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HomeMy WebLinkAbout03-27-13 (2) QUALIFIED DISCLAIMER In accordance with Internal Revenue Code Section 2518 (b) and pursuant to Section 6201 of the Pennsylvania Probate Estate and Fiduciaries Code, (20 PA.C.S.A. Section 6201), this Qualified Disclaimer is being executed by the undersigned beneficiary, JARED BRICKNER, in order to disclaim in whole all of his interest in the ESTATE OF BARRY R. BRICKNER: The undersigned, as one of the beneficiaries in the above-referenced Estate is hereby disclaiming her interest in the estate in favor of his mother, JONI BRICKNER, as evidenced by the undersigned's execution hereof. This disclaimer is executed as of this a5 day of March, 2013, the same being effective as of the date of death of the decedent, Barry R. Brickner on September 11, 2012. WITNESS: L (SEAL) ARED BRI KNER c STATE OF �e I�SL l V��l EGA-- °° © . c' . SS COUNTY OF On this, the C>CD day of March, 2013, before me, the undersigned' ai ficer, persona`f y'';1 appeared Jared Brickner, known to me or satisfactorily proven) to be the ion' whos am' �isD ( Y P ) P��. �� �n subscribed to the within instrument, and acknowledged that he executed the same for thec-f�urposes l therein contained. In witness whereof, I hereunto set my hand and of ci Seal. I (SEAL) Notary Public MoWAT FPN V NOTARIAL SEAL DARCIE A.NEIL,Notary Public Boro of Carlisle,Cumberland CountY My ConxnissW Expires Nov.24,2013 --