HomeMy WebLinkAbout11-06-14 (2) INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
Ccs NTY OF CUMBERLAND } S File Number 2014 00367
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Personal Representative(s)of the Estate of * Betty J.Gottshall,aka Betty Jane Gottshall
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.
loe
I verify that the statements made in this Inveneww
-
tory are true and correct. I understand that false stateAoe
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ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney-- (Name) *No Attorney. PERSONAL REPRESENTATIVES are (Supreme Court I.D. No.)
(Address) Robert C.Gottshall,Jr.and Susan J.Trego
(Telephone)
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO.
Feb.8,2014 1337 Kiner Blvd,Carlisle,PA 17015-Monroe Twp.
FIGURES MUST BE T OTALED
1. Citizens Bank Checking Account,No.6100741397 1,893.95
2. Citizens Bank Savings Account,No. 6250436988 3,075.32
3. Citizens Bank CD,No.6250436856 5,335.45
4. Central PA Teamsters, post-DOD payment 2030 M
5.Social Security 1,70Q200 m n
c7
6.Capital Blue Cross,refund r n 174 n
7.Clinical Accounting, post-DOD payment t A r- 28r�6 M to
T> cf) r
8.Erie Insurance refund "= �1,7 8.00 ca
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9.Cash of Decedent on hand at death 7 0 -rl 2M13
10. Furniture,old and used -� 200 r=
r-
11. 1989 Nissan Sentra ;y 4=00 v) o
(Attach additional sheets as needed)
TOTAL: 13,152.95
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