HomeMy WebLinkAbout03-12-15 (3) IN THE COURT OF COMMON PLIAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
In Re:
ESTATE OF JOHN D. WEARY Estate No. 21-15-0051
Late of Silver Spring Township,
Cumberland County, Pennsylvania; deceased
DISCLAIMER
1, 'Thomas J. Yeager; hereby declare that 1 am the nephew of John D. Weary,who died on
December 31. 2014 (the"Date of Death").
1 hereby irrevocably and completely disclaim and refuse to accept any and all rights, title
and interests that I may have to receive pursuant to Clause FIRST of the Last Will and Testament
of.lohn D. Weary. with respect to which I am a designated :beneficiary, all relating to any and all
interests given to me in the cabin. being Lease No. 1C 252 Waterrace Lane. Gardners.
Pennsylvania 17 324 (Tax Parcel No. 07412699252001 C252). The foregoing rights, title.and
interests shall collectively herein be referred to as the "Disclaimed Interests".
I hereby state and certify that I have not accepted any benefits or interest with respect to
the Disclaimed Interests on or following the Date of Death.
This document is intended to qualify as a disclaimer under Section 2518 of the Internal
Revenue Code of 1954,as amended, and under Chapter 62 of the Pennsylvania Probate, Estates
and Fiduciaries Code.
Dated this �-3 day of re b n146 ,2015.
Witness:
(SEAL)
THOMAS J. YEAGER
n rn
C— r c>
W
ACKNOWLEDGMENT
STATE OF COLORADO
SS
cowry OFGf
On this 23 day of 6 "Qr , 2015, before me, the
undersigned officer, a.Notary Public in and for he said county and state, personally appeared
Thomas J. Yeager, who, being duly sNvorn according to law, deposes and says that the facts set.
forth in the foregoing Disclaimer are true and correct to the best of her knowledge, information,
and belief and that she executed the same as her voluntary act and deed for the purposes therein
contained.
"Notary Public
AVCNDUA Y CULt,tt�S
NOTARY,PUBLIC
STATE OF COLORADO
MYCOMM
COMMISSION EXPIRES�041����8
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
In Re.
ESTATE 017 JOHN D. WEARY Estate No, 21-15-0051
Late of Silver Spring ToNvnship,
Cumberland County,Pennsylvania, deceased
RECEIPT OF DISCLAIMER
E. Pauline Weary, being duly sworn according to law.,deposes and says that she is the
EXCCLItfiX under the Last Will and 'I'estament of John D. Weary,dated September 25, 2012,and
that on the date and place as hereinafter set forth, she received the foregoing signed Disclairner
from 'I'lionias J. Yeager.
ESTATE OF 101-IN D. Wl---,'ARY,.
Deceased
WAle
Pauline Weary, Executfl-y—
Date: — 3/3)/,T Place: C)nj 6f omm/��
I
Yd
SWORN TO AND SUBSCRIBED before me this 3 day of MA-rC�
2015.
Notary Public
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
BETH B.LENGEL,NOTARY PUBLIC
SHIREMANSTOWN BORD,CUMBERLAND COUNTY'
My COMMISSION EXPIRES DECEMBER 12,2015