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HomeMy WebLinkAbout07-24-09Register of Wills of Dauphin County, Pennsylvania INVENTORY Estate of ~ Gt? ~~ ~t~ 11 ~CtCr~~S No. ~~~ D -Q1 ~ ~ra also known as Date of Death ~ l.' Deceased Social Security No. ~_o ~ .~<~ Personal Representative(s) of the above Estate, deceased, verify 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/We verify that the statements made in this Inventory are true and correct. I/{Ne understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. ~ Name of Attorney: I.D. No.: Address: Personal Representative• ~~~ ~~~~ ~ 7 ~ ~/C: / / 70 ~~ Dated -7- Description ~- Neu York L`r~•~~nui~ ~75~O~a~~- Z ~ FN ~ ~Zn~e stmen~-s # ~ `~D5~3 ~- ~ersan~l ~Ed~wt t~-~ 2p00 ~~~ir~~ Can vii ~~lL inferrest} 51 m ~-~rt ~~,eck~~ q~r~t~~.~~34~~~11 y #~~--os17s- jgq~ ~a PN~ ~,~~I~y G~~~nt (Attach Additional Sheets if necessary) Value 107i~q'3~ ~'7 4~ 5~0, n ~ ~~'715~~0 2~ 31 Z~, ~, .~~ ~r ,~ -o ~ -T ~ r- r ~„ C-.. fy ,-, ~ ~`t:l ~ --~ tv ~.C~ r > ~` ~ i Total:3~©t 3~~i ~q 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.