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HomeMy WebLinkAbout09-20-12 (2)INVENTORY REGISTER OF WII,LS OF CUMBERLAND COUNTI', PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA Z SS COUNTY OF CUMBERLAND f File Number 21 12 00494 Personal Representative(s) of the Estate of ALICE C. 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 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- C menu herein are made subject to the penalties of BERT . S H 18 Pa C.S. § 4904 relating to tmswom falsification to authorities. Attorney -(Name) HAROLD S. IRWIN. III (SupremeCowtLD. No.) 29920 (Address) 64 SOUTH PITT STREET CARLISLE PA 17013 (Telephone) 717-243-6090 DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO. 378 GREENSPRING ROAD 4/20/2012 NEWVILLE PA 17241 171-28-7212 FIGURES MUST BE TOTALED MEMBERS 1ST FEDERAL CREDIT UNION -Checking Account 3,045.03 Jointly Owned with son, Robert E. Smith Value listed is 50°~ of DOD value HIGHMARK -Refund 34.50 RETIREMENT CHECK 160.52 0 N PRE-PAID FUNERAL ACCOUNT ~ ~, .00 ~ ~ ~! 0 V ~~~ '~ ~". -n - ~ N ~~ W (Attach additlona[ sheets as needed) (Z O~'7,o 5' TOTAL: $~5 NOTE: The Memorendum of real estate outside the Commonwealth of Pennsylvmia may, et the election of the pers~roel reptesentetive include the value of each item, but such figures should not be extended into the total ofthe Inventory. (See 20 Pa. C.S. § 3301(6)) Fom RW-09 rev. /0./3.06