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INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYL VANIA
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF CUMBERLAND
} SS
File Nwnber 21-07-0516
I verify that the statements made in this lnven- }
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.
Personal Representative(s) o[the Estate of ELSIE W. EDGREN
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the persQJ1JI assets whSiver situate
~nd all of the real esta~e in t.he Commonwealth of Pennsylvania of said Decedent, that the valuation place~~site ea~em 0(.,,; sa.... !~;
Inventory represents Its faIr va.lue as of the dat~ of the dec.edent's death, and that Decedent. o~ed no~ ~tate ~side pf!tJ,ie;
Commonwealth ofPennsylvama except that whIch appears 10 a memorandum at the end of thIs Inventory. $ r- <n .) ~~-,~)
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Attorney -- (Name)
(Address)
(Telephone)
(Supreme Court J.D. No.)
DATE OF DEATH
LAST RESIDENCE
DECEDENTS SOC. SEC. NO
05/15/2007 770 S. HANOVER ST., CARLISLE, PA. 17013 337-42-8454
I FIGURES MUST BE TOTALED I
US SAVINGS BOND SERIES EE, ISSUE DT 9/92, FACE AMT 10,000, SERIAL NR X3oo5066EE
CHECKING ACCOUNT, CITIZENS BANK, ACCOUNTNR 610070-120-4
SAVINGS ACCOUNT, MEMBERS 1ST FCU, ACCOUNT NR 118262-00
CHECKING ACCOUNT, MEMBERS 1 ST FCU, ACCOUNT NR 118262-11
APP ARTMENT ENTRANCE FEE REFUND, CHAPEL POINTE, NOT RECEIVED AS OF 05-15-07
PENNSYL VANIA RENT REBATE, NOT RECENED AS OF 05-15-07
REFUND OF UNEARNED PREMIUM ON MEDICARE SUPPLEMENT INSURANCE
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY, POLICY NR 011041801 1
NOT RECEIVED AS OF 05-15-07
SAVINGS ACCOUNT, MEMBERS 1ST FCU, ACCOUNT NR 118262-05
CERTIFICATE, MEMBERS 1ST FCU, ACCOUNT NR 118262-40
MONEY MARKET, TO AMERITRADE, ACCOUNT NR 885-009765
525 SHRS EXC, TD AMERITRADE, ACCOUNT NR 885-009765
QUALIFIED DIVEDEND ON 525 SHRS EXC, EX-DIV DT 05- 11-07
PAYABLE 06/11/07, TO AMERITRADE, ACCOUNT NR 885-009765
11,224.00
5,422.79
25.06
85.59
21,000.00
500.00
449.90
3,514.40
15,192.42
l.32
40,561.50
231.00
(Anach additional.~heets as needed)
TOTAL:
98,207.98
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. CS 9330/ (h))
FormRW.09 rev. UJ./3.06
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