HomeMy WebLinkAbout07-02-14 (2) INVENTORY
REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA l}
COUNTY OF Cumberland J SS File Number 21-13-1141
Jackie R. Prock, Administrator
Personal Representative(s)of the Estate of Lorain Derick Hambright
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-
tory are true and correct. I understand that false state- Ja k'e R. Prock, Administrator
ments herein are made subject to the penalties of 114 8 Ashley Drive
18 Pa.C.S. § 4904 relating to unswom falsification to North Bethesda, MD 20805
authorities.
Attorney-- (Name) (Supreme Court I.D. No)
(Address)
(Telephone)
DATE OF DEATH LAST RESIDENCE DECEDENTS SOC.SEC.NO.
10/23/2013 5401 Oxford Drive,Apt.#16,Mechanicsburg,PA 17055
FIGURES MUST BE TOTALED
I. Property known and numbered as 5401 Oxford Drive,Unit 16,Lower Allen Township,Cumberland 83,407.83
County,Mechanicsburg,PA 17055, sale value
2. Belco Community Credit Union,checking account ending 30-0040 3,869.45
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3. Belco Community Credit Union,savings account ending 30-0001 s 18.00
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4. Cigna Assurance Program,account#64-023764-6 M c ��G,-409.81
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5. Internal Revenue Service,refund due the decedent on 2013 income tax return .rns - r
--12-,334.00
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6. Personal property,sale value_ -.. z ,M, rJ 71 e600.00
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7. PPL Electric,refund on electric service - a7) c-� '^'I 50.00
8. Wells Fargo,checking account#3625293497 0 t m96.50
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(Attach additional sheets as needed)
TOTAL: 118,385.59
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(6))
Form RW-09 rev. 10.13.06 �\
Good day to you
Could you be so kind as to time stamp the two pages of my filing and slip them into the addressed
Envelope.
Thank you in advance
Jackie R Prock Administrator
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