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INVENTORY
REGISTER OF WILLS OF
CUMBERLAND
~E~I~ .'.~ 4.+ w.'
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } I;'
COUNTY OF Cumberland } SS File Number 21-11-0847 _ OI~Fi sHi4 i, ''"
JUDITH ANN SOMERICK and MARTHA FRANCES MacADAM ~~f~~-f ~-~C~+~.~-x
Personal Representative(s) of the Estate of BERNICE M. PREDMORE
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 w ' h appears in a memor ndum at the end of this inventory.
I verify that the statements made in this Inven- ~ C~,u` ~ _ /1 _
tory are true and correct. I understand that false state- - F~d~ ______
UDITH A N SQMERICK
ments herein are made subject to the penalties of 3'
18 Pa.C.S. § 4904 relating to unsworn falsification to ~ MARTHA FRANCES MacADAM
authorities.
Attorney - (Name) James W. Appel
(Firm) Aooel & Yost LLP
(Supreme CouMI.D. No.) 07022
(Address) 33 North Duke Street, Lancaster, PA 17602-2842 ___
(Telephone) 717-394-0521
DATE OF DEATH I LAST RESIDENCE 1709 SherWOOd Road DECEDENT'S SOC. SEC. NO.
07/24/2011 New Cumberland PA 17070-1455 193-36-2573
FIGURES MUST BE TOTALED
Cash ...............................................................................................
Personal Property ........................................................................
Stoc kslListed ................................................................................
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 ........................
13,992.78
6,455.04
9,417.60
29,865.42
28,865.42
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 extendetl into the total of the Inventory. (See 20 Pa. C.S. § 3301(b))
Form RW-09 rtev. tats-zoos
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INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland } File Number 21-11-0847
DATE OF DEATH LAST RESIDENCE 1708 Sherwood Road DECEDENTS SOC. SEC. N0.
07/24/2011 New Cumberland, PA 17070-1455 193-36-2573
Cumberland County VA -death benefit
Homesteaders Life Company -refund burial insurance
John Hancock Life Insurance -premium refund
John Hancock Life Insurance -medical reimbursement
John Hancock Life Insurance -long-term care payment
Mellon Certified Restoration -deductible for water damage to residence
Oak Life Manor -refund
PA Dept. of Revenue -unclaimed property -Manulife Financial dividends
Proceeds 67 shs. Prudential Financial Corp. -stock sold before death, proceeds
received after death
USAA -balance due on water mitigation
Total Cash
Stocks/Listed
384.0000 shares Manulife Financial Corporation
Total Stocks/Listed
Mort~aQes/Notes Re eiv^ble
Note due from James D. P. MacAdams, dtd. 5/15/2011
Total Mortgages/Notes Receivable
100.00
568.45
448.12
6.08
1,540.05
500.00
6,355.00
36.63
4,105.34
333.11
13,992.78
6.455.04
6,455.04
9.417.60
9,417.60
(Attach additional sheets if necessary) Total Personal Property and Real Estate 29 865 42