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INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYL VANIA } SS
COUNTY OF
David W. Mickey , EXp.c.lltor
File Number 21-06-0077
Personal Representative(s) of the Estate of Ruth E. Mickey
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 memora dum at the end of this inv~ntory.
V~~
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. 9 4904 relating to unsworn falsification to
authorities.
David W. Mickey,
3 Andes Drive
Mechanicsburg, PA
17055
Attorney -- (Name) Richard C. Snelbaker
(Address) 44 West Main Street, Mechanicsburg, PA 17055
(Telephone) 717-697-8528
(Supreme Court I.D. No.) 06355
DATE OF DEATH
LAST RESIDENCE
DECEDENT'S SOC. SEC. NO.
January 13,2006
214 Cumberland Dr., Lower Allen Twp., Cumberland County, PA
201-18-6671
FIGURES MUST BE TOTALED
1. Property located at 214 Cumberland Drive, Lower Allen Township, Cumberland County, Camp Hill
P A (appraised value)
2. Capital Blue Cross, refund unused premium
3. Citizens Bank, checking account, #6100675300
4. Commonwealth ofPA, property tax rebate
5. Haband, refund due decedent for overpayment on merchandise purchased via mail
6. Hartford Life Insurance, death benefit from pension plan
7. Household goods retained by family (appraised value)
8. Moffit Heart & Vascular Group, refund due decedent for overpayment of medical expenses
9. West Shore Pathology, refund due decedent for overpayment of medical expenses
114,000.00
487.43
23,678,89
96,96
6,53
2,000,00
1,300,00
1,080.00
217,86
C)
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C)
CJ1
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(Attach additional sheets as needed)
TOT AL:
142,867.67
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. f 3301(b))
FormRW-09 rev, 10.13,06
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