HomeMy WebLinkAbout12-05-14 (2) INVENT�RY
REGISTER OF W1LLS OF Cumberland COUNTY, PENNSYLVAM�
COMMONWEAL'TH OF YENNSYLVANIA �/ � ��� /�� 2�
COUNZ'Y Op Cumberland } SS File Number � V�7 eJ
Personal Representative(s)oF the Estate of Lorraine D Sholley
deceased,depose(s)and say(s)that the items appearing in the fotlowing inventory include all ofthe personai 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- '� C�!��1.�'
� � , �ir��vra.L
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of ���� ��LN�` ����j�,� �� ��L/S�c�". �
1 8 Pa.C.S. § 4 9 0 4 re lating to unsworn fa lsi f ica tion to
authorities.
Attorney-- (Name) (Supreme Court I.D. No.)
(Address)
(Telephone)
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.N0.
09/24/2014 Chapel Pointe,770 S.Hanover St.,Carlisle,PA 17013
FIGURES MUST BE TOTALED
Memebers 1 ST Bank 55,685.55
Personai Property-Furniture,Jewelry,etc. 1,202.00
Partial Refund of Room Charges,Chapel Pointe Nursing Home,Carlisle,PA 1,639.67
Joint Tenant,Real Estate,467 Montour Rd,Landisburg,PA 17040 83,510.00
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(Attaeh additional sheets as needed)
TOTAL: 142,037.22
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personai representative indude the value of each
item,but such tigures should not be extended into the total of the Inventory. (See 20 Pa.C.S. ¢330/(b))
Form RW'-09 rev. t0./3A6