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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
2U08 ~'IA Y 20 PM 5: 0 I
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
Donald E. Smith and Violet E. Smith
Personal Representative(s) of the Estate of Myrtle M. Eshelman
File Number
CL~rT< C)F
21-08-0009 ODDi...g\)'~ r,'r'ii,I.R', T
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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.
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. S 4904 relating to unsworn falsification to
authorities.
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Violet E. Smith
(J..Y It) F /.;>oo.f
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Attorney -- (Name)
(Firm)
(Address)
(Telephone)
James D. Bogar
Bogar & Hipp Law Offices
One West Main Street, Shiremanstown, PA 17011
717-737-8761
(Supreme Court I.D. No.)
19475
DATE OF DEATH
12/10/2007
LAST RESIDENCE 1700 Market Street
Camp Hill, P A 17011
FIGURES MUST BE TOTALED
DECEDENTS SOC, SEC. NO,
197-05-7127
Personal Property
Cash ...... ...... .................. ..... .............. '" ... .................... ............. .......
Personal Property........................................................ .................
Stocks/Listed ..... ... .................. ................. ...... ..... ...... .... ... ..............
Stocks/Closely Held......................................................................
Bonds...... ...... ....................... ... ........... ....... .......... ............. ..... .........
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
All Other Property......................................... .............. ..................
61,986.91
Total Personal Property.........................................
61,986.91
Total Real Property................................................
Total Personal and Real Property.........................
61,986.91 I
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. S 3301 (b))
Form RW-09 Rev, 10-13-2006
INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21-08-0009
DATE OF DEATH
12/10/2007
Cash
LAST RESIDENCE 1700 Market Street
Camp Hill, PA 17011
DECEDENTS SOC. SEC. NO.
197-05-7127
Capitol Blue Cross - Refund of unearned premimium
97.20
Holy Spirit Hospital - Refund of overpayment of medical bill
31.00
Sovereign Bank - Checking Account Number 1681790440; Date of Death Value
$61,712.04; Accrued Interest from date of death $146.67
61.858.71
Total Cash
61.986.91
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
61.986.91