HomeMy WebLinkAbout08-13-15 (2) INVENTORY
REGISTER OF WILLS OF C U M B E R L A N D COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COLJNTY OF C U M B E R L A N D SS File Number 21 15 0�1.5i,,
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Personal Representative(s)of the Estate of C L A R K S B A K E R �' � � `� a
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deceased, depose(s)and say(s)that the items appearing in the following inventory include all of the pers�h��as�sets�h.�reveF-$it�te
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed o�sposite e'�s2� itert�'af�aid
inventory represents its fair value as of the date of the decedent's death,and that Decedent owned no real estatz outsicJe of the, :��
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. ' � ' �'�'
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I verify that the statements made in this Inven- � � �.�.�� �� o
tory are true and conect. I understand that false state- L A G 0 A S,
ments herein are made subject to the penalties of E X E C U T R I X
18 Pa. C.S. §4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) DAVID H STONE, ESQUIRE (SupremeCourtl.D. No.) 39785
(Address) 414 BRIDGE STREET P • 0 • BOX E NEW �UMBERLAND PA 17070-
(Telephone) «17) 7 7 4-7 4 3 5
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO.
1700 MARKET STREET
12/27/2014 CAMP HILL PA 17011-
FIGURES MUST BE TOTALED
Manor Care Nursing Home-refund on living expenses 1,289• 50
PNC Bank-Checking Acct #5140002369 1,374 • 95
Princ $1,374 •95, Int $•03
PNC Bank-Checking Acct #5140002369 - Accrued Interest � •03
PNC Bank-Savings Acct #5004692596 76,838• 69
Princ $76,838 •69, Int $2 •69
PNC Bank-Savings Acct #5004692596 - Accrued Interest 2 • 69
Santander-Cert of Deposit �0775547565 10,198 - 64
Princ $10,198 • 64, Int $2 - 43
Santander-Cert of Deposit #0??5547565 - Accrued Interest 2 • 43
(Attach additional sheets as needed)
TOTAL: 126,526 • 29
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./3.06 �\
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- Continuation of Inventory
CLARK S BAKER 21 15 �015
Decedent Name Pa9e� File Number
Description of Inventory
Santander-Cert of Deposit #7672248278 24,962 - 88
Princ $24,962•88, Int $2 •18
Santander-Cert of Deposit #7672248278 - Accrued Interest 2 - 18
Santander-Checking Acct �0771027974 4,723 . 58
Princ $4,723• 58, Int $. 04
Santander-Checking Acct #0771027974 - Accrued Interest 0 • 04
Santander-Savings Acct #074042444 4,2�2 . 14
Princ $4 ,202•14, Int $• 61
Santander-Savings Acct #074042444 - Accrued Interest 0 -61
Social Security Adm-check received 1,642 • 00
United States Treasury-Refund on 2014 1040 return 252 •00
Commonwealth of PA-Annuity check received 1,033• 93
subtota� S 36,819 • 36