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PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF C.qm bfr 1c,^ d 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: �0cl cinculai Ht)d,iE2. File No: --.621
a/k/a: (Assigned by Register)
iWa:
a/k/a: Social Security No:
Date of Death:�rQ a 0 13 Age at death:
Decedent was domiciled at death in " rt1�} ',< c� County, �rl s �;tt (state)with his/her last
principal residence at 1 ree h tinW l Ur
Street address,Post Of ice and bp Code City,Township or Borough County
Decedent died at
PLC W VI t l , Nur�ht,+OpJMrd 69
Street address,..s,Jffice and 4i C, IV City,Township or Borough County State
Estimate of value of decedent's property at death:
If r�
domiciled in Pennsylvania............................ All personal property $ a 1 s �d�3 1
]f not domiciled in Pennsylvania. .......'................ Personal property in Pennsylvania $
If not domiciled in Pennsy lvania. ........... ............ Personal property in County $
Value of real estate in Pennsylvania... .................................................. $
TOTAL ESTIMATED VALUE. ... S 0.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County
<A. Petition for Probate and Grant of Letters Testamentary �y
Petitioner(s)avers)he/she/they is/are the Executor(s)named i the last Will of the Decedent,dated U -�O { and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death of executor,etc.)
Except as follows:after the execution ofthe 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(g),and did not have a child born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
*NO EXCEPTIONS (D EXCEPTIONS
$. Petition for Grant of Letters of Administration (lfapplicable)
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lit urante abseew—,dur to inoritale rTl
If Administration,c.t.a. or d.b.n.c.ta.,enter date of Will in Section A above and c n ete listiRhei o
-,a C11 .,z
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for oie 1p beeiestablished4§defined
in 23 Pa.C.S. 3323 and was neither the victim of a killing nor ever adjudicated an incapacitated per o"n. M
§ (g) g J P P
NO EXCEPTIONS Q EXCEPTIONS %� t
Petitioner(s),after a proper search has/havc ascertained that Decedent left no Will and was survived by the fq1 pvd)ig spouse�Mny) hens(attach
additional sheets,if necessary):
Name Relationship txWress "
Form RW-o2 rev. 10/11/2011 Page 1 of a
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Printed Name Petitioner(s)Printed Address
The Petitioner(s)above-named swear(s)or affirm(s)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 Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the estate according to law.
Sworn t or,�ffirmed d subs ribed before �'ry Date 61-)(P ` j�
met i day of Date
By. Date
For the Register Date
BOND Required: ® YES Q NO To the.Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature:
( ) Short Certificate(s). . . . . .
( ) Renunciation(s).. . . . . . . . c7
( )Codicil(s). . . . . . . . . . . . . rn C-)
( )Affidavit(s).. . . . . . . . . . . °-
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name:
Commission. . . . . . . . . . . . . . . . . . Supreme Court r = FT,
Other . . . . . . . . ID Number: 6? �' -
• . . . . . . Firm Name: �. . . . . . . . Address: LJ 1- l rl
Phone:
Automation Fee. . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . . Email:
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 0.00
DECREE OF THE REGISTER
Estate of File
a/k/a:
AND NOW, deration 2f-the fore Ding Petiti
satisfactory proof having been presented b e me,IT IS DECREED that
ar reby granted to
in the above estate if applicable)that
the instrument(s) date
described in th ttion be admitted to probate and filed of record as the last Will (and Codicil(s))of Decedent.
SC-C ci�l e'r
Register of Wills
Form RW-02 rev. roi»izo11 ( Q � ) Page 2 of
Pal
Oath of Personal Representative Official Use only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Pri ed Name Petitioner(s)PrintedAddress
The Petitioner(s)above-named swear(s)or affirm(s)the tatements in the foregoing etition are true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of e Decedent,the Petit' ner(s)will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed before Date
me this day of Date
By: Date
For the Register Date
BOND Required: Q YES Q NO To the egister of Wills:
FEES: Please a er my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Sig ture:
( )Short Certificate(s). . . . . .
( )Renunciation(s).. . . . . . . .
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond... . . . . . . . . . . . . . . . . . . . . . Printed Name:
Commission. . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . . ID Number:
. . . Firm Name:
. . . . . Address:
. . . . . . . . Phone:
Automation Fee. . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . . Email:
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 0.00
pp
DECREE OF THE REGISTER
Estate of_\ oe l U ncci n 1 tyc File No: �I • '�' V�0 /
a/k/a:
AND NOW, aq" 4 Aorf ` 3 , in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT I DECREED that Letters _R '
are hereby granted to _t,1-
in the above estate and(if applicable)that
the instrument(s)dated �( ��.� �[�
described in the Petition be a mitted to probate and filed of record as the last Will (and Codicil(s))of Decedent.
A&W k W I
Register of WillsL Vn
Form RW-02 rev. 10111/2011 Page of3
H105.805 REV(9/11)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARRWWWtQifl4 gaFIG i4 icate this copy by photostat or photograph.
REGISTER OF '?1 -L.S
Fee for this certificate, $6.00 This is to certify that the information here given is
Z013 APR 26 correctly copied from an original Certificate of Death
���t`o� s� duly filed with me as Local Registrar. The original
CLERK C l ? z certificate will be forwarded to the State Vital
ORPHANS' C O U R T Records Office for permanent filing.
P 19435296 �uMBERLArdD CO., 0�,�91 = E�P��t,`'' YID APR P 4 P 13
---,MENT 0
Certification Number """"""""IIIIIj1 ocal Registra Date Issued
Type/Print In COMMONWEALTH OF PENNSYLVANIA.DEPARTMENT OF HEALTH.VITAL RECORDS
Permanent CERTIFICATE OF DEATH
Black ink State File Number:
1.Decedent's legal Name(First,Middle,last,Suffix) 2.Sex 3.Social Security Number 4.Date of Death(Mo/Day/Yr)(Spell Mo)
Joel Lincoln Hoover male 211-52-6078 April 2 , 2015
Sa.Age-last Birthday(Yrs) 5b.Under 1 Year 5c.Under 1 Da G.Data of Birth(Mo/Day/Year)(Spell Month) 7a.Birthplace(City and State or Fore lgn Country)
79-1 Months Days Hours Minutes C a r 1 3.s 1 e P A
49 April 4, 1963 7b.Birthplace(COunty) Cumberland
8-Residence(State or Foreign Country) 8b.Residence(Street and Number-Include Apt No.) Sc.Did Decedent Live in a Township?
Pennsylvania 961 Green Spring Rd !Yes,decedent llved In North Newton twp.
8d.Residence(County)
C umber 1 a n d 8e.Residence(Zip Code) 17 2 4 1 0 No,decedent hued within limits of city/born.
9.Eve n US Armed Forces? 10.Marital Status at Time of Death Married Q W(dowed 11.Surviving Spouse's Name(If wife,give name prior to first marriage)
EJ Yes I Pr No Ej Unknown JN Divorced El Never Married 0 Unknow
12.Father's Name(First,Middle,Last,Suffix) 13.Mother's Name Prior to First Marriage(First,Middle,Last)
Charles L. Hoover Shirle L_ Stitt
14-Informant's Name 14b.Relationship to Decedent 14c.Informant's Mailing Atltlress(Street and Number City,5taj Z' Code)
0
Christine L. Gutshall Sister 164 3u11s Head Road Newviei�e, 4
C _ f ace o Deat C ec on y one.-"..............'-'.......... ... ... ... .........
�_ If Death Occurred in a Hospital: �Inpatient ,If Death Occurred Somewhere Other Thari a Hospital: Hospice Facility Decedent's Home
° Q Emergency Room/Outpatient Ej Dead on Arrival _ Q Nursin Home/Long-Term Care Facility Other(Specify)
SSb.Facility Name(If not institution,give street and number; 15 c.City or Town,State,and Zip Code 16d.County of Death
961 Green S rin Road Newville, PA 17241 Cumberland
16a.Method of Disposition .® Burial E3 Cremation 16b.Date of Disposition 16c.Place of Disposition(Name of cemetery,crematory,or other place)
E3 Remoyal from State p Donatlnn 4/9/2013 Newville Cemetery
Other(Specify)
16d.Location of Disposition(City or To State and Zip) 17a.Sign atu�e o Funera Service icensee or Person in Charge of Interment 17b.License Number
Newville, PA 17241 FD 13895 T-
17,.Name and Complete Address of Funeral Facility
_ E CF Cf er Funeral Home Tnc. 15 Bi cr S i>rin Ave. Newv' e PA 17241
18.Decedent's Education-Check the box that best describes the 19.Decedent of Hispanic Origin-Check the 20.Decedent's Race-Check ONE OR MORE races to indicate what
,2 highest degree or level of school completed at the time of death. box that best describes whether the decedent the tlecedent considered himself or herself to be.
E3 8th grade or less Is Spanish/Hispanic/Latino. Check the"NO" 29 White Q Korean
0 No diploma,9th-12th grade box if decedent is not Spanish/Hispanic/Latino. Ej Black or African American Q Vietnamese
0 High school graduate or GED completed ba No,not Spanish/Hispanic/Latino �American Indian or Alaska Native F] Other Asian
IM Some college credit,but nO degree Ej Yes,Mexican,Mexican American,Chicano E3 Asian Indian Native Hawaiian
0 Associate degree(e.g.AA,AS) Yes,Puerto Rican E]Chinese 0 Guamanian or ChamorrO
0 Bachelor's degree(e.g.BA,AB,BS) �Yas,Cuban EJ Filipino Q Samoan
Ej Master's degree(e.g.MA,MS,MEng,MEd,MSW,MBA) Q Yes,other Spanish/Hispanic/Latino EJ Japanese C3 Other Pacific Islander
E3 Doctorate(e.g.PhD,EdD)or Professional degree (Specify) E3 Other(Specify)
(e. MD DpS,DVM,LLB JD
21.Decedent's Single Race Self-pesign anon-Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a.Decedent's Usual Occupation-Indicate type of work
White Q Japanese Samoan done during most of working life. DO NOT USE RETIRED.
Black or African American Korean 0 Other Pacific Islander C l e r l a a 1 S upp O r t
C3 American Indian or Alaska Native tj Vietnamese Q Don't Know/Not Sure S r
W Q Asian In [:3 Other Asian 0 Refused 22b.Kind of Bus]ness/Indust
Chinese Ej Native Hawaiian � Other(Specify) Commonwealth O f PA
a E3 Filipino O Guamanian or Chamorro _ HUM a n R(--l a t i o n s
ITEMS 23.-23d MUST BE COMPLETED 23a.Date Pronounced Dead(MO/Day/Yr) 23 b.51 nature of Person Pronouncing Death(Only when applicable) 23c.License Number
BY PERSON WHO PRONOUNCES OR
CERTIFIES DEATH a (�j Q-� I-^
q
23d.Data Signe (M Day/Yr) 24.Time of peat
d 3 -CjU ✓`^ 25.Was Medical Examiner or Coroner Contacted? El Yes No
CAUSE OF DEATH Approximate
26.Part 1. Enter the chain of....ts--diseases,injuries,o mpllcations--that directly caused the death. DO NOT enter terminal a ents such a cardiac arrest
In
respiratory arrest,or ventr cular fibril lanon ithout showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional line,If necessary Onset to Death
wM
IMMEDIATE CAUSE ---------------> a. /•I�i, CyM� / YOGI �ifC✓M d� ��4!1�1 _
(Final disease o ndition Due to(IV s a consequence of):
resulting in death)
b.
Sequentially list conditions, Due to(or as a consequence of):
if any,leading to the cause
listed on C
I=a. Enter the
UNDERLYING AUSE Due to(or as a consequence of):
(disease or injury that
Finitiated the events resulting d.
In death)LAST. Due to(or as a consequence of):
,j 26.Part II. Enter other s'gnif'ca nt conditions contributing to death but not resulting in the underlying cause glven In Part I 27.Was an autopsy performed?
° O Yes Q
� 28.Were autopsy findings available
to complete the cause of death?
p Yes O No
w 29.If Female: 30.Did Tobacco Use Contribute to Death? 31.Manner of Death
--- 0 0 0 Not pregnant within past year E3 Yes E3 Probably 1;1- turaI ED Homicide
� Pregnant at time I'death 0 No Ejj l known C3 ACCident E3 Pending In vestlgatiOn
m 3 Not pregnant,but pregnant within 42 days Of death M Suicide E3 Could not be determined
12 E3 Not pregnant,but pregnant 43 days to 1 year before death 32.Date of Injury(Mq/Day/Yr)(Spell Month)
0 Unknown if pregnant within the past year 33.Time of Injury
34.Place of Injury(e.g.home;construction site;farm;s h.-I) 3S.Location of Injury(Street and Number,City,State,Zip Code)
36.Injury at Work 137-If Transportation Injury,Specify: 3B.Describe How Injury Occurred:
0 Yes E3 Driver/Operator O Pedestrian
Ej No 0 Passenger C1 Other(Specify)
39a.Certifier(Check only one):
Cgrttifying physician-To the best of my knowledge,death occurred due to the ca use(s)and manner stated a manner ncing 8.Certifying physician-To the be of my knowledge,death occurred at the time,date,and place,and due to the c se(s)and m stated
0 Medical Examiner/COron he sl nation,and/or Investigation,),my opinion,d t/�,L QA urred at the time,date,and place,and due to the\ ee(ss))ann�d m n r stated
Signature of certifier: Title of certifier: eaI •,�s7! g� Lice a Number:( <VL�p 9a�et L-
39b.N e,Address ntl Zip Code o£ o Com pie0 ng Cause of Death(Item 2 n F*t-c.Date Signed(MO/Day/Vr)
r J. � d 7 r' 2oJ
40.Registrar's District N mber 41.Re is Signature 2.R gistrar File Date(MO Day/Yr)
o2,/� v- - 2o13
43.Amendments 11 411
O
H10
Disposition Permit No. [ REV 07/207/20
11
11065-1-5/Will/HDR/tmc 4/8/11 2:37 PM
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LAST WILL AND TESTAMENT r-
Gr:
OF
JOEL LINCOLN HOOVER
1, JOEL LINCOLN HOOVER, presently of Cumberland County, Pennsylvania, declare,
this to be my Last Will and Testament hereby revoking all Wills and Codicils previously made
by me.
MARITAL STATUS
I declare that I am a single man.
CHILDREN
I have two (2) children, now living, whose names and dates of birth are as follows:
JENELLE LEANN HOOVER BUTT born March 2, 1984
JEFFREY LYNN HOOVER born May 21, 1986
All references in this Will to my children include only the children named above.
PERSONAL PROPERTY
ARTICLE I
I direct that all of my household furnishings and tangible personal property be sold and
the proceeds added to my residuary estate.
If, however, I leave a memorandum setting forth directions as to the distribution of
certain items, I direct that my Executor take into account any such directions and make every
effort to distribute such property in kind consistent therewith.
RESIDUE
ARTICLE II
I give the rest, residue and remainder of my estate to my brother, GREGORY LYNN
HOOVER, presently of Newville, Pennsylvania. Should my brother, GREGORY LYNN
HOOVER, fail to survive me, then I give the rest, residue and remainder of my estate to my
mother, SHIRLEY LOUISE STITT HOOVER, presently of Newville, Pennsylvania. Should
my mother, SHIRLEY LOUISE STITT HOOVER, fail to survive me, then I give the rest,
residue and remainder of my estate to my sister, CHRISTINE LOUISE HOOVER
GUTSHALL, presently of Newville, Pennsylvania.
EXECUTOR
ARTICLE III
A. Appointment. I appoint my brother, GREGORY LYNN HOOVER, as
the Executor of this Will. In the event of the death, resignation, renunciation or inability
to act of GREGORY LYNN HOOVER in that capacity, then I appoint my mother,
SHIRLEY LOUISE STITT HOOVER, as the Executrix of this Will in his place and
stead. If my mother, SHIRLEY LOUISE STITT HOOVER, is unable or unwilling to
Page 2 of 8 Pages
act in that capacity, then I appoint my sister, CHRISTINE LOUISE HOOVER
GUTSHALL, as the Executrix of this Will.
B. Bond. No bond or other security shall be required of any Executor or
Executrix appointed in this Will.
C. Compensation. The Executor or Executrix shall receive reasonable
compensation for his or her services performed as determined by the Court in which this
Will is admitted to probate.
EXECUTOR POWERS
ARTICLE IV
I give my Executor in addition to and not in limitation of the powers given by law or by
other provisions of this Will, the following powers with respect to settlement of my estate, to be
exercised from time to time in the discretion of my Executor without further order or license of the
Register of Wills or of any court:
A. Investments. To retain any property, pending distribution hereunder, to
invest in or purchase any property without restriction to legal investments for fiduciaries, to
compromise claims, and to sell any property at public or private sale;
B. Securities. To hold shares of stock or other securities in nominee
registration form, including that of a clearing corporation or depository, or in book entry
form or unregistered or in such other form as will pass by delivery;
Page 3 of 8 Pages
C. Litigation. To engage in litigation and compromise, arbitrate or abandon
claims;
D. Distributions. To make distributions in cash or in kind at current values, or
partly in each, allocating specific assets to particular distributees on a non-pro rata basis, and
for such purposes to make reasonable determinations of current values;
E. Tax Returns. To make elections, decisions, concessions and settlements in
connection with all income, estate, inheritance, gift or other tax returns and the payment of
such taxes, without obligation to adjust the distributive share of income or principal of any
person affected thereby;
F. Loans. To pay off any loans I may have taken against any life insurance
policies owned by me that remain unpaid at the time of my death;
G. Borrowing and Encumbering. To borrow money from any person
including any fiduciary acting hereunder, and to mortgage or pledge any real or personal
property;
H. Property Management. To manage, control, repair and improve all real
and personal property;
I. Insurance. To procure and carry at the expense of the estate, insurance of
the kinds, forms and amounts deemed advisable by the Executor to protect the estate and the
Executor against any hazard;
I Employment of Attorneys, Advisors and Other Agents. To employ any
attorney, investment adviser, accountant, broker, tax specialist or any other agent deemed
Page 4 of 8 Pages
necessary in the discretion of the Executor; and to pay from the estate reasonable
compensation for all services performed by any of them;
K. Business Operation. To conduct alone or with others any business in which
I am engaged or in which I have an interest at my death, with all the powers of any owner
with respect thereto, including the power to delegate discretionary duties to others, to invest
other property held hereunder in such business and to organize a partnership or corporation
to carry on such business;
L. General. To do all the acts, to take all the proceedings, and to exercise all
the rights, powers and privileges which an absolute owner of the property would have,
subject always to the discharge of his fiduciary obligations. The enumeration of certain
powers in this Will shall not limit the general or implied powers of the Executor. The
Executor shall have all additional powers that may now or hereafter be conferred on the
Executor by law or that may be necessary to enable the Executor to administer the
provisions of this Will, subject to any limitations specified in this Will.
NO ALIENATION
ARTICLE V
No interest of any beneficiary under this Will or any codicil hereto shall be subject to
anticipation or voluntary or involuntary alienation.
Page 5 of 8 Pages
NO CONTEST
ARTICLE VI
If any beneficiary or remainderman under this Will in any manner, directly or indirectly,
contests or attacks this Will or any of its provisions, any share or interest in my estate given to
that contesting beneficiary or remainderman under this Will is revoked and shall be disposed of
in the same manner provided herein as if that contesting beneficiary or remainderman had
predeceased me without issue.
LEGALITY OF ARTICLES
ARTICLE VII
If any provision of this Will or of any codicil thereto is held to be inoperative, invalid or
illegal, it is my intention that all of the remaining provisions thereof shall continue to be fully
operative and effective so far as it is possible and reasonable.
TAXES
ARTICLE VIII
All estate, inheritance and succession taxes, together with any interest and penalties
thereon, payable as a result of my death and imposed with respect to any property, whether or
not disposed of by this Will, shall be paid out of the residue of my estate.
Page 6 of 8 Pages
IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my
Last Will and Testament, consisting of eight(8)typewritten pages, including this attestation
clause, to be executed, declared and published this—� day of ,
2011, at River Chase Office Center, 4431 North Front Street, Harrisburg, Pennsylvania.
�(SEAL)
O INCO OVER
Signed, sealed, published and declared by the above named JOEL LINCOLN
HOOVER, Testator, as and for his Last Will, in the presence of us and each of us, who, at his
request and in his presence and in the presence of each other, have hereunto subscribed our
names as witnesses thereto the day and year last above written.
—1 Residing at
� 2f�tsf3�r2c� . frT k-7 I I o
%tfy Residing at o'�3�3 oAn� s�r'a--
*- rr't s )'W3
kL Residing at 19NG (Y'V(`M]
Page 7 of 8 Pages
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN
We, JOEL LINCOLN HOOVER, the Testator,
iir d�
and , the witnesses, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as his Last Will; that
the Testator signed willingly and executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of the Testator signed the Will
as a witness and that to the best of his or her knowledge the Testator was at that time eighteen
(18 of age or old r, of sound and under no constraint or undue influence.
rn. � t (.
J N ER Witness
Witness i ness
Subscribed, sworn to and acknowledged before m=— - OOVER, the
Testator, and subscribed and sworn to before me b -
1 I
and fit,., —Lf , witnesses, this
day of , 2, 11.
: C
Notary Pdhlic
My Commission Expires:
DMMCJNW�ki.TM t�C'h�MW
NOTAR E'AL
Gwynne C. P in;' c Public
Susquehanna 7w�., r;,.;;;;n County
Page 8 of 8 Pages Mr COMMISSION LX.21;E,uLY 25,2013
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RENUNCIATION `� t1J —
A � �; ;='M1
i
cn 7C ewe
REGISTER OF WILLS ° C-) -73 -1
L Um % J COUNTY, PENNSYLVANIAD
ol
—0 C'.) cn —C
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M
Estate of ,1^® E L. �- v E A,- , Deceased
I,
6,P\ f 6 /\/ A/ ff D el V /� , in my capacity/relationship as
(Print Name)
Q d T ff i E-- k9 of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
C �1 1`5'T /*/,/ L L o (J-T S C T S tv 9 l
(Date) (Signal e)
C16 / & R ���SPR
(Street Address)
1C/ ,C- kj U T L L P R 1712
(City,State,Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me this day party executing this renunciation and certified
of that he or she executed the renunciation for the
purposes stated within on this day
of 4,P
A--0--- c e
Deputy for Register of Wills 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.)
Form RW-06 rev.10.13.06 *04,0 `Q"
My CamrnAS O*4%=5
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C$
Cp
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:0 r-
RENUNCIATION r—
<n
REGISTER OF WILLS
CUMil& Z,,, ✓P COUNTY, PENNSYLVA"i�19-
Estate of --7.9 e-- Deceased
1, S // T k- 4 a &/ 1S in my capacity/relationship as
(Print Nanze)
T if of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
C 8 /Z t-5,7- T--: 0 1/ 5 Z-- -5 �K -9
12 P
(Date) (Signature)
V6 / 6 R /94 17-7 Ad 19 'q
(Street Address)
/\/ E kj E711 /01 /7oz z/
(City,State,Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me this day party executing this renunciation and certified
of that he or she executed the renunciation for the
purposes stated within on this A a day
of O / 3
Deputy for Register of Wills Notary Public
My Commission Expires:
(Signature and Seal of Notary or Wao"iAmisi
administer oaths. Show date of pirat ion of non.)
Vft J Rft,NOY PW*
NW lk CWftftW Cough
Form RIV-06 rev. 10.13.06 My Commom ExpM 4140015