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INVENTORY
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
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File Number 2005-00986
Personal Representative(s) of the Estate of Francis R. Cooper
deceased, 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 Dece t owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorand of this inventory.
I 'fy tha th d . tho In ./ ...--::~ ....,...",,-:?
ven t e statements ma e m 1S ven_}, /// ~_../' ~~ .
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa.C.S. ~ 4904 relating to unsworn falsification to
authorities.
Attorney __ (Name) Michael S. Travis (Supreme Court J.D. No.) 77399
(Address) 3904 Trindle Road, Camp Hill, P A 17011
(Felephone) 717-731-9509
DATE OF DEATH
October 19,2000
LAST RESIDENCE
DECEDENT'S SOC. SEC. NO.
113 May Drive, Camp Hill, P A 17011
160-20-9785
nGURES MUST BE TOTALED
16 shares Bank. of Lilly Stock
56,000.00
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(AUach additional sheets as needed)
TOTAL:
56,000.00
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 Pa. c.s. J 3301 (b))
Form RW-09 rev. 10.13.06
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