HomeMy WebLinkAbout06-19-12 (2)INVENTORY
REGISTER OF W[LLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF Cumberland f SS
_ Connie L. Grazier, Executrix
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Personal Representative(s) of the Estate of Margaret E. Cook ~" +w ``~
deceased, depose(s) and sayl;s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all ofthe real estate in the Commonwealth of Pennsylvania ofsaid Decedent, that the valuation placed opposite each item ofsaid
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.
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!verify that the statements made in this Inven- '~ ~,2 ~~.~. ~~~
tory are true and correct. l understand that false state- Connie L. Grazie Executrix
ments herein are made subject to the penalties of p,0. Box 697
18 Pa.C.S. § 4904 relating to unsworn falsification to Millheim, PA 16854
authorities.
Attorney -- (Name) Keith O. Brenneman (Supreme Court LD. No.) 47077
(Address) Snelbaker & Brenneman, P.C., 44 West Main Street, Mechanicsburg, PA 17055
(Telephone) 717-697-8528
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. N0.
03/23/2012 549 Dogwood Drive, Mechanicsburg, PA 17055
I FIGURES MUST BE TOTALED
l . Comcast, 150 shares Class A common stock, Account #3500853939 4,497.75
2. U.S. Savings Bond, Series E, Bond No. L2029210258E 272.64
3. Sovereign Bank, checking account No. 1681703777 2,_528.37
4. Sovereign Bank, club account No. 1684001876 250.02
5. Sovereign Bank, money market account No. ] 684070422 19,952.46
6. Sovereign Bank, certificate of deposit No. 1685551499 ] 0,022.10
7. Comprehensive Financial Associates, investment account No. SCR360602 321,560.67
8. Susquehanna Conference, certificate of deposit No. 16461 20,000.00
9. Susquehanna Conference, certificate of deposit No. 19544 20,000.00
10. 1999 Honda Accord LX 6,525.OU
1 1. Optum Health, insurance refund 312.71
12. United States Treasury, 201 1 federal income tax refund
655.00
l3. PA Department of Revenue
201 ]state income tax refund
, 108.00
14. Stonebridge Life Insurance, long term care insurance refund
734.90
I5. Novitas, medicare refund
89 ~~
I6. United Healthcare, refund
i 3.80
(Attach additional sheets as needed)
TOTAL: I 407,523.34
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 ot~the Inventory. (See ZO Pa. C.S. ~ 330/(b))
Fornrkti'-09 re r. !0.13.06