HomeMy WebLinkAbout11-30-12 (2)INVENTORY
REGISTER OF WILLS OF CUMBERLAND-
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21 12 ~ 0985
Personal Representative(s) of the Estate of CAROL A. DUBLE
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- ~ ~
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tory are true and correct. I tuiderstand that false state- GERALD C. STAUFFER
ments herein are made subject to the penalties of
18 Pa. C.S. § 4904 relating to unsworn falsification to
authorities. -
Attorney -- (Name) HAROLD S: IRWIN, III (Supreme Courtl.D. No.) 29920
(Address) 64 SOUTH PITT STREET CARLISLE - PA 17013
(Telephone) 717-243-6090
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEC. NO.
210 BIG SPRING ROAD
8/30/2012 NEWVILLE PA 17241 206-32-1836
FIGURES MUST BE TOTALED
ADAMS COUNTY NATIONAL BANK
Savings Account
ADAMS COUNTY NATIONAL BANK
Checking Account
HIGHMARK
Refund
PRE-PAID BURIAL ACCOUNT
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(Attach addition sweets eeded) ~
3,304.58
945.37
- 100.00
1, 957.00
_ _ TOTAL: ~ 6, 306.95
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. 10.13.06