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HomeMy WebLinkAbout09-28-12INVENTORY ~_ _ L -.. REGISTER OF WILLS OF CUMBERLAND COUNTY PEI~~;YLVA~ A ~ `~~ , , Zl ~ . { ,~ c~ . N ~_ 1 COMMONWEALTH OF PENNSYLVANIA ~ ` - =' ~~• COUNTY OF Cumberland File Number _ 21-12-0063 `~ ~ -~" Oc ~~ ~-~ Adam Smith - ~ -~:; , ~ ` U n Personal Representative(s) of the Estate of Gary L Smith ~ 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 ap ears in a m~orandum ~ th of this inventory. ..-'` verify that the statements made in this Inven- ~,,. ,~~~ --` . .,,. tory are true and correct. I understand that false state- ~ ~ ~ ~ ~ ~ ~ ~-~' "' ~~ Adam Smith ~-- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) Mark A. Mateya (Supreme Court I.D. No.) 78931 (Firm) (Address) 55 W. Church Avenue, Carlisle, PA (Telephone) 717-241-6500 DATE OF DEATH LAST RESIDENCE 684 N Middle Road DECEDENT'S SOC. SEC. N0. 01/01/2012 Newville, PA 194-40-4562 FIGURES MUST BE TOTALED Personal Pro ~rtv Cash ............................................................................................... Personal Property ........................................................................ Stocks/Listed ................................................................................ Stocks/Closely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ................................................ Total Personal and Real Property ........................ 43,764.33 337,952.60 381,716.93 137,000.00 518,716.93 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)) Form RW 09 Rev. 10-13-2006 INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland 1 SS DATE OF DEATH I LAST RESIDENCE 684 N Middle Road 01/01/2012 Newville, PA Cash Total Real Estate 117.56 1.41 600.00 30,244.66 529.61 8,173.96 1,595.41 960.36 150.00 64.38 101.74 1,225.24 43,764.33 137,000.00 137,000.00 DECEDENT'S SOC. SEC. NO. 194-40-4562 Comcast -Refund on account for Cable. Account No. 09547-24098006 Dominion -Refund GMG Management -Apartment rental refund for 703 Louisa Lane, Mechanicsburg, PA New Cumberland Federal Credit Unioin -Checking account No. 76979-S4 New Cumberland Federal Credit Union -Savings Account No. 76979-S1 New Cumberland Federal Credit Union -IRA Account No. 76979 PNC Bank -Checking Account No. xxxxxx8974 PNC Bank -Mortgage payment for June 2012 and funds to correct overdraft of bank account PNC Bank -Funds to refresh personal checking account State Farm Fir 8< Casualty Co. -Refund on Policy No. 38-BO-C329-2 State Farm Mutual Automobile Ins. Co. -Refund on Policy No. 1109379613 US Treasury -Pension check CUMBERLAND Total Cash Real Estate - 684 N Middle Road, Newville, PA -Assessed Value COUNTY, PENNSYLVANIA File Number 21-12-0063 (Attach additional sheets if necessary) Total Personal Property and Real Estate 518,716.93 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } DATE OF DEATH 01 /01 /2012 LAST RESIDENCE 684 N Middle Road Newville, PA All Other Prop Federal Retirement Thrift Savings Plan File Number 21-12-0063 DECEDENT'S SOC. SEC. NO. 194-40-4562 Total All Other Property 337,952.60 337,952.60 -2-