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HomeMy WebLinkAbout11-04-09 (2) ,, INVENTORY REGISTER OF WILLS OF ~~,~y,~ 6~1~1 ao~ COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Lana Forconi and Karen Mohler File Number / /~' ~ ~ '~ /~~ Personal Representative(s) of the Estate of Beulah R Sheaffer deceased, depose(s) and say(s).that the items appearing in the following inventory include all of the personal situate and all of the real estatte In the Commonwealth of Pennsylvania of satd Decedent, that the valuation item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent own outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of tht I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ~ La Forconi ments herein are made subject to the penalties of ~ ~,/, 18 Pa.C.S. § 4904 relating to unsworn falsification to } ~~/~+ ~~i/ authorities. Karen Mohler Is wher r real esach ~{ `,-' i © ~ ~ '- . . ~^ Attorney - (Name) (Firm) (Address) (Telephone) (Supreme Court LD. No.) 3 -=~= DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. N0. 04/03/2009 PA ~ 3 " ~ ~ ~~ ~ ~/ 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 ......................... NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative inolude 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-sooe 2,248.92 2,248.92 I 2,248.92 I - - - REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF DATE OF DEATH LAST RESIDENCE 04/03!2009 pq Cash Nursing Home Insurance Nursing Home Insurance Refund Total Cash 691.20 1,497.60 60.12 2,248.92 (Attach additional sheets if necessary) Totat Personal Property and Real Estate 2,248.92 INVENTORY COUNTY, PENNSYLVANIA File Number DECEDENTS SOC. SEC. N0. r93-/k-