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HomeMy WebLinkAbout09-30-10 (2)INVENTORY COUNTY, PENNSYLVANIA REGISTER OF WILLS OF C U M B E R L A N D COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF CUMBERLAND File Number 21 10 0 415 Personal Representative(s) of the Estate of J E S S I E E- J O H N S O N sed de ose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate decea P f the real estate in the Commonwealth of Pennsylvania of saihDnd thattDecedent owned no real esotateooutstde of the of sai and all o inventory represents its fair value as of the date of the earsan a smemorandum at the end of this inventory. Commonwealth of Pennsylvania except that which app I verify that the statements made in this Inven- tory are true and correct. I understandenalties of tate- ments herein are made subject to the p J E S M • JOHNS O 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. '" (Supreme Court I.D. No.) 94892 Attorney -- (Name) DAVID J • LEDERMANN pA 17011 CAMP HILL (Address) 3425 SIMPSON FERRY ROAD (Telephone) 717-763-1121 DECEDENT'S SOC. SEC. NO. DATE OF DEATH 4/ PA 17015 1177-74-90 FIGURES MUST BE TOTALED WRONGRLANDECOUNTYRCOURT OFT COMMONAPLEASOEEDS CUMBE DOCKET N0~ 10-5178 GROSS PAYOUT OF CLAIMS $125,000AL7ACTIONOCLAIM•TO WRONGFUL DEATH CLAI AND 30i ALLOCATED TO THE SURVI n ("' f'rl ..niloit 1 aaau~or~~ ~.~~~.., ».... $37,500.00 NOTE: The Memorandum of real estate outside the Comm he total of the Inventorya (See 20 Pa. C.SIl§ 3301(b)~ ersonal representative include the value of each item, but such figures should not be extended into t tAST RESIDENCE 476 STONEHOUSE ROAD $37,500.00 ['J ~_ _~.. "'~ ~ `f:7 W ,~ Q ;~ -q - - i N _ ;'r, ~r `I~~ Form RW-09 rev. 10.13.06