HomeMy WebLinkAbout03-08-12 (2)INVENTORY
REGISTER OF WILLS OF cuMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF CUMBERLAND
File Number 21 11 0804
Personal Representative(s) of the Estate of JACK D • WAG 0 N E R
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 appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven- /u ~"~ ~ ` ~ ~
tory are true and correct. I understand that false state- C L- ~"x-~ ,1--
ments herein are made subject to the penalties of J A C E • WAG 0 N E R
18 Pa. C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) SUSAN H• CONFAIR (SupremeCourtLD.No.) 70241
(Address) 2331 MARKET STREET CAMP HILL PA 17011
(Telephone) 717-763-1383
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO.
100 MOUNT ALLEN DRIVE
6/9/2011 MECHANCISBURG PA 17055 166030264
FIGURES MUST BE TOTALED
Stocks & Bonds
Closely-Held Corporation, Partnership or Sole-Proprietorship `~ c.-- s~
-~ .i f.7 ~ ~--
Mortgages 8 Notes Receivable - CT t
i . ~ ;~ ~
~l~
_? t~
-n
Cash, Bank Deposits, & Misc• Personal Property `'' "~ --
D
1 %~ :.~
~ .r.7
M & T BANK - CHECKING ACCOUNT #88272001 3,3!i9.65
499 MITCHELL ROAD
MILLSBORO, DE 19966
SUSQUEHANNA VALLEY FEDERAL CREDIT UNION - SAVINGS #4019-00 1,387.13
3850 HARTZDALE DRIVE
CAMP HILL, PA 17011
SUSQUEHANNA VALLEY FEDERAL CREDI UN•-LIFE SAVINGS INS•#4019-10 2,000.58
3850 HARTZDALE DRIVE
CAMP HILL, PA 17011
(Attach additional sheets as
7,497.36
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(6))
Form RW-09 rev. 10.13.06
Continuation of Inventory
JACK D. WAGONER 21 11 08174
Decedent Name
Page 1 File Number
Description of Inventory
PERSONAL PROPERTY 500.[10
DEPARTMENT OF REVENUE - REBATE 250.[10
Real Estate
Subtotal 3 750.00
Grand Total S 7,497.36