HomeMy WebLinkAbout01-17-13 (3)INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF CUMBERLAND f SS
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COUN';~~ENNS`~~. VA~1
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Personal Representative(s) of the Estate of Mildred B. Steibing ~- ;;
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deceased, de ose s and sa s that the items a earin in the followin inventor include;a~ of the erso~al as~~ts`~vherever 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-
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name)
(Address)-
(Telephone)
(Supreme Court LD. No.)
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
05/30/2012 316 N. 28th Street, Camp Hill, PA 17011 198-16-8831
FIGURES MUST BE TOTALED
Real Estate - 316 N. 28th Street, Camp Hill, PA 17011
Cash at DOD in M&T Bank, 1200 Market Street, Lemoyne, PA, Checking Acct. # 28850211
Date of death Balance: 3,797.70 Less check clearing after DOD (30.00)
Reimbursement for County Taxes
Reimbursement for School Taxes
Reimbursement for Sewer
Highmark Reimbursement
PA Revenue 2011 Rent Rebate
Penn Waste Refund
State Farm Insurance Refund
PA American Water Reimbursement
UGI Reimbursement
Sale of Personal Items and Used Furniture
Used clothing, household goods, and furniture donated to Goodwill
(Attach additional sheets as needed)
150,000.00
3,767.70
170.74
1,627.80
114.78
250.43
975.00
28.80
43.92
2.98
323.40
1,840.00
960.00
TOTAL:. 160,105.55
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 j ~
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