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HomeMy WebLinkAbout10-24-11 (2)INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-11-0889 Randall F. Byra and Judith M. Byra Personal Representative(s) of the Estate of Grace J. Tipton 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 inv ntory. I verify that the statements made in this Inven- ~ G 1~-~ 1~ ~C~; ~ 1 tory are true and correct. I understand that false state- ~ R 1 F. yra ments herein are made subject to the penalties of ~ ~ ~ /~' - / 7 -~~ // 18 Pa.C.S. § 4904 relating to unsworn falsification to dith M. Byra authorities. Attorney -- (Name) (Firm) (Address) (Telephone) James D. Bogar (Supreme Court I.D. No;) 19475 Bogar 8~ Hipp Law Offices One West Main Street, Shiremanstown, PA 17011 (717) 737-8761 DATE OF DEATH LAST RESIDENCE Claremont Nursing 8r Rehabilitation Center DECEDENT'S SOC. SEC. N0. 07/24/2011 Carlisle, PA 17013 201-18-6093 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... :'~ 5,873:30 Personal Pro e ; `T? ~ ~ ''~ p rty ........................................................................ ,-- , - - ,. -~ , .. , Stocks/Listed ................................................................................ ,=- ~~ :..-~ - ,; Stocks/Closely Held ..................................................................... ~ ~ -~~ ~~ - -- Bonds ............................................................................................ ; .-; _ '' -- Partnerships and Sole Proprietorships ..................................... - ~- -._: Mortgages and Notes Receivable ............................................... n ~ -' ~~' -- ~~` All Other Property ........................................................................ -,~, Total Personal Property ........................................ Total Real Property ................................................ Total Personal and Real Property ........................ 5, 873.30 5,873.30 ' 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)) Form RW-09 Rey. ~o-~s-loos INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-11-0889 DATE OF DEATH LAST RESIDENCE Claremont Nursing $c Rehabilitation Center DECEDENT'S SOC. SEC. N0. 07/24/2011 Carlisle. PA 17013 201-18-6093 ~.I] Blue Cross/Blue Shield -Refund Claremont Savings/Activities Fund Account -Date of death balance - $1,735.47 PNC Bank -Checking Account No. 5140064391; date of death balance $3,852.76. This account was non-interest bearing Veteran's Administration -retirement payment Total Cash 195.07 1,735.47 3,852.76 90.00 5,873.30 (Attach additional sheets if necessary) Total Personal Property and Real Estate 5,873.30