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I
est\mls\GOODALLKdlsclaimer
IN RE: ESTATE OF KATHRYN L.
GOODALL, LATE OF UPPER
ALLEN TOWNSHIP, CUMBERLAND
COUNTY, PENNSYLVANIA,
DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-05-0262
DISCLAIMER UNDER 20 PA C.S.A. ~6201
I, KATHRYN C. BLACKBURN, Administratrix, C.T.A. of the Estate of
Nancy H. Goodall, one of the beneficiaries of KATHRYN L. GOODALL, late
of Upper Allen Township, Cumberland County, Pennsylvania, hereby
exercise the rights granted to Nancy H. Goodall in Chapter 62 of the
Probate, Estates and Fiduciaries Code, 20 PA C.S.A. ~6201-6107, and I,
as Administratrix, C.T.A. of the estate, hereby disclaim and renounce
any and all of the right, title and interest which Nancy H. Goodall
may have in the said estate as a beneficiary under the Last Will and
Testament of KATHRYN L. GOODALL.
IN WITNESS WHEREOF and intending to be legally bound hereby, and
intending that this disclaimer and renunciation shall be filed of
record in the Office of the Clerk of the Orphans' Court Division of
the Court of Common Pleas of Cumberland County, Pennsylvania, as
provided in 20 PA C.S.A. ~6204(a), I have hereunto set my hand and
"'~":I
( 0 'M da y 0 f
~~
, 2005.
sea'l: this
. (SEAL)
Kathr 'n C. Blackburn,
Administratrix C.T.A. of the
Estate of Nancy H. Goodall
~
eFA
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COMMONWEALTH OF PENNSYLVANIA:
SS:
COUNTY OF CUMBERLAND
On this, the
10 #.
day of
~
, 2005, before me
the undersigned officer, a Notary Public, personally appeared Kathryn
C. Blackburn, Administratrix, C.T.A. of the Estate of Nancy H.
Goodall, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal
the day and year first above written.
~'m~
Notary publi
COMMONWEALTH OF N
NOTARIAL SEAL
I TINA M. BURKEY, Notary Public
I New Cumberland Boro, Cumberland Co.
: My Commission Expires April 15, 2009
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