HomeMy WebLinkAbout12-09-13 GUARDIAN'S INVENTORY
�iEC��t�ct .;" , . .d u�-
R�G!S t :=g ��ii�'��F COMMON PLEAS OF ��M a��z i,�� COUNTY,PENNSYLVANIA
%L�i� C�L_C � F� � �� ORPHANS' COURT DMSION
C!��,�� �;
�p��Q y � C,�J�p i�an Incapacitated Person
��te.a� . . �n�f�� .��MIE M r�4�/� � ❑a Minor
CUMBERL � � �°.;.��--� I
No. �!- i z - �'.�(
f�-nini u q L ('su i9-R:D�AN S r��P R E'P[�R�r = ��c: Z o � 3
1. Real Estate: (Location,by whom occupied and rental Estimated Value:
terms,if applicable)
Zss" N. �aPt.,�i�2 Sr•, ��r z��r'hrr��N, �'/t r�oz-z �o�oov
E��zA�s�trttU�vN �3���0, L�c.t-srz�z C'o.
.. �c:c u�iC!'J" i3�: C��iL� Js},vE Mr�L��2
/�-�V D ��t��r�t7L�iz L oar M I c.LC�2
Sub-Total for Real Estate: �o�c v 0.00
2. Personal Property: °- Estimated Value:
�'/1/(�- A-�cc+viv t �IPC-r��eEn'1 Erv l" /N V�TMCT/T� (v 3.Sop
�',�i2r�iESc�1P dFl`�t���t- /9Mo. MC-�nl�s /s,— 8. I�c�
ClfECKrNG; MC�l3C-�s /sr. , M1pOLE?o��N, G�. �F,�oo
SuSQU�rF/arvNfi BfM�K ���Z�3L�7z�c�N� 1��, /.g� 3
SRv+�6-s � ME�.,�3ens fsT'.F S
APP�/AT�ti=s i¢-/c. /P�cc. wEts�tr�r: DRrc-� �rc �'o�:�o
f��eNrtvrr�, Tv c-z �ot�c�
�f}wN �QutPM�NT j P/f-T'/o FvRnriTu2s� ?�'O
90,r 4 ff� t�o
3. Jointly Held Property: Estimated Value:
(5et forth real and personal property owned by the Incapacitated Person JOINTLY with any
other person(s). State whether held ar tenants by the entiredes;ijnot,whether the right oj
survivorship exists.)
Jolntly Hdd Praperty
N/oNE
Fo,m c-oa rev.10.13.06 Page 1 of 2 (
�
Estate of CM��y J�ni� M r L��'R l�an Incapacitated Person
'1�a Minor
4. Anticipated Assets: Estimated Value:
(Set forth properry of any ldnd expected to be acquired hereajter,together with
anricipated date ofacquisition.)
Property AnBcipated Date
ofAcquisrtion
NONE
Sub-Tota[for Personal Estate: 0.00
(Attach additional sheets if necessary)
TOTAL OF ITEMS 1,2,3,and 4: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l�o,! 9�•00
Commonwealth of Pennsylvania : �
. ss. •
County of �un�r3�t��o :
— _C'N-RRL�s M �c�O�9�-��+ , says that the foregoing is a full,
Guardian -
true and complete Inventory of the Estate of� e1'�9-n/F �l/�!i��Ek ,
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 ) ��i�� ia�7 �r�i3
18 Pa.C.S. § 4904 relating to unsworn ) Guardian
falsification to authorities. )
Attorney for Guardian:
Supreme Court I.D.No.:
Address:
Telephone:
Form G-04 rev.10.13.06 Page 2 of 2