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Home My WebLink About11-18-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mary K Coury also known as Deceased File Number 21 - 10 -- ~ i y Social Security Number 198-22-9682 Gregory M. Kerwin, Esquire Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW:) ~'t'~_ A'p~+~J 11IJ IS~19 IU ~ ~- Q A. Probate and Grant of Letters Testamentaryjand aver that Petitioner(s) is/are the -~`t n~rmed in the last Will of the Decedent dated 04/08/1983 and codicil(s) dated 0 fI /V / ~ L ~,• C' 0 ~i ~ ti h'll.,t~ i/ /~ G~1L ~L ~ ~ w /V AT o yvr9 L ~~ G /V UWS'li.,r~f.~i~Al'Ll'1~~ ~AN ~Ar/~ ~ I~U~/yc €~ - __ _ (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 app Ica e, en er c. a ; n c . a ; pe en e i e; uran e a sen ia~uran~inon a e Petitioner(s~ after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and 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.) Name Relationship Residence O ~=, ._,_ ~. ~ ,~_. '~_f_; :~ ~ r-- "°~ ~ 5~ ~.,'' rn -- r ~~. ; ; , (COMPLETE IN ALL CASES.) Attach additional sheets if necessary. -~~ :~ ~y ~ ~ ~~: Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence: r-, ~_,~~ ~^; 1103 Yverdon Drive, Apt. B1, Camp Hill, PA 17011 (East Pennsboro Township) °° (List street address, town/city, township, county, state, zip code) Decedent, then 83 years of age, died on 10/21/2010 at Holy Spirit Hospital, Camp Hill, PA Decedent at death owned property with estimated values as follows: (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: ~tJQ N~ __ 50,000.00 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: ignature Typed or printed name and residence ^ A - O Gregory M. Kerwin, Esquire 4245 State Route 209 C 1 J Elizabethville, PA 17023 Form KW-Ul Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 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~re~ ntative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. // /I --. Sworn to or affirmed and subscribed before me this i ~ day of 11~i Gregory M. Kerwin, Esquire 1~(J ~+.k (t 1~~L ( [, ~ ~,~ Signature of Personal Representative ~ ~,, ~ ~ _`. ,, ..-_. (~ c~.a _.., - r ~ ~ .~ .r ` t -' For the Register Signature of Personal Representative ~~ y rn ~ ~ - ~ .r,: ~ t_i. , . ~ ~. _:~7 ;, ~ , 'L~ - ~:.: _) .t.. ~ -_ ... :..._r_t File Number: 21 - 10 - ! ~ ~ 1 ~ ~~ :_ r3 ,--, C':'? -- Estate of Mary K COUry Social Security Number: 198-22-9682 Date of Death: 10/21/2010 . Deceased AND NOW, ~LL~ ti~~ ~ 1Q ~'" ~' 2. ~~^; i 1 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters -~g~t~/ f~Clll.l,f ll f ~ -~i1 _t i 7 [.~r-1 C. yTl''i are hereby granted to Gregory M. Kerwin, Esquire in the above estate and that the instrument(s) dated 04/08/1983 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ........................................ .... $ CPrI ~ L' • L~ Short Certificate(s) ..................... ... $ , '~ . C; Renunciation(s) .......................... :; ... $ ~ ~," ~'~ j }F} F ~ f ~ ~, ~ $ I ~t ~ L~ $ $ $ $ $ $ TOTAL .................................... $ ; ~ ~, ~ ~~ (., Attorney Signature: Attorney Name: Supreme Court I.D. No.: 21222 ~.~y~~«~ ~~ ~.~~~~ ~~- ~ ~, 1 ~~ M Kerwin Kerwin & Kerwin Address: 4245 Route 209 Elizabethville, PA 17023 Telephone: 717/362-3215 E-Mail: gmkerwin@hotmail.com Form RW-OZ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 GCAL. REGISTRAR'S CERTI~'ICATIC)N ~3~ ~}EA''R ~'~NB~~Nff~G: it is illegal to duplicate tP~i~ ~co~ ~~,, ~)hca~ost~t or p~otoc~r~~i•I. 1 i'l'l' Itt~ lhi, ~=l'iilli::~.lk`, ",(1 ii? _P ___-1.6.8 0.5 5 2 8_ __ ,. ,:,, ~ ,1 ~ t nit>rm )i.iun h i~ _ ~~;.~n i~ ,,dr~'•Y ~/~ '~, o i;'('L't t ~ .tl r~s,(, 't ~ f+.~lll~il ( tl'I1R?a ll4' Jj l~t. lj}1 ~~ ~~`~c~~: ~ ~ct'y,. i'~.'-~'~ ili~t'~~ ('~3 i! , ! ( Cal {~l""_'1~~If~ll. (i)l` t)1"1~!f11a1 `~ ~ ~. ~''~' -. ~-~l t 'I'(I~ia .l(t. 1? ~i (~t! t!'(lt'll l i 11'i'ti` ~11iti1_' ~''1(l.l~ C.y . d' ' ~ y,.,r ~ ry .25, ~ j I _ ,~ i ~ r G : ~. F) : ~ ~. 4/~. '~ _` "s , t t ,.' i } ; ~ i i i (' `r'r _ ~ `~ `ti' , * .- :~ a (/ ~~ ~~~,~ ~`~~ ~~'~ Y O C T Z 5 Z 10 _ ~ ~ .F.; ;,,, ` ~"^..7 1 C C~ ~. ` 1 ..~ `•..... ~ T •;i -_."') . • 3 REV 1112008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS / PRINT IN ~""A"E"T CERTIFICATE OF DEATH ACK INK (See instructions and examples on reverse) CTATC CII L r,u woro 1. Name of Decedent (Frst, middle, last, suffix) 2. Sez 3. Social Secudry Number 4. Date of Death (Month, day, year) Mar Kell Cour Female 198 - 22 - 9682 October 21, 2010 5. Age (Lest Birthday) Under 1 ear Under 1 da 8. Date of Birth Mordh, de r 7. Binh ace C and stale or fa ' coon fie. Plop of Death Check on one Menthe Days Haas Minutes Hospital: Other 83 yre, June 10 , 1927 Lykens , PA ®Inpatler,t ^ ER / Outpadent ^ DOA ^ Nursing Home ^ Residence ^ other .specify: Sb. County of Death Bc. City, Boro, Twp. of Death 8d. Fadltty Name (If rrot instltutlon, give street and number) 9. Was Decedent of Hispenk Orgln? ®~ ^ YB5 10. Race: Amedpn Indian, Black, Whlte, etc. Cumberland E. Pennsboro map. Holy Spirit Hospital (If yes, spectty Cuban, Mexican, Puerto Rican, eta.) (SP~M white 11. Decedents Usual lion Kind o1 work d one Burin most of world Itte. Do not elate re8 12. Wes Decedent ever In the 13. DecederiYs Eduptbn (Speclty Doty highest grede comp leted) 14. Marital Status: Merced Never Martied 15. Surviving Spo use (If wife give maiden name) Kfnd of Work Kind of Bushressl Industry U.S. Amred Forces? Elementary /Secondary (0.12) College (1.4 or 5+) , , Widowed, Divorced (Spedly) , Secretor State Government ^ Yea ~ Na 12 1 Married Daniel (i. Cour 1 B. Decedents Mailing Address (Street, city I town, state, zip code) Decedents Did Decedent Actual Residence 17a.Stete Pennsylvania Liveina 17c East Pennsboro Decedent Lived in ~ Yes 110 3 Yv e r d o n Drive , Apt . B 1 • , - - Twp, Township? Cam Hill, PA 17011 17b.Counry Cumberland 17d. ^ Act ~eceden~livedwtthin Ciry I Boro 18. Father's Name (First, middle, last, suffix) 19. Mother's Name (Frst, middle, maiden sumeme) Charles P. Kelly Catherine Josephine Faust 20a. Iniortnants Name (type I Print) 20b. Infomient's Mellkg Address (Street, city I rown, state, zip code) Daniel G. Cour 1103 Yverdon Drive, A t. B1, Cam Hill, PA 17011 21a. Method of Disposition r ^ Cremation ^ Donation 21b. Date of Disposition (Month, day, year) 21c. Place of Dispositlon (Name of pmetery, crematory or other place) 21d. Lczwtion (Ciry! town, state, zip code) ® Budel ^ Removal from state i WeeCrsmetlonorponetlonAuthorized ^ Other . by Medcal ExemirbrlCaroner4 ^Yes^ Na October 26, 2010 Indiantown Gap National Cemetery Hanover Zap. , PA 17003 22a. Signature (or such) 22b. License Number 22c. Name and Address of Faclliry - FD 012 848 :f., Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Complete its -c rtilying 23a. To the best of my knowledge, death occurred at the time, date end place stated. (Signature and tiNe) 23b. License Number 23c. Date Signed (Month, day, year) physican is not available at 8me of death to prtlly pUSe Of death. Items 2446 must be completed by person 24. Time of Death 25. Date Pronounced Dead (Month, day, year) 28. Was Case Refered to Medical Examiner /Coroner for a Reason Other than Crematon or Donation? wfa pronounces deafn. '. ~~ ~ M. Ckfi)bt ;t' 21 r •2a I d ^Yes ®No CAUSE OF DEAT1i (See Instructlona and sxampka) r Approximate interval: Part 11: Enter other sigiificeM condttbns contribudrm to dealt, 28. Did Tobacco Use Contribute to Death? Item 27. Part I: Enter the chain of events -diseases, injudes, or compliptions • that drectly caused the death. DO NOT enter terminal events such as prdfac arrest, ~ Onset to Death but not resuPong in the undertying reuse given in Part I. ^Yes ^ Probabty respiratory arrest, or venMcular f~dllation without stowing the etiology. Ust any one cause on each Tine. , r ^ No ^ Unknown IMMEDIATE CAUSE (Fsxsl disease or condlfion resulting in death) i 29. If Female: ^ N to (or as a consequence of): r ri8al 9st ~, lt ~,, r b. ~/ // / ~~ ~ ~ ~r~`~l B~ ~,~~ i-T r ~ro the cause listed on line a ot pregnant within past year ^ Pregnant at tlme of death ^ . Erder UNDERLYING CAUSE Du o or s co equence oq: ~ - Not pregnant, but pregnant within 42 days (disease a 'm' tltat initiated the S. ~ ~ i everds resuPong In death) LAST. c a~ ~~ s~ v ~~ ~'~~~'L "'{ ~ of death ^ Due to (or as a consequence of): , - Not pregnant, but pregnant 43 days to 1 year f r b d th d' r r e o e ea ^ Unknown it pregnant within the pest year 30a. Was an Autopsy P rt d? 30b. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Descr@ie How Injury Occurred 32c. Place of Injury: Home, Fann, Sheet, Factory, e omre Avelleble Prbr to Completion ^ Natural ^ Homicide Office Building, etc. (Specity) of Cause of Death? ^ Yes ~ No ^Yes ^ Nc ^ Accident ^ Pending Investlgatlon 32d. Time of Injury 32e. Injury et Work? 32f. tt Transportation Injury (Specify) 32g. Location of injury (Street, city /town, state) ^ Suicide ^ Could Not be Determined ^Yes ^ No ^ Driver/Opereta ^ Passenger ^ Pedestrian M ^ Other • Spec(ly 33a. Certllbr (check ony one) 33b. tore and of Certlfier • CertByltg Ph9alalan (Pfryskaan prtiying pose of death when another pfryaician hea proraurrced death and completed Item 23) ~ . To the beet of my knoarbdge, death occurred dos to the cause(s) and numrNr u stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ • Pmnouneing uM artMying physician (Phyafcien both prorwundng death end pr8fykg to pose of death) 33c. Uar umber .Date Signed (Mordh, day, Year) To the beet of my WawNdgs, death occurred st the time, date, and place. and due to the eeuse(e) end msnner u aMed_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ .~ /D_ z ~ . l Q • htsdiml Examiner/Coroner ~ Ori tM beat of uuminrdWn sod / a Inwsdgation, in my opinion, death occurrod at the dma, data, end place, and due to the auaa(a) and manner u staterL ^ 34. Name and Address of Person Who /~,. Completed Cause of Death (ttem 27) Type /Print QQ ~ ~ ~ ~ $ ~ 35 Registrars S and District (..: / - ~ ~L~ L ` . - ~~ ~ / ~ a ~ ~ ~ ~ ~ 36. Date Flied (Month, day, year) /d/ .3'/ D/D lf~ F~n~ ; ~`7~. t-i~~e.,ers~s U~Pc PA I7 i o2. lCoi'7 Disposttion Permtt No. __ L.rl /7 2 ! ~ f ~rttsY 3'~il! ~cn~ (~1esYttittenY I, MARl~ K. CCURy, a~ GUanm~2ey~sbung, Cumben.~and Caunty, Penrvsy~van~.a, be~,ng a~ ~aund and di.~sna3~,ng m~,nd, memany and unden~sxand~.ng, heneby c{ecQane xh.us ~.n~s~tnumen~ ~a be my La~sx Gl~,Q~ and Te~s~amewt, nevaft~.ng any and a~'.~ w%~~~s b y me hene~a bane made . I TBM I . I d~.nec~t my hene~.na~ten-named Bxecutan xa nay a~.2 my 1u3~ debts , ~unena~' exnervse~s and adm~.n,vs~na-ti,an exne-vse~s , ~,na~ud~,ng ~.nhe~c.i,~ance ~~axe~s , a~ ~ aan ass may be canven~.ent a ten my decea~s e . ITBM II . I bequeath a~~' a ~ my ~ang~.bQe netvsana~ nnanelcty, ~,nceud~.ng au~amab~,~e~s , haws eha~d netus anae e ~~ec~t~s and axhen ~tang~.b.2e nenJs ana.~ n.nanetcty a ~ ~,%f2e natune, ~age~then w.ixh ex.vsfiing ~.n3unance na.ei.ci.e~s and nnaceed3 a ~ ~.vusunance an such nnapetrty, ~a my husband, DANIBL G. C(?URS~, nnav~.ded -~ha~t he ~sunv~.ve me by ~h.%tity (30) days . Shau~d my husband, DANIBL G. Cc~URy, nab be ~P.i, v~,ng a n the ~th~.n~y - ~%tus ~ (31 ~s ~) day a ten m y death , I b eq uea~h such ~ang~.bQe nen~sana~~y and ~.n~sunance ~henean, ass a ~ane~sa~.d, ~ta such a ~ my ch~.Qdneri ass ane then ~.%v.ing an xhe xh.vr.~y-~~x (31 ~s~) day a~ten my dea.~h, ~a be d~.v~.ded amang ahem a3 my Bxecu~an ~sha~2Q dec.%de, w.cth due negand fan ~he~c. nen~sana~ nne ~enence~ , ~.n ass nean.2y equal ~shane~s ass nnac~,icaQ. Any ~sueh atit~.c~e a~Qa~~ed xa a m~.nan, may , .in the ~ udgmewt a ~ my ~xeeuxan , ei~hen be de~%vened ~ta xhe m~.nan an any ~ ~..~ nen~s an xa ha.~d fan the mtinan . C CII ~ -~ ~ ~'~ I TBM III . Z g~.ve and bequeath : ~~' ?~ ~ `~ `~~ , ~' A. A.~~ my eh.y~s~aQ and an~`,i.que d-vshe~s xa my ~.us~en, KATHLBB t_~~>~ -x, ~ , y ~:~ ~._ B. $i , 000.00 xa (JUR LADY HtLP C1= CHRIST CHURCH, Lyhen~s , ~ ~°r.- `~"' 4 Pen-~vs y~vanc.a ; and C. $1,000.00 ~a 5T. TH~RBSA'S CHURCH, New Cumben~and, PenrvsyQvan~.a, fan genena~ nunna~sea and $l ,000.00 ~a be u3 ed fan Mays 3 ens . ITBM IV . AQ~ xhe ne~s~, ne~s~.due and nema.inden a ~ my ~~s~a~e, I gave, dev~.~e and bequeath un~a the UPPBR DAUPHIN NAT I DNAL BANK, a ~ M~.Q~e~us bung , Penn~sy~van~.a, ~.. urusuant xa the ~e~i.m~5 a a Tnu~sx A neemen~ dated the ~~,~~.. da a "~ n ~ ._ ~~ 19 83 , ~.n wh~.ch I am the Se~~Qan . ( ~ < (SBAL) ny aunt' Page 1 a ~ 2 Pages ;' ~ . ITBM V. I heneby nam~.na~e, carus~itu~te and anna~,n~t my husband, DANIEL G. Cc~URy, ass Bxecuxan a~ ~h.i,~ my La~sx W~,~.2 and Te~s~a.men~; ~.n the event my husband -vs unabQe an unw.%~~,%ng ~a ~elcve, 1 hexeby nam~.na~e, can~s~,ftu~e and arna~.nt the UPPER DAUPHIN NATIONAL BANK ass ~xecutan ~ ~ ~h.vs my La~s~t ~1-ie~ and Te~s~~amen~. I N GUI TN~SS (~HBR~01=, I have heneun~a ~s e~ my hand and ~s ea.2 xa ~h~.~s my La~S~ GU~,Q.~ and Te~s~amen~, ca-vs.us~,%ng a ~ ~,ua (2) ~ypewn,%t~ten pages , each bea~ri.ng my ~s.ig na~urce , xh~i~ ~ ~ ~ day a ~ (~ ~ ~;~ ~ ~. C A . D . 19 8 3 . Pack e 2 ~ ~ 2 Pag e3 ~._.. 1~~ ~.. ~6_z~, ~ s~AL~ t ~c y cuh. y f '-• Fem... ... \ '-.. OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mary K Court' Deceased Shirley G. Helwig (each) a subscribing witness to (Print Name/s) the x Will ~ Codicil(s) presented `~erewith, (each) being duly qualified according to la~,rr, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in his /her presence and in the presence of each other. l (Signature) Shirley .Helwig 557 Union Street (Street Address) Millersburg, PA 17061 (Cdy, State. Zip) ~.~ (Signature) ra O ^-- ~ , ~~SJ ~ r~ - (Street Address) ; '- `r~ ~ W ~ ~ ~ - .~ ,: (City, State. Zip) "r~ -~ . `.. "mot ~ ~ Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~~'~ day ., `~ ? ' ' 7 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 Seal ~~~ Tina t.. Lloyd, Notary Public Washington Twp., Dauphin County My Commission Expires Sept. 13, 2013 P !ns~ly nia ~sxiation f N taries NOTE: To be taken by Officer authorized to administer oaths. Please hav~~~'ht'C~ie ori~ina~'or copy of°ns~rument(s) at time of notarization. Form RW O3 Rev 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. ~' OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mary K Coury ,Deceased Kathy A. Mull (each) a subscribing witness to (Print Name/s) the x b'Vill ^ Codicil(s) presented herewith, (each) being duly qualifiied according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in his /her presence and in the presence of each other. ~ ./.,/~y/j /,1/ / (Signatur J Kat .Mull .. 151 Wagon Road (Street Address) Millersburg, PA 17061 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of. Deputy for Register of Wills NOTE: To be taken by Officer authorized to administer oaths ~ ~.~ ~ C O _ ~, , (Signature) J --p ~ '{t ~ ~. a ~.~ rte-- _.. ,, '"'~ c_~ . r I ~y r~'I _..r-_ ~, ~_ ^ iii ~~ ._ •~ - ~_, , ~ (Street Address) ' ~- ~ ~~~~ ~ ~:_. ~~ ~ ~I ~ _ J `` '~ ~J (City, State. Zip) ~? Executed out of Register's Office Sworn to or affirmed and subscribed befo,,rer me this ~~'~~ day -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.. ~~:~if~iVDC~vWE,~~ 'a }i t~F ~ENi'~~Y~OOA(~IA iVotarial Seal ~ i~a L. Lloyd. !Votary Public Washington Twp., Dauphin County MY Cornrr~isSion Expires Sept 13.2013 A+tem~aer, p,,n,,z~~o+~nie ,~sssocia4dnr- Please have present the original or copy of instrumen~~s~ at time of notarization. Form RW-O3 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. C. ~ ~. '" ~~ '" i I RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL`/ANI.A Estate of Mary K Coury ,Deceased i, DANIEL G. COURY , in my capacity/relationsriip 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 GREGORY M. KERWIN, ESQUIRE l l I c- (Date) G~f.~.,c e.~ (Signature) DANI G. COURY 1103 YVERDON DRIVE, APT B-1 Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ___ (Street Address) R.,? C~ CAMP HILL, PA 17011 ~ _: _, ~ ~ (City. State, Zip) I ~.i~-~ ~ ~ .~' rn -' f' --- :~;~ ' ~~ N s Offices Executed out of Register Q Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renu ciation for the ~ ~-~-- day purposes stated within on this of 1 ~r)~~'c'rn ~~ r -~ c~ i c' . E ~ °-~ ~. No ary 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 r''ENNSYLVANIA Form RW-06 Rey ~o-~s-loos Notarial Seal Tina L. Lloyd, Notary Pubric Washington Twp., Dauphin County My Commission Expires Sept. 13.2018 Copyright (c) 2006 form software only The Lackner Group, Inc. rlill~rTltNlr, Pflrran!>•IVarla dA,~q~ri~ligl4iOt~ G+f i•?At~rie~s ,_~ ; - ,~ C.. -~ ) _ 't .. ' ....~ r .. ' ,; , r ~, RENUNCIATION REGISTER OF WILLS QF CUMBERLANQ COUNTYt PENNSYLVANIA Estate of Mary K Coury ,Deceased ~~ Steve Wenzel, Vice President, Trust Officer of Susquehanna , in my capacity/relationship c)s .TRUST & ~VEST~IEDIT CQ~~~'t`~ ;'°~SUCCESSOR TQ UPPED. AAU~iIN ~TATI4~TA.T.± BANK alternate Executor of the above Decedent, hereby renounces the righ t to administer the Estate of the Decedent and respectfully request that Letters be issued to GREGORY M. KERWIN, ESQUIRE . ~ fug ~4 n ~ ~~s ~.~ 9 ,- ~~°,~~ ~ l(7 1~~iC~ ~Q~ ~ (oats) rs;~nature) Steve Wenzel, Vice President, Trust c7~~'ICER ~7 t-..a ~-~ ,, 1570 Manheim Pike, PO Box 3300 ~ ~~ (street Address) -~~.1~- ... ` t C7 I _ ~. 7l -;r t Lancaster, PA 17604-3300 ;=~= ~+~~ ~ -- f 'r ~ F- (C+tY, State, 2ipJ .~ ~- ~ `.-.? ~ ._S,.i ' C. ~, __ _ _. ~ . _ -~ f~ ~', r Executed in Register`s Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the this renunciation and certified xecutin rt before me this day g y pa that ie r she executed the renun ion for the purposes stated within on this _1~day of ~ v~ r of ~~ Deputy for Register of Wills Notary Pubic My Commission Expires: q"•~ I~ ~/~ (Si~naturo erxi seal of Notary or other official qualified to adrrdnlster oaths. Show date of exp(retion of Notary's commission.) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Donna L. Hofrman, Notary Public Manheim Twp., Lancaster County My Commission Expires .lan. 19, 2012 Member, Pennsylvania Association of Notaries Fo/m RW-06 Rev. 10-13-2006 Gapyrfght (c} 7.gD8 torrn software only T~ha Lr~CimBr Gaup, InC