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GUARDIAN'S INVENTORY
COURT OF COMMON PLEAS OF 6t'xAanY COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
Estate of \�)»� p ��Q.z)et' y, an Incapacitated Person
—43"4 a Minor
No. tai- 12' -635.1
1. Real Estate: (Location, by whom occupied and rental Estimated Value:
terms, if applicable)
(11 sislcrs irllev t)ol.,, O'na 1Ne1er Sheen, CV.L
4.
ii,. lktS ic ` b .
r\(A in re\oJt VO s i e z or ' s
ern ,iis ir��wx��0.rtCA -DAP Suh-Total r Real Estate: 0.00 2. Personal Property: i let L �' � °� x \ $ Estimated Val
cax a A-oki GA-t c- A'"tj wzrso� &V-Pet�ss 4)rou'T'
-felei\\s%on -� 11G .-
C1o4hes 100. —
��r rut•ciJ>,x a'iS.
3. Jointly Held Property: Estimated Value:
(Sel forth real and personal properly mvned by the Incapacitated Person JOINTLY with any _
other person(s). State whether held as tenants by the entlredes:if not,whedrer the righl of
survhvushyp exists.) m•3
Jointly Held Property
or\eA v.
°c�lez� or %eken S\ a�c..e.n•- ra 'r
llaln Bo.nt•,aa•,s Uc,lleye2 __�cc,� `-_� :�y
o
Form(3-04 rer. 70,13.06 Page I of 2
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Estate of 1�U t D g . W 9-0-U2J�- tian Incapacitated Person
®a Minor
4. Anticipated Assets: Estimated Value:
(Set forth property of any kind expected to be acquired hereafter.together with
anticipated date of acquisition)
Property Anticipated Date ,
ojACquisition .. .-
Iec� �0 1'Y\�
Oil\sbv� Q+t t� Sub-Total for Personal Estate. 0.00
(Attach ad(ional sheets if necessary)
TOTAL OF ITEMS 1,2,3, and 4: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00
Commonwealth of Pennsylvania
\\ : ss.
County of N30a
PQuli rye . MUi9 5 says that the foregoing is a full,
Guardian �_ � -
true and complete Inventory of the Estate of 1,)RU
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 L o
18 Pa.C.S. § 4904 relating to unsworn ) Guardian
falsification to authorities. )
Attorney for Guardian:
Supreme Court I.D.No.:
Address:
Telephone:
For;c-o4 rer. ro.r3.06 Page 2 of 2