HomeMy WebLinkAbout06-19-15 (2) • INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland File Number 21-09-1118
Charles P Holmes and Brett Guy Holmes
Personal Representative(s)of the Estate of Ba�b81'a Allll POtt@I'
deceased, depose(s)and say(s)that the items appearing in the following inventory include�II 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 decedenYs death,and that Decedent owned no real estate
outside of the Commonwealth of Pennsylvania except that which appears in a memo ndum at the end of this inventory.
I verify that the statements made in this Inven- _ �,�fn L►���
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tory are true and correct. I understand that false state' Charles P. Hol es ��
ments herein are made subject to the penalties of ,,.� _ _
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18 Pa.C.S. §4904 relating to unsworn falsification to Brett Guy H es
authorities.
e���3e��,���;
Attorney-- (Name) Jeffrey R. Boswell, Esquire U� (Supreme Court I.D. No.) 25444
(Firm) Boswell, Tintner& Piccola
(Address) 315 N. Front Street, Harrisbu�, PA 17108-0741
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(Telephone) 717-236-9377 __ ---
DATE OF DEATH LAST RESIDENCE 46 Erford Road DECEDENT'S SOC.SEC.N0.
11/2912009 Camp Hill, PA 17011 146-14-1176
FIGURES MUST BE TOTALED
Personal Pro�ertv
Cash............................................................................................... �-�8,608.65
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Personal Property........................................................................ � Q �' �µ� ���
Stocks/Listed................................................................................ �`y_; � r= :��' <_.>
Stocks/Closely Held..................................................................... �:. �� ,� � ' �,��
Bonds............................................................................................ �_� �� � �
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Mutual Funds.. �
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.............................................................................. -�,_:r .._,
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Partnerships and Sole Proprietorships ..................................... � -� - ---
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Mortgages and Notes Receivable............................................... �_ ..:� �� ;__ r,-�
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All Other Property........................................................................ ..�,' �,� '�" �i
Total Personal Property........................................ 19,608.65
Totat Real Property................................................
Total Personal and Real Property........................ C'- 19,608.65
NOTE: Item but such�fguresrshould ntot be eatended Inmo the total of helnventory�(See 20tPaeClSc§3301t�bj)personal representative include the value of each
Form RW-O9 Rev.10-13-2006 \�
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' INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland File Number 21-09-1118
DATE OF DEATH LAST RESIDENCE 46 Erford Road DECEDENT'S SOC.SEC.N0.
11/29/2009 Camp Hill, PA 17011 146-14-1176
Cash
AmeriGas -customer refund 225.94
Personal injury/motor vehicle accident claim -Estate of Barbara A. Potter v.Johnson - 15,940.07
CCCP 08-6157-net settlement proceeds($25,000-$9,059.93 attorney fees and
litigation costs)
PNC-overdraft litigation settlement 1.99
PNC Bank-BAP Regular Checking Account No. 5004145752 3,440.65
Total Cash 19,608.65
(Attach additional sheets if necessary) Total Personal Property and Real Estate 19,608.65