To the Executor of the Will of Joseph B. Dunn, Deceased:
I hereby claim the family exemption of $3,500 payable to me under 20 Pa. C.S.A. § 3121, and I request that this amount be paid to me in cash immediately.
I am the surviving spouse of Joseph B. Dunn and I resided with him at the time of his death.
Signed on ____________________, 20_____ ____________________
Jane R. Dunn
Always check for latest amendment to 20 Pa. C.S.A. § 3121, because the amount of the family exemption is periodically revised.