HomeMy WebLinkAbout05-14-12 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF NENNSYLVANIA 1 SS
COUNTY OF CUMBERLAND )
COUNTY, PENNSYLVANIA
File Number 2011-925
Personal Representative(s) of the Estate of Robert L. Keith, Jr.
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 in rentory.
;~
I verify that the statements made in this Inven-
tory are true and correct. 1 understand that false state-
ments herein are made subject to the penalties of ~ .~ ~,o.E~- ~yr,L~
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) Michael J. Wilson
(Address) 113 Iron Furnace Court
(Telephone) 717.795.6217
DATE OF DEATH LAST RESIDENCE
August l4, 2011 46 Trudy Circle Mechanicsburg PA 17050-3638
Pruco Securities -Account No. YC2C-4676-5905
Prudential -Account No. 0031000084
1988 Redman Mobile Home
52680
(Supreme Court LD. No.)
FIGURES MUST BE TOTALED
Refund -United Healthcare Insurance Company -Health Insurance Benefit
Refund -Office of the Controller Cumberland County -Burial Expense Refund
Refund - Verizon Wireless
Refund - DS Waters
Refund -Sgt Grit, Inc. -Burial Expense Refund
John Deere Mode12305 Compact Utility Tractor
(Attach additional sheets as needed)
TOTA L: I 41,671.37
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))
7,204.50
1,949.71
18,000.00
2,286.00
100.00
79.04
9.16
~ W' 42.96
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DECEDENT'S SUC. atc.;. rv~.
Form RW-09 rev. 10.13.06