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INVENT�RY
REGISTER OF WILLS QF CUMBERL.AND COUNTY, PENNSYLVANIA
� GOMMONWEAL7H OF PENNSYLVANIA
COUNTY OF Cumberland } Ss Fite Number 27-13-1166
Mary Ann Boilinger
( Personal Representafrve(s)ai the Estate of Ch1o8 M.Hair
� Chloe Marie Hair
` deceased,depose(s)and say(s)that the items appearing in the folbwing irnentory inciude aii of fhe personal assets wherever
, situate and alt of the real estate tn the Commonweafth of Pennsylvania of said Recedent,that the vafuation placed opposite each
ifem af said faventory represents its fair�a{ue as of the date of the deceder►Ys th,and that Decederrt owned no real estate
; outside of the Commonweatth of Pennsyivania excepi that which appe s in a emoran at end of this in tary.
I verify that the statemer�ts�made in this Inven- �
tory are true and correct.I understand that false state- Mary nn (nger
merrts herein are made subJect to the penal�es of �
' 18 Pa.C.S.§4904 refating to unswom fatsiflca4on to
` authorities.
�
: �
� Attorney- (Name) Robert C.Saidis fsuPreme Court�.o.�vo.l 21458 �
j (Ftm') Saidis.Sullivan&Roge�s �
' (A���) 26 W.Nigh Street,Carlisle,PA 1?013 f
(fel�hcxte} (717)243�Z22 - ----.- i
� on�oF oea�n+ LhST FtESiDENCE � L01�QSCIOrt W8y � OECEOENT'S SOC.SEC.NO. . �
j 09/13/2013 Carlisle,RA 17075 ;
�
FIGURES MUST BE TOTALED �
Personal Prooerlv !
� Cash............................................................................................... '
• persanal Property....................................................................,... � 35.8507� � �i
� Stocks/Listed.............�......:....:..................................................... -� � � r'T� n ;
Stocksl6losely Hefd. ............ ................................................. � "r! �a ��� cti i
� Bonds.. �;� A �? "� rn �
' Mutual Funds..................................................................... '�' c> r�' � �� �
...._ , _.«. .
, . ;
Partn�rshias and Sale Proprietorships..................................... `-' ca �.y 'i7 `.;.� � ,
.. c7 c."a -r; 3 � '
Mortgages and NoEes Receivabie............................................. c, � -r�
Atl Other ProPertY........................................................................ ' � c..� r--_, r�
� —�-- r' +'Tt �
` Totat Personal Pro �
, perty........................................ 35,�F72 N '*1 �
� !
Total Reai Property...................... '
.......................... ;
Tatai Personal and Real Property........................ �� g,,gg0,�� ;
rro�: rn�,�su�es re s`�no��a rro beO1�ex�en�ded��a�ne kro�ien�n�see 2o r�c.s�`�0.'§ssni@)?�OD�repre�ntanve�na�,de me,�o�e�n �
;
� r-am RW-(18 r�.tats.2ans
i �
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,.�. .,. �� .,��..���� ��.���.� ��:�� ,� �,- ��. � �.ti�,�� � 4 ..� _
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i
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland } ss File Number 21-13-1166
DATE OF DEATH LAST RESIDENCE 1 Longsdorf Way DECEDENT'S SOC.SEC.N0.
09/13/2013 Carlisle, PA 17015
Personal Pronertr
Final pension payment 486.23
Genworth Financial -Long Term Care Insurance payment 440.00
Omnicare 7.41
Orrstown Bank Checking Account No. 106004967 32,774.26
Refund from 2013 Income Tax 1,120.00
Refund from Highmark for prescription costs 1,079.82
Refund from Highmark for prescription costs 43.00
Total Personal Property 35,950.72
(Attach additional sheets if necessary) Total Personal Property and Rea) Estate 35,950.72