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INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-08-00251_
Marie E. Sheaffer
Personal Representative(s) of the Estate of CIetUS F. Ebersole
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 Mari``Sheaffer
18 Pa.C.S. § 490 relating to unsvrorn falsification to ~ __ _ _ _ _ ,~
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authorities. ~
Attorney -- (Name)
(Firm)
(Address)
(Telephone)
DATE OF DEATH
02/01/2008
Marielle F Hazen
Hazen Elder Law
_2000 Linglestown Rd., Harrisburg, PA 17110
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717-540-4332
LAST RESIDENCE 109 N. 34th St
Camp Hill, PA 17011
FIGURES MUST BE TOTALED
Personal Property
Cash ...............................................................................................
Personal Property .........................................................................
Stocks/Listed .................................................................................
Stocks/Closely Held ......................................................................
Bonds .............................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable ...............................................
All Other Property .........................................................................
Total Personal Property .........................................
Total Real Property ................................................
Total Personal and Real Property .........................
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DECEDENTS SOC. SEC. ND.
25,459.56
51,686.27
77,145.83
77,145.83
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. § 3301(b))
Form RW-09 Rev. ~o-i3-2006 \~
~ V
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS File Number 21-08-00251
DATE OF DEATH LAST RESIDENCE 109 N. 34th St DECEDENTS SOC. SEC. NO.
02/01/2008 Camp Hill, PA 17011
Cash
Wachovia Certificate of Deposit - #2303227364 25,459.56
Total Cash 25,459.56
Stock /Listed
Delaware Investments Trend Fund A Class #3-5035058701 -mutual fund 51,686.27
account owned as tenants in common with surviving spouse, Helen Marie
Ebersole. Total date of death value was $103,372.54
Total Stock /Listed 51,686.27
(Attach additional sheets if necessary) Total Personal Property and Real Estate 77,145.83