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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Cm,1MONWEALTH OF PENNSYLVANIA
COUNTY OF
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File Number
21-07-00986
Teresa J. Free
Personal Representative(s) of the Estate of
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all ofthe 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.
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1 ere sa J. r re~~
Susan C. Duncan
I verifv that the statements made in this Inven- }
tory are true and correct. 1 understand that false state-
ments herein are made subject to the penalties of
] 8 Pa.C.S. ~ 4904 relating to unsworn falsification to
authorities.
Keith O. Brenneman
Attorney -- (tv'ame)
(Supreme Court J.D. No.)
47077
(Address) 44 West Main Street, Mechanicsburg, PA 17055
(Telephone)
717-697-8528
375 Claremont Drive CarlisI
DECEDENT'S sac. SEC NO.
elATE OF DEATH
'cAST RESIDENCE
August 30, 2007
191-42-8592
FIGURES MUST BE TOTALED
PERSONALTY
1. M & T Bank checking account No. 523324655
$4,580.48
2. Fry Communications, employment benefit
387.29
3. Claremont Nursing Harne and Rehabilitation Center, Guest
Fund Account 4906
214.35
$5,182.12
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REAL ESTATE:
None
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(4ttach additional sheets as needed)
TOTAL:
$5,182,,12
NOTE. The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include ~1e value of each
Item. but such figures should not be extended into the total of the Inventory. (See 20 Fa. c.s. 93301(b))
Form R W-09 rev. 10 J 3. 06
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