HomeMy WebLinkAbout01-12-12 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF Cumberland
File Number 21 11 1253
Personal Representative(s) of the Estate of K. Edward Mullen
deceased, depose(s) and says} 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 Pennsylvamaexcept 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-
ments herein are made subject td the penalties of
18 Pa. C.S. § 4904 relating to ur~sworn falsification to
authorities.
Attorney -- (Name) William
(Address) 240-
(Telephone) ,~
DATE OF DEATH
/18/2011
f
ennet u en
[Z. Swinehart (Supreme Court LD. No.) 55806
6 Market Street Sunbury PA 17801
286-7777
LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
3807 OXBOW DRIVE
CAMP HILL PA 17011 16 61419 3 4
I FIGURES MUST BE TOTALED I
Proceeds of sale of miscellaneous personal property & guns
County Meadows West Shpre -refund
TDS -refund
Long term care benefit for (September, 2011
Long term care benefit for (October, 2011
n
Stone Valley Insurance - refund of insurance premium :;
7
i _ ~,
-,. r-
. rrT
Donegal Insurance -refund of insurance premium `
.~ c-~
_.,'.,
,: i .
~, _
I ~
(Attach additional sheets as n.
1,910.68
1,885.22
17.40
2,700.00
1,620.00
.~
r~s~ ~~
t __ , =x:60
~.
.s::: ~%
~ 178.00
~ry
-_';
~...r __. ~..'~
~q.:' ~.. i~'1 ~.
~~
TOTAL: ~ 8,819.14
NOTE: The Memorandum of real estateE outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each
item, but such figures should n{~t be extended into the total of the Inventory. (See 20 Pa. C.S. § 330!(b))
Form RW-09 rev. 1(,I. /3.06
Continuation of Inventory
K. Edward Mullen 21 11 12 5 3
Decedent Name Page ~ File Number
I
Description of Inventory
PPL -refund
Pinnacel Health -refund / co-nay
Holy Spirit Hospital -refund /I co-pay
Cash in possession of decedent
15.24
20.00
20.00
447.00
subtotal E 502.24
Grand Total S 8,819.14