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HomeMy WebLinkAbout04-20-12GUARDIAN' S INVENTORY COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION l ~ an Incapacitated Person Ma A. Barzda Estate of rY J ' p ~" ^ a Mind ~ ~„ ~~ ~~ ~~ No.21-10-0875 -v -~ ~ y r ? ~ ;' = `__ ' T ~ T ~yy1 ~ .. L. 1; 1 ~~ f_' "1 `• ~ 1 ~ ..~ ~~•J~ ., ~ _h, r J ~-~ r-r 1. Real Estate: (Location, by whom occupied and rental EstimaRied Valuer- ~•~ terms, if applicable) `°` Undivided one-third interest in 429 Criswell Drive, Boiling Springs, PA 21,000.00 Sub-Total for Real Estate: 21,000.00 2. Personal Property: Estimated Value: TransAmerica fixed annuity 116,000.00 TransAmerica single premium whole life insurance policy cash value 106,000.00 Allstate single premium whole life insurance policy cash value 108,000.00 PNC Bank check account 9,500.00 PNC Bank Certificate of Deposit 61,830.00 3. Jointly Held Property: Estimated Value: (Set forth real and personal property owned by the Incapacitated Person JO/NTLY with any other person(s). State whether held as tenants by the entireties; if not, whether the right of survivorship exists.) Jointly Held Property Form G-04 rev. !0.13.06 Page 1 of 2 ~~ Estate of Mary A. Barzda ~~an Incapacitated Person ' Da Minor 4. Anticipated Assets: (Set forth property of any kind expected to be acquired hereafter, together with anticipated date of acquisition.) Property Anticipated Date ojAcquisition None Sub-Total for Personal Estate: (Attach additional sheets if necessary) TOTAL OF ITEMS 1, 2, 3, and 4 :............................ . Commonwealth of Pennsylvania . ss. County of Cumberland . Ann P. Barzda Estimated Value: 0.00 401,330.00 422,330.00 says that the foregoing is a full, Guardian true and complete Inventory of the Estate of Mary A. Barzda the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unsworn ) falsification to authorities. ) /~ /. Guardian Attorney for Guardian: Wayne F. Shade, Esquire Supreme Court I.D. No.: 15712 Address: 53 West Pomfret Street Telephone: (717) 243-0220 Carlisle, PA 17013 Form G-04 rev. 10./3.06 Page 2 of 2