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INVENTORY
REGISTER OF WILLS OF CUMBERLAND
18067
(Telephone) 717-258-6844
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF CUMBERLAND f SS
Charles R. Folcomer, Sr.
Attorney -- (Name) ~ (Supreme Court I.D. No.)
(Address) 113 Front Street, Boiling Springs, PA 17007
ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Anthony L. DeLuca Esquire
Personal Representative(s) of the Estate of Char 1 e s R . Fo 1 c ome r
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- G
tort' are true and correct. I understand that false state-
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
May 12, 2010 1515 Lutztown Road, Boiling Springs, PA 164-28-6035
FIGURES MUST BE TOTALED I
Real Estate situated at 1~ Lutz own Road, Boiling
Springs, PA.
100 shares of Common Stock of Rite Aid Corporation
Account, #98181440 at M&T Bank
Account, #31003916168999, at M&T Bank
Account, #31003917713595, at M&T Bank
Miscellaneous items of personal property
1999 Dodge Caravan
Certificate of Deposit, #1008414273, at State Farm Bank
Certificate of Deposit, #1008034022, at State Farm Bank
Certificate of Deposit, #2037578642, at State Farm Bank
($155,000.00
1 35.00
23,545.00
2,005.89
2,025.71
778.00
2,500.00
2, 1 08.87
2, 1 31.55
5, 31 0.09
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TOTAL: $195,540.11
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(6))
COUNTY, PENNSYL`'ANIA
File Number 21 -1 0- 0 5 3 5
Form RW-09 rev. 10.13.06