HomeMy WebLinkAbout11-23-10 (2)INVENTORY
CUMBERLAND COUNTY, pg~SYLVANIA
REGISTER OF WILLS OF
COMMONWEC~BE~A~S~'VANIA ~ SS
COUNTY OF
T T P h'~ 5
of the Estate of 7°hn W ~ COgley' Sr. ersonal assets wherever situate
Personal Representative(s) earin in the following inventory include all of the p
deceased, depose(s) and say(s) that the items app g side of the
monwealth of Pennsylvania of said Decedent, that Decedent towned no r eal estaeach ite sai
and all of the real estate in the Com
inventory represents its fair value as of the date of th ears in a memorandum at the end of this inventory.
Commonwealth of Pennsylvania except that which app (~ (~ -1
\1_X, W
I verify that the statements made in this Inven- '~
tory are true and correct. I understand that enaltiesatof
ments herein4904 relating to, unsworn falification to
18 Pa.C.S. §
authorities.
Attorney -- (Name)
(T'elephone) 717____611=
File Number 2010-00229
41274
(Supreme Court LD. No.)
Stre~ ite 400, Lemoyne, PA 17043
DATE OF DEATH
February 26, 2010
114 Limestone Drive, Camp Hill, PA
Miscellaneous Household Items
Traveler's Insurance -- refund
FIGURES MUST BE TOTALED
Highmark -- health insurance premium refund
pA Property Tax Rent Rebate for 2009 property tax year
2004 Chevrolet Trailblazer
Kemper Annuity Payment
VA Burial Benefit
Worldcom Settlement Fund -- class action settlement check
DECEDENT'S SOC. SEC. NO.
187-16-4397
C7
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i -fin
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Elyse E. Rogers (~[
. ~ Keefer Wood Allen &
LAST RESIDENCE
114 Limestone Drive, Camp Hill, PA 17011
161,436.06
(Attach aaa~cw..~..,...,.,... __ _ ><v ~ r,,...
lvania may, at the election of the personal representative include the value of each
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsy
item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(6))
150,000.00
2,440.00
34.00
370.14
300.00
8,050.00
135.73
100.00
6.19
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Form RW-09 rev. 10.13.06