HomeMy WebLinkAbout11-24-10 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND SS File Number 21-09-0092
Personal Representative(s) of the Estate of CLARA M. KOONTZ
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.
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I verify that the statements made in this Inven- '~"~,~~C~-C.
tory are true and correct. I understand that false state- ~
ments herein are made subject to the penalties of
18 PaC.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) IVtichael Cherewka (Supreme Courtl.D. No.) 35073
(Address) 624 North Front Street, Wormleysburg, PA 17043
(Telephone) 717-232-4701
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
December 19, 2009 Mechanicsburg, Pennsylvania 201-18-6447
FIGURES MUST BE TOTALED
1. M&T Bank Account #913072164 7,483.43
2. Refund - Enola Commons - TV Cable 50.00
3. Refund - Enola Commons -Security Deposit 398.60
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(Attach additional sheets as needea~
TOTAL:
7,932.03
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the s~alue 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
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