HomeMy WebLinkAbout11-10-09 (2)REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland }
Janie A. Jackson
Personal Representative(s) of the Estate of Sample, Beverly
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 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 Janie A. Jackso
18 Pa.C:S. § 4904 relating to unsworn falsification to }
authorities.
Attorney -- (Name) Jean D Seibert (Supreme Court I.D. No.) 41713
(Firm) Wion, Zulli and Seibert
(Address) 109 Locust Street ~ Q ~ ~~-
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Harrisburg, PA 17101 ~ a:~ ~ ~ _
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Mi~ Y 1 wry k+~:...: -'f-~!
(Telephone) 717/236-9301 ~.r ~
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DATE OF DEATH LAST RESIDENCE
12 Marshal Drive 1-6 >
DECEDENT'
c C. NO.
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,
.
2/9/2009 Camp Hill, PA 17011 229-2 - 1 ~ ~
~-- ~ ~;
FIGURES MUST BE TOTALED ~-r~ c,n ~+ ~ ~ _'
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Personal Proae
M&T Bank Checking Account No. 9838681964 22,989.02
Accrued Interest 0.71
M&T Bank Certificate of Deposit No. 31003917029538 27,023.24
Accrued Interest 445.45
Toyota 10,525.00
Rings 130.00
File Number 21 - 09 - 0176
(Attach additional sheets if necessary) Total Personal Properly and Real Estate $63,915.18
REGISTER OF WILLS OF
INVENTORY
(continued)
CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY, PENNSYLVANIA
COUNTY OF Cumberland } File Number 21 - 09 - 0176
DATE OF DEATH LAST RESIDENCE 12 Marshal Drive I-s DECEDENTS SOC. SEC. N0.
2/9/2009 Camp Hill, PA 17011 229-20-5531
Income Tax Refund 1,007.00
Federal Retirement Pension 670.70
Comcast Refund 16.41
Rent Refund 441.00
Debt owed to estate for rent paid by decedent's estate for Beneficiary, Benjamin 666.65
F. Jackson after lease for decedent had ended.
Total Personal Property
63,915.18
2