HomeMy WebLinkAbout05-11-15 (3) INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-14-0821
Terry L. Blosser
Personal Representative(s)of the Estate of Ross C. Blosser, Sr.
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 ap-pa rs 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- erry L 1 ser n c70 m
ments herein are made subject to the penalties of o M c>.
18 Pa.C.S. §4904 relating to unsworn falsification to ry- -0 =n)
authorities.
Attorney-- (Name) Michael L. Bangs (Supreme CduR 11 D. N n;41463
(Firm) Bangs Law Office, LLC r—
(Address) 429 South 18th Street, Camp Hill, PA 17011 - c()
(Telephone) 717/730-7310
DATE OF DEATH LAST RESIDENCE 926 Valley Street DECEDENT'S SOC.SEC.NO.
08/15/2014 Enola PA 17025
FIGURES MUST BE TOTALED
Personal Property
Cash............................................................................................... 12,533.96
PersonalProperty........................................................................
Stocks/Listed................................................................................ 23,028.50
Stocks/Closely Held.....................................................................
Bonds.................:..........................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
AllOther Property........................................................................
Total Personal Property........................................ 35,562.46
Total Real Property................................................ 148,737.88
Total Personal and Real Property........................ 184,300.34
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
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-14-0821
DATE OF DEATH LAST RESIDENCE 926 Valley Street DECEDENTS SOC.SEC.NO.
08/15/2014 Enola, PA 17025
Commonwealth of Pennsylvania-State retirement payment 578.86
M&T Retirement Account distribution 238.32
Manulife Financial Corp. -dividend 139.91
MetLife-straight life benefit payment 178.00
Miscellaneous personal property 2,000.00
Refund from Liberty Mutual Insurance 49.44
Refund from Teachers Protective Mutual Life Insurance 2,423.43
Teachers Protective Mutual Life Insurance Refund 6,900.00
US Treasury-2014 income tax refund 26.00
Total Cash 12,533.96
Stocks/Listed
1,166.0000 shares Manulife Financial Corporation 23,028.50
Total Stocks/Listed 23,028.50
Real Estate
Real Estate-926 Valley Street, Enola. Tax Parcel#09-13-0999-030. Property sold to 148,737.88
Terry and Linda Blosser on 4/10/15;see settlement sheet attached.
Total Real Estate 148,737.88
(Attach additional sheets if necessary) Total Personal Property and Real Estate 184,300.34