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INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
courvnr oF Cumberiand Fiie Number 21-13-0836
Dixie L. Smith
Personal Representative(s)of the Estate of Martin J. Coble
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 decedenYs death, and that Decedent owned no real estate
outside of the Commonwealth of Pennsylvania except that which ppe�rs in a memor ndum at the end of this inventory.
I verify that the statements made in this Inven- �',,��� • %���v'`����
tory are true and correct. I understand that false state- � Dixie L.Smith T �
ments herein are made subject to the penalties of �
18 Pa.C.S.§4904 relating to unsworn falsification to
authorities.
Attorney-- (Name) Lauren E. Kays (Supreme Court I.D.No.) 205966
(Firm) Bogar& Hipp Law Offices
(Address) One West Main Street Shiremanstown PA 17011
(Telephone) 717-737-8761
DATE OF DEATH LAST RESIDENCE Forest Park Health Care Center DECEDENT'S SOC.SEC.N0.
05/04/2013 Carlisle, PA 17013 162-10-5109
FIGURES MUST BE TOTALED
Personal Propertv � � �
Cash............................................................................................... • ° �34,�1�t
Personal Pro ert �� ^'� �" �
py........................................................................ ..�' � c.-� cn :��
�,a, r-.. ......� ';•„w
Stocks/Listed................................................................................ , r-,. �-,�
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. _ cr� ._. , �
Stocks/Closely Held................................. _,„ u> �.Y., .0 ..
.................................... .._ �,..
r- ' '� , ca ��;-�
Bonds............................................................................................ �-, �R� =.;; :_i �° `i
Partnerships and Sole Proprietorships ' � r ���
_. �'..
..................................... -,���,,- �: �a
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Mortgages and Notes Receivable............................................... � � ,� �
All Other Pro ert t° �`�
p Y........................................................................
Total Personal Property........................................ 34,281.14
Total Real Property................................................
Total Personal and Real Property........................ 34,281.14
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))
Forr,�RW-O9 Rev.10-13-2006 �
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTYOF Cumberland } FileNumber 21-13-0836
DATE OF DEATH LAST RESIDENCE Forest Park Heaith Care Center DECEDENT'S SOC.SEC.N0.
05/04/2013 Carlisle, PA 17013 162-10-5109
Cash
American Funds Account(held by Member's 1st)-Account No.82781341. Date of 29,197.42
death balance$29,197.42.
Bank of Landisburg-Checking Account No.3729664. Date of death balance$3,747.83. 3,747.83
Banker's Life-monthly payment 45.11
Chevron-final retirement payment 578.97
Guardian Elder Care-refund 708.03
Omnicare Pharmacy-refund 3,�g
Total Cash 34,281.14
(Attach additional sheets if necessary) Total Personal Property and Real Estate 34,281.14