HomeMy WebLinkAbout08-09-11 (2)INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
William Engle
Personal Representative(s) of the Estate of Mae M En
CUMBERLAND COUNTY, PENNSYLVANIA
File Number 21-11-00733
a
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. irr a memora~nd__um at the_ nd of this inventory.
I verify that the statements made in this Inven- ~ ~ /.> ~~ /_~?-~ ~-.°
tory are true and correct. I understand that false state- ---L-'~~-
William Engle
ments herein are made subject to the penalties of
- - - ----
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) Marielle F Hazen, Esq. (Supreme Court I.D. No.) 68003
(F~rm) Hazen Elder Law ___ _
(Address) 2000 Linglestown Road, Harrisburg, PA_ 171_1.0 _
(Telephone) 717-540-4332
DATE OF DEATH
03/23/2011 LAST RESIDENCE Messiah Village
Mechanicsburg, PA 17055 DECEDENT'S SOC. SEC. NO.
207-28-7985
FIGURES MUST BE TOTALED
n =
Personal Property c.:a ~--. -~~
Cash ............................................................................................... .- -,
' -~i 21:;$45.86~f -_-,
p Y ........................................................................
Personal Pro ert
-;
" `- `~
n _
~
~
Stocks/Listed ................................................................................
~
.
~
Stocks/Closely Held ..................................................................... ~ ~-~ _.;,
;z
~.
Bonds ............................................................................................ _. _. _
-~~~ _ ~_~:
Partnerships and Sole Proprietorships ..................................... -`' ,.,, ~.~ ~.;
.....................
Mortgages and Notes Receivable .......................... `- ^~'
All Other Property ........................................................................
Total Personal Property ........................................
Total Real Property ................................................
Total Personal and Real Property ..................
21, 845.80
21,845.80
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 fgures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b))
Form RW-09 Rey io-is-zoos
INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland Fite Number 21-11-00733 _ _
DATE OF DEATH LAST RESIDENCE Messiah Village DECEDENTS SOC. SEC. NO.
03123/2011 Mechanicsbur PA 17055 207-28-7985
~~
Integrity Life Ins. Annuity Contract #2100162547
Total Cash
21,845.80
21,845.80
(Attach additional sheets if necessary) Total Personal Property and Real Estate 21,845.80