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HomeMy WebLinkAbout06-10-10 (2).~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF CUMBERLAND 09 0915 Personal Representative(s) of the Estate of Alice Virginia Bemiller deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the perso~al assets whenever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation plac~t~osite a item of std ,_ inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no realt~e outsid~f then' ~ ~ Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory ~ ~ ~~.. ~C ~";. ,~.~; j~ fib ~ © ~-`-~~, _:-r:.~ I verify that the statements made in this Inven- ~ ~ ~ r~ ~ ~ k ' r `~~ tory are true and correct. I understand that false state- ~'"' .._r.. ~ ments herein are made subject to the penalties of -~~ ~~~ ::~:. C"i `-1 ~ F : ~`: r"r^j 18 Pa. C.S. § 4904 relating to unsworn falsification to ~ authorities. ©, Attorney -- (Name) Heather D. Royer, Esquire (Supreme Court I.D. No.) 76327 (Address) 4431 N. Front Street, 3rd Floor Harrisburg PA 17110 (Telephone) X717) 234-2401 DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO. 570 Gutshall Road 9/16/2009 Boilin S rin s PA 17007 193-24-0128 FIGURES MUST BE TOTALED 570 Gutshall Road, Boiling Springs, PA 17007 ~ 94,000.00 Wells Fargo Stock (83 shares x 29.09 mean value) ~ 2,414.47 10 United States Treasury Series EE Bonds I 2,763.60 F&M Trust Checking Account No. 33-15835 I 32,736.43 Personal Property, Household Furnishings & Automobile I 2,529.00 Unclaime Property -Tyco Int'1 Ltd. dividends I 5.60 Other personal property appraised value 762.50 (Attach additional sheets as needed) TOTAL: 137,244.58 COUNTY, PENNSYLVANIA File Number ? 1 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 Continuation of Inventory fi Alice Virginia Bemiller 21 09 0915 Decedent Name Paae 1 File Number Description of Inventory Cash 424.04 Yard Swing ~ 75.00 Wells Fargo -cash in lieu of fractional shares ~ 22,76 Wachovia -dividend on unexchanged shares ~ 36.80 Highmark -refund of insurance premium 65.45 Safeco -refund of auto insurance premium 53.66 Embarq -refund of overpayment ~ 20.58 2009 Personal Federal Income Tax Refund ~ 443.00 Comcast -refund of overpayment 13.61 Leffler Energy -refund of overpayment 542.27 Allstate -refund of homeowner's insurance premium 302.00 Camp Hill ER Physicians -refund of overpayment ~ 33.81 Subtotal $ 2,032.98 Grand Total $ 137,244.58