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HomeMy WebLinkAbout05-04-15 (2) INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-14-1180 David G Williams - Personal Representative(s)of the Estate of Pauline Williams 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 .�ap in mem ora at the end of this inventory. I verify that the statements made in this Inven- / 1A tory are true and correct. I understand that false state- David G Williams ments herein are made subject to the penalties of 18 Pa.C.S.§4904 relating to unsworn falsification to authorities. Attorney-- (Name) Mark A. Mateya (Supreme Court I.D.No.) 78931 (Firm) Mateya Law Firm (Address) 55 W. Church Avenue, Carlisle, PA 17013 (Telephone) 717-241-6500 DATE OF DEATH LAST RESIDENCE 801 N. Hanover Street DECEDENT'S SOC.SEC.NO. 11/05/2014 Carlisle, PA 17013 FIGURES MUST BE TOTALED C Personal Property o _ rn c-) Cash............................................................................................... r �,� � ,00a:76:zJ Personal Property........................................................................ µ, > c-- r7l CD Stocks/Listed................................................................................ Stocks/Closely Held..................................................................... ` -' Bonds...... :................................................................................. ,1 ry Ir,J Mutual Funds......................:......................................................... --i r- ca Partnerships and Sole Proprietorships 17 Mortgages and Notes Receivable............................................... AllOther Property........................................................................ Total Personal Property........................................ 32,004.76 Total Real Property................................................ Total Personal and Real Property........................ 32,00_4.76 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.10-13-2006 ( � V INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-14-1180 DATE OF DEATH LAST RESIDENCE 801 N. Hanover Street DECEDENT'S SOC.SEC.NO. 11/05/2014 Carlisle, PA 17013 Church of God Home-Refund for assisted living expenses 6,831.81 Church of God Home-Refund for overpayment on Account No. 2531 20.00 Citizens Bank-Decedent's checking account No.584-9 21,558.40 Citizens Bank-Checking Account No. 501-6 1,460.58 Episcopal Church Medical Trust-Refund 105.00 First Citizens Bank-Account for pre-paid funeral expenses 2,028.97 Total Cash 32,004.76 (Attach additional sheets if necessary) Total Personal Property and Real Estate 32,004.76