The URL can be used to link to this page

Home My WebLink About05-06-11 (3)INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY of Cumberland County } S Simpson II File Number 21-10-01196 Personal Representative(s) of the Estate of Shirley Bennett LOTZ JERRY R. DUFFIE CJ ~-~ C1 a" ` m deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the perso~l~sets wha'~'~rever ;-- , situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation I~d oppos-ti a eat~i7 ~ item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent ov~d no real estate -n outside of the Commonwealth of Pennsylvania except that which pears in ~ m orandum at the end of fhis inventory.c~- I verify that the statements made in this Inven- ~ ~v,/ ~~c~ ~tr~-. tory are true and correct. I understand that false state- Richard S Simpson II ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Firm) (Address) (Telephone) (Supreme Court I.D. No.) 09601 P.~ ~~ rn -- JOHNSON DUFFIE STEWART & WEIDNER 301 MARKET ST LEMOYNE PA 17043-0109 17171761-4540 DA7E OF DEATH LAST RESIDENCE Messiah Village DECEDENTS SOC. SEC. NO. 11/27/2010 Mechanicsburg, PA 17050 202-20-6116 FIGURES MUST BE TOTALED Personal Pronertv Cash ............................................................................................... Personal Property ........................................................................ Stocks/Listed ................................................................................ Stocks/Closely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ................................................ Total Personal and Real Property ........................ 291,877.54 8,895.00 31,815.22 332,387.76 332,3t7.78 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. § 33D1(b)) Form Rw ifs! Rav. 10.13-2008 REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland County } DATE OF DEATH LAST RESIDENCE 11/21/2010 ~r881] File Number 21-10-01196 Messiah VIIla9e DECEDENTS SOC. SEC. N0. Mechanicsbu PA 17050 202-20-6116 2010 Federal Individual Income Tax Retum 950.00 Allstate Insurance Refund -Refund on Renters Insurance 52.00 Beneficiary: Residue of Estate Allstate Insurance Refund -Refund on Automobile Insurance 51.00 Beneficiary: Residue of Estate Ameriprise Annuity Account No. 93002115682 3 004 15,415.73 Ameriprise Annuity Account No. 93002407024 3 004 -Beneficiary: Estate of Shirley 38.753.33 Bennett Lotz Ameriprise Annuity Account No. 83003403328 4 004 -Beneficiary: Estate of Shirley 27,568.38 Bennett Lotz Ameriprise Annuity Account No. 93004115987 2 004 -Beneficiary: Estate of Shirley 47,059.41 Bennett Lotz Freedom Blue Premium Refund 132.80 Hartford Annuity 382.20 Holy Spirit Hospital -Refund on Account 75.00 Home Shopping Network (HSN) Refund on Account 5780-9795-3235-0858 -Beneficiary: 163.74 Residue of Estate Kay LLC d!b/a Home Instead Senior Care -Refund -Beneficiary: Residue of Estate 1.167.52 Pinnacle Health System Refund -Beneficiary: Residue of Estate 50.00 Reimbursement from The Law Offices of Pratz and Wallace -Error In billing 75.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 332,387.76 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland County } DATE OF DEATH LAST RESIDENCE M@SSfah Village DECEDENTS SOG. SEG. ND. 17/21/2010 Mechanicsbursl, PA 17050 202-20-6116 ReimburaemenVRefund of Retainer Check from Law Offices of Pratz and Wallace LLC - 2,990.00 Beneficiary: Residue of Estate Social Security -Payment of benefits 1,098.00 Sovereign Bank Checking Account No. 1051070267 13,853.08 Ameriprise Annuity Accounts - ~ Beneficiary: Estate Ameriprise Annuity Account No. 00086783808 8 021 (IRA) -Cash Account -Beneficiary: 30.990.27 Estate Ameriprise Annuity Account No. 00088783808 8 021 (IRA) -Trans Short Term Bond - C 10,208.89 Trans America Funds Beneficiary -Estate AmeHprise Annuity Account No. 93107812888 5 004 (IRA) -IRA Annuity Account 100,843.38 Beneficiary: Estate Total Cash 281,877.54 1995 Oldsmobile Ciera SL Sedan 4D -Kelly Blue Book valuation is attached Lady's 18K Yellow Gold Diamond Engagement Ring -Appraised by Joseph James Jewelers -Appraisal is attached to this Return Beneficiary: Dyane V. Smith Personal Property appraised by Chuck Bricker -Appraisal by Chuck Bricker, Auctioneer AU094-L Beneficiary: Dyane V. Smith Total Personal Property File Number 21-10-01196 2,675.00 5,250.00 970.00 8,895.00 -2- REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland County } File Number 21-10-01196 DATE OF DEATH LAST RESIDENCE Messiah Village DECEDENTS SOC. SEC. NO. 11/21/2010 Mechanicsbu PA 17050 202-20-6116 Stocks/Listed 1,040.1920 shares Ameriprise Mutual Fund Account No. 01013191525 7 002 - Transfer on Death 7,832.65 Account to Estate of Shirley Bennett Lotz 981.8880 shares Infl Prtct Services Secs B -Ameriprise Mutual Fund Account No. 01013480119 9 6.887.89 002 - Transfer on Death Account to Estate of Shirley Bennett Lotz 1.597.2310 shares Columbia Inflation Protected Securities Fund B - Transfer on Death Account to 16.914.68 Estate of Shirley Bennett Lotz Total Stocks/Listed 31,815.22 -3-