Loading...
HomeMy WebLinkAbout06-07-13 GUARDIAN'S INVENTORY COURT OF COMMON PLEAS OF . LM bf-r_ Iand COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION Estate of E6v 1 Man Incapacitated Person I®a Minor M m rn co M o� c nC3 �s = C.) z c nr z = 1. Real Estate: (Location, by whom occupied and rental EifmatRl Value: cl terms, if applicable) {7 nom(' •� � '-� x-" m o Cn Sub-Total for Real Estate: 0.00 2. Personal Property: Estimated Value: iS.ceA . elates U:L70 3. Jointly Held Property: Estimated Value: (Set forth real and personal property owned by the Incapacitated Person JOINTLYwith any otherperson{s). State whether held as tonani s by the""reties;ifnot,whether the right of survivorship exists.) Joi»t[y Held Property _ n c> (Y),P.. Farm c-04 rev.10.13,06 _ Page I of 2 Estate of �/�� y tan Incapacitated Person �7-- ©a Minor 4. Anticipated Assets: Estimated Value: (Set forth property of arty kind expected to be acquired hereafter,together with a,uicipated date of acquisition.) Fraperiy AndciperedDate - ofAcquisihon Sub-Total for Personal Estate: 0.00 64ttach additional sheets if necessar}J TOTAL OF ITEMS 1,2,3, and 4: . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 Commonwealth of Pennsylvania ss. County of- �6,dyd : n d& K. 2�[ t Y �P � says that the foregoing is a full, Guardian true and complete Inventory of the Estate of au 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 f J } hi l/'�fPr'c C �i�l l�li2t� 18 Pa.C.S. § 4904 relating to unswom } ardian falsification to authorities. ) Attorney for Guardian: -3301 I y y AA I t c4ie I Supreme Court I.D.No.:" Address: 15-1z) t--t: u S � Z Ct 61e Lgorn-0-e PR rilgnl 305-7 Telephone: Farm G-04 rev.10.13.06 Page 2 of 2