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Home My WebLink About03-11-13 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0726 John E. Eng Personal Representative(s) of the Estate of Adis A. Rasmussen 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 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- John E. Eng ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney (Name) George F Douglas, III Esq. (Supreme Court I. D. No.) 61886 (Firm) Salzmann Hughes, P.C. (Address) 354 Alexander Spring Road, Suite 1, Carlisle, PA 17015 (Telephone) 717-249-6333 DATE OF DEATH LAST RESIDENCE 801 N. Hanover Street DECEDENTS SOC. SEC. NO. 06/27/2012 Carlisle PA 17013 502-30-8261 FIGURES MUST BE TOTALED Personal Property Cash W= - 29 757.96 c°> w_ ax Personal Property c r" Ce Stocks/Listed p `-194.92 rn Stocks/Closely Held rc'- Bonds Partnerships and Sole Proprietorships Mortgages and Notes Receivable rte' `-3 All Other Property e.t I "J . Total Personal Property 54,752.88 Total Real Property Total Personal and Real Property 54,752.88 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. 10-13-2006 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0726 DATE OF DEATH LAST RESIDENCE 801 N. Hanover Street DECEDENTS SOC. SEC. NO. 06/27/2012 Carlisle PA 17013 502-30-8261 Cash Bank of America NA - refund of credit 3.00 Commonwealth of Pennsylvania - return of unclaimed property, MetLife dividend 13.52 Members 1st Federal Credit Union, Checking Account No. 29586-11 1,746.53 Members 1st Federal Credit Union, Savings Account No. 29586-00 1,486.67 Accrued interest on above item through date of death 0.26 MetLife Insurance Company, Policy No. 24517136A - life insurance death claim, 1,300.00 beneficiary is decedent's estate The Church of God Home, Inc. - refund of credit 8,605.33 USAA - refund of unused insurance premium 1,117.30 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-46 1,578.54 Accrued interest on above item through date of death 0.90 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-47 1,029.64 Accrued interest on above item through date of death 0.44 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-48 514.81 Accrued interest on above item through date of death 0.22 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-49 514.81 Accrued interest on above item through date of death 0.22 (Attach additional sheets if necessary) Total Personal Property and Real Estate 54,752.88 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0726 DATE OF DEATH LAST RESIDENCE 801 N. Hanover Street DECEDENTS SOC. SEC. NO. 06/27/2012 Carlisle, PA 17013 502-30-8261 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-50 6,177.96 Accrued interest on above item through date of death 2.64 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-51 5,148.29 Accrued interest on above item through date of death 2.20 Members 1st Federal Credit Union, Certificate of Deposit No. 29586-52 514.46 Accrued interest on above item through date of death 0.22 Total Cash 29,757.96 Stocks/Listed 456.8620 shares Oppenheimer Global Fund Class A; Account No. 003303300138303 24,994.92 Total Stocks/Listed 24,994.92 -2-