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~ic~und Ac~~-ice. St7larter Decisions.
17 South Second Street, 6~'' Floor
Harrisburg, PA 17101-2039
717.233.1000 Voice
717.233.6740 Fax
www.skarlatoszonarich.com
April 23, 2010
Register of Wills Office
Cumberland County Court House
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Veronica A. Gouffer
To Whom It May Concern:
Sharon K. Shaffer, Estate Administrator
sharon@skarlatoszonarich.com
I am enclosing an original and one copy of the Inheritance Tax Return and Inventory for
filing. Please time-stamp the extra copies and return to me in the envelope provided.
Also enclosed is a check in the amount of $30.00 in payment of the filing fees.
If anything further is required, please advise.
Sincerely,
,~ ' D.~ _.
Sharon K. Shaffer
Estate Administrator
Enclosures ~,Q ~ --, ~ ~ ='..
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A Member of LawPactTM - An International Association of Independent Law Firms
INVENTORY
'~ REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA 1 SS
COUNTY OF CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21-09-0748
Personal Representative(s) of the Estate of VERONICA A. GOUFFER
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 unsworn falsification to
authorities.
Attorney -- (Name) BRIDGET M. WHITLEY, ESQUIRE
/V
(Supreme Court LD. No.) 33580
(Address) 17 S. 2ND STREET, 6TH FLOOR, HARRISBURG, PA 17101
(Telephone) 717-233-1000
DATE OF DEATH
07/21 /2009
LAST RESIDENCE
1 LONGSDORF WAY, CARLISLE, PA 17013
FIGURES MUST BE TOTALED
PLEASE SEE ATTACHED
DECEDENT'S SOC. SEC. N0.
206-10-8650
35,035.45
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(Attach additional sheets as needed)
TOTAL: ~ 35,035.45
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. (See 20 Pa. C.S. § 3301(b))
Form RW-09 rev. 10.13.06
~'
Page 1
Estate of VERONICA A. GOUFFER
Estate Inventory
Valued as of Date of Death
Cash and Cash Equivalents
Cumberland Crossings -Refund
petty cash
Diakon Lutheran Social Ministries -
Account refund
Highmark Freedom Blue -Refund
M&T Bank Checking Account(see
attached statement)
Personal Belongings
Wiedeman Funeral Home -Refund
Total Cash and Cash Equivalents
Total Inventory
(1)
~ 50.11
2,368.50
179.24
31,915.67
100.00
421.93
$ 35,035.45
~ 35,035.45