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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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Edward P. Hair
sworn
according to law, deposes and says that he ~s the Executor
of the Estate of Sa ra V. Ha ir
late of ~-.E.~~.l!~.dd_le to~I.()_wE-~_hip -- , Cumberland County, Pa., deceased and that the
Edward P. Hair E
within is an inventory made by ., the said xec ut or
of the entire estate of said decedent, consisting of all the personal prop arty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
being duly
Swo rn
and subscribed before me,
[~~Al~kJAQA 0
lQX: 2006
Date of DetJth
(~~ /P ,,(~~ ' Executor
Executor. Administrator
Edward P. Hair
8 Mi 11 Road
arlisle, PA 17013
Address
2005
Day
Year
Month
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
SARA V. HAIR, Deceased
PERSONALTY:
1. Blue Cross, refund unused medical premium
2. Church of God Home, refund on resident care
3. Commonwealth of Pennsylvania, refund on 2005 Final Individual Tax Return
4. Edward Jones, Investment account #377-08785-1-4
5. M& T Bank, checking account #416398
6. M& T Bank, savings account #015004204213083
7. M&T Bank, Certificate of Deposit, account #031003913463095
TOTAL PERSONALTY:
REAL ESTATE:
Decedent owned no Real Estate at the time of her death
TOTAL PERSONALTY AND REAL ESTATE:
Page 1
$
294.61
47.01
60.00
125,573.75
997.52
20,687.18
25,306.37
$
172,966.44
$
0.00
$
172,966.44
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