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HomeMy WebLinkAbout10-24-12 (2)• INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS File Number 21-12-0133 couNTY OF Cumberland Ma Jane Fortne Personal Representative(s) of the Estate of Lee E FORTNEY, Sr. s that the items appearing in the following inventory include all of the personal assets wos to each deceased, depose(s) and say( ) situate and all of the reel resent it hfaC value as of the date of thle decedent s deah~ and t at Decedent~on ned no reap state item of said inventory p rn outside of the Commonwealth of Pennsylvania except that which appears in a memorandum t the nd ~invento ~ ~r J ~ I verify that the statements made in this Inven- ~ ~'e- ,~ ~ +_ ~ ~- tory are true and correct. I understand that false state- Mary Jane ortney _ _ _ r _ ~ - ments herein are made subject to the penalties of l ~ ~~~ ; ~ c r 18 Pa.C.S. § 4904 relating to unsworn falsification to J ~C ~ authorities. _- '{''n) _ ~ ~ f~~ D ^`i W ~ O Attorney - (Name) (Firm) (Address) (Telephone) EDMUND G. MYERS (Supreme Court I.D. No.) 20558 JOHNSON DUFFIE 301 MARKET STREET Lemo ne PA 17043 (717)761-4540 DECEDENTS SOC. SEC. NO. DATE OF DEATH 0112312012 LAST RESIDENCE 10 B Richland Lane ~~mn Neu. P4 17011 FIGURES MUST BE TOTALED personal Property Cash ............................................................................................... Personal Property ........................................................................ StockslListed ................................................................................ StockslClosely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property........••••••••••••••••••••••••••••••° Total Real Property ................................................ Total Personal and Real Property......•.•••••••-•••••••• 15,500.00 15,500.00 15,500.00 NOTE: item but~such figures shouldt ntot be eldctended Into theWOtal of heenventory~ (See X20 PaeCIS § 3301(bj)~rsonal representative inGude the value of each Form RIN-O9 Rev. 10-13-2006 t,~ REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } LAST RESIDENCE 10 B Richland Lane DATE OF DEATH Camp Hill, PA 1701 0112312012 ~~ Mg,T Bank CD MB.T Bank Checking Account 14,000.00 1,500.00 15,500.00 X55 ~~ ._ :~ INVENTORY CUMBER=~ Total Cash ~---- Total Personal COUNTY, PENNSYLVANIA File Number 21-12-0133 DECEDENTS SOC. SEC. NO. and Real Estate aaamo~d~ ~~ ~a~.~ ..