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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENN5YL VANIA
COUNTY OF Cumberland
Robert A. Rubin
Personal Representative(s) of the Estate of
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File Number
21.{j7.{j333
Thelma Ellen Jones
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 ttie 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 memora um at the end of this invento
I verify that the statements made in this Inven- }
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)
(Firm)
(Address)
(Telephone)
Lisa Comber Hall Esq (Supreme Court 1.0. No.)
Hall Law Offices, P.C.
Two West Market Street, Suite 403, West Chester, PA 19382-3006
(610) 344.{j136
56405
DATE OF DEATH
12/28/2006
LAST RESIDENCE 4837 E. Trindle Road
Mechanicsburg, PA 17055
FIGURES MUST BE TOTALED
DECEDENrs soc. SEC. NO.
195-07.{j841
Personal ProDertv
Cash.............................................................................................. .
Personal Property........................... ...... .......................... ..............
Stocks/Listed................................................................................ .
Stocks/Closely Held......................................................................
Bonds............................................................................................ .
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
All Other Property.... ....... ....... .................. ...... .......... ..... ..... ...........
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Total Personal Property.. ...................... .... .............
85,658.89
Total Real Property.. ........... ..... ..................... .........
Total Personal and Real Property.........................
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. !i 3301 (b))
Form RW-09 Rev. 10-13-2006
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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY , PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21.{J7.{J333
DATE OF DEATH
12/2812006
LAST RESIDENCE 4837 E. Trlndle Road
Mechanicsburg, PA 17055
DECEDENT'S SOC. SEC. NO.
195.{J7.{J841
Cash
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Bank of America Certificate of Deposit #408139107 - Titled Thelma F. Jones or
Ralph McCreight (Deceased; 000: 1010912003); Date Opened: 912111999; Value
as of 000
11.017.01
Accrued interest on above item through date of death
12.49
Bank of America Certificate of Deposit #409373911 - Titled Thelma F. Jones;
Date Opened: 1112112000; Value as of 000
25.098.43
Accrued interest on above item through date of death
26.35
Commonwealth of Pennsylvania - Proceeds from Unclaimed Property Claim
#99943692
62.50
Country Meadows Associates - Refund of Nursing Facility Residence Fees
2.384.48
Daupin County - Restitution from Legal Claim
71.56
Highmark Blue Shield - Prescription Drug Plan Premium Refund
26.57
Highmark Blue Shield - Health Insurance Premium Refund
293.05
Marion Center Bank Checking Account #6001282 - Titled Thelma F. Jones;
Date Opened: 111111988; Value as of 000:
556.90
Vanguard Prime Money Market Account #09901800041 - Titled Thelma F.
Jones; Value as of 000
45.684.49
Accrued interest on above item through date of death
175.06
85.408.89
Total Cash
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
85.658.89
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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY , PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21-07-0333
DATE OF DEATH
12/28/2006
LAST RESIDENCE 4837 E. Trindle Road
Mechanicsburg, PA 17055
DECEDENT'S SOC. SEC. NO.
195-07-0841
Personal PrODertv.
Tangible Personal Property - Decedent's Clothing, Furnishings, Jewelry,
Householed Goods, Etc.; Estimated Value as of 000
250.00
NOTE: Decedent Resided in a Nursing Facility and Owned Limited Articles of
Personalty
250.00
Total Personal Property
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