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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHANS' COUR,T DIVISION
In Re:
� ESTATE OF
ALAN T. NEUSBAUM, deceased, . Docket No. 2014-00303
Late of Hampden Township, ,
Cumberland County, Pennsylvania .
� DISCLAIMER
The undersigned, Nancy E. Neusbaum, intending to be legally bound, hereby
waives and discla.ims all of her right, title and interest as a bene�ciary under The
Revocable Trust of Alan T. Neusbaum dated May 14, 2003.
This Disclaimer is made pursuant to, and is subject to the conditions set forth
in Chapter 62, Section 6201 et seq. of the Pennsylvania Probate, Estates and
Fiduciaries Code, 20 Pa. C.S.A. §6201.
Dated: / p��`�' (SEAL)
Nancy E. eusbaum
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COMMpNWEAI,TH OF PENNSYLVANIA. ;
COUNTY OF � : SS.
C�t�P6��n
NANCY E. NEUSBAUM, being duly sworn according to law, deposes and says
that she is the disclaimant in the foregoing Disclaimer and that the informa '
tion _
contained therein is true and correct to the best of her information, knowledge and
belief.
� EAL)
NANCY E EUSBAUM
Sworn to and subscribed
before me this ��� day
of ,JL1��� � , 2014.
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Notary Public
My Commission Expires: �j�Z�+��5
(SEAL) �
NOTARIAL SEAL
JESSICA R PORTER
HARRISBURG CITy Public
My Commission ExpDes Jun 2902015
714753v1 '