HomeMy WebLinkAbout09-27-11 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland SS 21-10-0115
File Number
P. Kenneth Lehman, Executor
Personal Representative(s) of the Estate of Simon A. Lehman, Jr.
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 e random 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-
ments herein are made subject to the penalties of P• Kenneth Lehman, Executor
18 Pa.C.S. § 4904 relating to unsworn falsification to - X877 Hen ~ Ro ~
authorities. Chambersburg, PA 17202
Attorney -- (Name) Richard C. Snelbaker (Supreme Court LD. No.) 6355
(.9ddress) Snelbaker & Brenneman, P.C., 44 West Main Street, Mechanicsburg, PA 17055
(Telephone) 717-697-8528
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
January 28, 2010 233 Skyline Drive, Silver Spring Twp., Mechanicsburg PA 17050 177-24-6501
FIGURES MUST BE TOTALED J
1. U.S. Savings Bond, Series EE with $50.00 face value, Bond #L478112167EE 60.04
2. 2008 Honda Automobile, sale value 17,300.00
3. Bankers Life, refund unused premium on long terns care policy 684.37
4. Coventry Health Product Services, refund due the decedent 16.70
5. Mennonite Mutual Aid Association, refund unused premium on health insurance policy
263.87
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(Attach additional sheets as needed)
TOTAL
18,324.98
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))
F'orrn RDV-09 rev. 10.13.06
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