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HomeMy WebLinkAbout12-30-09 (2)INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland CUMBERLAND COUNTY, PENNSYLVANIA File Number 21 - 09 - 00620 Mary L. Martino Nancy H. Weimer Personal Representative(s) of the Estate of Hizer, Anna R. 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 ~ 18 Pa.C.S. § 4904 relating to unswom falsification to authorities. Mary ~. Attorney - (Name) Debra K. Wallet t„Q.,~. j(, i,Jµ,,,,r (Supreme (Firm) Law Offices of Debra K. Wallet (Address) 24 North 32nd Street Camp Hill, PA 17011 \.~ ~~i r`~'4~ rTl y,-, n ~; a 23989 ..:' _ ~'~'r~j r -•. _,~ ~ ~ .. 'F`. ~~ ~ r`~Y r-r"i ~' .~ ~ _.~ ~ ' 1'~ (Telephone) 7171737-1300 DATE OF DEATH LAST RESIDENCE 100 Mt. Allen Drive DECEDENTS SOC. SEC. N0. 6/20/2009 Mechanicsburg, PA 17055 219-07-6556 FIGURES MUST BE TOTALED Personal Property Wachovia Bank acct. #1010049618798 30,562.45 Refund of Blue Cross/Blue Shield premium 591.40 Independence Blue Cross payment -refund of supplemental insurance 1,068.00 Lancaster Emergency Associates -patient credit 33.46 No personal items -only clothes (in skilled nursing) 0.00 No cash in possession of Decedent (in nursing home) 0.00 Total Personal Property 32,255.31 (Attach additional sheets if necessary) Total Personal Property and Real Estate X32,255.31