HomeMy WebLinkAbout07-23-14 (3) i INVENTORY
REGISTER OF WII.,LS OF ���1�� COUNTY PENNS
, YL VAlVIA
COMMONWEALTH OF PENN$YLVANIA
COUNTY OF C.,�,u,.�Y�}.Q�✓l.Cc,,v� } SS /� J
File Number_ r/1 / /�- /�30
Personal Representative(s)of the Estate of Roxanne Allemen
deceased,depose(s)and say(s)that the items appearing in the following inventory include all ofthe personal assets wherever situate
and a11 ofthe real estate in the Commonwealth ofPennsylvania 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-
ments herein are made subject to the penalties of � n�Yu�
18 Pa.C.S. § 4904 relating to unswom falsification to �--
authorities.
Attorney-- (Name)
(Supreme Court I.D.No.)
(Address)
(Telephone)
DATE OF DEATH LAST RESIDENCE
DECEDENTS SOC.SEQ NO.
FIGURES MUST BE TOTALED
House
car 50,000.00
10,000.00
Personal Items were of no value and were either disposed of or donated to Salvation Army
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(Attaeh additional sheds as needed)
TOTAL: 60,000.00
NOTE: The Memorandum of reai eslate outside the Commonwealth of Pennsylvania may, at the eleclion of the personai representative inciude ihe 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
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