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INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA ,-.,,
COUNTY OF Cumberland } SS File Number 21-15-0626 c _ � � ,�
Terri L. Polinka � � �� �' ca
Personal Representative(s)of the Estate of June A. Hill �� �� t'� � ,� e�
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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 op"�bsite eae{�
item of said inventory represents its fair value as of the date of the decedenYs death,and that Decedent owned no re8�estate -��
outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inve tr�osy. � C:;
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I verify that the statements made in this Inven- ;
tory are true and correct. I understand that faise state- �' �� �'� `�
Terri L. Polinka o - �
ments herein are made subject to the penalties of �
18 Pa.C.S.§4904 relating to unsworn falsification to
authorities.
Attorney-- (Name) David J. Lenox (Supreme Court I.D.No.) 29078
(Firm)
(Address) g Tristan Drive, Suite 3, Dillsburg, PA 17019
(Telephone) 717-271-7175
DATE OF DEATH LAST RESIDENCE g30 S. 28th Street DECEDENT'S SOC.SEC.N0.
05/15/2015 Camp Hill, PA 17011
FIGURES MUST BE TOTALED
Personal Pro�ertv
Cash............................................................................................... 2,650.46
PersonalProperty........................................................................ 861.60
Stocks/Listed................................................................................
Stocks/Closely Held.....................................................................
Bonds............................................................................................
MutualFunds................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
AllOther Property........................................................................
Total Personal Property........................................ 3,512.06
Total Real Property................................................ 159,746.85
Total Personal and Real Property........................ 163,258.91
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)) �;�
Form RW-09 Re�.�o-�s-zoos
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INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland } File Number 21-15-0626
DATE OF DEATH LAST RESIDENCE 930 S. 28th Street DECEDENT'S SOC.SEC.NO.
05/15/2015 Camp Hill, PA 17011
Cash
Accrued Retirement Pay 573.00
M &T Bank acct#40813 16.75
M &T Bank acct#63234 2,060.71
Total Cash 2,650.46
Personal Pronert�
Miscellaneous property and furnishings 861.60
Total Personal Property 861.60
Real Estate
HUD Allocation- Sewer/Trash/Water 60.33
HUD Allocation-Local Tax 302.02
HUD Allocation-School Tax 1,384.50
Real Estate Situate at 930 S.28th Street, Camp Hill, PA- 158,000.00
Total Real Estate 159,746.85
(Attach additional sheets if necessary) Total Personal Property and Real Estate 163,258.91