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Register of Wills of CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Sarah M. Wertz
No. 21-09-0208
also known as Date of Death 12/10/2008
Deceased Social Security No. 203 -10 - 7017
Elmer H. Wertz,
Personal Representative(s) of the above Estate, deceased, verify 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 /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
Name of Marlin R. McCaleb Es Si nature• ~• `'~
Attorney: q • g
Elmer ertz
I.D. No.: 06353 Signature:
Address: 219 East Main Street
Mechanicsburg, PA 17055
Telephone: 717/691- 7770
Description
Address: 1003 Bridge Street
New Cumberland, PA 17070
Telephone: 717/774- 7745
Dated:
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Value
ra
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Total: 90 , 311.82
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.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #R W-~ (1992)
INVENTORY
Estate of: Sarah M. Wertz
Date of Death: 12/10/2008
County: Cumberland
PERSONAL PROPERTY:
Highmark Blue Shield, - 321.1.2
refund.
SecurChoice, - pre-need burial 1,618.05
trust.
1,939.17
STOCKS/LISTED:
Merrill Lynch Account No. 88,372.65
872-10388, - value of
securities: $88,187.89;
accrued dividends: $184.76.
88,372.65
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TOTAL RECEIPTS OF PRINCIPAL ............... 90,311.82
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