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fNVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
couNN oF Cumberland } ss
} File Number 21 -- 13 ' Q(A 3 3
Jane V.Wagner
Personal Representative(s)of the Estate of E. B@ttlfla W8y
deceased,depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever
situate and ail of the reai 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 memo ndum at the end of this inventory.
I veMy that the statements made in this Inven- �
tory are true and correct. I understand that false state- � Jan V.Wa ner
ments herein are made subject to the penatties of �
18 Pa.C.S.§4904 relating to unswom falsification to �
authorities.
Attomey- �Name) Jennifer B.Hipp
. (Supneme Court l.D.No.) $6556
�F"r"� Bogar and Hipp Law Offices
(Addr�ss) � West Main Street Shiremanstown PA 17011
(Te/ephone) 717-737-8761
DATE OF DEATH LAST RESIDENCE gethany Village DECEDENTS SOC.SEC.NO.
OZ/t1412013 Mechanicsbu PA 17055
FIGURES MUST BE TOTALED
r.�.;
Personal Pro�fir � Q � � rn "
Cash. � �o c� � �
..................................................................................... .~d
......... m -`�52,� �
� Personal Property.................................................................. � �'
Stocks/Listed ������ ,�, � m � '`'� m
................................................................................ � � � �
� . � :
Stocks/Closely Held................ cs �a
..................................................... d` � � � `�,,,s ..�.t
Bonds............................................................................................ c, � ��` � �
: � N � �
Partnerships and Sole Proprietorships..................................... -.� r..
-c
Mortgages and Notes Receivable....................... � � �"` �
� ........................ � ;.
AllOther Property...........:............................................................
Total Personal Pro e �
P �/........................................ 4,352.52
Total Real Property.............
...................................
Total Personal and Real Property........... h�h��`��������s��,�t �,��
............. � „
���
NOTE: The Memorandum of real estate outside the Commornnrealth of Pennsylvania may at the election of the personal repr�esentative include the value of each
item,but such figures should not be extended into the total of the Inventory.(See'10 Pa.C.S.§3301(b))
Form RW-09 Rev.ra��-2oos
. _ _ _ - - _ —
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLV
ANIA
COMMONWEALTH OF PENNSYLVANIA
courvn oF Cumberland } ss
}. File Number 21
DATE OF DEATH LAST RESIDENCE
02/04/2013 Bethany Village DECEDENTS SOC.SEC.NO.
Mechanicsbu , PA 17055
�b
Members 1st Federal Credit Union-Savings Account No.419806-00. Principal balance 2.273.52
at date of death$2,273.45;accrued interest$0.07.
Riversource-long term care insurance payment
2,079.00
Total Cash 4,352.52
(Attach additionaF sheets if necessary) Total Personai Properly and Real Estate 4.352.52