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HomeMy WebLinkAbout06-23-11 (2)INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Nicole M. Jordan Personal Representative(s) of the Estate of Connie Sue Jordan 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 pears in a memorand 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 Nic a M. Jordan 18 Pa.C.S. § 4904 relating to unsworn falsification to ~ --- - authorities. Attorney -- (Name) (Firm) (Address) (Telephone) Patricia R. Brown Esq. Salzmann Hughes, P.C. 354 Alexander Spring Road, Suite 1, Carlisle, PA 17015_ 717-249-6333 (Supreme Court 1. D. No.) 27474 DATE OF DEATH LAST RESIDENCE 360 Old State Road DECEDENT'S SOC. SEC. NO. 07/23/2009 Gardners PA 17324 190-54-4743 FIGURES MUST BE TOTALED Personal Pro ertv 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 ........................ 121,163.48 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(b)) COUNTY, PENNSYLVANIA File Number 21-09-0813 14,135.37 4,500.00 ~ ,- ".~- ~~ .., _ .-~ . -~ ~' ,~ i I y '~ ~~ .~ ` x .. 18fi35 3t''~ . 102,528.11 Form RW Q9 Rev. 10-13-2006 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-09-0 DATE OF DEATH LAST RESIDENCE 360 Old State Road 07/23/2009 Gardners PA 17324 Cash Carlisle Regional Medical Center -refund of overpayment Cornerstone Federal Credit Union, Regular Share Account #79712-01 Cornerstone Federal Credit Union, Regular Share Account #9712 Cornerstone Federal Credit Union, Share Certificate #9712-10 Accrued interest on above item through date of death Cornerstone Federal Credit Union, Share Certificate #9712-11 Accrued interest on above item through date of death Cornerstone Federal Credit Union, Share Draft Account #9712-07 Lightstyles Ltd. -final pay check PSECU, Checking Account PSECU, Savings Account United States Treasury -refund of overpayment of 2009, 1040 income tax 813 DECEDENT'S SOC. SEC. NO. 190-54-4743 Total Cash Personal Proms 1996 Ford Truck -VIN 1 FMDU35PSTUC58925 2002 Nomad Trailer -VIN 1SN200P202H000206 Total Personal Property 350.00 3.52 26.78 9,240.48 27.29 1,155.08 3.41 16.79 626.40 363.98 305.64 2,016.00 14,135.37 500.00 4,000.00 4,500.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 121,163.48 REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-09-0813 DATE OF DEATH LAST RESIDENCE 360 Old State Road DECEDENT'S SOC. SEC. NO. 07/23/2009 Gardners PA 17324 190-54-4743 Rea I Estate Real Estate situate at 370 Old State Road, Gardners, -Cumberland Co., PA at value owed to Mortgage Company (NOTE: This property was subject to mortgage foreclosure and conveyed via Sheriff Sale to lender for its lien and its costs ($1.00). Total Real Estate 102,528.11 102,528.11 -2-