HomeMy WebLinkAbout02-09-11 (3)r.,a
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INVENTORY ~~ =-~, tom' n
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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENN IA + r" i.l + rT
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COMMONWEALTH OF PENNSYLVANIA ~ SS s~j~~ ~ :r`y~~~
COUNTY OF File Number 21 10 X684 f_. ~,
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Personal Representative(s) of the Estate of WINIFRED A. WESTHAFER
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) DAVID H RADCLIFF, ESQ. (Supreme Court ID. No.) 25483
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(Address) 1011 MUMMA ROAD, STE 201 LEMOYNE PA 17043
(Telephone) 717 236-9318
DATE OF DEATH
LAST RESIDENCE
1283 EAST TRINDLE ROAD
DECEDENTS SOC. SEC.NO.
PA 1
FIGURES MUST BE TOTALED
35 Shares MetLife x$40.44
Comcast -Refund
Verizon -Refund
Medicare Part D Rebate
Penn Treaty -Premium Refund
Penn Treaty -Premium Refund
Penn Treaty - At Home Care Reimbursement
(Attach additional sheets as needed!
1,415.40
27.61
10.48
250.00
35.11
253.27
1,648.50
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. § 330/(6))
Form RW-09 rev. 10.!3.06 \~
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Continuation of Inventory
WINIFRED A. WESTHAFER
21 10 00684
Decedent Name Pa9e ~ File Number
Description of Inventory
ESTATE OF WINIFRED A WESTHAFER
FILE N0.21-10-00684
S.S. #193-24-2340
PERSONAL PROPERTY
Refrigerator $ 50.00
Microwave $ 25.00
Washer $ 25.00
Furniture $ 100.00
TV $ 25.00
Small Appliances $ 75.00
Push Mower $ 25.00
Dinnerware $ 50.00
Pots/Pans $ 25.00
Keepsakes $ 50.00
$450.00