Loading...
HomeMy WebLinkAbout02-07-13 (2)rceset PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name: Sandra Lee Smith a/k/a: a/k/a: a/k/a: Date of Death: January 29,2013 ,, File No: .'X ~" ~ l ~' `~ (Assigned by Register) Social Security No: Age at death: 72 Decedent was domiciled at death in Cumberland County, penns~lvania (state) with his/her last principal residence at 208 Senate Avenue, Apartment 814 in Camp Hill, Pennsylvania 17011 in Cumberland county Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 208 Senate Avenue, Apartment 814 in Camp Hill in Cumberland County in Pennsylvania Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania ............................All personal property $ 800.00 If not domiciled in Pennsylvania ........................Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ ~_p~ TOTAL ESTIMATED VALUE.... $ 800.00 Real estate in Pennsylvania situated at: (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough ~A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated thereto dated County and Codicil(s) State relevant circumstances (e.g. renunciation, death of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorced, was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), and did not have a child born or ad pted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. f NO EXCEPTIONS Q EXCEPTIONS Q B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate 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. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. Q NO EXCEPTIONS 0 EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived b~e following mouse (rand heirs (attach additional sheets, if necessary): ~ ~ ...T,l 1'p7 ~ -r, r-n Name Relationshi ~,~ ..~ ~ ess --~ c„. ~ i"n '~ ~ ~ ~ ~ ~ ~ C7~~ ~ ~~ °n T. "~ ...,. rn -n Form RW-02 rev. 10/11/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF ~ L)l "~i `~ } i- Petitioner ) Print ed N a m e nted Address etitioner(s) Pri P ,/r n ~i ~ ~, -, / p ~} /~ / r / /~ The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petitiov~n are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Dece nt, the Petitio (s ~-~! well and truly~administer the estate according to lawi .~ Sworn to or affirmed and subscribed before / ~ ~~~~~ Date ~ / me tr-;d5',~~~_'_ ¢ay ofd (~_1~ t~t'~.1 ~% ;'~( !_~~, Date By: For the Register - )( i Date Date BOND itequired: ~ YES ~'fil0 FEES: ~ ~) Letters ...................... $ ( .'~-. )Short Certificate(s)...... / ~-~ ~ ~` ~'~ ( -,)Renunciation(s)......... /~ ' ~ C ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ....... ~~;i ....... ~~ ~~ °~ ' Automation Fee . .............. ~ ; ~..- JCS Fee . .................... :~ ~~, , ~l_i ~~- TOTAL ..................... $ /7 ~~ ~~ (3:60 To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: Printed Name: Supreme Court ID Number: ~ .--"' ~~ ~ Firm Name: w ~ -~ ~, ~~ ~ Address: !'r'1 ~ G~ ~ ~~~ Z+ r r~ ,~ ~-~~ ~~~~ rv ~' Phone: C7 '~ -~°y ,~ -~t ~~ Fax: - ~ ~.`' - ~= - Email: -~ ~ ~ , r. Official Use Only DECREE OF THE REGISTER ~, Estate of Sandra Lee Smith File No: -- ~` ~ ~ ' "~' a/k/a: AND NOW, ` , ~ ~ ~ L~ ~ { C _ ji c ~ ~ f r ~~ ~ ~ ~.~ , in consideration of the foregoing Petition, satisfactory proof having been 'resented before e, IT IS_ DECREED that Letters (~~-." r~i '' ' ' 'r E t' ~ - are hereby granted to _ ~ ~ C ~`` ~-' ~ ~` ~ ~"`~~~' (~' 1(~~ ~" ~~ ~ = E the instrument(s) dated ~f' ~'"~ i " t_ i._1"; described in the Petition be admitted to Form RW-02 rev. 10/11/2011 in the above estate and (if applicable) that to and filed of record as the last Will (and Codicil(s)) of Decedent, ~ , Register of Wills ;, i" ~ ;'~ f '~~ ~ f ~ f' , ~ ~~~~~ ~'_ ~~ ,~ f ~-~ - '~} ti ~ ~~ ~ Page 2 of 2 RFCORu~.D DPPl~~ OF RF~l~3~R OF ~~~~.5 %~I3 FEB ? `~~110 ~~ ~I ~ ~.~~~.~~ CL~R~C 0~ EEB 0~1 ORPHANS GQURT ~~T.y~ °~ 2013 CUM /~ BERLAHD Cp,, PA Type/Print In Permanent Black Ink 1. Decedent's Legal Name (First, Midi Sandra Lee Smith Sa. Age-Last Birthday (Yrs) Sb. Unde Month; Sa Residence (State or Foreign Count PA 8d. Residence (County) Cumberland 9. Ever in US Armed Forces? _ Q Yes ® No Q Unknown 12. Father's Name (First, Middle, Last, COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICATE OF DEATH °, Last, Suffix) State File Number: 2. Sex 3. Social Security Number 4. Date of [ Female Janua 1 Year Sc. Under 1 Da 6. Date of Birth (Mo/Day/Year S ell Month) 7a. Birth lace Ci ) ( P p ( ty and State or Fore Days Hours Minutes Atlanta, GA August 30, 1940 7b. Birthplace (county) Fulton i) 8b. Residence (Street and Number -Include Apt No.) Sc" Did Decedent Live in a Township? 208 Senate Avenue, Apt. 814 ®Ves, decedent lived in E. Pennsboro 8e. Residence (Zip Code) 1 701 1 QNo, decedent lived within limits of ~ Marital Status at Time of Death Q Married ® Widowed 11. Surviving Spouse's Name If wife, Q Divorced Q Never Married Q Unknown ( give name prior to first marriage) twp. city/born. Levi Calvin Myers 13. Mother's Name Prior to First Marriage (First, Middle, Last) Eloise Neighbors 14a. Informant's Name o 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) Tracey M. Reichard Daughter G 104 Sarah Court Lewisber ry. PA 17339 _ _ _ _ _ 15a. Place of Death (Check only one) If Death Occurred in a Hospital: ~ Inpatient - - - I De c ° ~ f ath O curred Somewhere Other Than a Hospital Q Emergency Room/Outpatient Q ~ Hospice Facility Decedent's Home Dead on Arrival Q Nursi H e _ ~ ng om /Long-Term Care Facility Other (Specify) lSb. Facility Name (If not institution, give street and number) iSc Cit T Z " y or own, State, and Zip Code 208 Senate Avenue, Apt. 814 i5d. County of Death C • • m amp Hill, PA 17011 Cumberland 16a. Method of Disposition Burial - Q ® Cremation 16b D t f Di v . a e o sposition 16c" Place of Disposition (Name of cemetery, crematory, or other place) Q Removal from State Q Donation ~ 3 ' ~ I` 4r llk ~ l Z01 3 Other (Specify) Off `i Evans Crematory v 16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature ice Licensee or Person in Charge of Interment 17b. License Number Schaefferstown, PA 17088 --~- E 17c. Name and Complete Address of Funeral Facility Fa 012 848 L Parthemore Funeral Home 8~ Cremation Services Inc P O Box 431 1 303 , ., . . , Bridge Street New Cumberland, PA 1 7070 18. Decedent's Education -Check the box that best describes th 19 ~ e " Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to indi highest degree or level of school completed at the time of death b th b . ox at cate what est describes whether the decedent the decedent considered himself or herself to be Q 8th grade or less is S i h . pan s /Hispanic/Latino. Check the "N O" Q No diploma, 9th - 12th grade ® White Q Korean box if dec d t i e en s not Spanish/Hispanic/Latino. Q Black or African American Q ® High school graduate or GED completed ® No Vietnamese not S anish/Hi i , p span c/Latino Q Some college credit, but no degree Q American Indian or Alaska Native Q Other Asian Q Ves Mexican Mexic A , , an merican, Chicano Q Asian Indian Q Q Associate degree (e. g. AA, AS) Q Yes Puerto Rican Native Hawaiian , Q Bachelor's degree (e. g. BA, AB, BS) Q Chinese Q Guamanian or Chamorro Q Ves Cuban , Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes other Spanish/Hi i , span c/Latino Doctorate (e.g. PhD, EdD) or Professional degree Q Japanese Q Other Pacific Islander (Specify) (e. MD DDS, DVM, LLB, JD Q Other (Specify) 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a Decedent's U I ® White Q J .rt--~ C/~ N N J CL6 C C6 C/~ 0 u v O_ apanese Q Black or African Amer{can Q Samoan ~ Korean Q Ocher Pacific Islander Q American Indian or Alaska Native ~ Vietnamese Q Don't Know/Not Sure Q Asian Indian 17 Other Asian Q Refused ~ sua Occupation -Indicate type of work done during most of working life. DO NOT USE RETIRED. Caregiver Chinese 17 Q Native Hawaiian Q Other (Specify) Q Fili ino 22b. Kind of Business Industry / p Q Guamanian or Chamorro Human SerVICe S ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (Mo/Day/Yr) 23b. Signature of Person Pr BY PERSON WHO PRONOUNCES OR i onounc n g CERTIFIES DEATH Death Onl when a ( y pplicable) 23c. License Number 23d. Date Signed (MO/Day/Yr) 24. Time of Death 9:30 am 25. Was Medical Examiner or Coroner Contacted? ® Yes Q N CAUSE OF DEATH o 26. Part 1. Enter the chain of events--diseases, injuries, or complications--Shat directly caused the death DO NOT res i t t ^ Approximate . en p ra er terminal events such as cardiac arrest, ~ ory arrest, or ventricular fibrillation without~!sho~wing She etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessa Interval: • ,,~/{ / / /j ~~~L ry. ~ Onset to Death IMMEDIATE CAUSE ---------------> a. / (/V l (/C lll///lll ~ ... - 7 ~ (Final disease or condition ~~~]]]!!!~//~~`!!!///lll--- ~~2 ^ Due to (or as a conse uence of resulting in death) /~ ~~/ q ) i ^ equentially list conditions, ^ Due to (or as a consequence of): if any, leading to the cause ~l i/~ listed on line a. Enter the c, (/ ^ ^ Q UNDERLYING CAUSE Due to (or as a conse uence of (disease or injury that q )~ ^ ^ ~ initiated the events resulting d, in death) LAST. ^ ^ u Due to (or as a consequence of): ^ ^ a~ ° 26. Part 11. Enter other s~nificant conditions contributive to death but not resultin n the underl B i ying cause given in Part I ^ ^ ~ . 27. Was an auto s p y performed? Q Yes ® No m 28. Were autopsy findings available a 29. If Female: to complete the cause of death? 30. Did Tobacco Use Contribute to Death? ® Not pregnant within past year Q Yes ® No 31. Manner of Death ' Q Pregnant at time of death Q Yes ,~~roba bly ~ural Q Homicid ~ Q Not pregnant, but pregnant within 42 days of death Q No Q Unknown " e Q Accident Q Pending Investigation r-- Q Not pregnant, but pregnant 43 da s to 1 y year before death 32. Date of Inju (M /D Q Suicide Q Could not be determined ry O ay/Yr) (Spell Month) Q Unknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e. g. home; construction site; farm; school) 3 " 5. Location of In u J ry (Street and Numbe r, County, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yes Q Driver/Operator Q Pedestrian - Q No Q Passenger Q Other (Specify) 39a. Certifier -physician, certified nurse practitioner, medical examiner/coroner (Check only one): ~Errtifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated. Q Pronouncing ge Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated. Q Medical Examiner/Coroner - O h sis f exa inat on /or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner stated. Signature of certifier: Title of certifier: ~/,~ /7~P>H~~~7/~ License Number (/~ 39b. Name, Address and Zip C de of Person Completing Cause of Death (Item 26) ~~~ ~-( 39c. Date Signed (Mo/Day/Vr) 40. Registrar's District Number ~ ~ ~~r~ Sv{ ~ l t o 1 /3 ~ / 2of3 41. Registrar's Sign atu ~ 42. Registrar File Date (Mo/Day/Yr .c 'sue ~ " ~ / ~ ~s~.yfl ~~7 ~!' ~ ~ ~ ) 43. Amendments ~ Disnncitinn Permit Nn llh l ~li L-l~.i 29, 201 3 H 105-143 LAST WILL AND TESTAMENT I, SANDRA L. SMITH, of the Township of Loyalsock, County of Lycoming and Commonwealth of Pennsylvania, do hereby make my Last Will and Testament and revoke all Wills and Codicils by me at any time heretofore made. 1. PAYMENT OF DEBTS AND FUNERAL EXPENSES. I direct that all my just debts and funeral expenses shall be paid from the assets ~f,my estate as n ~., ~ ~ ~, soon as practicable after my decease. ® --n ~ c ~ ~~ ~ ' _ W ~,,r~ ;,k 3 ° 2. SPECIFIC BEQUEST OF JEWELRY. ~ ~~~ ,, ~ ~ ' ~ ..J ... ~.~~ ~, (a) I give and bequeath my white gold dia~rr~~jr~~l ring to'n~y u ._ dau hter, DANA K. GRISWOLD. g ~ ., ., _ , _ ~.; ~ t ~ .- ,....~ ~~ ~.~. ~~ ~~ (b) I give and bequeath my yellow gold diamond ring to my daughter, TRACEY M. REICHARD. (c) I give and bequeath my blue sapphire diamond ring to my daughter-in-law, SANDRA MINICH. (d) I give and bequeath my yellow gold amethyst ring to my granddaughter, ASHLEY GRISWOLD. 3. GIFT OF LIFE ESTATE IN RESIDENCE. I give and bequeath a life estate in my residence situate at 2012 Reed Street, Williamsport, Pennsylvania, together with all household goods and furnishings therein, to my good friend, MONICA M. KITCHEN, for her life so long as she desires and McCORMICK LAW FIRM $35 w.F~URTHST. continues to use said premises on a regular basis as her home, subject to she WILLIAMSPORT, PA. paying all costs of maintenance thereof, including real estate taxes, assessments, insurance, and ordinary repairs. Said property shall be insured by her in an amount equal to the fair market value of said property and said insurance shall also insure the interest of the remaindermen as well as herself. Upon the death of my good friend, Monica M. Kitchen, or at such prior time that she no longer uses said premises on a regular basis as a home for herself, I direct my personal representatives hereinafter named to sell said real and personal property and distribute the net proceeds thereof in equal shares to my three (3) children, JEFFREY V. MINICH, DANA K. GRISWOLD and TRACEY M. REICHARD. 4. GIFT OF RESIDUARY ESTATE. I give, devise and bequeath all of the rest, residue and remainder of my estate, both real and personal and wherever situate, in equal shares to my three (3) children, JEFFREY V. MINICH, DANA K. GRISWOLD and TRACEY M. REICHARD. In the event that any of my children shall fail to survive me, and shall leave issue surviving me, the within bequest shall not lapse but shall pass to such surviving issue, who shall take per stirpes the share which their deceased parent would have taken had he or she survived me. 5. TRUST UNTIL AGE TWENTY-ONE (21). Should any person be under the age of Twenty-One (21) at the time of my death, I give, devise and bequeath his or her said share of my estate to my daughter, DANA K. McCORMICK LAW FIRM I I 835 W. FOURTH ST. WILLIAMSPORT, PA. Z GRISWOLD, as Trustee, IN TRUST, to hold, manage, invest and reinvest the share so received, to collect the income and after paying all expenses incident to the management of the Trust, to apply such parts of the net income and principal as may be necessary, in the sole discretion of my said Trustee, for the support, welfare and education, including education at an institution of higher learning, of said person until she reaches the age of Twenty-One (21). Should said person die before obtaining age Twenty-One (21), the Trust shall terminate as to his or her share and said share shall be distributed to his or her heirs, but subject to the terms of this Trust. In case of vacancy in said office of Trustee, I hereby appoint my son, JEFFREY V. MINICH, as Alternate Trustee. 6. PERSONAL REPRESENTATIVE. I nominate, constitute and appoint my three children, JEFFREY V. MINICH, DANA K. GRISWOLD and TRACEY M. REICHARD, as Co-Executors of this my Will. 7. WAIVER OF BOND. I direct that no fiduciary under this Will shall be required to give bond in any jurisdiction in which he or she may act, conditioned upon the faithful performance of the duties of said office. 8. TAXES. I direct that all estate, inheritance and succession taxes on property passing on account of my death under this Will or otherwise except as set forth below shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration, and all legacies, McCORMICK LAW FIRM 835 W. FOURTH ST. WILLIAMSPORT, PA. 3 devises and other gifts of principal and income made by this, my will, or by any Codicil hereto, shall be free and clear thereof. In the event that, at the time of my death, I own securities registered in beneficiary form pursuant to ZO Pa.C.S. ~ 6401, et seq., then any such taxes due as a result of the transfer of such securities upon my death shall be borne by the registered beneficiary and not by my estate. 9. RESTRAINT ON ALIENATION. I direct that all legacies and all shares and interests in my estate, whether principal or income, while in the hands of my personal representative or trustee herein appointed, shall not be subject to attachment, execution, or sequestration for any tort, debt, contract, obligation, or liability of any legatee or beneficiary, and shall not be subject to pledge, assignment, conveyance or anticipation by any legatee or beneficiary 10. FIDUCIARIES' POWERS. I direct that my personal representative and trustee herein appointed, in addition to and not in limitation of any authority given to the same by law, shall have the following powers: A. For the payment of debts or for any purpose of administration or distribution, to sell, mortgage, lease, alter, improve, partition and exchange all or any of my property, real or personal, at any time during the administration of my estate or the continuance of said Trust and at the termination thereof for purposes of distribution, selling at public or private sale without an order of court for such prices and upon such terms as to cash and McCORMICK LAW FIRM I I 835 W. FOURTH ST. WiLLIAMSPORT, PA. 4 credit as said Fiduciary deems best, and to grant and convey good and sufficient title without liability on the part of the purchasers to see to the application of the purchase or consideration moneys, any statute, rule or case law to the contrary notwithstanding; B. To retain for distribution in kind all stocks, bonds and other investments made by me, or in the absolute discretion of said personal representative or trustee to convert the same into cash, whether or not such conversion is necessary, any statute, rule or case law to the contrary notwithstanding; C. To retain as investments of the Estate and Trust, all stocks, bonds and investments owned by me and to invest and reinvest in other stocks, bonds, shares in mutual investment trusts, common trust funds and other investments, without being confined to what are known as "legal investments" and to sell and transfer the same, either in person or by attorney, without liability on the part of the purchasers to see to the application of the purchase or consideration moneys. 11. INTERPRETATION. The following interpretations shall apply to this Will (a) Throughout this Will, when the masculine, feminine or neuter gender is used inappropriately, it shall mean the appropriate gender, and unless the context requires otherwise, the singular number shall include the plural and vice versa; McCORMICK LAW FIRM 835 W. FOURTH ST. WiLLIAMSPORT, PA. 5 (b) Any reference in this Will to "children", "descendants" or ~~issue" shall include adopted persons and persons born before or after the date of this Will, unless otherwise stated; (c) The headings at the beginnings of paragraphs and sub-paragraphs in this Will are for reference purposes only and shall be disregarded in the construction of this instrument unless the context clearly indicates otherwise. IN WITNESS WHEREOF, I have hereunto set my hand and seal this `~ day of ~~ 2007. 1 ~~ ~-~f~~ (SEAL) Sandra L. i h Signed, sealed, published and declared by the above named Testatrix as and for her Last Will and Testament in our presence, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. .;. . William L. Knecht, Esquire f McCORMICK LAW FIRM 835 W. FOURTH ST. WiLLIAMSPORT, PA. (7 COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF LYCOMING ) We, SANDRA L. SMITH, the Testatrix, and the witnesses whose signatures appear below, and whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed this instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix and of each other, signed the Will as a witness and that to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sandra L. S ith William L. Knecht, Esquire McCORMICK LAW FIRM I I 835 W. FOURTH ST. WILLIAMSPORT, PA. 7 Subscribed, sworn to and acknowledged before me by SANDRA L. SMITH, the Testatrix, and subscribed and sworn to before me by the witnesses above named, this ~~~ day of /'~~ , 2007. otary Public (~nlt~c~~r~al~ of Pr~n:~lv~r4r~ iF' f i~~'ZI Iw~ ~ ~fi a.ra ~~~`. ~ ~Y/~^J P ~~}iY RfV C6~'~ tal x~1~~F ~~gi"~~ ~". ~''.'4tCi~i~'" C(?U~1 McCORMICK LAW FIRM I I 835 W. FOURTH ST. WILLIAMSPORT, PA. 8 RENUNCIATION ~ ~ z.. r ~' ~ ~ REGISTER OF WILLS ~ ` ~ Cumberland cz COUNTY, PENNSYLVAN~', ~c V Estate of Sandra Lee Smith I, Dana Griswold daughter (Print Name) j'~.: _~ ~ ~`7` r"*'1 C7 ~ ~~ cox ~ ~ ~~ ~ ~~ ~ _ ;.~ ~~ -r ~' ~~ H Cn O C7a '~"t Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Tracey Reichard February 4, 2013 (Date) (Signature) 8308 Carderock Drive (Street Address) Bethesda, MD. 20817 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and su scribed before me this day of Deputy for Register of Wills 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 ~ ~ e~ c~ ~ o~- ..o ,: r ,~ >c My Commission Expires: 0 ~ ~ 6 -~ ~ ~~ ~ `~' (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 +'=`~NG KI HONE ri'~~~~ t ~ ,' ~t: STATE OE~~~~~iYL~~~~ ~~~rw (..~~~; n~~~~;~ian ~xpiras Aril ~ ~~1$~ 3 RENUNCIATION REGISTER OF WILLS Cumberland COUNTY, PENNSYLVANIA C~ ~; rrte~... A` W 7C7 m ~~ w~ ; ~ ~,,, r-- -~~ ~~ ~" ~ rr~ ~t ~_~t ~ ~ ~ Q ~ c.~ c~ ,~,~ ~~,~ ~..~ om o ~ n . H t/) O Estate of Sandra Lee Smith Deceased I~ ~~~~~y ~~~• % ~~ j~l ~l~ , in my capacity/relationship as (Print Name) ®~IV administer the Estate of of the above Decedent, hereby renounce the right to e(cedent and respectfully request that Letters be issued to /" ~ ~ l.~ ~ ~ I (Date) (City, State, Zip) 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 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 1<EBR~AR`t Zo i3 ~ ~` Notary Public My Commission Expires: ~',,N~ L5't 2or ~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMQNWEALTFi ~?F PENNSYLVANIA Form RW-06 rev. 10.13.06 Natarlel Seas Steven V. Gc~bat, id~st~~l Pubii~ Lemoyne BOrO~ Clim~rjn~"aCf ~E1Unt}( s My Commisslon Expfre~ une z~, 2014 Member, Pennsylvane~ ASSCSNatiora cif ~©taries