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REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland }
Mark D Grim Jr
Robert Kreitz Esq
Personal Representative(s) of the Estate of Irene Grim
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 excep4 that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Irlven- ~ -~-
~~~ _~/"
tory are true and correct. I understand that false slate-
ments herein are made subject to the penalties cf Mark D Grim Jr
18 Pa.C.S. § 4904 relating to unsworn falsification to }
authorities.
Attorney - (Name)
(Firm)
(Address)
(Telephone)
(Supreme Court I.D. No.)
Roland 8~ Schlegel PC _
627 N. 4th Street, Reading, P_A 19603-0902
610-372-5588
DATE OF DEATH LAST RESIDENCE Country Meadows of West Shore DECEDENTS SOC. SEC. N0.
12/18/2008 Mechanicsburg, PA 17050 174-09-8321
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 .........................
2,853.02
~ 2,5.33 _ .
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5,818.35
- 5;818.35
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative inGude 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
COUNTY, PENNSYLVANIA
File Number 21-09-0260
N
REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF Cumberland File Number 21-09-0260
DATE OF DEATH LAST RESIDENCE Country Meadows of West Shore DECEDENTS SOC. SEC. NO.
12/1812008 Mechanicsburg, PA 17050 174-09-8321
Cash
Commonwealth of PA - 2008 personal income tax refund 1,657.00
Country Meadows -refund on unused room and board 1.196.02
Total Cash 2,853.02
Personal Property
Coins -per appraisal attached 2,965.33
Total Personal Property 2,965.33
(Attach additional sheets if necessary) Total Personal Property and Real Estate 5,818.35