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' INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA '
COMMONWEALTH OF PENNSYLVANIA
COIJNTY OF CLJMBERI.?►ND } SS 21-13-0248
File Number
ROBERT C.NIKOLAUS � ��'��'�
Personal Representative(s)of the Estate of �;
deceased,depose(s}and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate I�
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 appeazs in a memorandum at the end of this inventory. � ';
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I verify that the statements made in this Inven- � ,��.r� �� ��=9�,.,�P.�' I ,;
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 unswom falsification to
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authorities. i �''
� '''
NATHAN E.SAXTON � '''
Attorney-- (Name) (Supreme Court I.D.No.) 312619 i i
(Address) 327 LOCUST STREET,COLUMBIA,PA 17512 � �
(7'elephone) 717-684-4422
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DATE OF DEATH LAST RESIDENCE DECEDENT S SOC.SEC.NO. I ''i
O1/17/2013 940 WALNUT BOT"TOM ROAD,CARLISLE,PA 17015
FIGURES MUST BE TOTALED � �'
MBtT CHECKING ACCOUNT � '''
7,929.21 � '
CONTINENTAL LIFE INSURANCE PREMIUM REFUND 160.65 j �'�,';
IMAGING ASSOCIATES REFUND 10.10 � I
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(Attach addttional sheets as needed) � �
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� TOTAL: 8,099.96 �',
N01'E: Tho Memorandum of real estate wqside the Commonwealth of Pennsylvania may,at the election of the personal ropresencative include the value of each '!'
item,but such figur�should not be extpdod into ttk tWa1 of the Inventory. (See 20 Pa.C.S.,¢3301(b))
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Form RW-09 rev.10.13.06 ��,
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