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INVENTORY
REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland SS File Number 2�'�2-0258
Roxanna Rae Kuykendall, Executrix
Personal Representative(s)of the Estate of Barbara A. Brozack
deceased,depose(s)and say(s)that the items appearing in the following inventory include all ofthe 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 exce�that which appears in a memorandum at the end of this inventory.
1 verify that the statements made in this Inven- �.y�� � --� ��� �
tory are true and correct. 1 understand that false state-
ments herein are made subject to the penalties of Roxanna Rae Kuykendall, Executrix
18 Pa.C.S. § 4904 relating to unsworn faisification to 1348 Zi�m_erman Road
authorities.
Carlisle, PA 17015
Attorney-- (Name) Keith O. Brenneman,Esquire (Supreme Court LD. No.) 47077
(Address) snelbaker&Brenneman,P.C.,44 West Main S[reet,Mechanicsburg,PA 17055
(Telephone) 717-697-8528
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC.SEC.NO.
12/29J2011 914 Wertzville Road,East Pennsboro Twp., Enola, PA 17025
F[GURES MUST BE TOTALED
l, Property known and numbered as 914 Wertzville Road,East Pennsboro Twp.,Cumberland County 125,508.25
Enola,PA 17025,sale value
2. 2005 Jeep Grand Cherokee,sale value 11,500.00
3. East Pennsboro Ambutance,refund due the decedent 658.80
4. Highmark,premium refund on health insurance due the decedent 10.80
5. Household goods,net proceeds from sale of household goods sold at public auction by Erb Auction 4,735.10
6. Me�ico,refund due the decedent 9.94
7. Member's lst Federal Credit Union,savings account#221999-00 2,135.29
8. Member's 1 st Federal Credit Union,checking account#221999-11 7,654.35
9. Member's lst Federal Credit Union,investment savings account#221999-OS 1,300.10
10. State Farm Insurance,premium refund due the decedent on auto policy 32.7A
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(Attach additiona!sheets as needed) � � �`�
TOTAL• � 153,6�5�1
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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 10 Pa.C.S.§3J01(bJJ /''�r�
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Fornr RW-09 rer. l0.13.06 -
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