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HomeMy WebLinkAbout09-26-14 (2) INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS File Number 21-13-0519 Personal Representative(s)of the Estate of F.CLYDE BURGETT deceased,depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate and all ofthe 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- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney-- (Name) DOUGLAS G.MILLER (Supreme Court I.D. NO.) 83776 (Address) 60 WEST POMFRET STREET,CARLISLE,PA 17013 (Telephone) (717)249-2353 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO. 04/17/2013 3605 SPRING ROAD,CARLISLE,PA 17013 FIGURES MUST BE TOTALED 3605 SPRING ROAD,CARLISLE,PA 17013 1,100,000.00 SOVEREIGN BANK-CHECKING ACCOUNT#1661337074 6,016.13 SOVEREIGN BANK-MONEY MARKET ACCOUNT#7673013983 6,280.12 M&T BANK- CHECKING ACCOUNT#9858887830 19,823.24 ORRSTOWN BANK-ACCOUNT#4000045383 19,820.09 WESTERN&SOUTHERN LIFE-ANNUITY#W0020603584 10,090.72 WESTERN&SOUTHERN LIFE-ANNUITY#W0020736776 7,139.60 ry cn o c s rri o Cl> � o -n rn x o co M Ar ry -ice rn a5 rrt m J a o 0 n c� -r l -ri tz. crnc7 w `t r— rn Cn (1) <D (Attach additional sheets as needed) TOTAL: 1,169,169.90 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(6)) Form RW-09 rev. 10.13.06