HomeMy WebLinkAbout07-31-13 �
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 b ant of LetteFS in the appropriate form:
Decedent's Information �I J �;�, ��
Name: Anna M Trump File No:
a/k/a: Anna M Nieves (Assigned by Register)
�a: Anna M Gramm
a/k/a: Social Security No: 162-54-0049
Date of Death: 10/31/2012 Age at death: 51
Decedent was domiciled at death in Cumberland County,pennsvivania (stare)with his/her last
principal residence at 62 �-IoQtQwi Rd Q�I�ng�D nvc 17D�7 �mherland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 503 N.21st St�reet Camn Hill, 17011 Cumberland
Street address,Post Office and Zip Code City,Township or Borough County State
Esrimate of value of decedenPs property at death:
If domiciled in Pennsylvania............................ All personal property $ 900.00
IJnot domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domicited in Pennsyh�nin. ....................... Personal property ir.County $ 5p�ppp_p�
Value of real estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE. ... $ 50.900.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,ijnecessary.) Street address,Post Office and Zip Code City,Township or Borough County
�.�� �
� A. Petition for Probate and Grant of Letters Testamentarv n �; � rr�
Peritioner(s)aver(s)he/she/they is/are the Executor(s)named in the(ast Will of the Decedent,dated� � � ,,M-�, �nd Codicil(s)
thereto dated � ���_�
State relevant circumstances(�g.renunciation,death of executor �'°' W �'1 `�
A � m � � �
Cf>
Except as follows:after the execution ofthe instrument(s)offered for probate Decedent did not marry,vr�s not dr"�orced�as no�p�+to a pending
divorce pmceeding wherein the grounds for di�rorce had been establis�ed as defined in 23 Pa.C.S. 3:�3(�and not h�ve-etchild bom or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an ineapacitated pers � ;:� �j
►--• a-_ rn
O NO EXCEPTIONS o EXCEPTIONS " � i""'
�. fV '�
❑ B. Petition for Grant of Letters of Administration (If applicabie) °�
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate
If Administration,c.t.a. or db.n.c.ta.,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 estabtished as defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
�NO EXCEPTIONS �EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relations6i Address
Angel R.Nieves Jr. Son 201 Maple Ave Apt. 1-i Marysville,Pa 17053
Michael J.Nieves Sr. Son 101 Andrew Court Carlisle,Pa 17015
Lisa M.Bevan Daughter 409 N.Walnut St.Mechanicsburg,Pa 17055
Kenneth W Nieves Son 36 Mill St.Lot 2 Mount Holly Springs Pa 17065
Form RW-02 r�.loi»no» Page 1 of 2
Oath of Personal Representative Officia]Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
CO�TNTY OF �'UMBERLAND f '
Peritioner(s)Printed Name Petitioner(s)Printed Address
Kenneth W Nieves 36 Mill St Lot 2 Mount Holl S rin s Pa 17065
The Petitioner(s)above-named swear(sj or affirm(s)the statements in the foregoing Perition aze true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the Decedent,the Petirioner(s) d truly administer the estate according to law.
Sworn to or ffirmed and subscribed before ,� � � ��r�� Date �✓_ 3�/.2o I 3
�
me ay of ,� Date
By: � � 1.I'�,' Date
For the Register Date
BOND Required: o YES � To the Register of Wills:
FEES: Please enter my appearance by my signature be�w:
Letters. . .. . .. . . . . .. . . .. . .. .. $ ��>•��' Attorney Signature: C W � �
O
� � C..._ tS� �
( /L� ) Short Certificate(s).. .. . . ,(,�� � � � �� �
( '17 )Renunciation(s).. . .. . .. . �5•L� � � � � �-� �
( )Codicil(s). . . . . .. . . .. . . %� �*, �'� I'41
I""' GJ Y
( )�ffidavit(s).. . .. . .... .. y> U� -�3 �
� a;,
Bond... ..... .. . . .. .. . . .. . . . . Printed Name: _ � ' � --t; �-r; -'�"rt_
Commission. . .. .. . . .. . . .. . .. . Supreme Court �� �.,� � ,�� •w--
C"� :. �„�
Other . .. . . . ID Number: ,;-.� �"= �, " - t,�
i,T b� � 1 . .. . . . [S•c,U ,; '� ,.._. c.�
� . .. . . . I.'�•U�J Firm Name: '�'� � � 'T1
�� ;�
� . .. ... .. , ' � Address:
--- -------___ _... . .. . . Phone:
Automation Fee. . . . . .. . . .. . .. . �'"-„� Fax:
JCS Fee. . . . .. .. . .. . . . . . ... .. ., Email:
TOTAL. . . .. . . .. . . . . .. . . . .. . $ .
DECREE OF THE REGISTER
Estate of Anna M Trumn File No: �� "�� —� !�
a/k/a:
� i �
AND NOW, �t ,�,in consideration of the foregoing Petition,
satisfactory proof having bee re nted be re me,IT IS DECRE�D that Le ers �Q��(1 f�'1C I'1�L4`l,f
are hereby granted to ��111'1 e�� Vti. (�,j Q V P�
in the above esta�e and(if applicable)fhat
the instrument(s)dated (`X'��'}�.y� I 2, �� �
described in the Petition be admitted t�and filed of record as the last Will(and Codicil(s))of Decedent.
, �
�i � ) i �
Register of Wills ��' � `�� ,
Form RW-02 rev.I D/ll/2011 age 2 of 2
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H105.$�5 RLV(4111) �
LOCAL REGlSTRAR'S CERTIFIGATION OF DEATH
WARNING: It is illegal tq duplicate this capy by pho#ostat or photagraph.
������`� ������ �� This is to certify that the iriformation here given is
Fee for this certificate, $5.{� ��,,,",.,,,. ,,,
�{��J��`�� �� �#��� n�¢�,jH OF PF�;'-__ canectly copied from an original Certificate af Death
,��'��,�r y`r.� duly filed with me as Loca] Registrar. The original
%�i j� �(j�, �� ��'t� � =- 9' certificate will be forwarded to the State Vital
�� a' ' az Recards Office for permanent filing.
P 18 8� 3 2 � 0 �L���{ �� ������ . EQ'1�'����r, �7�5��,'F��s.'t���'�m.
�,�dr�C" �ap �/zat2
0 R P�i A N 5 C�U f�T `�AIMf N1,flF„�����,
��,
Certification Number ���,,�$������ ��`i �� "" Local Registrar Date Issued
Type/Print In COMMONWEA4TH QF P6NNSYLVANIA�DEPARTMENT OF HEALTH�VITAL RECORI75
r��ma�en: CERTEFIlCA7E C}F �EATH
Btack��k State File Number:
1.Decede�t's l.egal Name(First,Middlc�last,Suffix) 2.Sez 3.Soclal SeCUrity Number 4.Oate of Death(MO/Oay/Yr)(Spol Mo)
Anna M. Trum F_ "I 62-54-0049 Oc obc. 3"1 2 'I
9a.Age-Last Birthtlwy(Yrs) Sd.Undar 1 Year Sc Under 1 Oa 6.Osie o1 Birth(MO/�ay/Year)(Spell Mo�th) ]a.Olrth lace(City aeid State or Foretgn Cauntry)
� . ( rv�a�cns oev� Hours Minutes PYi�Lla_ PA.
5 h �Sr-g� D�C� 2� l 9 6 O �b.Blrthpiaca(COU�ty)
Ba.Resldence{Stais or Foraygn Co4niryj 8b.Resic4er�te(Street artd Numbcr-irtciuda Apt No.} $ Qid DacBdenT LNe in a Tpwnshtp7 .
p Ei 2'7 HOC?t OW 1 RG3. �ves,aeceden�Iwed�n M rl O
aa.n�s�aeR�e�ca�,�cv> Bo i 13 n s i n PA
m 8e.Residence(2IP Code) �Na,decedent itved within limits of city/boro.
9.EvBr in US Armed Forces7 10.Marlial 5tatux ai Time of�cath �Married Widowed 11.S�rvlving Spo�xe's Namc(if wffe,gtve name pribr ta flfst Marriagej
Q Yes �No �ilnknown [�Oivorced �Never Mar�iad �Unknow
12.FatheY's Name{FIrsY,Middle,Lmsi,SufFlx) 13.Mother's Neme Prior io First Marriage(Flrsi,Mlddl�,Last)
Donald E_ Gramm Florenc� C� Allen
14a.Informant'S Name 146.RelaNqnship ta Oacedenk 14c.InformanY'a Malling Atltlress(SCreet and Number,City,StaCe�21p CodeJ
� � � IC n e h � 'eve n e� o� �.3.... �..---... Lat --- °- t....H 11.... ...�J.. .:.s .�
. 1,a, ice p Deat C
........."'".....""".Y,.......""...."""....."'"........,�y! ...........................""'"....'"".... ..........."""..,......."""",.......�:.�.�.. ... .......
w p - �Ho5�Ica Facfii••••. •� •• •• •• ••• •• •••
'�. If Deeth Qccur mtl in a Hosp{Tal: CM teipeLlenc � -�t 6�aLh Occurred Same here Other Than a Hes ttai� {S ty ��Dec�der�YS Hame
� �f EmeYgenC RpqmJOUtpatletrt Osad on Arrivat �j Nursing Wome/tong-Term Ca�e FBCll�ty Other(5 ecify)
� 156.Facility Nama(If not Instltution,giVe street and number; 15c City or Town,State,and Zip Gode SStl.County of Peat � .
� Iil H Z I1C1
� � 16a.Met od o1 D spositlon 0 Burial j�] Gremation 386.Date of Disposition 16c.Place of Dlspos(tion(Name Pf cemetery,crematory,or ptheY placiC}
� 0 Ramava!{rom Stake �LtonaHOn
otr,e.cs e�� � I3ov_ 2 20'I Hallin �:r FH r�mator
Z 16tl.location of Disposition(Cicy or Towri,State,and Zip) 11a.5{ ture o?Funera!Servtae ltc<nsee oh in Ch rge o4 intarment 27b.ltcanse Number
� Mt. Ho11y Springs,PA 17065 _ FD-011932-L
17c.flame and Comptete Address af Funeral Facitlty � ct 1Pt201'E VE�
;� Mt Ho1.1 � rin � PA 'I 7065
+� 18.DecedmnYS EducaHOn-Check C e ox th�t bes descrlbeS ihe 19. dcni o Htspanlc Orfg{n-Check tfie 20.D�aedenYs Rece-CheCk OIJE OR MORE raCas to indicate wfiat
hfghest[i�egrae or Ievei aP s<haoi comptexed at tfie tFme af deaiti. box that best dascrlbes wheTher the deCed4nt the decedmt constderad himseif or her5eif to be.
� $in grade or Imss �s Spanish/HlspaniC/LaHno. Check iha"fJO" White [J Korean __
� dipioma,%h-12th grade box ff dec<dent ts nat SpanishJHispaniC/taTtno. Blatk ar African Rmarlcan [�Viekriam�s�
High Schoqi gYaduate oY GED CoMpietetl O,not Spanish/Hispanic/Latino Q Ame�ican Indlan oY AlaSka NBtive 0 OYher Aslan
p 5ome college credit,buC no dagreR []Yes,Mexican.M�xtcan AmericYn,Chlcanp �Asian Indlan � Native Hawaliart �
�AssocFate degrec{e.g.AA,AS} j,;�Yes,Pverta Rican �Ghinese 0 G�amanlan or Chamorro
� Bachelor'S degraa(��6�gA,AB,BS) C]Y�s,Cuban �FIIlpino 0 Samoan
� Master's deg�ec{e.g.MA,M5,MEng,MEd,MSW,MBA} [�Ycs,ather SpanishfHlspanic(l2�ttno Q Japanese [� Otfie�PaciFlC is7a�tdef
� DoctoraM(e.g.PhD,EdD)or Profcssianai dCgrae (Specify) �Other(Speclfy)
.MO Op5 bVM ILB,JD
21.Decedent's S3ngla Raee Seli-Designation-Check ONLY CiNE to i�dfcate what the decmdant conside�sd filmseif a�harse�i Lo be. 22a.becadent'a Usuai Octupation-inditate type of work
�+I'�/hite [�lapane5e []Samaan � done during most oP working Ilfe. DO NOT USE RETfRED.
�Black or AfN<an AmaACan [,�Korean Q Other Paciflc tsi8indeY
� QAmericanfndianoYAiaskaNaHve [�Vletnamese OQ'on'tKnow/NatS�re D�S$�b�-@C�
d Asian Indlan C]Oxher Asian Q fiefus�md 226.K(r�tl af BuslrteSS{industry
� �Chirfese �j Native Hawaftan Q 4thar(Spetify}
O Filip�no p c,�ar.�an�a.+orchmmorro � Unemployed�/Disabi.li�ty
i EMS 23a-23d MUST B COMPlETEO 28a.D�te Pra�ouriced Deatl{MO Oay Y 23b.Stgnmture of Pa�son Prar�ourtcing Deat (Oniy whsn appiica e) 23c.Llcense Nurnbei
BY PE/i50N WfiO PRONOUNGES QR �^f�, �f �.+ �
CERTIFIES DEATH OG� �r �+""1 f+ y�,�Q„L A_ . h�.G'2�'Z t l.�
23d.Date Signed{MOJDayJYrj 24.Tima af Oeath ����''� �`�'�N r"'F�J�.3 J�OUI
t Z�Q ��.� Q 25.Was Metlical xOminCr oY C er ConTactedT Q Ves No
CAUSE OF LIEATIi f ppproKimate
z6.Part 1. Enter the chain of events--tllseases,InJurles,or compllcatlons--that direc2ly caused the death. DO NOT e�nter terminal events such as cardiac arrest, ; Ir+terval:
respiraLOiy arrest,oi ventricuta�fl6Milation wiYtfOUY shawing ttfe�tiology. DO M4T A69REYIATE. Enter o�tiy o�t�caUSe Ot�a IiYte.Add atldit{onaF Itnts tf neCesSary � Q+tSet tq DeHth
/ga`Yl iuLc
IMMEDIATE CAUSE ------------> a. �
{��nat disease or Conditbrr Pu�ta(ar as a mnsaqv�mnca ofl:
.esu,ans in deainl �'/!�Ox�/t - �
6.
SequenXlaily iist eond{kions� / " Ou to iar as a coeisoqusnca ofj: �
H any,Ieatling to khe cause �c�-yy/1-j��h,
Ilsted on Iine a. Enter th� c. ! �
VNOERlY1NG CllVSE r D fo(dY as 0 ConSequCnce M}:
,�y (dl5eas�G or injurylhat y� �y(C!(, .�,�����, �
s SniYlatetl Lhe @YGrtiS raSWTSn$ c!. �
� in d�ath)tAST. Due to(or as a consequence o�: �
�° 26.Part ti. £n2er qther�g,iti t nd"ti t ib U t d th but not rbsWttY�g In the u/�dertying cause g7ven In Part i 2l.Was an autopsy perFarmed?
g �„L GO t-f"V1..G L.+e Q H"O.tr.f . ..rl�b�`f i ge^��:.41�t £t-t_�i J�.:�[ ` f+G!�t(t.F as.ws.�•toa:v��ai�a:�.nebie
'��- ���,'� fo compYes�he causc Mfadeath7
� 29.if Femal�: 30.oFd 7obattv Us Gantrtbute to peatFi 31.Manner of Reath
Q Nat pregnant wlthin past year [] `�es � Prdbably � Natural � NortYicide
Q Pregnant at iime of daath (� No [� Unknown �Accidcnt � PendErag InvastFgaTtqn
� � No�prmgnatit,but pregnank within 42 days of death Q SW cide [] Cou�d nat be dec�rmined
f.�. Q Not pregnant,bUt pragnant 43 tlays to 1 year befo�e de�th 32.DaKe of Inj�ry(M4/DayfYr)(Spell Month)
`) � V nknown ff pregnant wiihtn the Aast year 33.T(me of ir�)ury
6 34.Place of InJUY'y(e.g.hqme;con5truction site;farm;school) 35.Locafion of in)ury(Street.and Number,Clty.Stata,Z!p Cade) .
�
r�"" 36.In}ury at Work 37.If Trbnsportation In}ury,SpeGtfy: 3$.Descrtbe How 4njury Otcurred:
`. ` (� Yes d Driver/Operator � Pedestrian
Q NO 0 PasSeng�r Q Oth pacify)
39a.CErtiFl4r(Check only dne):
� Q Gertitying Rhy5lcian-To the bes f my kno led deatN occurreti due to th8 eause{s}and manner sTated
[�Pronoursdng 8a Ger'ttfying physi ian o t esi 4f my knowletlge,deatM1 occurred st the Hme,date,antl pi8ce,and duc to thd caus6�s)and manner sTated
� Medical Examiner/COror�er-C5 th 1 s exaMinakion,�d/�vestfgatlon,In my opinion,dew�h o/t,Xy�Ur�nd at the Nme,dat¢,antl p1aCe,and tlue to the GGaj 1er(S��d maltneY stak'8tl
� SFgnatuYe af ccrt(flar: �� TiUe of certifler: •'`Ji LiCense Number. • v �
396.Name�Address antl Zip Code t Person Completing Cause of Death{IXem 2 ) 3 .D�te Stgned(M /Day }
^ Lt iv1/}-r✓r� J ?+ �� i iC�ct'� tl�L-t� t�'7 J x- �a i O L•�.C. �'� 2� L
� 40.Regisirar'=bisttict Number 41.Reglstrar ature � 42.R(e�$\5straY FHB Oatm{MO Day �r)
��. ,4�`.� � ���
� 43.Amendments
�
�ISposition Permit No. �'1 '17��V„� N305-349
_ _ _ . _ , ," ,-_ ,. ..., _. . __
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ANNA MAY NIEVES c� � � � ` �
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I , ANNA MAY NIEVES, of the Township of Monroe, County of
Cumberland and Commonwealth of Pennsylvania, being of sound mind,
memory and understanding, do hereby publish and declare this to
be my Last Will and Testament, hereby revoking and declaring null
and void any and all Wills and Codicils heretofore written by me. �
ITEM I. I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be convenient to
the proper administration of my estate.
ITEM II. I give, devise and bequeath my entire estate
remaining after payment of debts and expenses unto my father,
Donald E. Gramm, Sr, and to my mother, Florence Catherine Gramm,
or the survivor of them.
ITEM III. In the event my father and mother predeceases me,
I order and direct that the rest, residue and remainder of my
estate be divided among my children living at the time of my
death.
ITEM IV. I nominate, constitute and appoint my father,
Donald E. Gramm, Sr. Executor of this my Last Will and Testament.
Should he predecease me or be unable or unwilling to serve, I
then nominate, constitute and appoint my mother, Florence
Catherine, Executrix in his place and stead.
I direct that my Executor/Executrix shall not be required to
post bond other than their personal assurance for their duties as
Executor/Executrix.
IN WITNESS WHEREOF, I , Anna Mag Nieves, have hereunto
� �1
subscribed my hand to this my Last Will and Testament, this ��
day of October, 1994 . ,
rY� - � ��
:=�'._�����Y�� t�
Anna May Nieves
SIGNED, PUBLISHED and DECLARED by the above-named Anna May
Nieves, as and for her Last Will and Testament in the presence of
us, who at her request and in her presence and in the presence of
each other, have signed our names as attesting witnesses hereto.
�� i
�-� C?��-.� residing at v � �Ill�
,
; � � �� �� ^ residing at '��.�. � /`�` / ���
• RE�O;��� ���"(C� �F
['5}_�,�� _� �� '- '�s E
i...VIV S .w{� i. lio:..�
RENUNCIATION `,;�;j� �v,; �1 F� 1 �9
REGISTER OF WILLS C�.���C G�;��
CUMBERLAND COUNTY, PENNSYLV �r ��S' C��,��;T
Ctlt���RL;���� ^�., F�;
Estate of ANNA M. TRUMP , Deceased
I, /`�I't9E l ��p� !V�dd�s v� • , in my capacity/relationship as
(Print Name)
SO+'1 of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
KENNETH WAYNE NIEVES
l/ �/�o? � '
(Date) (Signatare)
�a� .�,o� �v� �,�-P��
(Street Address)
��i^ S v��� � /�O.S'"3
�crry,sr e,zrp�
Executed in Register's Office Executed out of Register's Office
Sworn to ar 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 renunciat' for the
purp es stated within on this day
f ,
Deputy for Register of Wills yary Public p r` � �Il �, n C�
M Commissi n Ex ires. �i ��
(Signature and Seal of Notary or other official alified to
administer oaths. Show date of expiraUOn of Notary's Commission.)
COIVA40NWEALTH OF PENNSYLVAMA
Form RW-06 rev.10.13.06 j�jQ'j'�pj,$FAT,
Manci M.Kennedy,Notary Public
Monaghan Twp,York County
My commission ex ires Au ust 21 2015
�;�C��E�'-�� ���'�CL OF
���'.:��:s� 0� ��<'f!LS
RENL7NCIATION ,_, ,,;
._��:3 �u�_ 31 Pf� 1 29
REGISTER OF WILLS C?4;�ti �;
CUMBERLAND COUNTY, PENNSt��,�"rA���' �v�,`h i
GL�':�Er�a..,�;=-.'^ Cv., FA
Estate of ANNA M. TRUMP , Deceased
I, ^,�/'/��' �/� �i'l//�'G%°�' .>,� , in my capacity/relationship as
(Print Name)
, �Qy' of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
KENNETH WAYNE NIEVES
�/ / / — /V � r /� y '�
�DQ12� S1gYJQh[YC�
��� �/'�'�:+,,,1 ��ti✓`�
(Street Address)
�
����� � ��� ���l �
(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 renu c' t�g�► for the
pu tate within on this 1�� day
of , �
r
a
Deputy for Register of Wills ot ry Public � n I, ���
My Commissio Expir • L
(Signature and Seal of Notary or oth offici ualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVAMA
NO'TARIAL SF.Ai"
Form RW-06 rev.10.13.06 Mazci M.Kennedy,Notary Public
Monaghan Twp,York County
My cotamission ex�ires August 21,2015
.. __ . . ... :... .„. .:,.. . . .. . . .. ..,.: ..... 1 ,... . . . . ....... .. _... ... ..
i��V V:�iJ`si�U ����+S��n� O�
�svC�c,-�.;� Cl� .. ;'_...!_S
RENUNCIATION
:'��i:; �ti�_ 31 Fi�1 1 29
REGISTER OF WILLS ����� �E
CUMBERLAND COUNTY, PEN1���,�IJ�N��;,Y=;J�.�'
CUF��E��.�i�'� ��., r�
Estate of ANNA M. TRUMP Deceased
I, �.-�i5� (1� � �U-�VG�.r'� , in my capacity/relationship as
(Print Name)
�CI.�A��-�Pf of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
KENNETH WAYNE NIEVES
I� - I�1 -�o�a ��� ��.�
�Dare� �;gna�ure�
�—�0�'( fJ V�cl,��v..�c S\
(Street Address)
�C.G��- �c. � l0�1�
(ciry,srate,zip)
Fxecuted 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 renun iaf��j o.�n for the
pu o s state within on this r r►"1 day
of � , �01 a
,���
Deputy for Register of Wills o ry Public /
My Commissi n Expi �� �� �1�
(Signature and Seal of Notary or oth r officiaYqualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
Mazci M.ICennedy,Notary Public
Form RW-06 rev.10.13.06 Monaghan Twp,York County
M commission expires August 21,2015
f�ECG����". P°"��"� �F
€�E�(S � r;� vr � _�
OATH OF SUBSCRIBING WITN��S��,�S� �} n
S �
Eti�i t� 't_ ` i� 1 LiJ
REGISTER OF WILLS C L�i�� C�=
CUMBERLAND COUNTY, PENNSYL�I�'�ir S' i��i=�i
CUt�S��L�,r�� 'j�:�., �;`�
Estate of �a M. Trump a.k.a Anna M.Nieves , Deceased
Joyce Stuckey , (each) a subsEribing witness to
(Print Name/s)
the�Will ❑Codicil(s)presented herewith, (each) being duly qualified according to law, depose(s) and
say(s)that she/�t� was/�re� present and saw the above T�estater-/Testatrix sign the same
and that she/-�C/they signed the same and that she/�� signed as a wimess at the request of
the �"/Testatrix in her/�* presence and in the presence of each other.
(s' aru e) (signarare)
'v
152 Robson Road
(Street Address) (Street Address)
Dillsburg,Pa 17019
(Ciry,State,Zip) (Ciry,State,Zip)
Executed in Register's Office Executed out of Register's Office
Swarn ta or affirmed and subscribed Swarn to or affirmed and subscribed
before me this day b ore me this�;�� day
of , of ,�.
1
Deputy for Register of Wills ry Public
My Commissi n Ex e 2����,j
(Signature and Seal o Notary or othe ia qualified to
administer oaths. Show date of ex 'ation otary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrume� SYLVAMA
NOTARtAL SFAi•
Form RW-03 rev./0.13.06 Marci M.ICennedy,Notary Public
Monaghan Twp,York County
My commission ex ires August 21,2015
��€�U���i..r' rf�Ya� i JI�. ��
C1'�- ,,_
���"��""��-�� , ��%�
���� s
. ,��; 31 ' � 29
;'�;��
JU�_ Fi'�
OATH OF NON-SUBSCRIBI�TG WIT�1���,���
0 R��i��Ea S' ��v���-;'i
REGISTEROFWILLS c(}��3CRL��'�+� ����� ��
�v.vcc�-�l4.,�.� COUNTY, PE��tNSYLVANIA
Estate of f���� l�'(` �/��� ,Deceased
��Cl�t-�A .i.��v�n �� and ,
(each)being duly qualified according to law, depose(s) and say(s)that she/he/they was/were well-
acquainted with ��,•`c` �_ �(v��U and am/are familiar
with the handwriting and signature of the decedent, and that the signature of ���c� ��, 1�il��P
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of -�-1�r-,�.cti 'I�. T�v-=�v..l�
is in his/her own proper handwriting.
� �� ` „
( ignature) � (Signnture)
�Q� ��Yti'� l `
(Street Address) (Stree�Address)
( G2 r/la�� �/i, ( �(,� � j
(City,State,Zip (City,Srate,Zip)
Executed in Register's Office
Sworn to or affirmed and s�bsc;ribed
before t 's M 1� .day
,�•
eputy fo egi f ills
Form RW-04 ,��v.rn.i3.nh
_ _ � , .: , , �,-� .�_..,� _
,�,W.,�.�..�.. ,� .��. �, � �.�� , .
After receiving my mother's Last Will and Testament from Jane M. Alexander(Attorney at Law), I was
told I would be unable to receive a"Statement of Subscribing Witness" from Eva Brandnbaugh who was
one of the witnesses signed on my mother's Last Will and Testament, because she past away
approximately 3 years ago.
�
� o��d��
Kenneth Wayne Nieves
� 36 Mill St Lot 2
Mount Holly Springs Pa 17065
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