HomeMy WebLinkAbout02-21-14 (3) INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND SS File Number 21 12 01223
Personal Representative(s)of the Estate of JOHN MICHAEL HAILEY
deceased,depose(s)and say(s)that the items appearing in the 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 appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven-
tory are true and correct. I understand that false state- A R.
MILLER
ments herein are made subject to the penalties of D SSA R.
18 Pa.C.S. §4904 relating to unsworn falsification to MICHAEL HAILEY
authorities. "f
Attorney -- (Name) CHARLES E. PETRIE (Supreme Court I.D.No.) 29029
(Address) 3528 BRISBAN STREET HARRISBURG PA 17111
(Telephone) (717) 561-1939
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO.
1017 HARRIET STREET
11/21/2012 CARLISLE PA 17013 1226663805
FIGURES MUST BE TOTALED
211 SHARES OF WELLS FARGO COMMON STOCK @$32.59/SHARE 6,876.49
ORRSTOWN BANK IRA#1 n 13 ,40.24
ORRSTOWN BANK#2 69;693`70
PROGRESSIVE INSURANCE REFUNDS
CJ
PROCEEDS FROM AUCTION SALE OF PERSONAL PROPERTY 2,180.33
ACCOUNT AT CORNERSTONE FEDERAL CREDIT UNION 1,740.30
1995 FORD 2,362.00
(Attach additional sheets as needed)
TOTAL: 187,662.20
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may,at the election of the personal representative include the value of each
item,but such figures should not be extended into the total of the Inventory.(See 20 Pa.C.S.§3301(b))
Form RW-09 rev.10.13.06 `p�
Continuation of Inventory
JOHN MICHAEL HAILEY 21 12 01223
Decedent Name Page 1 File Number
Description of Inventory
1994 VOLVO 300.00
REAL ESTATE AT 1017 HARRIET STREET 99,200.34
CUMBERLAND COUNTY, PA
SEE ATTACHED SETTLEMENT SHEET
180.80
ACCOUNT AT CITIZENS BANK
ERIE INSURANCE HOMEOWNERS REFUND 117.00
Subtotal $ 99,798.14
Grand Total $ 187,662.20