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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BENION HARRY G JR
315 MONROE ST
MECHANICSBURG, PA 17055
n__n__ fold
ESTATE INFORMATION: SSN: 097-38-8143
FILE NUMBER: 2106-0408
DECEDENT NAME: BENION ELLEN N
DA TE OF PAYMENT: 02/05/2007
POSTMARK DATE: 02/05/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 05/03/2006
NO. CD 007774
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,276.00
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TOTAL AMOUNT PAID:
REMARKS:
CHECK#1007
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$1,276.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
INVENTORY
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
} SS
File Number 21-06-0408
ELLENN. BENION
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 situate
and all ofthe 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 memorandu t the end of this inventory.
I verify that the statements made in this Inven-1
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
10 D.... r' C' I: AnnA ..-oln"';_", +^ n'fts"'''^..-n .f:':a1",;.r;f'toI)+;"'" +1'\
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authorities.
Attorney __ (Name) LOWELL R. GATES, ESQUIRE
(Address) 1013 MUMMA ROAD, SUITE 100, LEMOYNE, PA 17043
(Fe/ephone) (717) 731-9600
(Supreme Court J.D. No.) 46779
May 3, 2006
Manor Care, Carlisle, PA 17013
097-38-8143
DECEDENrs soc. SEC. NO.
DATE OF DEATH
LAST RESIDENCE
FIGURES MUST BE TOTALED
1. Real Property located at 1714 Bridge Street, New Cumberland, P A 17070
2. Stocks and Bonds
3. Cash, Bank Deposits & Miscellaneous Personal Property
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(Attach additional sheets as needed)
TOTAL:
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160,000.00
402,251.00
61,989.00
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624,240.00
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 Po. C.S. f 3301(b))
Form RW-09 rev. 10.13.06
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