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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
In Re:
ESTATE OF ROSARIO J. MANIGLIA, Estate No. 2010-00568
Late of Lower Allen Township, Cumberland
County, Pennsylvania, deceased
DISCLAIMER
I, Dorothy M. Maniglia, hereby declare that I am the wife of Rosario J. Maniglia, v~ho died
on May 3, 2010 (the "Date of Death").
I hereby irrevocably and completely disclaim and refuse to accept any and all rig ts, title
and interests that I may be entitled to receive pursuant to: (1) Item III (Personal Prope y) and
Item IV (Residue of Estate) of the Last Will and Testament of Rosario J. Maniglia dated {July 27,
2004; (2) Merrill Lynch IRA (Account Number 872-70855), with respect to which 'I am a
designated beneficiary; and (3) Item 2 under the beneficiary designation for Merrill Lynch IRA
(Account Number 872-96811) consisting of approximately $170,000 in value, with respect to
which I am a designated beneficiary. The foregoing rights, title and interests shall collectively
herein be referred to as the "Disclaimed Interests".
I hereby state and certify that I have not accepted any benefits or interest with respect to
the Disclaimed Interests on or following the Date of Death.
This document is intended to qualify as a disclaimer under Section 2518 of the jlnternal
Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania F~robate,
Estates and Fiduciaries Code.
Dated this '~ ~ day of Au-~'u- ~~ , 2010.
Witness:
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF C ~mb~-a. ~~
On this ~~` day of ~ , 2010, before me, the undersigned officer, a
Notary Public in and for the said co ty. and state, personally appeared Dorothy M A~aniglia,
who, being duly sworn according to law, deposes and says that the facts set forth in the
foregoing Disclaimer are true and correct to the best of her knowledge, information, anjd belief
and that she executed the same as her voluntary act and deed for the purposes !therein
contained.
aoM~w~xn~ of Pa~us~.vANrA
norarlaF sell
edty Ann McMullan, Notary PubMt n n
Penn Twp., ~v ~ ~'-`~C~t---
Carranbelon Tin. 28, 2014
• ~ ~n orNorarks otary Public
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF
On this, the ~- day of , 2010, before me, the undersignied',of1•ICer,
personally appeared PETER J. RESSLER, QUIRE, Supreme Court I.D. No. 06844, known to
me (or satisfactorily proven) to be a member of the bar of the highest court of said stag and a
subscribing witness to the within instrument, and certified that he was personally present when
Dorothy M. Maniglia, whose name is subscribed to the within instrument executed the same,
and that the said person acknowledged that she executed the same for the purposes therein
contained.
otary Public
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• ~B~irle:l7in. 28, 2014
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2
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
In Re:
ESTATE OF ROSARIO J. MANIGLIA, Estate No. 2010-00568
Late of Lower ANen Township, Cumberland
County, Pennsylvania, deceased
RECEIPT OF_DISCLAIMER
Richard J. Maniglia, being duly sworn according to law, deposes and says thalt hle is the
Executor under the Last Will and Testament of Rosario J. Maniglia dated July 27, 200, end that
on the date and place as hereinafter set forth, he received the foregoing signed Discl~imler from
Dorothy M. Maniglia.
ESTATE OF ROSARiO J. MANIGLIA,
Deceased
Richard J. Mani la xecutor T
Date: s 1 ~ ~ 1 ~ `~
Place: /~avr~'i,hv~~ , i7-d-
SWORN TO AND SUBSCRIBED before me this ~ ~~" day of Z' ,
2010.
Not Pub
o~~~TM of vawu
Natadal seal
Betty Mn McMuBaty Notary publlt
~~~, 2014
P~ pssodatton of Notaries
528974v1
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