HomeMy WebLinkAbout09-16-10 (2)INVENTORY
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF CUMBERLAND
COUNTY,
File Number 21
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Personal Representatives} of the Estate of BETTY F • PETERS . °~' -- `~~~'
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.
I verify that the statements made in this Inven-
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa. C.S. § 4904 relating to unsworn falsification to
authorities.
~i~~Ne ~~ ~ v~l,a LL~e Y ~~ ~ i l~l
KENNETH A. SHOLLEY, ADMINISTRATOR
Attorney -- (Name) GERALD J • SHEKLETSKI, ESQ • (Supreme Courtl.D. No.) 40486
DATE OF DEATH
REGISTER OF WILLS OF
(Address) 414 BRIDGE ST. NEW CUMBERLAND PA ],?070
(Telephone) ?17-7?4-7435
LAST RESIDENCE DECEDENTS SOC. SEC. NO.
639 GETTYSBURG PIKE
8/26/2009 MECHANICSBURG PA 17055 200227426
FIGURES MUST BE TOTALED
PERSONAL PROPERTY
1• CITIZENS BANK CHECKING ACCOUNT NUMBER 6100702871
2• PERSONAL PROPERTY AUCTION SALE PROCEEDS
3• UNITED STATES TREASURY REFUND CHECK - 2009 FORM 1040
4• PA FORM 40 INCOME TAX REFUND CHECK
REAL ESTATE
1• 639 GETTYSBURG PIKE, MECHANICSBURG, PA ],7055
(Attach addltlonal sheets as needed)
2,243.96
1, 028.83
85.00
124.00
150,000•DO
TOTAL: I L 5 3, 4 81.7 9
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(6))
CUMBERLAND
Form RW-09 rev. 10.13.06