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HomeMy WebLinkAbout01-16-15 (3) INVENTORY REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS File Number 2006-00062 Personal Representative(s)of the Estate of Margaret M.Kocher 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- ��, ments herein are made subject to the penalties of �,�,t�� ,� `J�,�. �''��,� 18 Pa.C.S. § 4904 relating to unsworn falsification to `� ' � authorities. Attorney-- (Name) Dale K.Ketner (Supreme Court I.D. No.) 89302 (Address) 129 Market Street,Millersburg,PA 17061 (Telephone) �17-692-1500 DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO. 12/24/2005 100 Mt.Allen Drive,Mechanicsburg,PA FIGURES MUST BE TOTALED Supplemental Inventory ING USA Annuity Death Benefit 30,971.50 Voya Insurance and Annuity Death Benefit(related to above death benefit) 7,818.99 �-•.a c.._-7 � � � .�..'3 l'�'7 � O ��� C7 C17 '� ^� � � 'O —.�,,,'� ; �':J f�"f � .+".j rJ p"'� ..�-� ,,._ Q� _ i T.J � '.-;1 � .-. "`L� '1 . ♦:i ;'� � -�.� , , . .._. _ _ C"� . . W i- f'i�7 �"_ _.Y ._, C.J � `rt .� � (Attach additiona[sheets as needed) TOTAL: 38,790.49 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(b)) 1 Form RW-09 rev. l0.13.06