HomeMy WebLinkAbout08-30-06 (2)
WA YNE F. SHADE
Attorney at La"
53 West Porn Ire! Street
Carlisle, Pennsylvama
17013
t>
IN RE: ESTATE OF
M. EUGENE MILLER, JR.,
Deceased, Late of the
Township of North Middleton
Cumberland County, Pennsylvania
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-06-236
DISCLAIMER AND RENUNCIATION OF
BENEFICIAL INTERESTS PURSUANT TO
20 Pa.C.S. 96201, et seq.
I, STEPHANIE \1. COULSON, a daughter ofM. Eugene Miller, Jr.. late of North
Middleton Township, Cumberland County, Pennsylvania, Deceased, hereby state, as
follows:
1. My father died testate on December 14,2005. His Last Will and Testament
dated April 16, 1999, \\as duly probated with the Register of Wills of Cumberland
County, Pennsylvania, on March 16, 2006, and is recorded at 21-06-236.
2. Pursuant to 20 Pa.C.S. 96201, et seq., I hereby disclaim and renounce all
beneficial interest I am to receive in UnumProvident Group Life Insurance policy number
1072 in the face amount of $50,000 on the life of my father.
3. I have not accepted any interest in the property which I am disclaiming herein.
4. I have not received any consideration for making this Disclaimer and
Renunciation. ",-,
o C7,
SO a;
5. I intend this Disclaimer and Renunciation to be an irrevoJ~d ~ualified
.:::5-q G) .
refusal by me to accept any beneficial interests to which I am entitk(t.~4!~e p~pert;y.~~
(~-) '::) -11 ~
~)c= ~ F ,
disclaimed herein except as under the said Last Will and Testamen\~f-ky fatfrer.
Coo!"!
WAYNE F. SHADE
/\ttorney- at La\\
53 \-Vest Pomfret Street
CarlISle. P~nns\l\ania
17013
IN WITNESS \,-'HEREOF, and intending to be legally bound hereby, and
intending that this Disc laimer and Renunciation shall be filed of record in the Office of
the Clerk of the Orphans' Court of the Court of Common Pleas of Cumberland County,
___'JI!
Pennsylvania, I have hereunto set my hand this ;",/ > day of March, 2006.
/1/ ,i(,./? ,,/'.' / . ,(, '. .',
/,,,',.(,//1'.4'.l-l/"/ 1..,,[1(/< f)-'ll /
Steph~nie M. Couison -
COMMONWEALTH OF PENNSYLVANIA)
) SS:
COUNTY OF CUMBERLAND )
On this, the Jtt~ day of March, 2006, before me, the undersigned officer,
personally appeared STEPHANIE M. COULSON, 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 \,-'HEREOF, I hereunto set my hand and official seal.
{2;;/it~
"~~~~AL y ~!~t.!:.~h-,r~s Y LV ANift-.
NOT AR!AL SEAL. I
CONNIE: ,i TRITT Notary PUb;iC
C,'"" 60<0 ,C"me,,,oo' Cooot, -I
~om~i_~-S!On t:\'0(~~:Y~- Or;tr)ber ~- 200P I
~___ v.._....)
WA YNI' F. SHADE
Attornev at LaV\
S3 V/est POl11fret Strcl:t
Carlisle. Pcnnsyhania
17()1~
.......,
\/ .
IN RE: ESTATE OF
M. EUGENE MILLER. JR.,
Deceased, Late of the
Township of North Middleton
Cumberland County, Pennsylvania
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYL VANIA
: ORPHANS' COURT DIVISION
: NO. 21-06-236
DISCLAIMER AND RENUNCIATION OF
BENEFICIAL INTERESTS PURSUANT TO
20 Pa.C.S. S6201, et seq.
I, KATHRYN N. MILLER, surviving spouse ofM. Eugene Miller, Jr., late of
North Middleton Town;;hip, Cumberland County, Pennsylvania, Deceased, hereby state,
as follows:
1. My husband died testate on December 14,2005. His Last Will and Testament
dated April 16, 1999, ",as duly probated with the Register of Wills of Cumberland
County, Pennsylvania, on March 16, 2006, and is recorded at 21-06-236.
2. Pursuant to 20 Pa.C.S. 96201, et seq., I hereby disclaim and renounce all
beneficial interest I am to receive in the following:
( a) The interest of my husband in certain real estate premises, with
improvements thereon erected, known and numbered as 450 McClures Gap Road,
Carlisle, Pennsylvania;
(b) The interest of my husband in certain real estate premises, with
"'~'"
C) c,-,
improvements thereon erected, known and numbered as 542~a Cie~ Point -,
~J:f~ ~ '
Boulevard North, St. Petersburg, Florida; c~ 3( C)
C~:)
')0 'Tl
-..,-
,----'........-
::0
:-1'~) --f
..J>
\J
......
w
j"; ;
(.n
0',_'_"
WAYNE F. SHADE
Attorney at La"
.53 \\/~st Pomfret Street
Carlisle. Pennsylvania
1701"
(c) The interest of my husband in one hundred sixty (160) shares of the
common stock of Miller Insurance Associates, Inc.;
(d) My interest as beneficiary ofCNA Life Insurance policy number
AURE002803 in the face amount of $600,000 on the life of my husband; and
(e) My interest as beneficiary of UnumProvident Group Life Insurance
policy number 1072 in the face amount of $50,000 on the life of my husband.
3. I have not accepted any interest in the property which I am disclaiming herein.
4. I have not received any consideration for making this Disclaimer and
Renunciation.
5. I intend this Disclaimer and Renunciation to be an irrevocable and unqualified
refusal by me to accept any beneficial interests to which I am entitled in the property
disclaimed therein except as under the said Last Will and Testament of my husband.
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 of the Court of Common Pleas of Cumberland County.
Pennsylvania, I have hereunto set my hand this ~Od day of March, 2006.
& aJ),r n J1j;1iv<J
K thryn . MIller
W A YNF F. SHADE
Attorney' at L3\\
53 \\./CSl Pomrret Street
Carlisle, Pcnnsylv'ania
17013
COMMONWEAL TH OF PENNSYLVANIA)
) SS:
COUNTY OF CUMBERLAND )
On this, the rJ.~u.. day of March, 2006, before me, the undersigned otliceL
personally appeared KATHRYN N. MILLER, 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 hereunto set my hand and ot1icial seal.
NO~bI91~
vLAL
:+]!ary PUD~ic
:u"'jer'and CO"f1lY
C.\~~Qr':€r 2008