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HomeMy WebLinkAbout09-27-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION ORPHANS COURT DIVISION IN RE: NO.: 21-11-0057 PARTIAL DISCLAIMER OF INTEREST PURSUANT TO 20Pa.C.S.A. & 6202 I, Carolyn G. Anstine, am a resident of Cumberland County, Pennsylvania, residing at 211 N. 24th Street, Camp Hill, PA 17011, and hereby state as follows: I am the sole residuary beneficiary named in the Last Will and Testament of my father, Ward E. Green. Said Will was probated in the Register of Wills Office of Cumberland County and numbered 21-11-0057. I hereby wish to disclaim any interest in One Hundred Thirty Thousand ($130,000.00) Dollars of the residue of said estate, and it is my expectation that this amount would therefore pass to my brothers (sons of the decedent), Ward E. Green, III and Jeffrey D. Green by virtue of the intestate act as they are the closest surviving heirs. Dated: ~~" ~~ C' ' ~ r`( i'~l _ CAROL G. A STINE ,~ o -,x, __ _~ -- ,. z; -; z~ c ; __ _. r- __-,-- __,, _ ~ - -, -.~-; -, -,-, Estate of Ward E. Green COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF YORK On this the < ~`~~ day of - ~ ~ , 2011, before me, a Notary Public, the undersigned officer, personal y appeared Carolyn G. Anstine, known to be (or satisfactorily proven to be) the person whose name is subscribed to the within instrument as Principal, and acknowledged that she executed the same for the purposes therein contained. - '1 `~ ~:~ ~ Notary Public My Commission Expires: COMMONWEgLTH OF PENNSYLVANIA NOTARIAL SEAL Lon A. Graham, Notary Public City of York, York County My Commission Expires May 28, 2014