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HomeMy WebLinkAbout01-07-13 (3)INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA COI.INTY OF Cumberland } ss Verna L. Call and James O. Walmer Fife Number 21-12-04$6 Personal Representative(s) of the Estate of Jean Elizabeth Walmer deceased, depose(s) and say(s) chat the items appearing in the foHatr~ing inventory include all of the personal assets wherever situate and aft of the real estate in the Commornvealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said tnventory 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 memorandurTi at he end of this inventory. r`~ ~ __` 1 lerify that the statements made in this Inven- '~)V/ _ ~ , _ --- -ory are true and correct. I understand that false state- Verna L. Cail menls herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsiftcaNon to James O. Walmer authorities. Attorney -- (Name) Linda J. Olsen Es q. (Su~rertre Court J.O. No.1 92858 fF'rr"J Hazen Elder Law _ _ (A~dressJ 2000 Linglestown Rd. ,Harrisburg, PA 17110 __ (7ete~hona) 717-540-4332 t):,Ta: cr t,E:,.}r t.rasr rzirs:r,Er:ct: 5225 Wilson Lane cECSCe~:rs s:.~ scc r;o 0410712012 Mechanicsburg, PA 17055 201-16.30$4 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... Personal Property ........................................................................ StockslListed ................................................................................ StockslClosely Held ..................................................................... Bands ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Rea! Property ................................................ Total Personal and Reai Property ........................ n '=J ~~ r {..3 C. w Y ~ 6 C~A : ~ ~' °~ ~ 40T696.83~ ' ~ - ~ ~ r ."_ _, ,, _ . _. .. r. ~ _. _, ._ ~, , ~, . ...,, gM 6' i ~~ 1 ,= E M, .~ r~--~ ~ ~... ~' ~~ 407,696.83 407,696.83 NpTE Thy l'.4~mOrandum at rear estate outs~ne ih: Cornmdr:«a~th of Penr~syvania may, at the ete~t~or~ ar :t.L pe~s~7nat r~presenlat~ve inC;uC? the ti•altbe o! eacn item, Gut such figures should net be exier:ded mto the total vl tttiC Inven;py (See 2G Pa C S § 33rJt (oly CUMBERLAND COUNTY, PENNSYLVANIA !corm RtN Q$ R.JV 1!A r: •2C~5 / V4./ I~fVENTORY REGISTER OF WlL.LS OF CUMBERLAND COUNTY, PENNSYLVANIA C4MM©NYVEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Verna !.. Gall and James O. Walmer Fite Number 21-12-0486 Personal Representative{s} of the Estate at Jean Elizabeth Walmer deceased, deposes} and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real e5iate 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 oavned no real estate outside of the Commonwealth of Pennsylvania except that vrhich appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. t understand that false state- ~ _ ____ _ _ _ _.___ __ _ Verna L. Call i rnents herein are made subject to the penalties of ~, f~ ~~ § 9 ~ - ._._ i$ Pa.C.S. 4904 relatin to uns~rorn falsi8catian to "~ ~ ~~~~' 4 James O. Walmer authorities. Attorney -- (Name) (Firm) (Address) (Telephone) Linda J. Olsen, Esq. Hazen Elder Law _ 2000 Lin lestown Rd, Harris_bur PA 171'10 _. __._..__~_ _ __---. > ._..__..._. ~t ___ 717-540-4332 ____ ()ATE C)F gEAfiN o4ro7/2o12 LAST RESt(JCNCE 5225 Wilson Lane Mechanicsburg. PA 17055 FIGURES MUST BE TpTA~ED Personal Prooertu Cash ............................................................................................... Personal Property ........................................................................ Stocksll.isted ................................................................................ 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 ........................ {Supreme Court i. D. Nv.) 92858 E]ECEpCMT'S 50C 5EC NQ 201-16-3084 407,696.83 4o7,s9s.s3 dQ7,696.83 Np7E The Memorandum pf real estate puts~ue the Common,vealih v' Pennsylvanra may, at the e~eei+t5n of she persona! re~reseniat~ve in~lutlQ thz v<31ue of each stern, but suii'~ fic~uces sheutti not be ext?rtdt't3 Gn:~ the tcta~ at th,e Irrentory. {aee ~~ Pa C ~ ~ 33~ttbl) INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0486 DATE OF DEATH LAST RESIDENCE 5225 Wilson Lane 04/07/2012 Mechanicsburg, PA 17055 Cash DECEDENT'S SOC. SEC. NO. 201-16-3084 PNC Acct. #10-4322-0737 James Walmer owner/Jean Walmer Benef. - -owner by 1,974.90 operation of law; spouse, James Walmer, died 4/3/2012 PNC CD # 31300215982 25,038.22 PNC checking acct. #1043220729 672.40 PNC checking acct. #5070072571 86,550.61 PNC Saving Acct. #5005798608 101,554.65 Refund -Bethany Village parking space 15,000.00 Refund -Federal tax 2011 return 4,000.00 Refund from Asbury Communities -living facility 305.03 Refund from Omnicare, Inc. overpayment of medicines for Jim Walmer 22,87 Refund from United Healthcare - Rx insurance premium 36.60 Refund - PA Treasury 2011 tax return 245.00 Social Security benefits -checks not received before death 2,090.40 Sovereign CD #1685550517 25,031.21 State Farm Bank CD #1003936471 62,633.27 State Farm Bank CD #1015914193 81,425.64 State Farm -final termination payment for James Walmer 1,116.03 (Attach additional sheets if necessary) Total Personal Property and Real Estate 407,696.83 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } DATE OF DEATH LAST RESIDENCE 5225 Wilson Lane DECEDENT'S SOC. SEC. NO. 04/07/2012 Mechanicsburg, PA 17055 201-16-3084 Total Cash 407,696.83 File Number 21-12-0486 -2-