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INVENTORY
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland ~ SS
Personal Representati
.,.., .,, .~,~ ~~~d~r or tlma T.
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherP~ver
situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation ced opposde each
item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent ow o real ee~ate
outside of the Commonwealth of Pennsylvania except that whlc
pears in a ~ orandum at the end oft entory. to
I verify that the statements made in this Inven- fTi , ;
tory are true and correct. I understand that false state- = ro '_~
ments herein are made subject to the penalties of Roger . Kreps _
i vi-.~~ Qy v.e.
18 Pa.C.S. § 4904 relating to unswom falsification to f ~.~, "~
authorities. nQ. - T----
Attorney - (Name)
(Fimr)
(Address)
(Telephone)
DATE OF DEATH
04/06/2012
Jennifer B.
717-737-8761
FIGURES MUST BE TOTALED
Persona
Cash .................................................................
Personal Property ...........................................
Stocks/Listed ...................................................
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 ........................
r ~" ~
O
(Supreme Court I.D. No.) 86556
DECEDENTS SOC. SEG N0.
9,706.11
9,641.36
5,800.00
20,000.00
45,147.47
COUNTY, PENNSYLVANIA
File Number 21-12-0481
LAST RESIDENCE 5225 Wilson Lane
CUMBERLAND
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal represEfntativeindude the value of each
item, but such figures should not be eMended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b))
Form RW-09 Rev m-os-zoos
1
REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } SS
DATE OF DEATH LAST RESIDENCE
Da/oann~~ 5225 Wilson Lane
Cach
File Number 21-12-0481
~~
DECEDENT'S SOC. SEC. NO.
SS
Cash
50.00
PNC Bank -Checking Account No. 5005799678. Date of death balance $9,656.11. This
account is non-interest bearing. 9.656.11
Total Cash
9,706.11
Personal Pre~rt
Jewelry -Value per appraisal.
9,491.36
Personal Property -Sold at private sale
150.00
Total Personal Property
9,841.36
Sto _~c/I ic4ae,1
800.0000 shares Aberdeen Asia Pacific Income Fund -Stock
5,800.00
Total Stocks/Listed 5.800.00
~9II~S
Lancaster County Hospital Authority -Revenue Refunding Bond -Landis Homes
Retirement Community Project -Series of 1998 20,000.00
Total Bonds
20,000.00
(Attach additional sheets if necessary) Total Personal Property and Real Estate
45,147.47