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HomeMy WebLinkAbout09-08-05 IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DNISION INRE: ESTATE OF WILLIAM N. NICHOLS, DECEASED NO. 21-05-0125 DISCLAIMER The undersigned, Georgia Nichols, being the surviving spouse of William N. Nichols, intending to be legally bound, makes the following disclaimer: Disclaimant hereby disclaims her Y, survivorship interest which she may have in the following parcels of real estate: PropertY Dauphin County Parcel Number Appraised Value 12/11/04 Appraised Value One- Half Interest 100 North 2nd Street Harrisburg, P A 04-032-004 $240,000.00 $120,000.00 This Disclaimer is irrevocable and unqualified. IN WITNESS WHEREOF, the undersigned has set her hand and seal this day of ~ ~fu- ,2005. r&~ ( Pcrl Wltnes Gw~',;v/cL-~ ~ Georgia Ni Is ,-, . ) :IC-- ':'-'-1 , rA:; '~ &13: ....., = <;:..;) ..:;,.rt U) j"'1'l -0 I OJ :TJ r,-'l C) _ C~ ::r:J C:J ")-1 C::::'J -u C) ~, - :n : C) ,.--m ._-,-).:~ ..OJ f~~ ~ ~ CXl COMMONWEALTH OF PENNSYLVANIA COUNTY OF On this, th~t...nay of ~2005, before me, a Notary Public, the undersigned officer, personally appeared Georgia Nichols, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed same for the purposes therein contained. SS IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. ~~ Notary Pu hc My Commission Expires: (SEAL) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL CYNTHIA J. RULE, Notary Public Camp Hi>> Boro., Cumberland County . My Commission Expires February 3, 2008