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11-02-12 (2)
INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS File Number 21 12 0 9 6 4 Personal Representative(s) of the Estate of DOROTHY M • SELLER S 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. 1 verify that the statements made in this Inven- tory are true and. correct. I understand that false state- J O H I D B Y R L E C U T O R ments herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to 316 THIRD S T • , NEW CUMBERLAND , P A 17 0 7 0 authorities. Attorney -- (Name) GERALD J • SHEKLETSKI, ESQ • (Supreme Courtl.D. No.) 40486 (Address) 414 BRIDGE ST • NEW CUMBERLAND PA 17070 (Telephone) DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO. 1100 GRANDON WAY 8/22/ FIGURES MUST BE TOTALED PERSONAL PROPERTY NONE REAL ESTATE L• 1D7 POPLAR ROAD, NEW CUMBERLAND, PA• YORK COUNTY REAL ESTATE TAX PARCEL 27000003001980-00000 9059 128,899.00 n ~r,., ~:.-~, - ~ ~ r, ~'' tm ~ W a ~ ~ ~ N ~.~ ~ .~ © - c . ; ~ . 3+ ~ ° '~ 1 ~ ~ ~ '~ O a ~" (Attach additional sheets a~ needed) 128,899.00 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)) FormRW-09 rev. !0./3.06