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ESTATE OF PATRICIA J. BALLOTS, DECEASED
NO. 21-06-01068
DISCLAIMER
Thomas A. Ballots, Executor of the Estate of Debora J. Humberston (formerly Debora J.
Ballots), hereby exercises the rights granted in Chapter 62 of the Probate, Estates and Fiduciaries
Code (the "PEF Code"), and, on behalf of the said Debora J. Ballots Humberston, hereby disclaims
and renounces any interest to which she may be entitled under Item Two of the Last Will and
Testament of Patricia J. Ballots dated February 22,2005, and under applicable law.
IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this
Disclaimer and Renunciation shall be filed of record in the Office of the Clerk ofthe Orphans' Court
Division of the Court of Common Pleas of Cumberland County, Pennsylvania, as provided in
Section 6204 of the PEF Code, I have hereunto set my hand and seal this 30 -fA. day of
~ ,2007.
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Thomas A. Ballots, Executor of the
Estate of Debora J. Humberston
(formerly Debora J. Ballots)
COMMONWEALTH OF PENNSYLVANIA )
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COUNTY OF CUMBERLAND
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On this, the .30 -M day of ~ ' dJD 0 1 , before me, a notary public,
personally appeared Thomas A. Ballots, Executor of the Estate of Debora J. Humberston (formerly
Debora J. Ballots), known to me to be the person whose name is subscribed to the within instrument,
and acknowledged that he executed the same for the purposes therein contained.
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COMMONWEALnI OF PENNSYLVANIA
NOTARIAL SEAL
Conine L. Myers. Notary Public
Carlisle Borough, Cumberland County
M commission ex . es 27.2011
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