HomeMy WebLinkAbout06-06-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Sara Jane Caum
also known as
,Deceased
COUNTY, PENNSYLVANIA
File Number 21-- ()~ ~~i~ I
Socia! Security Number 168-24-3021
Janet L. Morris and Susan L. Royal
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A'or'B'BELOW:)
X~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the
last Will of the Decedent, dated 04130/1999 and codicil(s) dated
Slate relevant circumstances, e.g., ronunaation, death o/executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
ap rca , en er. c..a.; ..n.c..a.; rte e; ran e a sen ra; uran a mrno a e
Petitioner(s) after a proper search has/have ascertained that Decedent left no WiII and was survived by the following spouse (if any) and heirs: (If
Administ-a6on, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list ofheirs.)
Name Relationship Residence
C7 c
C o
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(COMPLETE IN ALL CASES.) Attach additional sheets if necessary. . = `= ~ t r=i ==~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal re~at `_
16 Amherst Drive, Camp Hill, Lower Allen, Cumberland, PA 17011 ~ c ^rT ~ -_
(List street address, towrut:ity, township, county, state, zip code) ~ ~ iV ~- - ..__
Decedert, then 79 years of age, died on 05/24/2008 at Hoty Spirit Hospital twV ~ f ~ _,
Decedent at death owned property with estimated values as follows: G ^~,
(If domiciled in PA) All personal property $ p ~~~ JQ ~
(If nat domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Persona! property in County $
Value of real estate in Pennsylvania $ ~
situated as follows: 16 Amherst Drive, Camp Hill PA 17011
Wherefore, Petitioner(s) respectfully reQuest(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Signature Typed or printed name and residence
/~~ ,.,¢ ~ ~ n Royersford, PA 19468
L. Royal
4747 Berry Road
Fredonia, NY 14063
Fo~t~ ~~Rev. 10-13-2006 Copyright (c) 2006 form software ony The Lackner Group, Inc. Page 1 or 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA } SS
couNTY of Cumberland
The Petikioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief of Petitioners} and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law. ,
Sworn to or affirmed and suh~scribed
before me this lia day of
Jc.~e ~~
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D .,~~1.(~ 1.~
For the Register
Janet L. Morris
Susan L. Royal
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File Number: 21-- O~ ~Cj ~~ ~ _'~ C~7
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Estate of Sara Jane Caum , Dece ed N
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Social Security Nnumber: - 168-24-3021 Date of Death: 05/24/2008
AND NOW, ~'! C' CIS ~~~ ~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Janet L. Morris and Susan L. Royal
in the above estate
and that the instrument(s) dated 04/30/1999
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
Letters .............~~..().:~'E~~...... $ 7~ y
Short Certificate(s).........a ~....... $ y
Renunciation(s)............ °"~........... $
c~,~l $ ~5
~.~LP $ ,v
~~ ~ $ ~~
$
TOTAL ....................................
$ _,~,
~~-~~
Supreme Court I.D. No.: 78658
Davis Bennett 8~ Spiess LLC
address: 130 West Lancaster Avenue
PO Box 191
Wayne, PA 19087-0191
Telephone: 610-688-6200
Form RW O2 Rev. 10.13-2008 Copyright (c) 2008 form software onty The Lackner Group, Inc. Pa e 2 of 2
9
Attorney Signature: ~,~~f~"`- /~ ~ /? •~ `~
Attorney Name: Carol R. Livingood Esq.
I I Ui. ft05 ILf ~- 10 V!(P i
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
..WARNING: tt is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, X6.00
P 1441196
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
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PEnMANENT CERTIFICATE OF DEATH -
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su::"'NK (See instructions and examples on reverse) STATE FILE NUM ~s
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, Hama a Decedent Frst coddle last suMal 2 Sea 7. Saml Secunry Number a. Oata oY Deam IMCnm. day
SARA JANE CHUM Female 168 _ 24 _ 3021
6 Aqa Mast &nnnayl UnRi t year Under t day 6. Dale d BiM lMonm. nay. year) 7. &nnpace ICdy and dale a fo rego country) Ba. Place of Dean ICnecx only ones
79 "°'~` °a'a "°"" """'°' Sept 9
1928 pA
Pittsburgh MosDaar Omer:
Yrs. , , ^ Inpauem ®ER ~ Outpatient ^ DDA ^ Nursug Home ^ Reswenu ^OtfNr - Spealy.
90 County d Deann Bc. City, Bao. TWD. of DeaM ce. FaDary Name (II not uuatutwn. qve sheer arA numparl ~ 9. Was Decedent of Hisparuc Orgur? ~ No ^ Yes 10. Aaca: Amencan neon, Btaca. Ydge, elc
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I(nd d WU1 Nag of &+suvrss I aqusuy U.S. Armed Forces? Elementary I Secondary (0-t 21 College (7-a or 5.1 Wxlowed, Dnaced (SpecUy)
Guidance Counselor Education pyea C8~ 12 6 Never Married
76 Decedaa's Maliny Address 191eet. ary town, stale. zp code) DeceneMS OM Oecedanl
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Wallace Caum
20a eeorrtunrs Name (Type I Paul 2W. Inlormanl's MaWg Adaess (SDae , ody r town, stale. z9 mtlel
Jan Morri:> 26 Henry Drive, Royersford, PA 19468
2ra. gettnd d Dutposngn ^ Crerreriat ^ Caution 210. Dale d Dispostam (Month, Day, year) 21 c. Place d Disposttgn )Name d cemetery• crematory or odter place) 21 d. Lomm~ ICM ~ town, state. zp Dodo)
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MRB:bh 4/21/99 06508 4/23/99
I, SARA JANE CAUM, of Camp Hill, Cumberland County, Pennsylvania, revoke
my prior Wills and declare this to be my Will.
FIRST: Debts and Funeral Expenses. I direct that the expenses of
my last illness, funeral and burial be paid out of my estate.
SECOND: Tangible Personal Property. I give all my tangible personal
property together with any insurance thereon, to my sister, BETTE C. ROYAL, of St.
Davids, Pennsylvania, if she survives me. 1f she does not, I give the same to my
brother-in-law, DOUGLAS D. ROYAL, my niece, JANET ROYAL MORRIS, and my
a niece, SUSAN ROYAL JONES, or the survivor or survivors of them, to be divided
z among them as they may agree.
THIRD: Specific Cash Bequests. 1 hereby make the following
N specific cash bequests:
A. The sum of FIVE THOUSAND DOLLARS ($5,000.00) to
the ENDOWMENT FUND OF DERRY STREET UNITED METHODIST CHURCH, of
Harrisburg, Pennsylvania.
o B. The sum of FIVE THOUSAND DOLLARS {$5,000.00) to
o SYRACUSE UNIVERSITY, of Syracuse, New York.
FOURTH: Residuary Estate. I give the residue of my estate, real and
personal, to my Trustee hereunder to hold and manage and distribute the net income
and principal as follows:
A. If my sister, BETTE C. ROYAL, survives me,
commencing from the date of my death and during her lifetime:
1. The net income shall be paid to her in quarterly or
more frequent installments.
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2. As much of the principal as my~ ~'t~stee may from
time to time think desirable for her maintenance, health and suppor~~a~aririg: in rind
her station in life and standard of living, shall be paid to her or aped d~ctly-for;
these purposes by my Trustee. I direct that my Trustee shall be lr~ in ~xper4d~rl~'
principal pursuant to this subparagraph. v~ ~ -_ ;-;
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MRB:bh 4/21/99 06508 4/23/99 4/29/99
3. My sister shall have the right to withdraw from
principal during any calendar year, the sum of $5,000 or 5 percent of the value of
the trust determined as of the time prescribed by Section 2041 of the Internal
Revenue Code, as the same may be from time to time amended, and any
departmental regulations thereon, whichever is the greater, which right shall be
noncumulative.
B. Upon the death of my sister, BETTE C. ROYAL, (or upon
my death if my sister does not survive me, anything above to the contrary
notwithstanding) myTrustee shall divide the then-remaining principal into equal trusts
so that there will be one trust for each child of my sister, namely, JANET ROYAL
MORRIS and SUSAN ROYAL JONES, either then living or then dead but survived by
issue then living, and thereafter as to each such trust:
1. During the lifetime of each such child:
3 a. The net income from such child's trust shall be
W paid to such child in quarterly or more frequent installments.
b. As much of the principal of such child's trust as
my Trustee thinks desirable for such child's maintenance, health, support and
education, including post graduate or professional school, bearing in mind such
child's station in life and standard of living, either shall be paid to such child or shall
be applied directly for these purposes. In addition my Trustee may pay directly
tuition or medical expenses of such child's children. I direct that my Trustee shah be
liberal in making expenditures pursuant to this subparagraph.
c. Such child shall have the right to withdraw at any
time the then-remaining principal of such child's trust, which right may be exercised
in whole or in part and from time to time.
2. Upon such child's death (or at the time for setting
apart a child's trust for any child who dies before such time) the then-remaining
principal of such child's trust shall be paid:
a. To such child's then-living issue per stirpes, or
in default of issue,
b. To the then-living issue of my sister, BETTE C.
ROYAL, per stirpes, (the portion thus accruing to a child of my sister for whom any
principal is then held in trust hereunder to be added to and thereafter treated as if it
had originally constituted principal of such child's trust); or in default of such issue;
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MRB:bh 4!21/99 06508 4/23/99
c. ONE-QUARTER (1 /4! to SYRACUSE
UNIVERSITY, of Syracuse, New York, and
ONE-QUARTER (1 /4! to ALPHA PHI
FOUNDATION; of Evanstown, Illinois, and
ONE-HALF (1 /2) in equal shares to those of the
group composed of my cousins, LEONARD MOPPET, of Honolulu, Hawaii, PAMELA
GEARHART, of Ithaca, New York, BARBARA WERNER, of Brookline, Massachusetts,
and ARTHUR WERNER, of Wilmington, Delaware, who are then living provided that
if any of said cousins are not then living but have issue then living, such issue shall
take per stirpes the share to which the deceased cousin would have been entitled if
then living.
FIFTH: Direct Distribution by Executor: In any instance where a
share in my estate would be distributable to a beneficiary of such trust when
received by the Trustee, my Executor may make distribution directly to such
beneficiary.
SIXTH: Adopted Beneficiaries. In construing this Will, wherever
m there is a gift to a person or class described by relationship to me, or to another, any
W adopted person shall be considered for any purpose hereunder as the child of the
w adopting parent or parents.
SEVENTH: Minor Beneficiaries. Whenever a minor becomes entitled to
principal as a result of my death but passing outside this Will, it shall be retained by
my Guardian and as much of it, and of the income from it as my guardian may from
time to time think desirable for the maintenance, health, support and education,
including college, of such minor, shall be expended for these purposes by paying bills
directly or by payments to the minor, his or her duly-appointed guardian or any
person or organization taking care of the minor. Any income not so applied shall be
accumulated and the unexpended principal and income shat! be distributed to the
minor at majority, or to his or her estate. My Guardian shall have no further
responsibility for funds so paid or applied.
EIGHTH: Beneficiaries Under 35 or Disabled. I direct that if any
beneficiary (1) under the age of 35 or, (2) in my Trustee's opinion, disabled by
advanced age, illness or other cause, becomes entitled to a distribution of income or
principal of any trust hereunder, it shall be held and managed as a separate trust as
follows:
A. As much of such income or principal or both as my
Trustee may from time to time think desirable for the maintenance, health, support
and education, including college and post graduate or professional school, of such
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MRB:bh 4/21/99 06508 4/23/99
beneficiary, shall be expended for these purposes by paying bills directly or by
payments to the beneficiary; or to his or her duly-appointed guardian, or any person
or organization taking care of the beneficiary, for the exclusive benefit of such
beneficiary. My Trustee shall have no further responsibility for any expenditures so
paid or applied.
B. The balance, including accrued and accumulated income,
shall be distributed to the beneficiary at age 35 or to the disabled beneficiary when
he or she, in my Trustee's opinion, becomes free of disability, as the case may be,
or to his or her estate.
NINTH: Earlv Termination of Trusts. Whenever my corporate
Trustee, in its discretion, shall determine that the size of any trust hereunder does not
warrant the cost of continuing the trust, or its management would be impractical for
any other reason, my Trustee, without further responsibility, may pay the then-
remaining principal together with accrued and accumulated income to the income
beneficiary thereof. If such beneficiary is a minor or is, in my Trustee`s opinion,
disabled by advanced age, illness or other cause, my Trustee may pay the same to
the parent, duly-appointed guardian or any person or organization taking care of the
beneficiary. Also, if the beneficiary is a minor, my Trustee may appoint and pay the
same to a Custodian for the minor under the Uniform Transfers to Minors Act of any
state. My Trustee shall have no further responsibility for such payments.
~, TENTH: Undistributed Income. Except as otherwise provided herein,
o all income not distributed to a beneficiary before termination of his or her interest
o shall be treated as though it had accrued thereafter; likewise, no credit or accrual
w shall be made for taxes, commissions or other charges theretofore made against
o income. My Trustee, however, may make exceptions hereto in its discretion.
ELEVENTH: Protective Provision. No interest in income or principal shall
be assignable by a beneficiary or available to anyone having a claim against a
beneficiary, before actual distribution to the beneficiary.
TWELFTH: Death Taxes. i direct that aii estate, inheritance and other
taxes in the nature thereof, together with any interest and penalties thereon,
becoming payable because of my death with respect to the property constituting my
gross estate for death tax purposes, whether or not such property passes under this
Will, shall be paid from my residuary estate.
THIRTEENTH: Tax Options. My Executor may make any law-given
elections which may affect the income and estate taxes as well as the relative shares
of beneficiaries, such as taking administration expenses as deductions for either
income or estate tax purposes, selecting options for the payment of life insurance,
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MRB:bh 4/21 /99 06508
employment benefits and death benefits, redeeming corporate stock and allocating
the generation skipping tax exemption. Any such elections shall be binding upon,
and not subject to question by any affected persons, and my Executor shall not be
required to make adjustments between principal and income.
FOURTEENTH: Additions. With my Trustee's approval, anyone may add to
the principal of any of the trusts under this Will.
FIFTEENTH: Management Provisions. In addition to the powers granted
by law, any Fiduciary appointed hereunder shall have the following powers,
applicable to principal and income, which shall be exercisable without leave of court
and shall continue until distribution is actually made:
A. To retain and to invest in all forms of real or personal
property, including, but not limited to, all types of stocks and bonds, whether or not
of my corporate fiduciary or of a holding company controlling my corporate fiduciary,
including participations in common trust funds operated by my corporate fiduciary,
regardless of any limitations imposed by law on investments by any such fiduciary
or any principle of law concerning investment diversification.
B. To buy investments at a premium.
C. To hold property unregistered or in the name of a
~, nominee.
0
D. To give proxies.
E. To compromise claims, including any questions relating
to any policy of life insurance. My fiduciary shall not institute litigation to collect any
policy unless my fiduciary is indemnified for costs, counsel fees and other expenses
of such litigation.
F. To join in any merger, consolidation, reorganization,
voting trust plan or other concerted action of security holders and to delegate
discretionary duties with respect thereto.
G. To borrow funds from anyone, whether or not the lender
is also a fiduciary hereunder who may be acting as a lender in an individual capacity,
and to pledge real and personal property as security for the repayment of the funds
borrowed.
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MRB:bh 4/21 /99 06508
H. To sell at public or private sale to any person or
corporation, for cash or credit or partly for each, to mortgage, exchange, repair, after,
improve or lease for any period of time, any real or personal property, and to give
options for sales, exchanges or leases.
I. To distribute assets in cash or in kind, or partly each,
and to make non pro rata distributions. All distributions shall be valued as of the time
of distribution.
J. To retain and to pay carrying charges on any
unproductive real estate.
K. To assume the continuance of the status of any
beneficiary with reference to death, marriage, divorce or other cause in the absence
of information deemed reliable by my fiduciary.
L. To allocate any property received or charge incurred to
principal or income or partly to each without regard to any law defining principal and
income or any rule of trust accounting.
M. To lend money to, or to buy real and personal property
from, a fiduciary under my Will or trust, even if my fiduciary is also the borrower or
seller. This right may be exercised for any purpose which my fiduciary may think
expedient.
N. To pool the assets of all the trusts hereunder for
purposes of investment and administration, allocating to each such trust an undivided
interest in the pooled assets.
0. To receive the proceeds of any life insurance policies,
annuities, profit-sharing or pension plans, or other employment benefits or Individual
Retirement Accounts, made payable to my Trustee and to retain, administer and
eventually distribute the same as though they had constituted a part of my residuary
estate.
SIXTEENTH: ApQointment of Fiduciaries. I appoint my sister, BETTS C.
ROYAL, Executor of this Will and Guardian of any property which passes to a minor
and with respect to which I am authorized to appoint a guardian and have not
otherwise specifically done so. If my sister should fail to qualify or cease to act I
appoint my brother-in-law, DOUGLAS D. ROYAL, as Executor and Guardian in her
stead. Should my brother-in-law fail to qualify or cease to act, then I appoint my
nieces, JANET ROYAL MORRIS and SUSAN ROYAL JONES, or the survivor of them,
Executor and Guardian in his stead. 1 appoint my sister, BETTS C. ROYAL, as
Trustee under this Will and I direct that she shall select a corporate Trustee to serve
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MRB:bh 4/21/99 06508
with her, such corporate Trustee to be a corporation having trust powers in
Pennsylvania. If my sister fails to qualify or ceases to act, I appoint my brother-in-
law, DOUGLAS D. ROYAL, as Trustee in her stead with the same direction that he
select a corporate Trustee to serve with him unless one is already serving. In the
further event that both my sister and my brother-in-law fail to qualify or cease to
serve, I appoint my nieces, JANET ROYAL MORRIS and SUSAN ROYAL JONES, or
the survivor of them as Co-Trustees, with the same direction that they select a
corporate Trustee to serve with them unless one is already serving. No bond shall
be required of any fiduciary hereunder in any jurisdiction.
SEVENTEENTH: Provisions Re~ardinq My Fiduciaries.
A. My corporate fiduciary shall be entitled to compensation
for its services hereunder in accordance with its Standard Schedule of Charges
currently in effect at the time its services are called upon and from time to time
during the period over which such services are performed.
B. No individual fiduciary who is a beneficiary shall ever
participate in the exercise of, or decision not to exercise the discretion to pay income
or principal to, or to apply income or principal for the benefit of, any beneficiary, the
determination whether a beneficiary is disabled, the decision to terminate any trust
hereunder, the allocation of any receipt or expense to principal or income, or the
decision whether to use expenses as income or estate tax deductions.
C. Any Trustee hereunder may resign and be discharged
from all liability, and any trust hereunder may be settled, by agreement with all
parties in interest who are sui juris. Such agreement shall bind all persons, whether
or not then in being or under a legal disability, then or thereafter entitled to any
portion of the trust, and shall effectively release and discharge my Trustee for the
acts and proceedings so accounted for. The settlement may also include the
approval of the account of an executor or another Trustee if my Trustee has received
property in distribution of that estate or trust.
D. My individual Trustee or co-Trustee shall have the right,
by giving notice to the corporate Trustee then acting, to require said Trustee to resign
and to select a new corporate Trustee (such substitute to be a corporation having
trust powers in Pennsylvania) by written notice to the corporate Trustee and to all
beneficiaries who are sui juris, effective upon the written acceptance of the
substituted Trustee.
E. It is my wish, but not a direction, that my Fiduciaries
employ the services of G. David Bias, presently at Legg Mason, as investment advisor
and broker.
-7-
MRB:bh 4/21/99 06508
EIGHTEENTH: Usage. In construing and interpreting this instrument any
term describing a fiduciary shall include all genders, shall be construed as singular or
plural, and shall include successors, as the situation may require.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
~~- , 1999.
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Sara Jane Caum
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Signed, Sealed, Published and Declared by SARA JANE CAUM, the above named
Testatrix, as and for her Will, in the presence of us, who at her request and in her
presence, and in the presence of each other, have hereunto subscribed our names
as subscribing witnesses.
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MRB:bh 4/21/99 06508
COMMONWEALTH OF PENNSYLVANIA:
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COUNTY OF .
I, SARA JANE CAUM, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Will; that I signed
willingly, and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sara Jane Caum
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witnesses, w se names are signed to the attached or foregoin instrument, being
duly qualified according to law, do depose and say that we were present and saw
Testatrix sign and execute the instrument as her Will; that she signed willingly and
that she executed it as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatrix and in the presence of each
other, signed the Will as witnesses; and that to the best of our knowledge, the
Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
WITNESS:
WITNESS: ~~ ~ "
Subscribed, sworn to and acknowledged before by SAR JANE CAUM, the
Testatrix an subscribed and sworn to before me by ` ~ ~ ~
and _,~~ >~ ,witnesses, on ~,- /' ~~ , 1999.
Notarial Seal /~ `
Jolene J. Davis, Votary Public
Radnor T~,~rp., D~iGvvare County ~'
My Commission Expires i=eb. 12, 2001 N ry Public
Member, Pennsylvania Association of Notaries
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REGISTER OF WILLS OF
RENUNCIATION
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of Sara Jane Caum
of the above Decedent, hereby renounce the right to
1, _ Bette C. Royal in my capacity/relationship as
(Print Name)
Executrix named in the Will
administer the Estate of the Decedent and respectfully request that Letters be issued to
Janet L. Morris and Susan L. Royal
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(Date)
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(Signature) Bette C. Royal /
510 Hillaire Road
(Street Address)
St. Davids, PA 19087
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy far Register of Wills
Executed ouf of Register's
Before the undersigned person.
party executing this renuncratioi
that he or she executed the ren
purposes stated within on thl;i~
Deceased
nom'``'
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Notary Public
My Commission Expires: ~l ` 3 "c~ ~j ~ ~
(Signature and seal of Notary or other official qualfied to
COMMOnNWEALTHhOF PEN~~~-~'~~~s wmmission.)
Notarial S~
Barbara A. Halh'nain. No4ary Public
~~ Tom„ pyre Coun1Y
My Commission Expires ~WY 3.2011
Member, Pennsylvania Association of Notaries
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RENUNCIATION
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Sara Jane Caum ,Deceased
Douglas D. Royal in my capacity/relationship as
(Prior Name)
Successor Executor named in the Will
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Janet L. Morris and Susan L. Royal
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(Dora) (signature) DOU I s D. Royal -: ~ c
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510 Hillaire Road ~"_= ~'~ ~ °' '_'
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_St. Davids, PA 19087 n ~~ tv ~ ~'
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(City, Srare, Zip) ~
Execufed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
party executing this renunciation and certified
before me this- day that he or she executed the renunciation for the
of purposes stated within on tr ~ '`day
of ~-, ~'c?t~8
Deputy for Register of Wills Notary Public
My Commission Expires: '~ ` 3 ` ~o ~ ~
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commission.)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Barbara A Nalhnan, Notary Ptrefic
Radnor Twp., Delaware Cotnty
My Ctxnmissior- Expires Jtdy 3, 2011
Form RW-O6 Rev. 1413-2006 Copyright (c) 2006 torte software dd¢IfrHBf~clr~ll6ugi~t7hie ASSOCIBtiOrt Of NOt2r18S