HomeMy WebLinkAbout09-22-09 (2)INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland }
Janie R. Baker
File Number 21-09-0166
Personal Representative(s) of the Estate of William J. Otstot
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 Bald 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 owno real est~$
outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of thi v~ntory. ~
I verify that the statements made in this Inven- ~ ~ ~ '~ ~ m ` ,
tory are true and correct. I understand that false state- SIT ~, ~' C7 'Q~
ments herein are made subject to the penalties of Jefnie R. Baker ~ ~ N -. ' -
18 Pa.C.S. § 4904 relating to unsworn falsification to } _ _ ~v~a ~ ~ _ :,
authorities. ~ ~ ~w-- ~ '
:_~ ~= ~ ~-
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Attorney -- (Name) Michael L. Bangs (Supreme Court I.D. No.) 41263
(Firm)
(Address) 429 South 18th Street, Camp Hill, PA 17011 ~ _ _ _
(Telephone) 717/730-7310
DATE OF DEATH I LAST RESIDENCE Country Meadows I DECEDENT'S SOC. SEC. NO.
01/20/2009 Mechanicsburg, PA 17050 174-05-3820
FIGURES MUST BE TOTALED
Personal Prouert
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 .....................
87,602.09
87,602.09
..87,602.09
CUMBERLAND COUNTY, PENNSYLVANIA
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. 10-13-2006
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
couNTY of Cumberland } ss File Number 21-09-0166
DATE OF DEATH LAST RESIDENCE Country Meadows DECEDENT'S SOC. SEC. NO.
01/20/2009 Mechanicsburg, PA 17050 174-05-3820
Cash
PNC Bank -Savings Account
Refund from Highmark -premium refund
Refund from Highmark
Total Cash
87,357.88
204.61
39.60
87,602.09
(Attach additional sheets if necessary) Total Personal Property and Real Estate 87,602.09