HomeMy WebLinkAbout06-03-15 INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND SS File Number 21 14 0445
Personal Representative(s)of the Estate of ELIZABETH A G O U S E
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- D A W N N E T R TLE, EXECUTRIX
ments herein are made subject to the penalties of
18 Pa. C.S. §4904 relating to unsworn falsification to
authorities. i f
Attorney -- (Name) DAVID H STONE, ESQUIRE (Supreme Court I.D. No.) 39785
(Address) 414 BRIDGE STREET P - 0 - BOX E NEW CUMBERLAND PA 17070-
(Telephone) (717) 774-7435
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO.
5225 WILSON LANE
3/22/2014 MECHANICSBURG PA 17055- 1172-
FIGURES MUST BE TOTALED
Avalon Insurance Company-refund on premium 85. 80
Capital Blue Cross-refund on prescriptions 660 . 15
Com of PA-Owner/Rent rebate check received �, rn 'A0 . 00
o 6' o
Foremost Insurance-refund on premium , CO 1� 1 • 75
Gingrich Memorials-Money held for headstone ' 3 400
prior to death t— rn
Leffler Energy-refund on service at property ,, 254 . 00
Net proceeds of personal property sold at auction 808 . 20
by Newberry Peddlers Market in January 2015
(Attach additional sheets as needed)
TOTAL: 1421791 . 00
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(6))
Form RW-09 rev. 10.13.06
Continuation of Inventory
ELIZABETH A GOUSE 21 14 0445
Decedent Name Page 1 File Number
Description of Inventory
Ohio Casualty-refund on cancellation 630 . 00
Property located at 520 Eutaw Ave New Cumberland 120,000 . 00
Cumberland County, PA sold to Thomas E . Dixon and Mary
Jean Dixon, husband and wife on April 1, 2015
SecurChoice-Account held for funeral expenses 15,417 .74
prior to death as per funeral home
Susquehanna Bancshares Inc-Checking Acct 25. 36
#10008203415 Princ $25. 36
Subtotal $ 136,073 .10
STONE LAFAVER & SHEKLETSKI
ATTORNEYS AT LAW
414 BRIDGE STREET
DAVID H.STONE POST OFFICE BOX E OF COUNSEL
GERALD J.SHEKLETSKI NEW CUMBERLAND,PA 17070 CHARLES H.STONE
www.stonelaw.net JON F.LAFAVER
TELEPHONE(717)774-7435
FACSIMILE (717)774-3869
June 3, 2015
Cumberland County Register of Wills
1 Courthouse Square
Room 102
Carlisle, PA 17013
Re: Estate of Elizabeth A. Gouse
File No.: 21-14-0445
Greetings:
Please find enclosed two original Inheritance Tax Returns, and an original Inventory
form in the above referenced estate.
Enclosed is a copy of the cover page of the Inheritance Tax Return and a copy of the
Inventory form. Please time stamp those copies and return them to us in the enclosed self-
addressed, stamped envelope, which I have provided for your convenience.
Please note that these documents are being sent via regular United States Mail and this
letter has been post marked on June 3, 2015.
Thank you for your attention and assistance in this matter. Please don't hesitate to contact
us should you have any questions regarding this matter.
Very truly yours,
STONE LaFAVER & SHEKLET
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Enclosures -; r� Q
cc: Dawnn E. Trostle, Executrix : vi