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HomeMy WebLinkAbout12-31-12 (2) INVENTORY REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA SS 21-12-0293 COUNTY OF Cumberland File Number Treva L Bryson and Landis D Kautz Jr Co-Executors Personal Representative(s) of the Estate of Frances 1. Kautz deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and al l 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- -T,-Lt ~ tory are true and correct. I understand that false state- reva rys Landis D. Kautz, ments herein are made subject to the penalties of 20 Bayberry Drive 8448 S. Florence Avenue 18 Pa.C.S. § 4904 relating to unsworn falsification to ec anies urg, Tulsa, OK 74137 authorities. 17050 Attorney (Name) Keith O. Brenneman, Esquire (Supreme Court I. D. No.) 47077 (Address) Snelbaker & Brenneman, P.C., 44 West Main Street, Mechanicsburg, PA 17055 (Telephone) 717-697-8528 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 03/03/2012 Manor Care, 940 Walnut Bottom Road, Carlisle, PA 17015 196-14-3523 1 FIGURES MUST BE TOTALED 1. Dr. Anstagt, refund due the decedent 107.22 2. Pennsylvania Department of Revenue, revenue refund due the decedent 266.00 3. Refund due the decedent on 2011 Income Tax Return 180.00 4. Verizon, refund due the decedent 28.69 5. Wells Fargo, investment account #58348052 / 3064522422 71,047.16 C') c' - :k7 © R1' t rT w c, cf.' c) (Attach additional sheets as needed) TOTAL: 71,629.07 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)) Form RW-09 rev. 10.13.06 ICJ;