HomeMy WebLinkAbout08-19-11 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF DAUPHIN
COUNTY, PENNSYLVANIA
File Number 21 10 1217
Personal Representative(s) of the Estate of WILBUR J. LEHMAN
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 place~o~losite eac'Ii item_of ~
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real;t3Le outsid~:_~f thee'
Commonwealth of Pennsylvania except that which appears in a memoranAdum~'at the end of this inventory ~~? T ~ ~ <;,`;
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 RONALD L. LEHMAN ' , = ~ _,
_~ - -
18 Pa. C.S. § 4904 relating to unsworn falsification to - -~ ` ~ !~
authorities. - --: j
Attorney -- (Name) HEATHER D. ROYER, ESQ. (Supreme Court LIJ. No.) 76327
(Address) 4431 N. FRONT ST., 3RD FLOOR HARRISBURG
(Telephone) 717-234-2401
PA 17110
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO
CUMBERLAND CROSSINGS - 1 LONGSDORF WAY
11/21/2010 CARLISLE PA 17015 201-16-5525
FIGURES MUST BE TOTALED
738 WEST MAPLE ST., PALMYRA, PA
(ASSESSED $11,641 X 7.04 CLR)
PSERS -FINAL PENSION BENEFIT CHECK
MEMBERS FIRST CHECKING ACCOUNT #XXXX-0011
MEMBERS FIRST SAVINGS ACCOUNT #XXXX-0000
MEMBERS FIRST CERTIFICATE OF DEPOSIT #XXXX-0043
NORTHWEST SAVINGS CERTIFICATE OF DEPOSIT #XXXX025
NORTHWEST SAVINGS CERTIFICATE OF DEPOSIT #XXXX390
(Attach additional sheets as needed)
81,925.64
425.31
10,194.48
51,284.23
5,036.86
5,007.47
5,026.85
183,529.74
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 ZO Pa. C.S. ,¢ 3301(bJ)
Form RW-09 rev. 10.13.06
Continuation of Inventory
WILBUR i. L.EIIMAM 21 10 1217
Decedent Name Pape 1 File Number
Description of Inventory
NORTHWEST SAVINGS CERTIFICATE OF DEPOSIT #XXXX033 7,486.11
REFUND -GOOD SAMARITAN OVERPAYMENT OF MEDICAL BILL 41.00
REFUND -CUMBERLAND CROSSINGS 2,401.00
REFUND - AARP UNUSUED PREMIUM 18.95
2005 HONDA ACCORD -SOLD 13,000.00
REFUND - RIVERSOURCE UNUSED PREMIUM 173.02
VETERANS BURIAL ALLOWANCE 100.00
REFUND -STATE FARM AUTOMOBILE INSURANCE UNUSED PREMIUM 81.23
REFUND - 2010 FEDERAL TAX RETURN 590.00
REFUND -SOCIAL SECURITY UNDERPAYMENT 675.00
REFUND -DISCOVER CARD OVERPAYMENT 0.12
STATE FARM -OVERPAYMENT 62.47
Subtotal S 24,628.90
Grand Total S 183,529.74