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HomeMy WebLinkAbout05-21-10 (3)INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Steve A. Kauffman COUNTY, PENNSYLVANIA File Number 21-08-0826 Personal Representative(s) of the Estate of Clinton E. Kauffman 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 whic a pears in a error ndu t the end pf~this invent. I verify that the statements made in this Inven- ~ ,~,~, y~. ~ ;:__,7 0 . ~ tory are true and correct. I understand that false state- _-, - ~-'- Steve A. Kauffman ~ ~ ~"" ments herein are made subject to the penalties of ~ it ~ -~ 18 Pa.C.S. § 4904 relating to unsworn falsification to - '~ N -- - authorities. `' c - ~.. Attorney -- (Name) Robert C. Saidis Esq. (Supreme Courtl.D. No.jC~ 21458' (Firm) Saidis, Flower & Lindsay (Address) 26 West High Street, Carlisle, PA (Telephone) 717-243-6222 DATE OF DEATH I LAST RESIDENCE 48 Llmeklln Road FIGURES MUST BE TOTALED Personal Property 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 ........................ 789, 278.02 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 Rey io-is-zoos 568,833.02 7,445.00 576,278.02 213,000.00 INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY, PENNSYLVANIA COUNTY OF Cumberland } File Number 21-08-0826 DATE OF DEATH LAST RESIDENCE 48 Limekiln Road Cash Department of the Treasury -Refund for the 2008 personal income tax return Erie Life Insurance Proceeds ING Direct Deposit Life Insurance -Deposited 4-9-2009 M & T Bank Checking Account #3740994300 M 8~ T Bank Saving Account 015004198283704 Misc Deposit Refund Refund from American Education Services Refund from Capital Blue Cross -for Alexander Spring Emergency Physicians Refund of Overpayment of Insurance -Erie policy West Perry School District -Final paycheck Total Cash Personal Property 2004 Saturn Vue Total Personal Property 2,732.00 401,039.50 277.53 156,098.16 493.58 1, 544.90 95.68 204.07 158.51 594.00 37.00 5,558.09 568,833.02 7,445.00 7,445.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 789,278.02 INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS uH i t Ur UtATH 07/30/2008 LAST RESIDENCE 48 Limekiln Road Carlisle, PA 17015 File Number COUNTY, PENNSYLVANIA 21-08-0826 DECEDENT'S SOC. SEC. N0. 176-44-1014 Residence-48 Limekiln Road, Carlisle, PA -All that certain parcel of land with improvements thereon erected known and numbered as 48 Limekiln Road more particularly bounded and described in Deed Book 273 at page 3522 with a tax parcel identification number 46-20-1780-009. Total Real Estate CUMBERLAND 213,000.00 213,----_ -2-