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HomeMy WebLinkAbout06-01-10CJ`/-~%tl SUPPLEMENTAL INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS 21 00-0398 File Number Personal Representative(s) of the Estate of Barbara Ann McCarthy a/k/a Barbara A. McCarthy 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 appeazs in a memoran um at th end of this inventory. I verify that the statements made in this Inven- ~'~ ~ G~`~.o ~ tory are true and correct. I understand that false state- ( l'~- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorne ame Heather D. Royer, Esquire 76327 Y -- ~ ) (Supreme Court LD. No.) (Address) 4431 N. Front Street, 3rd Floor, Harrisburg, PA 17110 (Telephone) (717) 234-2401 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 04/17/2009 11 Hartzdale Drive, Camp Hill, PA 17011 209-28-9279 FIGURES MUST BE TOTALED 1. 2009 1040 Income Tax Refund 1,079.00 ev e=, ->: _~ ~ " t.__ - - x i ~ f. -` ~ -. ~~~-, ~~~ ~ % - - -~ r _ a , © , l r (Attach additional sheets as needed) AL: ~ 1,079.00 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 ZO Pn. C.S. ~' 3301(6)) Form RW-09 rev. 10.13.06