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Home My WebLink About09-28-09INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland } Laverne C Black COUNTY, PENNSYLVANIA File Number 21-09-0360 Personal Representative(s) of the Estate of Glenn W Black tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. deceased, depose(s) and say(s). that the items appearing in the following inventory include all of the personal assets wherever situate and alf of the real estate tn`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. verify that the statements made in this Inven- -.. ~~ _ _ -- Attorney -- (Name) (Firm) (Address) (Telephone) James D. Hughes Esq. SALZMA_NN HUGHES PC _ ______ 354 Alexander Spring__Road, Suite 1, Carlisle, PA 17015 717-249-6333 DATE OF DEATH LAST RESIDENCE 142 Old State Road 03129/2009 ~ ~ Gardners, PA 17324 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... Personal Property ......................................................................... Stocks/Listed ................................................................................. Stocks/Closely Held ...................................................................... BO n d5 ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... Total Real Property ................................................ Total Personal and Real Property ......................... DECEDENT'S SOC. SEC. NO. 176-26-2285 r•s • . ~ 115,5.35 ,,,., ~~ 2,1+4.64 - _~, ' -~= `-?70 488.53 <- , _ ~? . ,.: ~~> I ~ fV ., ~ ~:._ .., r.~ _ _ :~ ` -1 c.n ~;~ ~ o , 188,224.52 504,000.00 ~-:.692,224.52 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)) Laverne C Black (Supreme Court I.D. No.) 58884 Foam RW-09 Rey. ~o-is-zoos •~~ REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-09-0360 _ _ _ __ __ DATE OF DEATH LAST RESIDENCE 142 Old State Road DECEDENT'S SOC. SEC. NO. 03/29/2009 Gardners, PA 17324 176-26-2285 Cash Citi Smith Barney, Bank Deposit Program -Account No. 54J-03174-16-4JX 10,822.04 Citi Smith Barney, Western Asset Money Market Fund Class A -Account No. 37,445.00 54J-03174-16-4JX Commonwealth of Pennsylvania - 2008, PA40 income tax refund 290.00 Erie Insurance Exchange -refund due to cancellation of homeowners policy 345.00 Erie Insurance Exchange -refund due to cancellation of homeowners policy 950.00 Laverne C. Black -County tax refund based on tax proration upon sale of 142 244.72 . Old State Road Laverne C. Black -School tax refund based on tax proration upon sale of 142 90.94 Old State Road Members 1st Federal Credit Union, Certificate of Deposit #280366-40 17,881.76 Accrued interest on above item through date of death ~ 63.10 Members 1st Federal Credit Union, Savings Account #280366-00 2,185.93 Accrued interest on above item through date of death 1.26 Nationwide Life Insurance Co. - 2/14/2008 interest check never cashed 789.25 Nationwide Life Insurance Co. -12/16/2008 interest check never cashed 31.75 Orrstown Bank, Certificate of Deposit #4000025543 -issued 4/30/08; due 5,324.04 7130109; rate 2.72°1° (Attach additional sheets if necessary) Totat Personal Property and Real Estate 692,224.52 INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA COUNTY OE Cumberland } SS File Number COUNTY, PENNSYLVANIA 21-09-0360 „__ _ _ _ _ _ DATE OF DEATH LAST RESIDENCE 142 Old State Road DECEDENT'S SOC. SEC. NO. 176-26-2285 03/29/2009 Gardners, PA 17324 Accrued interest on above item through date of death 0.80 Orrstown Bank, Certificate of Deposit #4000025544 -issued 4130108; due 10,603.87 7!28109; rate 1.24% Accrued interest on above item through date of death 0.72 Orrstown Bank, Checking Account #106002981 6,828.15 Accrued interest on above item through date of death 0.01 Orrstown Bank, Checking Account #404411 ~ 18,916.08 Accrued interest on above item through date of death 0.49 Orrstown Bank, Checking Account #404438 2,119.44 Travelers Cheques 400.00 United States Treasury - 2008, 1040 income tax refund 237.00 • Total Cash 115,571.35 Personal Prope Highmark, refund of unused premium 7.07 Household Goods -net proceeds of sale 753.56 Prudential -replacement check for uncashed check dated 6/12/2007 1,394.01 Total Personal Property 2,154.64 -2- INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-09-0360 _ _ __ DATE OF DEATH LAST RESIDENCE 142 Old State Road DECEDENT'S SOC. SEC. NO. 03/29/2009 Gardners, PA 17324 176-26-2285 Stock /Listed Citi Smith Barney -Account No. 54J-03174-16 2,460.0000 shares Black Rock Muniyield PA Insured Fund Inc - MPA 27,545.85 552.0000 shares Dreyfus Strategic Municipals Inc -Com; LEO 3,655.62 967.6710 shares Evergreen Trust Core Bond Fund B - ESBBX ~ 6,536.62 901.8980 shares Pimco Funds Pacific Investment Management Series - GNMA Fund CL 10,223.01 B; PBGNX 703.0380 shares Seligman National Municipal- Fund -Class A; SNXEX 5,198.97 1,207.0000 shares Van Kamp American Trust Investment -Com; VGM 13,231.74 383.0000 shares Van Kamp AMR Cap PA Value Municipal -Com; VPV 4,106.72 Total Stock /Listed 70,498.53 Real Estate Real estate situate at 130 Old State Road, Gardners, PA -see appraisal 125,000.00 attached Real estate situate at 134 Old State Road, Gardners, PA -see appraisal 112,000.00 attached Real estate situate at 136 Old State Road, Gardners, PA -see appraisal 110,000.00 attached -3- INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA couNTY of Cumberland } SS File Number _21-09-0360 _ __ _ _ ________ DATE OF DEATH LAST RESIDENCE 142 Old State Road DECEDENT'S SOC. SEC. NO. 03129/2009 Gardners, PA 17324 176-26-2285 Real estate situate at 142 Old State Road, Gardners, PA -see appraisal attached _ Total Real Estate 157,000.00 504,000.00 -4-