HomeMy WebLinkAbout05-15-15 (2) INVENTORY
REGISTER OF WILLS OF CUMBERLAND CO[INTY, PENNSYLVANIA
COMMONWGALTII OY'PHNNSYLVANIA
COUNTV OP S5 Pilc Numbcr �� �4 1012
Personal Represen[a[ive(s)ofthe Es[a[e of Mary R Roupas
deceased,depose(s)and say(s)lhat�he items appearing in the following invenmry include all oCthe personal asseLc wherevec situate
and all ofthe real estate in[he Commonweal[h of Pennsylvanie of said Decedent,lha[the valuation pleced opposite each item of said
imentory represen[s its fair value as of the date of'Ihe decedenPs death,and that Decedent owned no real estafe outside ofthe
Commonwealth of Pennsylvania except that which appears in a memorandum at[he end of this inventory.
I verify that lhe sTatemenls made in this Imen- l �I , ��'��j�, ��/����C i
tory are Irue and mrzecl. i wderstand[hat false s[a[e- �
ments herein are made subject to the penalties of
I S Pa C.S. §4904 relating ro unswom falsitication ro
a�thorities.
A[[orney -- (Nome) Theresa L. Shade Wix Esq. (Svpreme Cnurt!D. No.) 43089
(Address/ 4705 Duke Street Harrisburq PA 17109
(Telephone) (717)652-8455
on.Eoroen.H us.aesioEr�eE oeceoeurssacsEc.Ho
412 Spring House Roatl
10/9/2014 Camp Hfll PA 17011
FIGURES M1JST BE TOTALF.D
Safeco Insurance Refund 164.09
American Water Enterprise Refund 24.54
United Heal[h Care Insurence Refund 208.00
Unitetl Health Care Insurance Refuntl 4����
PA Media Group, Newspaper Subscription Refund 9525
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(Altoch addiNotta!sheets as tteededJ � �
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TOTAL: - ��'� 533.56
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NOTB Th Me orandum ofrcal rstatc oul'd@ C mn onweapF of Pennrylvnn x me} t thc cle Y n ofthe personei rep�entetive Indudc tFc��u�o(cech
-n�but rvch fcures should not M1 .t J d into�hc mtel of�he Iwcnm �.(S �0l¢ CS.9 3301�hL � � -�
Form RI4'-09 rev. lOJ3Dfi �