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HomeMy WebLinkAbout12-07-11 (2)S~F~~~ME~.~~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS File Number 21 I0 00888 Personal Representative(s) of the Estate of Ann M. Dykstra a/k/a Ann Marie Dykstra deceased, depose(s) and say(s) that the items appearing m 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 memorandum at the end of this inventory. I verify that the statements made in this Inven- ,~ tory are true and correct. I understand that false state- ~~~ `r (~~~ merits herein are made subject to the penalties of Pau] S. Cribbins 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) Benjamin J. Butler (Supreme Court 1. D. No.) 81948 (Address) 1007 Mumma Road Suite 101 Lemo ne PA 17043 (Telephone) 717.236.1485 DATE OF DEATH LAST RESIDENCE 4110 Carrington Court West 8/14/10 Mechanicsburir DECEDENT'S SOC. SEC. N0. PA 17050 528-64-7592 FIGURES MUST BE TOTALED Cash, Bank Deposits, & Misc. Personal Property Cash 4,256.18 `.~ __ ` :;.: 3's ~ --:~ -- :~_~ _W...y '' T ~- -~ ~~{ Yl L (Attach additional sheets as needed) TOTAL: ~ 4,256.18 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value ot'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 rev. 10.!3.06