1205
FIGURES MUST BE TOTALED
Personal Property
Cash ...................................................:.........:.....:........................:..
Personal Property .........................................................................
Stocks/Listed .................................................................................
Stocks/Closely Held ....................:.................................................
Bonds ................................................... ......................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable ...............................................
All Other Property .........................................................................
Total Personal Property .........................................
Total Real Property ................................................
Total Personal and Real Property ...........:.............
266.52
~ _~~
~p
~ ,.
c7 43~30.7~~ `-
r ~. ~
-..: cn
.
~
~ - r
~::+;1
~~ ~ G
-
~„~ ,
rt.,..s
~ .. ~ __,,
,,-~ {.
pl
'
W
v'~
}~
y
S
458,497.27
458;49727
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the elec 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 Rey. ~o-~s-zoos
Trams L. Ols
~'
' INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-08-1205 -
DATE OF DEATH LAST RESIDENCE Bethany Village, 325 Wesley Drive DECEDENT'S SOC. SEC. NO.
11/11/2008 Mechanicsburg, PA 10755
Cash
Asbury Communities, Inc. -refund of credit 2,241.56
Commonwealth of Pennsylvania - 2005, PA40 income tax refund 635.53
Commonwealth of Pennsylvania - 2007, PA40 income tax refund 907.17
Commonwealth of Pennsylvania - 2008, PA40 income tax refund 271.00
Edward Jones Money Market Account #377.-10162 1.07
FIA Card -refund of credit 4.72
PNC Bank, N.A., Checking Account #5140189629 9,035.23
State of NY -refund of unearned premium ~ 496.26
The Prudential Insurance Co. of America -Life Insurance Policy #D50 171 243, 5,440.15
payable to the Estate
Union Fidelity Life Insurance Co. -Life Insurance Policy #30L373982000, 2,500.b0
payable to the Estate
Union Fidelity Life Insurance Co. - refund'of unearned premium 11.00
United Healthcare Insurance Company -refund 33.82
United Healthcare Insurance Company -refund 8.30
United Healthcare Insurance Company -refund - 9.01
United Healthcare Insurance Company -refund 1.37
(Attach additional sheets if necessary) Total Personal Property and Real Estate 458,497.27
' INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-08-1205
DATE OF DEATH LAST RESIDENCE Bethany Village, 325 Wesley Drive DECEDENT'S SOC. SEC. N0.
11/11/2008 Mechanicsburg, PA 10755
United Healthcare Insurance Company -refund 1.37
United Healthcare Insurance Company -refund 393.96
United States Treasury - 2008, 1040 income tax refund 3,675.00
Total Cash
Stock /Listed
Edward Jones Account #377-10162
1,595.3730 shares American Funds Short Term Bond Fund of America -Class A; ASBAX
257.6850 shares Capital Income Builder Fund -Class A; CAIBX
211,822.0000 shares Cash Management Trust of America -Class A; CTZXX
548.7180 shares Dodge 8~ Cox Income Fund - DODIX
3,861.2350 shares Franklin Income Fund -Class A; FKINX
150,266.0000 shares Franklin Money Fund -Class A; FMFXX
377.7830 shares Franklin Mutual Shares Fund -Class A; TESIX
869.5840 shares Income Fund of America Fund -Class A; AMECX
836.4970 shares Templeton Global Bond Fund -Class A; TPINX
406.4860 shares Templeton Growth Fund -Class A; TEPLX
Total Stock /Listed
25,666.52
15,586.79
10,526.43
211,822.00
6,244.41
6,525.49
150,266.00
5,859.41
11,348.07
9,335.31
5,316.84
432,830.75
-2-