INVENTORY
REGISTER OF WILLS OF
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COMMONWEALTH OF PENNSYLVANIA
File Number
SS
County of
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)
I verify that the statements
made in this Inventory are true
________________________________
__________________________________
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and correct. I understand that
Name of Corporate Fiduciary
Signature of Personal Representative
statements herein are
false
________________________________
__________________________________
made subject to the penalties
of 18 Pa.C.S. § 4904 relating
Name of Representative and Title
Signature of Personal Representative
to unsworn falsification to
________________________________
__________________________________
authorities.
Signature of Officer/Representative
Date
(Supreme Court I.D. No.)
Attorney --
(Name)
(Name of Law Firm) _____________________________________________________________________________
(Address)
(Telephone) ___________________________________________________________________________________
(Email)
____________________________________________________________________________
DECEDENT'S SOC. SEC. NO.
DATE OF DEATH
LAST RESIDENCE
FIGURES MUST BE TOTALED
(Attach additional sheets as needed)
$0.00
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