HomeMy WebLinkAbout03-21-12 (2)INVENTORY
REGISTER OF WILLS OF cuMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA 1 SS
COUNTY OF CUMBERLAND J
File Number 21 11 0731
Personal Representative(s) of the Estate of CLARE G . T R A C Y
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-
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa. C.S. § 4904 relating to unsworn falsification to
authorities.
CLARE M.KOERNER
Attorney -- (Name) DAVID W. REALER (Supreme Courtl.D.No.) 20868
(Address) 2331 MARKET STREET CAMP HILL PA 17011
(Telephone) 717-763-1383
DATE OF DEATH
LAST RESIDENCE
801 N. HANOVER STREET
DECEDENTS SOC. SEC. NO.
5/27/2011 ~CARLI$LE PA 17013 I20
FIGURES MUST BE TOTALED
Stocks & Bonds
n
>~
Closely-Held Corporation, Partnership or Sole-Proprietorship '~r~l~
_~
rd
`' J
Mortgages & Notes Receivable --%C
Cash, Bank Deposits, & Misc. Personal Property~t'
JOHN HANOCK LIFE INSURANCE COMPANY - REFUND OF LONG
TERM INSURANCE
NEW YORK STATE AND LOCAL RETIREMENT SYSTEM - PENISON BENEFIT
PERSONAL PROPERTY
additional sheets as
-~ ~ rr C
,
fTt N ! "-t r
~ --
O -, ' . ~~;
--
--n r;
'
__
r?
cn C~
cam:
3,456.00
1,328.13
100.00
12,915.35
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(b))
FormRW-09 rev. 10./3.06
Continuation of Inventory
CLARE G• TRACY 21 11 0731
Decedent Name
Pa e 1 File Number
Description of Inventory
CHURCH OF GOD AND TWO EMPIRE PLAN
GILBERT L• DAILEY FUNERAL HOME INC• - REFUND
Real Estate
7,800.09
231.13
Subtotal I E 8,031.22
Grand Total I S 12.915.35