HomeMy WebLinkAbout02-21-08
ESTATE OF
DOROTHY G. SUTHERLIN,
Deceased
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYL VANIA
NO. ~1-Ol-OSS7
DISCLAIMER
COMMONWEALTH OF VIRGINIA
C"7"Y
~OF Note FoLK.
: ss.
The undersigned, RICHARD R. GROSS, hereby renounces and disclaims his right, title,
and interest in and to the residuary bequest. The undersigned's interest in the residuary bequest
arises out of the provisions of paragraph Fifth of the Will of the decedent dated July 17,2003.
I declare that I will not accept, either at present or in the future, from the Executor of the
Estate or the Executor's successors, any portion of the income of the Estate derived from the
disclaimed assets or any interest in the disclaimed gift which may be sought to be paid to me in
accordance with any right, title, or interest which I had at any time before the execution of this
disclaimer. It is my intention in executing this disclaimer to terminate my interest in the specific
property listed above as effectively as would my death.
The undersigned does not renounce or disclaim any other property, right, title or interest
in the remaining assets of the Estate of DOROTHY G. SUTHERLIN.
This disclaimer is made pursuant to 20 Pa C.S. Section 6103, et seq., and shall be
irrevocable. '2cfJ2~
RICHARD R. GROSS
SUBSCRIBED, SWORN TO AND ACKNOWLEDGED BEFORE ME, a Notary Public,
this f. '3tr\ day of ~~t , 2007, by the said RICHARD R. GROSS, known to me to be
the person whose nam is subscribed to the foregoing instrument, and acknowledged that such
instrument was his free and voluntary act for the purposes expressed.
~ YVlI;~'~eu.fl
Notary Public
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AINLEY MICHELLE S~)
Notory PublIc
COMIftOI.. aant\ of VIrgInIa
j __ COIMtJIllon ........ Now JO. 2010
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Acc~ed ...n ' 2007
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RICHARD R. GROSS, Executor
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