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SIIPPLII�IENTAL
INVENTORY
REGISTER OF WiLLS OF Cumberland COUNTY, PENNSYLVANIA
COMMONWF.ALI'H 01=PENNSYLVANIA
COUNTY OF Cumberland SS File Number 2�-��-0634
Keith 0. Brenneman, Administrator C.T.A.
Personal Representative(s)of the Estate of Blair McClenachan
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- �n�"'�
tory are true and correct. I understand that false state- Keith 0. Brenneman, Administrator C.T.A
ments herein are made subject to the penalties of 44 West Main Street
18 Pa.C.S. § 4904 relating to unsworn falsification to Mechanicsburg, PA 17055
authorities.
Attorney-- (Name) (Szrpreme Court LD. No.)
(Add�•ess)
(Telephone)
DATF.OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO.
04/11/2011 1880 Douglas Drive,Carlisle, PA 17013
FICURES MUST I3E TOTALED
**** SUPPLEMENTAL INVENTORY****
I. Orrstown Bank,Certifica�e of Deposit#4000034462 ]0,839.6�
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(A1laclr addilionnl slieets ns needed)
TOTA L: 10,839.6i2
NOTE. The Memorandwn of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of eaeh
item,but such tigures shauld not be e�tcnded into Ihe[otal of[he Inven[ory. (See 10 Pn.C.S.,�330!(b)J
Forur RII'-09 �-e,. fn.�3.n6 �
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