INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA
County of
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SS
File Number
I verify that the statements
made in this Inventory are true
and correct. I understand that
false statements herein are
made subject to the penalties
of
18 Pa.C.S. § 4904 relating
to unsworn falsification to
authorities.
}
(Name of Law Firm) _____________________________________________________________________________
(Address)
DATE OF DEATH
LAST RESIDENCE
DECEDENT'S SOC. SEC. NO.
FIGURES MUST BE TOTALED
(Attach additional sheets as needed)
TOTAL:
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 eff. 09.01.16
(Telephone)
___________________________________________________________________________________
____________________________________________________________________________
The undersigned,
_______________________________________________________________________________, Personal
Representative(s) of the Estate of ___________________________________________________________________________
deceased, depose(s) and say(s) that the items appearing in the following Inventory include all of the personal assets wherever
situated 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 Decedent's death, and that Decedent owned no real estate
outside of the Commowealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory.
Corporate Fiduciary (if applicable)
________________________________ __________________________________
Name of Corporate Fiduciary Signature of Personal Representative
________________________________ __________________________________
Name of Representative and Title Signature of Personal Representative
________________________________
Signature of Officer/Representative
Attorney --
(Name)
(Supreme Court I.D. No.)
(Email)
__________________________________
Date
