HomeMy WebLinkAbout01-05-06
Cumberland County
INVENTORY
Estate of Smith, Winifred E.
also known as
, Deceased
No. 21 05 0832
Date of Death 9/13/2005
Social Security No. 217-2p-3205
,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory incl~de all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, tha~ 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this jnventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein ma~e are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney: William S. Dick
I.D. No.: 24566
Address: 13 West Main Street
Wavnesboro
Telephone: (717) 762-1160
PA 17268
Personal Representative:
John A. Smith
Dated
Description
Government Obligation Fund, Ephrata National Bank
Account # 50-00-8012-00-2
60 shs Honeywell International Inc. (HON) @ 39.00/sh
Proceeds of Erie Family life Annuity
account #25N638, payable to decedent upon the death of her son,
Thomas, who died July 1, 2005.
Treasury Bank Certificate of Deposit, Ephrata National Bank
Principal $100,000.00; interest accrued to dod $12.60
Ephrata National Bank
checking account # 84-347-4
Shippensburg, Health Care Center
refund of nursing care payment
(Attach Additional Sheets if necessary)
Val~e
58,726.36
2,340.00
10,810.00
100,012.60
1.86
3,420.00
Total
175,323.20
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the persqnal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
Smith, Winifred E.
Pace 1
Description of Inventory
Description
Uncashed dividend check from Honeywell International, Inc. (HON)
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Subtotal $
Grand Total $
21
Value
05
175,323.20
0832
12.38
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