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INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA ~ SS
COUNTY OF CUMBERLAND
COUNTY, PENNSYLVANIA
File Number
11 0677
Personal Representative(s) of the Estate of Helen B. Hill
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets whenever situate
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed ~posite eaclfsem of sai~
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real es~~utside o~;fhe ~'
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. ~-`~' ~~-Y f ~~' ~~__%
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I verify that the statements made in this Inven- ~ ~ ~ ~ '
tort' are true and correct. I understand that false state- /// c -~
Nancy S. Hill hwine - _3"
ments herein are made subject to the penalties of v ~ _; _
18 Pa. C.S. § 4904 relating to unswom falsification to - "~ - J
authorities. ~ t~ `" _T
Attorney -- (Name) Benjamin J. Butler (Supreme Court I.D. No.) 81948
(Address) 1007 Mumma Road, Suite 101 Lemoyne PA 17043
(Telephone) 717.236.1485
DATE OF DEATH LAST RESIDENCE
5225 Wilson Drive
2/28/ I 1
FIGURES MUST BE TOTALED
Cash, Bank Deposits, & Misc. Personal Property
2005 Buick LeSabre (approx. 45,000 miles)
John Hancock Life Insurance Company -Long Term Care Premium Refund
John Hancock Life Insurance Company -Long Term Care Payment
PNC Bank -Credit Balance
PNC Bank -Checking Account XXXXXXXXXXXX0997
Comcast -Refund
(Attach additional sheets as needea
DECEDENT'S SOC. SEC. NO.
17055 X
7,500.00
205.45
11,047.50
1.48
210.08
18.70
TOTAL:
18,989.82
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))
Form RW-09 rev. 10.13.06
Continuation of Inventory
Helen B. Hill 11 0677
Decedent Name Page ~ File Number
Description of Inventory
Discover Cazd -Overpayment Refund ~ 6.61
subtotal ~ S 6.61
Grand Total I S 18,989.82