HomeMy WebLinkAbout02-18-10 (2)INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
couNTYOF Cumberland
Debra L. Worden
Personal Representative(s) of the Estate of Na
CUMBERLAND COUNTY, PENNSYLVANIA
A. Worden
File Number 21- h '
deceased, depose(s) and sav(s) that the items appearing in the following inventory include all of the personal ;
situate and all of the real estiffe in the Commonwealth of PennsyylIvania of satd Decedent, that the valuation pls
item of said inventory represents its fair value as of the date of tFte decedent's death, and that Decedent owne
outside of the Commonwealth of Pennsylvania except that which a~p~pe~a/rs~ ,inn, a memorandum at th~e~e~nd~ o~f~this
1 verify that the statements made in this Inven- ~ Jam" "w ~ ~~Z~ i~(J~.fL/K~
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of ~ Debra L. Worden
18 Pa.C.S. § 4904 relating to unswom falsification to
authorities.
Attorney - (Name)
(Firm)
(Address)
(Telephone)
James D. Bogar
& Hipp Law Offices
(Supreme Court I.D. No.) 19475
One West Main Street, Shiremanstown, PA 17011
717-737-8761
DATE OF DEATH I LAST RESIDENCE 1000 Claremont Drlve DECEDENTS SOC. SEC. No.
11/29/2009 Carlisle, PA 17013 175-16-7359
FIGURES MUST BE TOTALED
Personal Prooertv
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 .........................
2,470.31
2,470.31
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania 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 Inventory. (Sea 20 Pa. C.S. § 3301(b))
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Form RW-09 Rev. 10.132(86 ~V1N\~^1~I'1
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INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland }
CUMBERLAND COUNTY, PENNSYLVANIA
File Number 21-
DATE OF DEATH I LAST RESIDENCE 1000 Claremont Drive DECEDENTS SOC. SEC. NO.
11/29/2009 Carlisle, PA 17013 175-16-7359
Cash
Capital Blue Cross -Refund
Claremont Rehabilitation and Nursing Center -Refund of balance of funds in
Guest Fund Account
Total Cash
123.50
2,346.81
2,470.31
(Attach additional sheets if necessary) Total Personal Property and Real Estate 2,470.31