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REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } 55
COUNTY OF Cumberland }
Gerald L. Underkoffler
Personal Representative(s) of the Estate of Underkoffler, Ada B
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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 Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. 0 ;:::;
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File Number 21 - 07 - 0544
I verify that the statements made in this Inven- }
tory are true and correct. I understand that false state- -, - Id
ments herein are made subject to the penalties of era
18 Pa..~.S. 9 4904 relating to unsworn falsification to }
authorities. -
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Attorney -- (Name)
(Firm)
Jean 0 Seibert
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Wion, Zulli and Seibert
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(Supreme CourtJ:D.No.)
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41713
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(Address)
109 Locust Street
Harrisburg, PA 17101
(Telephone) 717/236-9301
DATE OF DEATH
5/23/2007
LAST RESIDENCE 129 Walnut Bottom Road
Shippensburg, PA 17257
I FIGURES MUST BE TOTALED I
DECEDENTS soc. SEC. NO.
185-03-5439
Personal Property
Note from Joseph and Amy Underkoffler to Ada B. Underkoffler
26.038.19
F&M Trust Checking Account No. 34-97704
1.859.19
Acrrued interest to date of death
0.52
F&M Trust Money Market Account No. 70-71167
66.670.78
Acrrued interest to date of death
198.03
06-07-07 Aetna Life Insurance
1.502.21
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$97,461.48
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REGISTER OF WILLS OF
INVENTORY
(continued)
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21 - 07 - 0544
DATE OF DEATH
5/23/2007
LAST RESIDENCE 129 Walnut Bottom Road
Shippensburg, PA 17257
DECEDENT'S SOC. SEC. NO.
185-03-5439
06-22-07 Rothermel Funeral Home Refund
484.68
07-19-07 Outlook Pointe Senior Care Refund
634.00
08-20-07 Hershey Foods Health Care Plan B Refund
36.13
08-20-07 F&M Trust Refund for overcharged on check printing
37.75
Total Personal Property
$97,461.48
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