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Inventory Form. This is a Pennsylvania form and can be use in Philadelphia Local County.
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Tags: Inventory, Pennsylvania Local County, Philadelphia
FILE IN DUPLICATE
Will
20
No.
Filed
Adm.
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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INVENTORY
Personal
Representative(s)
of the Estate of
Deceased, being duly sworn according to law, 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 verity 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. Section 4904 relating to
unsworn falsification to authorities.
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Attorney - (Name)
(Sup. Ct. I.D. No.)
(Address)
DATE OF DEATH
NOTE:
LAST RESIDENCE
DECEDENT’s SOCIAL SECURITY NUMBER
The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the
personal representative(s)include the value of each item, but such figures should not be extended into the
total of the Inventory. (See Section 3301(b) or PEF Code of 1972)
This form to be used only in estates of persons dying on or after February 23, 1956.
APPENDIX A: Form 5 - Inventory
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