HomeMy WebLinkAbout04-01-15 (2) INVENTORY
REGISTER OF WILLS OF Cu�^n��� I c►,� COUN'I'Y, PENi�1SYLVANIA
COMMONWEALTH OF PENNSYLVANIA �
COUNTY OF SS File Number �� l � � � �0 a'
Personal Representative(s)of the Estate of I �l���I � �'*� ��
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 memarandum at the end of this inventory.
�',.-1� .�
I verify that the statements made in this Inven- „o�l���� `�;�`I��
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) ���G n S����- _ (Sa�preme CourtLD.No.)��5 �/S�
^-- �y
(Address) 3 ``b � ��iNnLL �� ( Am� �ill I�A J'7o / I
(Telephone) �� � ��0 �� So� 9
DATE OF DEATH LAST RESIDENCE rn�s S/Q h /V l�l 1f S / 'v G- I"�n''N �"`,,. DECEDENT'S SOC.SEC.NO.
o �- f3-do� y /oo l�l-� /-�Jle,� �2 I�ech/�N�csbu�-w ,4 ��7os�' - /�'��-
FIGURES MiJST BE TOTALED
1� N� S ToC � ��, oo U
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w _a � r._
lr,,. ��- CZ: l� �� [_
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�s E:+`- r—'1 ��a:J �' �.�J
t,A,} t.t.� � Q �
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U3 C� � O.. aj
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c.,
(Attach additional sheets as needed)
TOTAL: `���� 0.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election oi tlie personal representative include the value of each �
item,but such figures should not be extended into the total of the Inventory. (See 30 Pn. C.S.�3301(G)%
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Form RW-09 rev. l0.13.06 �,�