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HomeMy WebLinkAbout05-17-10 (3)INVENTORY REGISTER OF WILLS OFCUMBERLAND COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF CUMBERLAND COUNTY, PENNSYLVANIA File Number 2 O 10 0 0 013 Personal Representative(s) of the Estate of Donald C Stouffer 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. ~ rv A ~ -^ ^ ~ I verify that the statements made in this Inven- ;~, , , ~ ` ' ~ ~'r - tor are true and correct. I understand that false state- ~ ' `" ', meets herein are made subject to the penalties of Phyllis George ' ; ~ ~~-c ~ , -~ -. r 18 Pa. C.S. § 4904 relating to unswom falsification to r~ 7 authorities. ~ ~ ~_: (Supreme Cou'rt~D. No.) x,7993 ~` r=~ Attorney -- (Name) Jan L Brown ~~ , _a (Address) 845 Sir Thomas Court Suite 12 Harrisburg ~' f~A 1710 (Telephone) 717-541-5550 DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO. 304 Lamp Post Lane 12/31/2009 Cam Hill PA 17011 201-16-5402 FIGURES MUST BE TOTALED Citizens Bank Checking 610076-475-3 Citizens Bank Savings 6140-186099 Real estate tax reimbursement State Farm; auto insurance cancellation refund 2005 Chevrolet Malibu LS VIN 1G1ZT52895F305024 Household goods and furnishings 304 Lamp Post Lane, Hampden Township, Cumberland County, PA (Attach additional sheets as needed) 20,176.03 1,141.84 203.67 81.13 6,000.00 3,036.00 280,100.00 TOTAL: ~ 310,738.67 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. 5~ 3301(b)) Form RW-09 rev. 10.13.06