Disclaimer in Accordance with 20 Pa. C.S.A. 6201




Jane R. Dunn died on March 29, 2001, without a Will, survived by her four children, James, John, William, and Mary Dunn. Her probate estate consists of real estate known as 54321 First Avenue, Philadelphia, Pennsylvania, valued at $25,000, and other assets valued at $10,000.
Her probate estate is subject to the payment of funeral expenses, administration expenses, debts and taxes totaling approximately $5,000, leaving a net distributable estate of $30,000.
Letters of Administration were granted by the Register of Wills of Philadelphia County on April 15, 2001 to William Dunn.
The intestate laws of the Commonwealth of Pennsylvania provide that where a person dies without a Will and leaves no surviving spouse, the surviving children shall be entitled to share the estate equally.
  James and John Dunn are married, have no issue and have made homes of their own. William and Mary Dunn are unmarried and were members of Decedent's household at the time of her death.
  James and John Dunn desire to disclaim their intestate interests in their mother's estate.

Therefore, intending to be legally bound hereby, we, the undersigned children of Jane R. Dunn, Deceased, do hereby disclaim the interest in the estate of Jane R. Dunn, Deceased, to which each of us is entitled under the intestate laws of the Commonwealth of Pennsylvania.

We have hereunto set our hands and seals this _____ day of _____________, 20 ____.
James Dunn
      John Dunn
On this ______ day of _________________, 20____ , before me, the undersigned, a Notary Public in and for the Commonwealth of Pennsylvania, personally appeared James and John Dunn, satisfactorily proven to me to be the persons described in the foregoing Disclaimer, who acknowledged that they executed the same for the purposes therein contained and that they desired it to be recorded as such.
Notary Public
Note: An Affidavit must be attached to permit recording of Disclaimer affecting real estate. 20 Pa. C.S.A. 6204 governs filing, delivery and recording of Disclaimer. Reference should also be made to 20 Pa. C.S.A. 2204 (regarding Disclaimers resulting from spousal elections), 72 Pa. C.S.A. 1716(c) (regarding inheritance tax consequences of Disclaimer and time period), and Internal Revenue Code 2518 (regarding gift tax consequences of Disclaimer and time period.)

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