HomeMy WebLinkAbout10-25-11INVENTORY
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
File NumbN~' 11 0368
Personal Representative(s) of the Estate of Ann E. Minich
deceased, depose(s) and say(s) that the items appearing in the following inventory include al] of the er
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation lace ..
inventory represents its fair value as of the date of the decedent's death, and th p ~~sets whErever ~ ,
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of th' P ~Ite ea~}3; item`:a~'~a~ ;
at Decedent owned no real ~~tsid~c~f the _
Is inventory rr ~.:;:~ _' - ~ `
,~.,r~
I verify that the statements made in this Inven- ~~ ~ ~
tory are true and correct. I understand that false state- " ~~`~ ~' ~~'
._: c-: __
ments herein are made subject to the penalties of `'
_.. ,
18 Pa. C.S. § 4904 relating to unsworn falsification to ~' ~~
authorities. <:.r- ~-~~ Cj
Attorney -- (Name) Ste hen J. Ho Es uire
(Address) 19 S. Hanover Street Ste. 101 (Supreme Court I.D. No.) 36812
Carlisle PA 17013
(Telephone) 7172452698
DATE OF DEATH
1 /25/201
2005 Chrysler Sebring
1964 Plymouth jury
.~
Unum Disability Payment
High,~iark Insurance Refund
Highmark Prescription Insurance Refund
Footlocker Stock Dividend
Unum Disability Lump Sum Benefit
additional sheets as
REGISTER OF WILLS OF CUMBERLAND
COUNTY, pENNSYLVANIA
LAST RESIDENCE
43 Pleasant Hall Road
} SS
FIGURES MUST BE TOTALED
DECEDENTS SOC. SEC. NO
3 184-36-6499
3, 750.00
4,000.00
1, 092.44
28.67
10.28
1.50
4, 096.65
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal reprOTALe incl 17 907 25
item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ,¢ 3301(b)J
ude the value of each
Form RW-09 rev. 10.13.06
Ann E. Minich
Decedent Name
Continuation of Inventory
Description of Inventory
2010 Federal Tax Refund
Estate checking account interest May 2011
Estate checking account interest June 2011
Estate checking account interest July 2011
Footlocker stock
Members 1st account# 104389-11
Estate sale
Footlocker stock dividend
Members 1st checking account# 76591-11
Members 1st savings account# 76591-00
0040-19 month CD 76591-40
21 11 0368
File Number
1,413.00
0.05
0.26
0.24
180.22
272.46
24.50
1.65
712.06
2, 011.36
311.91
Subtotal S 4 927 71
Grand Total S
17, 907.25