HomeMy WebLinkAbout04-22-15 (2) SU PPL E-mG�AL
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND SS File Number 21 08 0666
Personal Representative(s)of the Estate of DAVID L. MAYS
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- 6
ments herein are made subject to the penalties of Wanda Lou Mays, Executrix
18 Pa.C.S. §4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) JACQUELINE A. KELLY (Supreme COurtl D.No.) 91973
(Address) 845 SIR THOMAS CT STE 12 HARRISBURG PA 17109
(Telephone) 717-541-5550
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO.
173 CREEK ROAD
11/1/2007 NEWVILLE PA 17241
FIGURES MUST BE TOTALED
Survival action damages pursuant to Court Order dated 2013. 22,416.31
Cumberland County Court of Common Pleas No. 09-6667
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TOTAL: 22,416.31
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))
Form RW-09 rev. 10.13.06 \��
Jan L. Brown & Associates
ATTORNEYS AND COUNSELORS AT LAW
JAN L. BROWN,ESQUIRE BRENDA F.KEPHART,LEGAL ASSISTANT
JACQUELINE A.KELLY,ESQUIRE JUDITH A. EBERSOLE,ADMINISTRATIVE ASSISTANT
CHRISTA M.APLIN,ESQUIRE MELISSA L. SMITH,LEGAL ASSISTANT
KATHERINE Y.KAUTZ,LEGAL ASSISTANT
April 21, 2015
Register of Wills
Cumberland County Courthouse
One Courthouse Square ,
Carlisle, PA 17013 :Cn' '
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Re: Estate of David L. Mas ' ' r� r'0 ' ' rn
Estate No. 21-08-0666
Executrix: Wanda Lou Mas
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To Whom It May Concern:
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Enclosed for filing are an original and two copies of the Supplemental Inheritance.Tax
Return and an original and one copy of the Supplemental Inventory for the Estate of David L
Mays. A check in the amount of$30.00 made payable to the Register of Wills for the filing
fees of the supplemental inheritance tax return and inventory is also enclosed.
Please return a time-stamped copy of each document in the envelope provided. Also,
please forward the receipts of payments to my office.
Sincerely,
Jacqueline A. Kelly
JAK/mis
Enclosures
cc: Wanda Lou Mays
Olde English Gap 845 Sir Thomas Court • Suite 12 • Harrisburg,PA 17109
Telephone(717)541-5550 • Fax(717)541-9223 • Email:JLBassoc@janbrownlaw.com • www.janbrownlaw.com
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