HomeMy WebLinkAbout03-21-13 GUARDIAN'S INVENTORY
COURT OF COMMON PLEAS OF.C.1202:46,CLIA„aL COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
Estate of & ?ra O D Cam'S 1 E3 an Incapacitated Person
' 0 a Minor
No. 21 - 124-1(12-
1. Real.Estate: (Location,by whom-occupied and rental Estimated Value:
terms,if applicable)
1I (Pt
Sub-Total for Real Estate: OA)
2. Personal Property: Estimated Value: ._._
i I a, e; ei c ,rit(• Cu 0e' .s t • CatAAAJ- titii Agq t2—.4.Hi)
r a. ,...• _ • a f•. i Ai.• LIZ 1.1 12-31-i 2)
3. Jointly Held Property: Estiin d.Value:
(Setf0Mh real and personal properly owned by the Incapacitated person JOINTLY with any 0 .r, . =
other person(s). State whether held as tenants by the entireties;if not,whether the right of "' m c,
survivorship exists) = 73 M 45 O
lolntly Held Property rn -ti n = CP
23 n f rti.1 in m
Waz � ►-+ cam
es a
C)
p C t-• -_ 0
I. r m.
r.
-o en ire '
as Lf 1
Form G-GI rev.!0.13:06 Page I of ),.11--.)
Estate of lee, Dr.e S Elan Incapacitated Person
'SO a Minor
4. Anticipated Assets: Estimated Value:
(Setfarth property ofany kind expected to be acquired hereafter.together with
anHcipmad date acquisition.)
Pry Anticipated Dote
of Acquisition
Sub-Total for Personal Estate: 0.00
(Attach additional sheets f necessary)
TOTAL OF ITEMS 1, 2,3,and 4: 1 109%,7(4'
Commonwealth of Pennsylvania :
ss.
County of Caxnl_, ____ _ :
1.0 . A' a S...MA _ says that the foregoing is a full,
Guardian
true and complete Inventory of the Estate of &?XCC. DC LLJ S
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 ) [4593 f
Inventory are true and correct. I under- )
stand that false statements herein are ) I_ d �C�
made subject to the penalties of ) _ _ - )n►�IA00
18 PaC.S. §4904 relating to unsworn ) Guardi
falsification to authorities. )
Attorney for Guardian: U 2 (fir
Supreme Court I.D.No.: R'I q 02
Address: 222
Elizabefli tau/N Pft (7022
Telephone: 7 17-":3 k,i i-13 76
Fes,G-04 rev.10.13.06 Page 2 of 2