HomeMy WebLinkAbout05-16-13 (2) INVENTORY
REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland 5S} File Number 21.11-0902
Sharon S. Umholtz and Creedin L. Stoner Ca—Executors
Personal Representative(s)of the Estate of Rozella M.McLane a/k/a Rozella May McLane
deceased,depose(s)and say(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 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. 1 understand that false state-
ments herein are made subject to the penalties of Sharon S. Umholtz r edin L. Stoner
18 Pa.C.S. § 4904 relating to unswom falsification to 821 Boiling_Spri gsgoati 5bf r• Marble Street
authorities. Mechanicsburg, PA 17055 Mechanicsburg, PA
17055
Attorney-- (Name)Keith O.Brenneman,Esquire (Supreme Court 1.t7. 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 SOO.SEC,NO.
08/05/2011 100 Mount Allen Road,Mechanicsburg,PA 17055
FIGURES MUST BE TOTALED
1. Diamond Saphire ring and miscellaneous jewelry,sale value$568.00 and Diamond Solitaire Ring, 1,718.00
appraised value$1,150.00,
2. Series E,$500.00 Savings Bond 2,635.20
3. Refund on 2011 Federal Income Tax 239.00
4. Beaver Creek,refund :-.; 500.00
5. Modem Woodmen,Life Insurance policy#5851803-S in which the beneficiary was the estate m ml 1,06535
G7
6. Prudential Life Insurance policy 4M03005455&#M51125014 in which the beneficiary was thetg;ta"{ G-3 Cl 1,052,23
7. Thrivant Financial for Lutherans Life Insurance policy#3129566& 10403417 in which the ben;9cfVEyrn- , ,�1 6 75,606.84
was the estate 3 W. er,
8. I ighmark,health insurance premium refund due the decedent c-; ='—'r -n "n 665.21
CfJ r"' rrt
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(Attach additional sheets as needed}
TOTAL: 103,481.83
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 An.CS.§3301(b))
Fornt RW-09 rev. 10.13.06