RENUNCIATION REGISTER OF WILLS Estate of (Name or Corporate Name) , Deceased The undersigned, _____________________________________________, in the capacity/relationship as _____________________________________ of the above Decedent, hereby renounces the right to administer the Estate of the Decedent and, to the extent permitted by law pursuant to 20 Pa.C.S. § 3155, respectfully requests that Letters be issued to ____________________________________________________. (Date) Name of Corporate Fiduciary (if applicable) __________________________________________ Signature of Officer/Representative _________________________________________ Title of Officer/Representative _________________________________________ Address _________________________________________ _________________________________________ Telephone _________________________________________ Email Executed in Register's Office Sworn to or affirmed and subscribed before me this _______________ day of ______________________, _______. ______________________________________________________ Signature of Person ____________________________________ Address ____________________________________ ____________________________________ Telephone ____________________________________ Email Executed out of Register's Office Before the undersigned personally appeared the party executing this Renunciation and certified that he or she executed the Renunciation for the day purposes stated within on this of , . Deputy for Register of Wills Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 eff. 09.01.16 American LegalNet, Inc. www.FormsWorkFlow.com