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GUARDIAN'S �NTORY
COURT OF COMMON PLEAS OF GLt����^� COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
� � C� S 0 an Incapacitated Eerson
Esta.te of i'�� M� � ��_ '}.��,�r � �Q �` . .
o `� �,�, rn
c�
No. ��' 13"�I�-i� � -v r�? a' `�'
� c, �' v�' �a
� }�„ Ir-- w � �
. �► � � ~ %� �
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� 1. Real�st$te: (Locatio�,by whom occupied and rental Esti�a�d�'v.'al� � '�� c7��� �� �
terms,if applicable) :,�, -~� � M
�„ m �' �
. - �,A . , _ . . . .: . .
Sub-Total for Real Estate: 0.00
2. Personal Property: Estimated Va1ue: �
^�._ _.Ci _... __ �; :�l�"��!�
, �„��Ul?�
. /v�i �. . 1. ��- � . �. .
3. Jointly Held Property: Estimated�Value; .
(Set forth real and personal property owned by the Incapacitated Person JOIIVTLY with any .
other person(s). State whether held as tenants by the entireties;ijnot,whether the right of • . .. - .
survivorshep e�rists.) .
.lointly Held Proptrty .
h��
Form G-04 rev.10.13.06 Page 1 of 2
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. ,
.
•
� l�an Incapacitated Person
Estate of�(��� �Ytii�/�p,� S�-�e ,f
�'a Mmor,
4. .A.nticipated Assets: Estimated Value:
(Set forth property of any kind expected to be acquired hereafter,togetlier with
anticipated date of acquisition.)
Property Andcipated Date �
of Acquisition �
�� ,vv'J
. Sub-Total for Personal Estate: 0.00
(Attach additional sheets f necessary) � . . :� � � .
TOTAL OF I'1'EMS 1,.2,3,and 4: . . . . . . . . . . . . . . . . . . . . . . . . . . . . � -QD ��� � .
.. Commonwealth of.Pennsylvania : . �, ,
: ss.
� County of�1 �1.��: , . .
p\�¢., J , says that the foregoing is a full,
Guardian
true and complete Inventory of the Esta.te of �(„�,,�� /Yl.i�«.�,P�l� �"� ,
the aforesaid Incapacita.ted Person or Minor; and that all of the information set forth herein is
. . true and correct to the best of the Guardiau'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 ) . _ . � �
, . ma.de subj ect to the penalties of ) _ � -
18 Pa.C.S. §4904 relating to unswom ) Guardian � � �
falsification to authorities. ) . . � . . .
�. Attomey for Guardian: ��nG�-)r� ��
Supreme Court I.D. No.: � �
. .. _ . . .
. . Address: C� ��t�� r s-��Z'P�r .
. _ ,�'a���sL� �J9 I��)3
Telephone: � 11-2�'1.3'�� l
Forns G-04 rev.10.13.06 Page 2 of 2