HomeMy WebLinkAbout09-18-13 (2) INVENTORY
REGISTER OF WILLS OF C u�wt�'lviv IAnn.��. COLJNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA 1 �
COi1NTY OF � f SS File Number
Personal Representative(s)of the Estate of ` NGn'Y75
deceased,depose(s)and say(s)that the itetns appearing in e 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 appeazs in a memorandum at the end of this inventory.
I verify that the statements made in this Inven- ��j,� „ //�11,A� ��'�'�'��� L ,, �
tory aze true and conect. I understand that false state- �A 6 �1�� —=�«�I wc,
ments herein are made subject to the penalries of
18 Pa.C.S. § 4904 relating to unswom falsifica6on to
authorities.
Attorney-- (Name) (Supreme CourtLD. No.)
(Address)
(Telephone)
OATE OF DE4TH LAST RESIDENGE DECEDENT'S SOC,SEC.NO.
c . 2 Zo�Z ` " , o �
FIGURES MUST BE TOTALED
��^�:,(� , :;Q � c:co�,r�—( �ivaru�. �� Sl �o�O- 3
J 1 �
(Attach additiona[shee[s as needed)
TOTAL: S� 0G� 7 �
NOTE: The Memolandum af real estnte outside the Commonweatth of Prnnsylvania may, at the election of the personal reprcsentative include the value of each
item,but such Fgurcs should mt be utended inm the Wtal of the Invenrory. (See 20 Pa.CS.§3301(b)J
Farm RW-09 rev. 10.73.06