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HomeMy WebLinkAbout02-27-13 (2)INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 1 SS COUNTY OF ) File Number 2112-0875 Personal Representative(s) of the Estate of Nancy M. Myrick 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. [ 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) Jane M. Alexander, Esquire (Address) 148 S, Baltimore Street Dillsburg, PA 17019 (Telephone) 717-432-4514 DATE OF DEATH LAST RESIDENCE 08/05/2012 12 East Green Street, Mechanicsburg, PA 17055 FIGURES MUST BE TOTALED 1. PNC Checking Account # 5070089621 Date of Death Value 2. Highmark Premium Refund 3. Carlisle Regional Medical Center Refund (Attach additional sheets as needed) DECEDENT'S SOC. SEC. NO. 203-24-9187 4,760.66 173.37 _ 18.11 4 L~1 w co rnm ~~ ~ ~?o ~~ ~ ~~ ~ D ~ rv ~ mm ~ n -.~ ~ v ~ a o v ~, --v -rt --r, c~ ca ~ .,~ -pt o~ .=:n ~ ~ r- rn ~~ ° ~o n w -n AL: ~ 4,952.14 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. § 330!(6)) (Supreme Court /. D. No.) 7355 Form R W-09 rev. 10.13.06