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HomeMy WebLinkAbout10-13-14 (3) f INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS File Number 21 14 0671 Personal Representative(s)of the Estate of DORINE B. PAYNE 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- JUDIT INKOVI I z ments herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to wnsworn falsification to authorities. Attorney -- (Name) CHARLES E. PETRIE (Supreme Courtl.D.No.) 29029 (Address) 3528 BRISBAN STREET HARRISBURG PA 17111 (Telephone) (717) 561-1939 DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO. 4837 E. TRINDLE ROAD 6/25/2014 MECHANICSBURG PA 17050 FIGURES MUST BE TOTALED SALE OF 400 SHARES OF EXELON STOCK 25,356.60 r� d C= �. M o M u'} --i F� Cry YrI U'} r'} J j ) ry M s-- N 'Tt (Attach additional sheets as needed) TOTAL: 25,356.60 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 \