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INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS °~~- ~,
COUNTY OF Cumberland } File Number 01119
Jeffrey R. Boswell
Personal Representative(s) of the Estate of Mary E. Smith
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 ced opposstta each
item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent ov o real emote
outside of the Commonwealth of Pennsylvania except that which appears in memorandum at the end of tktt~entory.r ,
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I verify that the staternents made in this Inven- ~` ~ -
tory are true and correct. I understand that false state- } - - ~Xzca ~4`( ~ ~i ;
ments herein are made subject to the penalties of J R. Boswell - s,.;
18 Pa.C.S. § 4904 relating to unsworn falsification to } ~ . ,. -r
authorities. ~ -? -''
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Attorney -- (Name) Jeffrey R. Boswell Esquire (Supreme Court I.D. No.) 25444
- ----
Firm) Boswell, Tintner & Piccola
(Address) 315 N. Front Street _, Harrisburg, PA 17108-0741
- -- __ - -
(Telephone) 717-236-9377
DATE OF DEATH LAST RESIDENCE 1700 Market Street DECEDENT'S SOC. SEC. NO.
11/05/2007 Camp Hill, PA 17011 184-12-3693
FIGURES MUST BE TOTALED
Personal Propert
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 .........................
17,135.96
1,070.00
4,476.72
5,960.93
28,643.61
28,643.61
NOTE: The Memorandum of real e:>tate 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-~9 Rev. 10-13-2006
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Cash
File Number 01119
DECEDENT'S SOC. SEC. NO.
184-12-3693
Coins - 4 Mercury dines
2.40
HCR ManorCare -resident trust account
1,071.75
Metropolitan Life Insurance Company -Policy No. 19298669 A
8,368.81
Metropolitan Life Insurance Company -Policy No. 106732302
581.26
Sovereign Bank -cash in bank
6,730.21
Sovereign Bank -cash
81.53
U.S. 2007 economic stimulus refund
300.00
Total Cash 17,135.96
Personal Property
Personal Property -pursuant to appraisal of Ibis Appraisal Report dated 1,070.00
December 19, 2007 -attached
Total Personal Property 1,070.00
Stock /Listed
69.0000 shares MetLife -stock
4,476.72
Total Stock /Listed 4.476.72
Bond
58,042.2000 AllianceBernstein -Intermediate Bond AFund -Account No. 7600044814
5.960.93
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS
DATE OF DEATH LAST RESIDENCE 1700 Market Street
11/05/2007 Camp Hill, PA 17011
(Attach additional sheets if necessary) Total Personal Property and Real Estate
28,643.61