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HomeMy WebLinkAbout02-15-12INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS ~~f Charles H. er, Jr., Executor CHARLES H. DILLER. 3R. Personal Representative(s) of the Estate of EDITH C. McCQNNELL 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 Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this) Inventory are true and correct. I understand ) that false statements herein are made subject ) to the penalties of 18 Pa.C.S. § 4904 relating ) to unsworn falsification to authorities. ) Attorney -(Name) (Address) DATE OF DEATH ~ LAST RESIDENCE ~ DECEDENT'S SOC. SEC. NO. 09!1912011 3100 Grandon Wav. Suite 514. Mechanicshurg. PA 17050 70R. t R_7257 FIGURES MUST BE TOTALED 1. Mid Penn Bank Checking Acct. #18007989 570,050.54 2. Mid Penn Bank Checking Acct. #1$014183 504.72 3. Retirement for September 2011-Tyco Electronics, AMP pension plan 470.58 4. Refund, prepaid medical, Capital Blue Cross ~ x.21 -~ n ~a ~ as ~t.~ ~ cri r o -~~' -~ ~ ~ ~ ~. C Q ~ Attach additiano! sheers as needed 71,611.05 TOTAL: vv>>;: i ne memoranaum of rear estate outsiae me 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. ~ 33(1!(6)) Form RW-09 rev. 10.13.06 652668.1 File Number 20-11-1035 (Supreme Court I.D. No.) a~ r ,~ t~ `z; . ~=; "T? r'r'1 ~ Q -7'T