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Keset r=orm
INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA .,
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COMMONWEALTH OF PENNSYLVANIA <=c~~ ~~, ~ , x-
COUNTY OF DAUPHIN } SS ;::~a _.7 ~, ~ ~~~
File Number 21-10-1265 ~ - ;:,-
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Personal Representative(s) of the Estate of Cameron M. Dunn .. ^3 ~ -~
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deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the persapa~ assets wi~ereve~~~it~a;te
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation place7c~opposite ea~}~ iten~~f~id
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no rf;al estate-outside of't~e
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
18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
Attorney -- (Name) James D. Cameron
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Craig C. Dunn, Executor
(Supreme Court I. L). 1Vo.) 58998
(Address) 1325 North Front Street, Harrisburg, PA 17102
(Telephone) (717) 236-3755
DATE OF DEATH LAST RESIDENCE
December 19, 2010 4305 Motter Lane, Camp Hill, PA 17011
DECEDE=NT'S SOC. SEC. N0.
041-10-8641
FIGURES MUST BE TOTALED
Cash in residence
Bankers Life & Casualty Company (refund of premium--long term care policy)
Bankers Life & Casualty Company (refund of premium--Medicare supplement policy)
Centric Bank certificate of deposit number 3021971
Integrity Bank checking account number 201042692
PGA of America (dues refund)
PSECU check payable to Decedent (received prior to death)
PSECU regular share account S01
PSECU share account S50 (certificate of deposit)
State Farm Automobile Insurance Company (refund of premium--auto policy)
Miscellaneous tangible personal property (appraised value)
Verizon (refund on account)
2002 Ford Windstar VIN 2FMZA52482BA65533
(please see attached continuation sheet)
(Attach additional sheets as needed)
86.70
856.08
975.18
90,000.00
160,767.09
102.50
163.78
5.23
90, 000.00
166.79
1,509.00
44.10
5,475.00
TOTAL: I $891 _145 Rn
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. 10.13.06
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Inventory
(page 2)
Estate of Cameron M. Dunn
No. 21-10-1265
State Farm (refund ofpremium-homeowner's policy) 201.31
United States Treasury (refund due per Form 1040; tax year 2010) 197.00
PA Department of Revenue (refund due per Form PA-40; tax year 2010) 118.00
Vanguard investment account (transfer on death registration) 132,711.56
Accrued dividends, Vanguard investment account
(transfer on death registration) 255.53
E*Trade Financial investment account number 5566-5739
16,820.84
TD Ameritrade investment account number 881-3 86753
208,790.11
Real estate situate at 4305 Motter Lane, Hampden Township,
Cumberland County, Pennsylvania, more particularly described in
Cumberland County Record Book 247, Page 2629
(assessed value times common level ration of 1.0) 181,900.00