HomeMy WebLinkAbout08-05-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of• JUDITH J. SHUEY
also known as
,Deceased
File Number r~ ~ ~ ~~ ~+ C1G~
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.•)
.4. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Co-Executor named in the
last WIlI. of the Decedent dated March 23, 1995 and codicil(s) dated N/A
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(State refevant circumctancec, e.g., renunciation, death nfexecutnr, etc.)
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the ttr$i~ijment(~~offered
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for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -
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B. (Jrant of Letters of Administration ~'' Ste}
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; duranl~=m ni nritate) -
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) an(3~teirs: (lf
Administration, c. t. a. or rl b.n.c.t.a., enter date of Will in Section A above and complete list of heirst)
Mark William Shuey ~ Son (1104 East Powderhorn Road, Mechanicsbtue, PA 17050
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in C~ttnberland County, Pennsylvania with his /her last principal residence at
213 Norman Road Camro Hill, Cumberland County, Pennsylvania 170ll
(List street addrecc, town/city, township, county, state, zip code)
Decedent, then 74 years of age, died on July 26, 2008 at The Todd Home and Rehab Center, 1000 West South St.
Carlisle, Pennsylvania 17013
Decedent at death owned property with estimated values as follows;
(If domiciled in PA} All personal property $ 2,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 140,000.00
situated as follows: 213 Norman Road, Camp Hilt, Pennsylvania 17011
Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Si lure T ed or rioted name and residence
ark William Shuey 1104 East Powderhorn Road, Mechanicsburg, PA 17050
Fnrm,ew-nz rev. !0.13.06 Page I of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUN"CY OF CUMBERLAND
SS
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 a: affirmed and subscribed
before me the ~ day of
C~
Signature gfPereonal Representative
~ J Signature gfPersnnal Representative
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For rate Register
Signal<rre nJ'Persnnal Representative
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File Number: ~ ~ ~-' ~ ~} ~(..7"( ~ ~ -
Estate of JUDITH J. SHUEY y
Deceased ~
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Social Sec ity Number: 204-26-8135 Date of Death: July 26, 2008
AND NOW, ~~ , in consideration of the foregoing Petition, satisfactory proof
having. been presented before ~ e, 1T 1S DECREED that Letters Testamentary
are hereby granted to Mark William Shuey
in the above estate
and that the instrument(s) dated March 23, 1995
described in the Petition be admitted to probate and filed of record as the last
FEES
Letters ....t ~at ~~ . $ ~~ ~c+
Short Certificate(s) .. ~ ... $ al `} o
Renunciation(s) .... a ... $ S (~~
... $ ~~
Attorney Signature:
(and Codicil(s)) of Decedent.
Supreme Court 1.D. No.: 18067
$ Address:
... $
... $
... $
' ' ' $ Telephone:
... $
0 ,~,~.
TOTAL .............. $ c~~'
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
717-258-6844
Porm Rw-oz rev. rn.13.n~s Page 2 of 2
Attorney Name: Anthony L. DeLuca, Esquire
05.80 REV (01/071
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
rr"ee for this certificate, $6.00
P 14~4202~
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 Oyffyi~ce for ermanent filing.
LG~m. ' ;C L 910
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Local Registrar Date Issued
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REV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
4nRNIEriT" CERTIFICATE OF DEATH
cK INK See instructions and exam les on reverse a t ~~ ~'~ ~~
p ~ STATE FILE NUMBER
1. Name of Decedent (First middle, last, supix) 2. Sex 3. Social Security Number d. Date el Death (Month, day, year)
Judith F. Shue- female 204 ~26 `8135 Jul. 26 2008
5. Age (Last 8inhday) Untler 1 year Ureer 1 da 6. Date of Birth (Month, tlay, ear) 7. &nhplace (City and state or lorei country) 6a. Place of Death (Check Doty one)
MenIM Days Hpxs MkMes Hospp2l'. Other.
7 4 Yra May 2 7, 19 3 4 S e r a n t o n, P A ^,npalfent ^ ER / Outpatient g ^ Residence ^Other Slxciry
^ DOA ursin Home
eb. County of Death &. City, Boro, Twp. of Death 6d. Facility Name pl not Institution, give street and number) 9. Was Decedent of Hispank Origin? No ^ Yes 10. Race: American kMian, Black, Whke, ek.
Cumberland Carlisle Sarah Todd Home (Il yes, spedry Cuban,
Mexican, Puerto Rican, etc) (¢peyifyJ
W l11 C e
11. Decedent's Usual Occu tpn Nlntl of work d orre tlu " moss of workin tile. Oo ref sp[e refired 12. Was Decedent ever in the 13. Decedent's Education {Specify only highest grade compl eted) 14. Marital Status: Marred, Never Marred, 15. Surviving Spo use pf wife, give maiden name)
Kind of Work Kintl of Busirress I Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specity)
A enc on A in ^Yea a 12 2 divorced
16. Decedent's Mailing Address ;Street, city I town, state, zip code) Decedent's Did Decedent
Pennsylvania Uve ur a 17c
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id
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ede
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213 Norman Rd . ence
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Township?
Cam H i 11 , P A 17 01 1 17b. County Cumber 1 a n d nd.~wp, Decadent Dyad wihin
Actual Limps pf r a r i i G~ P city / Bom
16. Famer's Name (First, mitlMe, teal, supix) 19. Mother's Name (First, midtlle, maitlen surname)
n am Ruth Smith
20a. Infomanl's Name (Type I ~4'rint) 20b. Informant's Mailing Address (Sheet, city I town, state, zip code)
PA17050
Mechanicsburg
Powderhorn Rd
1104 E
Mark W. Shuey ,
.,
.
21a. McMotl of Dispospion ~Gremation ^ Donalbn 21b. Date of Disposition (MOOIh, day, year) 2tt. Place of Disposition (Name of cemetery, crematory or omen place) 21 tl. Loetion (City I sown, stale, zip codel
~~~
^ Burial ^ moval from Stale ,Was Cremation or Doatlon Auptorized J u l y 2 9, 2 0 0 8 H o 11 fi n g e r Crematory t. H o 11 y S p r i n
er . Specity~ i by Medial Examiner I Coroner? Yes ^ No
twe d Funeral m N:ensee for person acting es such) 22b. License Number 22c. Name and Atltlress of Facility
FD-013163-L Musselman FH~CS,324 Hummel Ave.,Lemoyne,PA17043
to Hems 23a-c onN'~en certilyirg 23a. To the best of my fuawledge, death agyrred of the (ime, date aM place sffited. (Signahue and title) 23b. Uanse Number 23c. Date Signed (Month, day, year)
an is not available at lima of deaN Ic //
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- cepuse W death, , f
- Items 24-26 must be competed by person 24. Time of DeaM .Date Pronounced Deed (Hoorn, day, year) 26. Was Case Reterretl to Metlicel Examiner I Coroner for a Reason Other Irian Cremation or onahon?
woo pnprarxrces death. 7 /'` , M. ^ Yes No
CAUSE OF DEATH (See Instruetlone and examples) r Approximate interval. Pan II: Enter other sianifxznt conditions contnbupno ro death, 28. Ditl Tobeccro Use Contribute to Death?
Item 27. Pan I: Enter pre ffi~-glgyeDlg -diseases, inryries, or wmpicaNons - Ilat direclN eased Me death. DO NOT enter temnnal evenh such as ard'ac anesG Onset to DeaM but rrol resulting in the undertyug cause given in Pan I. ^ Yes ^ Probaory
respiratory anasl, or ventricular fibrillatbn wNroW showing the etiology. list only one cause on each line. ~
No ^ Unknown
IMMEDIATE CAUSE IFlnal disease or `, i U ~~
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Z9. If female.
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condilbn resuMng m aM) ~~ a
yv ^
Due to (or as a consequence oQ
Sequentially list conditions, if any. b r Nol pregnant wnFin pass year
^ Pregnant at lime of tleath
leading to Ilse ease listed on Tire a. Due to or as a Cons uence o ' r
Enter (he UNDERLYING CAUSE ( ~ U~ r ^ Nol Dregnent but pregnant within 42 days
(disease or irtjury tha7 iniliafetl the C i
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LAST cl death
ng in
eat
)
.
events resu
Due to (or as a consequence op' r Nol
^ pregnant, but pregnant 63 days l0 1 year
d. belore death
^ Unknown II pregnant within the pall year
30a. Was an ANOpsy 30b. Were Autopsy Findings 31. Mannar of Death 32a. Dale of Injury (Momh, day, year) 32b. Describe How Injury Occortetl 32c. Poore of Injury Home, Fann Street Factory,
Pedonretl? Available Prior to Completion
atural ^ Homicide OIfMe Builtling. etc. (SpecityJ
of Cause o1 Death4
^ Yes ~ No
^ Yes ^ No Acdtlent ^ Pandmg Investigatim 32d. Tune of Injury 32e. Injury at Work? 32f. It Trensponaaon Injury (SpedtyJ 32g. Location of Injury (Street, city /lows, slalel
^ Suicide ^ Could Not be Determined ^ Ye5 ^ No ^ Dover /Operator ^ Passenger ^Petleslnan
M aher - Sve~yty:
33a. Ceniller (check Doty one)
skian has prorwuncetl tleath antl completed Item 23)
cause of death when another ph
siclen (Ph
sician cediryin
• Cenityin
h 33b S tu(~antl Tipe of Camper
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To the beat of my knowledge, death occurred due to the cause(s) and manner es stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ J
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• Pronouncing arM oenpying pMsiclan (Physician both pronouncing death and cenirying to cause of death)
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d 33c. License Number 33d. Sryned (Month, tlay, year)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To tM bag of my xnowledge, death occured at the time, date, and plea, and due la the cause(s) end manner as state 1•y`-D Q 1 1. Z ~ t ~. J Vt•.~ Z q
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• Medaal Examiner! Coroner
On the heals of examination and 1 or Investigation, in my opinion, death occurred et the time, dale, and place, and due to the ease(s) arW manner as steted_ ^ ,
34 Name antl Adtlress of Person Who Completed Gause of Death (Item 27) Type / Pnnf
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35. Regist Sgnature and
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LAST WILL AND TESTAMENT = c~ ,r ~
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JUDITH J. SHUEY `"','3 ~ ~"
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I, JUDITH J. SHUEY, a resident of 213 Norman Road, Camp Hill,
Cumberland County, Pennsylvania being of sound mind, memory and
understanding, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all Wills and Codicils
heretofore made by me.
ITEM l: I direct that all my just debts, the expenses of my
last illness and funeral expenses be paid as soon after my decease
as the same can conveniently be done.
ITEM 2: I direct that there shall be paid out of my residuary
estate all estate, inheritance and like taxes together with any
interest or penalty thereon imposed by the government of the United
States, or any state or territory thereof, or by any foreign
government or political subdivision thereof, in respect to all
property required to be included in my gross estate for estate,
inheritance or like tax purposes by any of such governments,
whether the property passes under this Will or otherwise,
excluding, however, any property over which I have a taxable power
of appointment, provided, however, that no residuary beneficiary
shall by reason of this provision be denied the benefit of any
deduction, credit, favorable rate of tax or other benefit which by
law enures to such beneficiary.
~'1
UDIT J. UEY
1
LAST WILL AND TESTAMENT
OF
JUDITH J. SHUEY
ITEM 3: I specifically bequeath unto my son, DONALD ALAN
SHUEY, if he shall survive me, the Civil War belt buckle, if owned
by me at the time of my death. It is my wish that this item remain
in the family and be passed on to future generations.
ITEM 4: I specifically bequeath the brass kettle, ming vase
and roll top child's desk, if owned by me at the time of my death,
unto whomever of my children, MARK WILLIAM SHUEY, DAVID JOHN SHUEY,
and DONALD ALAN SHUEY, who desire these items. If and in the event
that my children are unable to decide who is to receive these
:items, it is my wish that the Co-Executors of my estate, by
majority vote, determine who is to receive each of the above
mentioned items. It is my further wish that these items remain in
the family and be passed on to future generations.
ITEM 5: I give, devise and bequeath all of the rest, residue
and remainder of my estate, real, personal and mixed, of whatsoever
kind and nature, and wheresoever situate at the time of my death,
in equal shares, unto my children, MARK WILLIAM SHUEY, DAVID JOHN
SHUEY and DONALD ALAN SHUEY, provided, however, that they survive
me and are living sixty (60) days after the date of my death.
~l
DITH J. S EY
2
LAST WILL AND TESTAMENT
OF
JUDITH J. SHUEY
ITEM 6: If and in the event that a child of mine does not
survive me and is not living sixty (60) days after the date of my
death, then and in such event, I give, devise and bequeath the
interest in my estate, which such deceased child would have
received, if living, to the issue of said deceased child, per
stirpes.
ITEM 7: I hereby nominate, constitute and appoint my
children, MARK WILLIAM SHUEY, DAVID JOHN SHUEY and DONALD ALAN
SHUEY, Co-Executors of this my Last Will and Testament, with full
power to do any and all things necessary for the complete
administration of my estate, and direct that no bond or other
surety is required of them in this or any other jurisdiction for
their performance of this office.
ITEM 8: If any provision of this Will or of any Codicil
hereto is held to be inoperative, invalid or illegal, it is my
intention that all the remaining provisions thereof shall continue
to be fully operative and effective, so far as is possible and
reasonable.
IN WITNESS WHEREOF, I, JUDITH J. SHUEY, the Testatrix, have to
this my Last Will and Testament, typewritten on four (4)
J DITH J. S EY
3
LAST WILL AND TESTAMENT
OF
JUDITH J. SHUEY
consecutively numbered pages, subscribed my name and affixed my
seal this ~~/~. day of March, 1995.
(SEAL)
Signed, sealed, published and declared by the above named JUDITH J.
SHUEY, as and for her Last Will and Testament, in the presence of
us, who have hereunto subscribed our names at her request, as
witnesses hereto, in the presence of the said Testatrix, and of
each other.
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OATH OF SUBSCRIBING WITNESS(ES) `-~-} 1 ~ -
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RE ISTER OF WILLS ~~ ~ ~ ~'
COUNTY, PENNSYLVANIA _;_,
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Estate of ~~tJdf `f~"Li ~ ..~~ U y ,Deceased
D¢/I,~~~ia~t.'/ ~• ~Lc~c>a . ~`SQui r,~ , (each) a subscribing witness to
(Print Name/s)
theJ~Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
nay(s) that sloe.,/ he / t~e~ was / present and saw the above 'F~statar_/ Testatrix sign the same
and that sly. / he / tke~ signed the same and that sue/ he / t~ signed as a witness at the request of
the T°-,'-Testatrix in her /~- presence and in the presence of each other.
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(~iignature) (Signature)
(Street Address)
(City, State, Zip)
lxecuted in Register's Office
Sworn to or affirmed and subscribed
before me this _ ~ day
of ~~ ~.
Deputy fob Regis'ter~f Wills
(Street Address)
(City, State, Zip)
Executed oast of Register's Office
Sworn to or affirmed and subscribed
before me this day
of
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.)
PJOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-03 rev. !0.13.06
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OATH OF NON-SUBSCRIBING WITNESS(E~~
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REGISTER OF WILLS - =; ;--, , -
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Estate of ~TtJO f ~ ~t ~. _.~~1 rJV' 1/ ,Deceased
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(each) being duly qualified according to law, depose(s) and say(s) that sue-/ he / was / a~a well-
acquainted with mud i~ ~ ~": S,~ U iP V and am/axe. familiar
with the handwriting and signature of the decedent, and that the signature of `~U d / ~ ~~ -~~- u ~~/
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~ cl~~~G ~" .
_ S!7 (J P ~/ is in I.i}e~/her own proper handwriting.
(Si~nuture
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affir~r~ed and subscribed
before me tiAis ~ day
of ~~ _, ~~
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Deputy or Regi r of Wills
(Signature)
(Street Address)
(City, State, Zip)
Form RW-04 rev. 10.13.06
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RENUNCIATION
REGISTER OF WILLS
CUMBERLAND
COUNTY, PENNSYLVANIA
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Estate of Judith J. Shuey ,Deceased
I, David John Shuey , in my capacity/relationship as
(Print Name)
Co-Executor and son
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Mark William Shuey
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(Dale)
(Signature)
49 Longview Circle
(Street Addresa)
Berwyn, Pennsylvania 19312
(City, Slate, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of_ ,
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
purposes stated within on this ~~' day
of ' , ~,ZdC~ ~'
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Deputy for Register of Wills
Notary P a~l`ic
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Comnussion.)
Fnrm RW-Oh rev. 10.13.Oh
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NCilkt7~/li ~EAC
~''«R.;OQtE A DEtUCA
.y NOfpry P~u~b~l~i~cy ~~~
~..rww~ ~Y."r~~t7~-t.p~tAS Nov ~ 2011
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RENUNCIATION
REGISTER OF WILLS
CUMBERLAND
COUNTY, PENNSYLVANIA
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Estate of Judith J. Shuey ,Deceased
I, Donald Alan Shuey , in my capacity/relationship as
(Print Name)
Co-Executor and son
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Mark William Shuey
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(Dale)
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.!.3.06
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(Signature) i
4872 Chew Chase Dri e
(Street Address)
Chevy Chase, Maryland 20815
(Ci[y, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
parry executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this ~ day
// //.
Notary I~b1ic
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's ConmussionJ
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