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Register of Wills of Cumberland County, Pennsylvania
INVENTORY
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Estate of EVANS, RUTH R.
No. 21 - 06 - 00916
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also known as
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, Deceased
CHARLES W. EVANS
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following
Inventory include all of the personal assets wherever situate and all of the real estate located 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 the 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/We verify that the statements made in this Inventory are true and correct. I/We understand
that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn
falsification to authorities.
Attorney:
JERRY R. DUFFIE
Personal Representative
Signature: u.~ ~, ~"I'\ ff'...... EXn,,_
CHARLES W. EVANS
I.D. No.:
09601
Signature:
Signature:
Address:
P. O. BOX 109
lEMOYNE" PA 17043-0109
Address: 225 SOUTH 17TH STREET
CAMP Hill, PA 17011
Telephone: (717) 602-3377
Dated: i ~ Q 1
Telephone: 717/761-4540
Personal Property
Household Goods - items from assisted living residence at nursing home.
250.00
Jewelry - adeemed
0.00
M&T Bank - Checking Account No. 28850912 - Date of death balance, plus accrued
interest.
10,923.16
M&T Investment Group - Account No. 1104329502 -
Date of death balance
58,756.92
Prudential Mutual Fund - Account No. 03535338711 -
Date of death balance
1,628.09
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$155,841.32
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of EVANS, RUTH R.
also known as
, Deceased
No. 21 - 06 - 00916
Date of Death 9/20/2006
Social Security No. 209-16-6109
Wachovia Securities - Account Numbers - 3042-1788
Date of death balance
76,021.68
East Pennsboro Ambulance - refund
80.00
Verizon - refund
5.49
HCR - ManorCare - refund
288.69
United Security Assurance - premium refund - Nursing Home Insurance
180.30
FIA Card Services - refund
7.00
Prudential Insurance - Policy No. 062605295
Beneficiary: Estate of Ruth R. Evans
7,699.99
Total Personal Property
$155,841.32
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