HomeMy WebLinkAbout12-07-09 (5)INVENTORY
REGISTER OF WILLS OF ~c~n~'~l_.~,2-c-r~-,c t~ COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA l SS
COUNTY OF J
File Number ~ ( ~ ~ Dna~
/ 't LC-c ~ ~'1 ~ S M / ~ ~
Personal Representative(s) of the Estate of W (-
deceased, depose(s) and say(s) that the items appearing in the following inventory include all ofthe 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.
]'~ verify that the statements made in this Inven- SVS/u~~T S ~; 1-f ~KPC~ X~
tory aze true and correct. I understand that false state-
ments therein aze made subject to the penalties of
18 Pa.C'.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) (Supreme Court I.D. No.)
(Address)
(Telephone)
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
FIGURES MUST BE TOTALED
~~M~ `~ l ~s ~v~
1~~~ Toy~,~ ~~y
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~~ ~~''~~t--2-5 I~ ~- Sr ~, i ~' Sal`,.-~i tied s ~t L ~ ~
(Attach additional sheets as needed)
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I V
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rr C. ,'~ c.. "t
TOTAL: I ~ ~~ , -~yZ 0.00
NO'I'E~ '~fhe Memorandum of real estate outside the Commonwealth of f"ennsylvania 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 Inven[ory, ISee 10 Pa. C.S. ,~ 330!(6))
Fornt RW-OI rev. 10.13.06