HomeMy WebLinkAbout11-05-10 (2)INVENTQRY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENI~~.,VAN~ -_ ~` ~`
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COMMONWEALTH OF PENNSYLVANIA r~~ rte"' ~
COUNTY OF CUMBERLAND } SS File Number 2110-0035 ~-;_.. -='_- ~ ~-,~ ;~-,
Diana D. Miller ~~_,~} ~- ~~ ,~
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Personal Representative(s) of the Estate of Troy A. Burkholder ~'~ ~ N ; : ~- ` ~'
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the pe~onal assetscvehere~er's~#-date
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite'e`~ch 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.
Attorney -- (Name) Craig A. Hatch, Esquire
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(Supreme Court I.~. No.) 76361.
(Address) Gates, Halbruner, Hatch & Guise, P.C., 1013 Mumma Road, Suite 100, Lemoyne, PA 17043
(Telephone) 717-731-9600
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
November 20, 2009 8 Cedar Road, Carlisle, Cumberland County, Pennsylvania 17015 18$-20-8796
FIGURES MUST BE TOTALED
Juniata Valley Financial Corp., common stock
Prudential Financial common stock
First National Bank -Certificate of Deposit No. 1730072635
OM Financial Life Insurance Co. -refund
Erie Insurance -premium refunds
Cash Refunds
Miscellaneous Personal Property
Discover Card -refund
US Treasury -decedent's 2009 federal income tax refund
PA Department of Revenue -decedent's 2009 state income tax refund
Snedeker Oil -refund
Verizon -refund
Prudential -life insurance policy of Mary A. Burkholder paid to Estate of Troy A. Burkholder
(Attach additional sheets as needed)
17,169.56
4,998.00
1S,30S.S4
450.00
219.00
754.00
37,91 S.SO
1.49
1,1SS.00
290.00
479.SS
8.01
1,439.20
TOTAL: ~ 80,185.1 S
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