Loading...
HomeMy WebLinkAbout04-15-11INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF DAUPHIN COUNT~~, PENNSYLVANIA File Number ? 1 Personal Representative(s) of the Estate of MICHAEL C. MCLAUGHLIN 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 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) HEATHER D. ROYER, ESQUIRE (Su~~reme Court LD. No.) 76327 (Address) 4431 N. FRONT STREET, 3RD FLOOR HARRISBURG PA 17110 (Telephone) (717) 234-2401 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 7 WHITE OAK BOULEVARD 6/10/2010 MECHANICSBURG PA 17050 178-38-1026 FIGURES MUST BE TOTALED PROCEEDS FROM SALE OF 2006 HUMMER H3 PROCEEDS FROM SALE OF 2002 LEXUS LPL FINANCIAL INDIVIDUAL ACCOUNT 1226-1481 UNUM LIFE INSURANCE POLICY PREMIUM REFUND CAPITAL BLUE CROSS PAYMENT OF AMBULANCE CLAIM PA TURNPIKE EZPASS REFUND ALLSTATE INSURANCE PREMIUM REFUND ~dd ~ ~.)4~ ~~~~~~' 1~~~~'~~~~ ~~~~~~~ S.=~lb~d~0 ~~ ~!~~~~ (Attach additional sheets as needed) NOTE: The Memorandum of real estate outside the Commonwealth of Pf item, but such figures should not be extended into the total of the Form RW-09 rev. 10.13.06 16,000.00 19,500.00 479.88 1,140.98 1,250.00 16.50 213.92 AL: 38,651.28 ~~y, aX,t~e~Ieelion~laf-t person,~l representative include the value of each ~~ 10 0635 Continuation of Inventory MICHAEL C. MCLAUGHLIN 21 10 0635 Decedent Name Pa e 1 File Number Description of Inventory ALLSTATE INSURANCE REIMBURSEMENT FOR TOWING MICHAEL MCLAUGHLIN, LLC 50.00 0.00 MORTGAGE NOTE FROM ROBERTA M. KLEIN TO MICHAEL C. MCLAUGHLIN ~ 0.00 Subtotal ~ $ 50.00 Grand Total ~ $ 38.651.28