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HomeMy WebLinkAbout08-26-10~ _i REV-1162 EX111-961 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17126-0601 RECEIVED FROM: BROWN PATRICIA R 354 ALEXANDER SPRING RD CARLISLE, PA 17013 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 162-36-8470 FILE NUMBER: 2110-0105 DECEDENT NAME: FRAKER ARLENE DATE OF PAYMENT: 08/26/2010 POSTMARK DATE: 08/26/2010 COUNTY: CUMBERLAND DATE OF DEATH: 10/01 /2009 TOTAL AMOUNT REMARKS: NO. CD 013259 CHECK# 5048 ', INITIALS: SAP SEAL RECEIVED BY: GLENDA EARNER ST~ASBAUGH REGISTER OF WILLS I, REGISTER OF WILLS ACN ASSESSMENT MOUNT CONTROL i NUMBER ''~ 1N`J.~NTORY REt^iS'TER Of WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Deanna Salisbury Personal Representative(s) of the Estate of Arlene Fraker deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal a sets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation pfa d apposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned o real estate outside of the Commonwealth of Pennsylvania except that whi appears in a me orandum at the end of this i ventory. I verify that the statements made in this Inven- ~ j ~,d~` ~ .~ It ~,(j~;•r•.•- li tory are true and correct. I understand that false state- v Deanna Salisbury ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney - (Name) (Firm) (Address) (Telephone) Patricia R. Brown Esq. (Supreme Court f.~. No.) 27474 Salzmann Hughes, P C 354 Alexander S rin Road Suite 1 Carlisle PA 717-249-6333 DATE OF DEATH LAST RESIDENCE 4029 Carlisle Rd 1010112009 Gardners, PA 1 FIGURES MUST BE TOTALED Personal Proms Cash ............................................................................................... Personal Property ........................................................................ StockslListed ................................................................................ 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 ........................ NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may at the election of the personal representative include thevalue of each item, but such figures should not be extended into the fatal of the Inventory. (See X10 Pa. C.S. § 3301(b)) i Form RW-09 Rev. 10-132006 File Number 21-10-0105 DECEDENT SOC. SEG. no. 162-36 840 C'7 C i~t'' := ' C/~ ~--' C7 i ~:C7. :~, ~ _o -•i v 78.66 ~00.~-~ f N _- . C"7 t71 ~_~ ; 3 r"~ -,r ~:~ `: , CJi :-~.~ t~ -;,; 55, 078.66 .' F ~' f~~` ~~ 55,078.66 REGlS~ER OF WILLa _OF CUMBERLA°ND COUNTY, PENN~YLWANlA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland File Number 21-10-0105 DECEDENTS SOC. ISEC. NO. DATE OF DEATH LAST RESIDENCE 4029 Carlisle Rd 10/01!2009 Gardners PA 17324 162-36-847 ~b Estate of Dallas J. Paxton -1/3rd residual distribution HMA -Physician Management -refund Total Cash Personal Pro~ertr 2002 Dodge Intrepid -VIN 2B3HD46R72H101296 Total Personal Property 53,228.66 50.00 53__. 1,800.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 55,078.66