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Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of JACOBS, MARTHA A.
No. 21 - 06 - 00600
Date of Death 6/29/2006
Social Security No. 211-22-6693
also known as
I Deceased
HAROLD O. JACOBS RAY E. JACOBS
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following
Inventory include all of the personal assets wherever situate and all of the real estate located 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 the 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/We verify that the statements made in this Inventory are true and correct. I/We understand
that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn
falsification to authorities.
Attorney:
EDMUND G. MYERS
Personal Representative
Signature: ~ c; ~ L.v~.( 6"' c..
HAROLD O. JACOBS
Signature: ~~ B~ec..
RAY . J~OBS
1.0. No.:
20558
Signature:
Address:
P. O. BOX 109
LEMOYNEII PA 17043-0109
Address: 524 N. THIRD STREET
WORMLEYSBURG, PA 1"~3
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Telephone: (717) 737-1715 ~J-~ 5J
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Telephone: 717/761-4540
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Personal ProDerty
Household Goods - Appraised Value
N
1,omo
1988 Chevrolet Corsica Sedan - Date of death value
575.00
Susquehanna Valley Federal Credit Union
Checking Account No. 10833-40 - Date of death balance.
12,227.32
Susquehanna Valley Federal Credit Union
Savings Account No. 10833-00 - Date of death balance, plus accrued interest.
3.470.26
Susquehanna Valley Frederal Credit Union
Money Market Account No. 10833-35 - Date of death balance, plus accrued interet.
56,243.35
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$369,158.01
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Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of JACOBS, MARTHA A.
also known as
, Deceased
No. 21 - 06 - 00600
Date of Death 6/29/2006
Social Security No. 211-22-6693
West Shore A.L.S. - refunds
157.08
Senior Blue - premium refund
264.00
Total Personal Property
$73,948.01
2
, .
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of JACOBS, MARTHA A.
also known as
, Deceased
No. 21 - 06 - 00600
Date of Death 6/29/2006
Social Security No. 211-22-6693
Real Estate
Real Estate - 1128 - 1130 Laurel Avenue, Township of Lower Allen, Cumberland
County, PA. (Deed Book - H, Volume 19, Page 254).
Assessed Value - Copy of 2006 Real Estate Tax Notice attached.
146,550.00
Real Estate - 526 North Third Street, Borough of Wormleysburg, Cumberland County,
PA. (Deed Book E, Volume 22, Page 516)
Sale Price - Coov of Settlement Statement attached.
80,000.00
Real Estate - 530 Third Street, Borough of Wormleysburg, Cumberland County,
PA. (Deed Book B, Volume 24, Page 932).
Assessed value - Copy of 2006 Real Estate Tax Notice attached.
68,660.00
Total Real Estate
$295,210.00 .
3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
:ECEIVED FROM:
MYERS EDMUND G
301 MARKET STREET
PO BOX 109
LEMOYNE, PA 17043
------ fold
ESTATE INFORMATION: SSN: 211-22-6693
FilE NUMBER: 2106-0600
DECEDENT NAME: JACOBS MARTHA A
DATE OF PAYMENT: 11/01/2006
POSTMARK DATE: 10/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/29/2006
NO. CD 007378
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,550.92
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TOTAL AMOUNT PAID:
~EMARKS:
CHECK# 541
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$1,550.92
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
. ..
TO Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
FROM
JOHNSON, DUFFIE, STEWART.
WEIDNER
Attorneys at Law
P.O. Box 109
lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: October 30, 2006
SUBJECT:
Estate of Martha A. Jacobs
No. 21-06-00600
Enclosed for filing in the above-captioned Estate are the following:
1. Original Inventory.
2. Original and copy of Inheritance Tax Return.
3. Check in the amount of $30.00, filing charges.
4. Check in the amount of $1,550.92, Inheritance Tax.
An envelope is enclosed to forward the receipts to me. Thank you.
SIGNED: Cindy Hubler, Estate Administration Paralegal
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· 021A $ 02.07'
00'04(368026 OCT 30 2008
. IMIlEO FROM Zll'CODE 11043
RECORDED OFFICE OF
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2006 NOV -, PH 12: 51
CLERK OF
ORPH/~.N'S COURT
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First Class Mail
LAW OFFICES
JOHNSON
DUFFIE
301 MARKET STREET
P.O. Box 109
LEMOYNE, PA
17043-0109
To:
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387