HomeMy WebLinkAbout04-15-15 (3) GUARDIAN'S INVENTO�Y
COURT OF COMMON PLEAS OF CUMBERLAND __C�u[_1I�TTy,PENNSYLVANIA
ORPHANS' COURT DIVISIOfl�
Emil Anne Smoker _ ��an Incapacitated Person
Estate of Y -- ' ❑a Minor
No.21-2012-00540
1. Real Estate: (Location, by whom occupied and rental Estimated Va��e:
terms, if applicable) � � � rn
_ � � a ..�� ".
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---- �-�> rr F-+ "-� �
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;.;:t �~� � ",� -�y _r�
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:.;Y i:��... ' _ �"',
Sub-Total for Real E.st�rte: ' =�i W ��� �'
rv cn Q
�` N
2. Personal Property: Estimated Value:
Bed ---- 25.00
Dresser �� 25.00
clothing _ _ 50.00
Ipad � � 200.00
DVD collection _ ___ SO.OQ
music collection _ � 10.00
toys/games/puzzles/books _ 15.00
DVD Player and small TV ____ 25.00
3. Jointly Held Property: Estimated Value:
(Set forth real nnd personal property mvned bv the Incapacitated Person JOIN'lL I'�cith a��v
other person(sJ. State N�hether held as tenants by the entireties;if not.whether the r•i,�;lrt oj�'
survivorship exists.J
Joint/y Held Properly�
� 0.00
Form G-04 rev. l0.13.06 Page 1 of 2
ir u ir i urir uu ,
�[�✓]an Incapacitated Person
Estate of Emily Anne Smoker — � ' a Minor
_, r..�
4. Anticipated Assets: Estimated Value:
(Set.forth property of aay kind ezpected to be acquired hereafter,together with
aniicipated daie of acqursit�on.)
Properry Anticipated Drz�re
ojAcquisitiro�*e
Sub-Total for Personal Est�rrte: 400.00
(Attach additional sheets if necessary)
TOTAL OF ITEMS 1,2,3, and 4: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400.00
Commonwealth of Pennsylvania :
: ss.
County of Cumberland :
Dawn Michelle Smoker ___, sa�rs that the foregoing is a full,
Guardian
true and complete Inventory of the Estate of Emily Anne SmokJ��r _ ,
the aforesaid Incapacitated Person or Minor; and that all of the i�nf'u��mation set forth herein is
true and correct to the best of the Guardian's knowledge and bel ief.
I verify that the statements made in this ) - - ., , r �
Inventory are true and correct. I under-
� ����'� � i'���
stand that false statements herein are ) �,,,� � l� ;;'
made subject to the penalties of ) ----..--�.
18 Pa.C.S. § 4904 relating to unsworn ) Guardian
falsification to authorities. )
Attorney for Guardian: ___..__..
Supreme Court I.D.No.: _.___.__..
Address: _�..---.
Telephone: __—..__..
FormG-04 re��.1a�3.o6 Page 2 of2