HomeMy WebLinkAbout03-24-14 (2) INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-13-0454
Steven D. Goss
Personal Representative(s)of the Estate of Janice P.Archibald
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 pe In a memorandum at the end of this inventory.
I verify that the statements made in this Inven- r X,6 C 3/7-0//4
tory are true and correct. I understand that false state- or Steven D. Goss
ments herein are made subject to the penalties of
18 Pa.C.S. §4904 relating to unsworn falsification to
authorities.
Attorney-- (Name) David J. Lenox (Supreme Court I.D. No.) 06298
(Firm)
(address) 8 Tristan Drive, Suite 3, Dillsburg, PA 17019
(Telephone) 717-271-7175
DATE OF DEATH LAST RESIDENCE 1903 Columbia Ave DECEDENTS SOC.SEC.NO _
04118/2013 Camp Hill, PA 17011
FIGURES MUST BE TOTALED
Personal Property
Cash............................................................................................... 26,984.89
Personal Property........................................................................ s ;
C) rnM
Stocks/Listed................................................................................ W M =B o
Stocks/Closely Held..................................................................... rn s c'> o
M r- r\3 rn m
Bonds............................................................................................ y z M s M y
MutualFunds................................................................................ z ° °xt
Partnerships and Sole Proprietorships ..................................... o �rl 3 n
Mortgages and Notes Receivable............................................... M
All Other Property ......................... ° c n
p rty...............................................
Total Personal Property........................................ 26,924.89
Total Real Property................................................ 157,000.00
Total Personal and Real Property........................ 183,924.89
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.10-13-2006
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-13-0454
DATE OF DEATH LAST RESIDENCE 1903 Columbia Ave DECEDENTS SOC,SEC.NO.
04118/2013 Camp Hill PA 17011 160-36-5039
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2000 Honda Odyssey Mini Van: 4,900.00
Metro Bank Certificates of Deposit: 4,460.77
Metro Bank checking account: 2,129.11
Milton S. Hershey Medical Center(refund): 20.00
Misc. personal property: 750.00
PA Media Group(refund): 20.47
PSECU Account-Reference#5196434797886: 12,974.84
PSERS (final amount): 233.78
Tax refund: 916.00
The Hartford (insurance refund): 157.00
Verizon(refunds): 159.39
Zions Bank(refund): 203.53
Total Cash 26.924.89
Real Estate
Property situate at 1903 Columbia Ave., Camp Hill, PA: 157.000.00
Total Real Estate 157,000.00
(Attach additional sheets if necessary) Total Personal Property and Real Estate 183,924.89