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HomeMy WebLinkAbout02-06-13 (3)~ an Incapacitated Person Estate of ~ U~ ©a Minor Estimated Value: 4. Anticipated Assets: (Set,forlh properh~ o/~am• kind expected to be acquired herea%ler, together ~i~ith anticipated date o/ acquisitiorl.l Property Anticipated Date of Acquisition ~•~ ~.0~ Sub-Total for Personal Estate: (Attach additional sheets if necessary) • ........................~ ~D 1°12. . TOTAL OF ITEMS 1, 2, 3, and 4: ..... . Commonwealth of Pennsylvania S~ : ss. County •f ~~}~~ ,says that the foregoing is a full, Guaf~diaf~ ~~ ~ ' ~~~ true and complete Inventory of the Estate of ' the aforesaid Incapacitated Person or Minor; and that all of the information set forth herein is true and correct to the best of the Guardian's knowledge and belief. I verify that the statements made in this ) Inventory are true and correct. I under- ) stand that false statements herein are ) made subject to the penalties of ) 18 Pa.C.S. § 4904 relating to unsworn ) falsification to authorities. ) f, ~,~ --~ Guardians' Attorney for Guardian: _ Supreme Court I.D. No.: Address: Telephone: Page 2 of 2 Form G-O4 rer. l0.13.06