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HomeMy WebLinkAbout02-11-11 (2)INVENTORY REGISTER OF WILLS OF cuMeERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSY VANIA COUNTY OF ~„~~~ ~ ~ ~ SS File Number 21 10 0638 Personal Representative(s) of the Estate of HAMILTON M . H E N R Y 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. Attorney -- (Name) SUSAN H - CONFAIR (Supreme Courtl.D. No) 70241 un i c yr utA ~ M /6/ (Address) 2331 MARKET STREET CAMP HILL PA 17011 (Telephone) 717-763-1383 LAST RESIDENCE 408 HUNTINGTON AVENUE DECEDENTS SOC. SEC. NO. Stocks 8 Bonds GE/FULTON STOCK FULTON DIVIDEND PA 17025 X04924 FIGURES MUST BE TOTALED Closely-Held Corporation, Partnership or Sole-Proprietorship Mortgages & Notes Receivable Cash, Bank Deposits, & Misc- Personal Property METRO BANK - CHECKING #512002064 3801 PAXTON STREET, HARRISBURG, PA 17111 (Attach additional sheets as needed) 9,861.50 3.15 r,s ~ ~ ' ~ ~ ~'~ C ~ r ~ 't7 _._, ~ to ~ - -t- -~-t ~ ;; ~--~ r tv ~~.. ~ ~'~"C7 ' c~~ ~ ~ 6,669.48 ru'1'AL: 19 , 5 4 2.8 6 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)) Form RW-09 rev. /0.13.06 Continuation of Inventory HAMILTON M• HENRY 21 10 0638 Decedent Name Page 1 File Number Description of Inventory FUNERAL REIMBURSEMENT CASH ON HAND PERSONAL PROPERTY COUNTY BURIAL AWARD COMCAST REFUND AUTO POLICY REFUND - ERIE INSURANCE HOMEOWNER'S INSURANCE POLICY REFUND Real Estate 2,000.00 25.00 500.00 100.00 73.73 229.00 81.00 Subtotal 5 3, 0 0 8.7 3 Grand Total S 19,542.86