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HomeMy WebLinkAbout08-05-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of JAMES F. STEINMETZ File Number 21 08 ~ also known as ,Deceased Social Security Number Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executrix named in the last Will of the Decedent dated 1/31/2006 and codicil(s) dated none Miriam A. Steinmetz, appointed primary Executrix, has renounced as evidenced by Renunciation filed herewith (State relevant circumstances, e.g., renunciation, death of 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 (If applicable, enter: e.t.a.; d. b.n.c.t.a.; pendente lire; durante absentia; durante minoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) end heirs: (If Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ - CO w Name RPlatinnchin uo~:,to~ _. ~ ~- '~ ( ~i _ ~ i~l ? ~ -~ --i lt,? (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death ]vania, wyjkt his /her last at (List street address, town/city, township, county, state, zip eode)~ V Decedent, then ~ years of age, died on ~~~~~ ~~ at ~ ~/.l~'zJ ~ ' ~LPG~C~A-I~~"~`~~ Decedent at death owned property with estimated values as follows: ~G ~~~ r7d (If domiciled in PA) All personal property $ --~ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 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 Jessica Flinn 508-865-8616 Page 1 of 2 Form RW-02 rev. 10.13.06 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND The Petitioner(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 Petitioner(s) 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 subscribed before me the ~ ,.~ day of q '~ 1 ~ ~ Fir the Register of Personal Representative Jessica Flinn Signature of Persona! Representative r.;. C7 L` "-~ O ,° ~ ,~ `::' , Signature of Personal Representative ~ ~7 - '_~<~ _ ~ ~-- cj ~~ : . - ~, cry _, `_ ~ File Number: 21 b~ G ~°jG~ ~-? ~.o ~t~ y ~ Estate of JAMES F. STEINMETZ ,Deceased ~ Social Security Number: 201-18-6155 Date of Death: AND NOW, _~~ , 2008 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Jessica Flinn in the above estate and that the instrument(s) dated January 31, 2006 described in the Petition be admitted to probate and filed of record as the last Will„(and Codicil(s)) of Decedent. FEES Letters ......~?~C~u....... $ q b Short Certificate(s) •~••••••• $ Renunciation(s) .•.••••.~•.••.• $ S-- t,~~~1 .... $ 1S J c~P .... $ ( D ~.~.~ .... $ s .... $ .... $ .... $ .... $ .... $ .... $ p0 TOTAL ............................. $ ~~ Register Wills ~ r (~V' `7 Attorney Signature: ~, Y Attorney Name: No V. Otto III Supreme Court LD. No.: 27763 Address: 10 East High Street Carlisle PA 17013 Telephone: 717-243-3 341 Form RW-(12 rev. 10.13.06 Page 2 of 2 105.805 REV (OIIU7) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ,try/°""""---. This is to certify that the information here given is nl p~1H OF pE-' rtific te of Death l d f n fi l C tl Ny~ '~ ~E rom an o na e a correc co e l=_ ,~~` o~ - duly filed w th me as Local Registrar. The original ?,~ _ ~ za certificate will he forwarded to the State Vital ~°, - yam= a~ Records Office for permanent filing. *; o~ _ - ~g9r _ ~~P~~, lltl M E u 2 8 2008 ENT O ---. """"""//tll Date Issued Local Registrar ~~ E'~ `-a ~ ~. ~. ~ _ - 7~ C7 c? I -- tom") • 1 - J y+ - - 1 - _ ~~ J-vJ.,,i ~ i c..~t 0 §~ NIBS-t43 REV nrzoofi COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE/PRINT IN PERMANENT CERTIFICATE OF DEATH BLACK INK (y (~ ~,~~/~~y1 (See instructions and examples on reverse) STATE FILE NIIMRFR lJl \ ~ )~ VT A ~I ~V JI ~~ z 1. Name o' Decedent (First, mkAe, lea, wPox) 3. S 5ecurdy Numba 4. Dale of Deem (Month, day, year) James F. Steinmetz ale 2 Oi i$ - 61SS - July 23, 2008 5. Age (last anlday) Urger t year Under 1 der 6. Date of Binh (Month, day, year) 7. BlMplace (City and slate «lor eign country) m. Place of Death (Crock Doty me) g9 kamw Dera Hove Nlmwc June 14, 1919 Harrisburg PA Hospital: Omer: Yre Inpa6enl ^ ER / Wtpamnt ^ DOA ^ Nursing Home ^ Raskience ^Olner. Spenty: fib. Counts of Deam Ac. City, Born, Twp. of Deem 8tl. Fadliry Narre (N not astilulbn, l@ve street ant armber) 9. Was Decedent of Hispenk Odgin? ~ No ^ Yes 10. Race: Am«k• n Indan, Black, While, em. Cumberland S. Middleton Zttp Carlisle Regional Medical Center (rcyea,apedtycdmn, (sue MexNan, Pueno Rican, etc.) White 11. DeceMnt's Usual tion Kind of wale dale most of wo ' Nle. Do not slate relied 12. Was Decetlant aver in the 13. DecedenYS Education (Speply Doty Mghesl grade completed) 1I. Marital SYetus: Marred, Never Marred, 15. Surviving Spouse (II wife, give maiden name) Kant d Work KiM o(Buaness /Industry U.S. Armed Forces? Elementary / Sacordary (0-12) Cdlege (tom or 5+) W~~~~ ~o~ (~M Phot ra ®Yes ^Na 12 s Married Miriam Adams t6. Decedent's McNirg Address (SUea, city /town, state, zip code) Decedents DM Decetlenl Pitt St 121 S Actual Residerxa 17a. slate X11 Lrie In a 17c. ^ Vas, DecetleN Lived in rwp, Ta h ? . . wns ~p nd.®NO.DecNenlUVedwdNn Carlisle nb cagnly Cumberland Carlisle PA 17013 . Acual Umis of city/Bao 16. Fame's Name (First, middle, lest, sumx) 79. Momets Name (Bret, mldtlle, maiden wmane) Charles Steinmetz Annie Fidler 20a. IMOimenYs Name (7ype /Print) 20b. InlomienYs Mailkg Address (Sheet c4Y I form, state, zp age) Jessica Flinn 4 Houghton Rd., Sutton MA 01590 21 e. Memod of Disposlllon i [~Cremetlon ^ Doretion 21 b. Date of Dlspo'srckn (MOnm, day, year) 21c. Place of Dispui6on (Nana of cemetery, crematory «omer place) 21tl. Location (City /loom, stale, zip rode) ^ Bunal ^ Removal from Stale I Wq CnmaNOn «DOnatlon Aullarhetl ^ ome- ~ spemry: : by Medkal Fxamkl« / camn«? p Yaa ^ Na Jul 28 2008 Hof fman-Roth Funeral Herne Carlisle PA 22a, agwNre W F as 226. license Number 22c. Name and Address W Fadliy Hof fman-Roth Funeral Home & Crematory - ~ °~ 138425 list PA 17013 Canplae Gems 23ac arty when cenilykg 2 . Ta me best of my bwwkdga, death aaurretl a the tlme, date ant place staled. (Signature and Mlle) 23b. License Number 23c. Data skUned (Month, day, year) ptrysitlan is not avaaede et dme d deem k cercty raaaa a Beam. gam 2x26 rout m ccepkbd by parson 24. Time of Death 2iDere Praxanaed De9tl (MOnm, day, year) 26. Was Case Relened to Madicel Examiner /Coroner for a Reason Omer than Cremation err Donation? who prawunces death. ~ 3 ~, ~;~ '~ M, Jvs) v~y 'Z 3 f Z vV ~ Ca ^Yes ~ No CAUSE OF DEATH (See inatructlona arts examples) r gpproximale interval: Pan II: Enter other si~lnficant canNlions contributing to tleelh 2B. Ditl Tobacco Use ConlMUte to Deam? Item 27. Pan I: Ema me thole of evens - dseeses, kjuries, or compNCaeaw -Ulel diredty caused me deem. DO NOT enter terminal menls such as cemiac artea, Onset to Deam but na rewMng in me ulbedying cause given In Pan I. ^ Yes ^ Probedy rmpiafory artast «venidcukr YdrRetion caiman showirp the sskk9Y. Ua only one cause on each line. r r ^ No nkrgwn IMMEDIATE CAUSE IFrlel disease « ~a mndNon resultin m Beam) 1 C I 1 F- f 29. II Female: g _~ a, ( i L.~J}C,y~~~ IYI¢.CLrtilk?y7 i t~ ~ I ~ ^ Duet (« es a coneequence o~~ 1 Sequerimlty 4a caditias,damy, p, ~l~"IZ ~y'V:.•~-~C i N 1JIr''~' Notpregnantwimkpestye~r ^ Pregnanta Ume of deem kaNng to the cause sted on Noe a. Due to «as a m ce of Enter me UNDERLYING CAUSE (~ ~ ^ N« pregnant but Pregnant wimm 42 days r ~L~ ~ (dseaw a klury met irnlletetl the c, t i Lk /~ t events resulting n deem) LAST. d deem D k (« as a consequence o0: ^ Nn pregnan, but pregnant 13 days to 1 year a ,~ 4r d C-Cl i mtore deem . . z ^ Unmown d preg:unt wittgn me past year 30e. Wes an Aukpsy Sob. Were Aukpay Findngs 31. Mawr of Deem 3'19. Date of Inury (Mont, tlay, year 32b. Describe How Injury Occurted 32c. Place W Injury: Home, Fa , Sores, Factory, Perfumed? Available Pd« k Canpletion Nalurel ^ Hgmkale Ofice Baidkg, etc. (Speay) n Cause n Deem? ^ Vas ~NO ^ Yes ^ NO ^ Attkenl ^ Pendng Imestigatbn 32d. Txn9 of Injury 32a. Injury at Work? 321. II Trenspatetkn Injury (SPenN) 829. Local of Injury (Slrea, city /town, state) ^ Sukide ^ Cab Nd m D«emJned ^ Yes ^ No ^ Driver /Operator ^ Passamda ^Pedeslrien M Other - Spedry: 33a. Certifier (UUreddl oNy one) 33b. SgreWre and rNe of CerMrer • Cartllyvg phyaklen (Ptrysidan ceNlying cause of deem when Brother physician has pronounced deem and axrpleted hem 23) - To tm DestMmy kmwkbge, deem occurred due to the causels)and manner a5 abted_________________________________ ^ tiavti • Pmrouncing and cenltying physklen (Physkian both proroundng Mom and cenilying to reuse of Mom) 33c. Lwense Number 33d. Dale Sgned (MOnm, deY. yea) To dce best Of my knowledge, tlealll oocuned aI me time, tlale, end pkce, and due td the cause(s) end manner as stated- _ _ _ _ _ _ _ _ _ _ _ . Medkal Exsmirrr/COrorwr ------ 1 2 M,7 y3y TzS~ Uw '2fi ~,V y On the male of exemkatkn 9M / or Mveetlgatbn, in my opmkn, death occurretl et the tkre, dose, orb place, antl due to the cause(s) antl manner as staled- ^ , 4 ~ Nam ~ Address of Persm Who Carnpleted Cause of Deem (Item 27) Type /Print C Ht N l M ~ t 3fi. Regic~ awre entl Diatom r h - ~ ~ I 1 ~ r~ ~ \ ~ V ~ Date Fled (Mmlh, tlay, year) r n ~ S nA~E NVk Co-. 1. } l`. YLy..o•...~r r•vc..6r,•„A c,....l~a-- . ~ `~" _ -~`~ ~ V Disposiaon Permit NO. \ J ~1~~ ` FaFILES\DATAFILE\Eslate Planning\6886. Lh.wi11.2006 LAST WILL AND TESTAMENT I, JAMES F. STEINMETZ, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publi~sl~ and decl~ this to be my Last Will and Testament, hereby revoking any and all former Wills or Cod ails by C: ~ Ci made. ' =~ ` _~ ~ ::: ~ cn ITEM ONE -' ,-~ --~ ~>, __~ I direct that all my legally enforceable debts, funeral expenses, testamentary exnses and ' c. all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEI'c~ FIVE hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO In the event my spouse shall predecease or fail to survive me by thirty (30) days, then I give such items of personalty as are itemized in a certain list attached hereto to the persons named thereon, which list is signed and dated by me at the end thereof. ITEM THREE If my spouse, MIRIAM A. STEINMETZ, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, unto my said spouse, absolutely. If my said spouse does not so survive me, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FNE hereof. ITEM FOUR In the event my said spouse shall disclaim all or any portion of any devise or bequest made to my spouse under the foregoing ITEM THREE, then the amount otherwise payable shall be held by my Trustee under ITEM FIVE hereof. For purposes of the Trust established under ITEM FIVE hereof, my said spouse shall not be deemed to have predeceased me by virtue of my said spouse's exercise of the right to disclaim set forth herein. ~~ J.F.S. Page 1 of 7 Pages ITEM FNE RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS THREE and FOUR hereof, if any, for the following purposes: A. My Trustee shall pay the net income, at least quarter-annually, to my spouse, MIIZIAM A. STEINMETZ, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse. B. My Trustee shall further pay to my said spouse, annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the Trust hereunder. This power shall be noncumulative and maybe exercised only by an instrument in writing signed by her and delivered to my Trustee within the first thirty (30) days of fiscal year of this Trust. C. Upon the death of my said spouse my Trustee shall distribute the principal in the following manner: 1. I give the sum of Ten Thousand Dollars ($10,000.00) unto each of my grandchildren, RICHARD L. ALEXANDER, CYNTHIA A. SHARP, JESSICA FLINN and JENNIFER JOSEPH. 2. All the rest, reside and remainder of my estate I give as follows: a. Fifty percent (50%) thereof unto my daughter, ANNE LUCINDA WESTIN; b. Twenty-five (25%) thereofunto my granddaughter, JESSICA FLINN; and c. Twenty-five (25%) thereof unto my granddaughter, JENNIFER JOSEPH. E rte. J.F.S. Page 2 of 7 Pages 3. In the event my daughter, ANNE LUCINDA WESTIN, shall predecease or fail to survive me, I direct that her share shall be divided equally between her children, RICHARD L. ALEXANDER and CYNTHIA A. SHARP. ITEM SIX POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution. A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of the Trustee) or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration oi' any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; F. To assume continuance ofthe status ofanybeneficiarywith regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; ~~ ,f J.F.S. Page 3 of 7 Pages G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; I. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of the fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts J.F.S. Page 4 of 7 Pages may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a full and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as maybe rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SEVEN PROTECTIVE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. / ~~ ~ i J.F.S. Page 5 of 7 Pages ITEM EIGHT APPOINTMENT OF EXECUTRIX AND TRUSTEE I nominate, constitute and appoint my spouse, MIlZIAM A. STEINMETZ, as Executrix of my estate. In the event that my said spouse shall predecease me or fail to act as Executrix, then I appoint my granddaughter, JESSICA FLINN, as Executrix of my estate. I nominate, constitute and appoint my spouse, MIRIAM A. STEINMETZ, as Trustee of any trust created hereunder. In the event that my said spouse shall fail or be unwilling to continue to act as Trustee, then I appoint my granddaughter, JESSICA FLINN, as Trustee of any trust created hereunder. ITEM NINE WAIVER OF BOND I direct that neither my Executrix nor my Trustee, or their successors, shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this ~~~ day of ~`' ,?t.~1'Ir~~'~ , ~ U ~. I "`_.~ ~' ,~. ~ ~ ~ (SEAL) ~J mes .Steinmetz ~` SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. _~~ f ---. r~ Page 6 of 7 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND We, James F. Steinmetz, No V. Otto III, and r'~'<<~ ~~ ~ ~ r Y '~:~ r, .~`'~c., ,the v Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that the Testator has signed willingly, and that the Testator executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of hisJher knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ./ - -"- -` :\ Testator Witness 3 Witnes Subscribed, sworn to and acknowledged before me by James F. Steinmetz, the Testator, and subscribed and sworn to before me by No V. Otto III and ~'~ `~~~~~ ~2- Y- ~r ~~ l,;b o ~~_ ,the ~fi ry-~ ~ "~ ~ 'G,. witnesses, this <~/ day of ~ ~ C ~ ~LL otary Public 4' NOTARIAL SEAL CORRINE L. IVIYERS, NOTARY PUBLIC CARLISLE BOR©, C9UN7Y OF CUMBERLAND MY COMMISSION EXPIRES MAY 27, 2007 Page 7 of 7 Pages .~\ °~ ~~~ RENUNCIATION ~> ~~ REGISTER OF WILLS ` = ~= f7J L? ~ - CUMBERLAND COUNTY PENNSYLVANIA - - ~; ~ ~-- , = r~ t ~, _ -J .~v ~~ ~ I Estate of JAMES F. STEINMETZ ~beceased ' I, MIRIAM A. STEINMETZ , in my capacity/relationship as (Print Name) Executor of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to JESSICA FLINN . 7~3/ /o £~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Form RW-06 rev. ]0.13.06 Q `~ `.~- L (Signature) 121 South Pitt Street (Street Address) Carlisle PA 17013 (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purpose tat within on this •3/s7F' ,day of , 2oog Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEALpublic Corrine L. Myers, Notary Carlisle Borough, Cumberland County My commission expires May 27, 2011