HomeMy WebLinkAbout07-09-07
ESTATE OF
ELLEN FRANTZ SHORB
Deceased
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-06-0978
INRE:
RECEIPT AND RELEASE
I, JUDITH S. HEMPT, the undersigned, being a beneficiary under the Estate of ELLEN
FRANTZ SHORB, deceased, do hereby:
1. State and acknowledge that I am an adult individual;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative of the Estate;
3. Acknowledge that I have received all sums of money and personal property to which I
am entitled as a beneficiary of the Estate of ELLEN FRANTZ SHORB;
4. To the extent of said distribution, release JUDITH S. HEMPT, Executrix of the Estate
of ELLEN FRANTZ SHORB, and her heirs and personal representatives, from all liabilities,
whether due to her negligence or otherwise, which she may have by reason of her administration
of the Estate;
5. Agree to refund to the Estate and to the said JUDITH S. HEMPT, Executrix, any
portion of the distribution to which I am not properly entitled, and, to the extent of said
distribution, to indemnify ~gn ~.~.F~t~riQ. claims made against her and to reimburse her
.r:diiVJ ~hNVHdOO~'
:jO >18318
and the Estate all expenses and costs Incurred in connection with any such claim; and
E~ :21 Wd 6- lOr LODl
~,
6. Declare that this instrument shall be legally binding upon me, my personal
representatives, and assigns.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this J r-~ day of
J~ ' ,2007,
c;;~s II~
J ITH S. HEMPT
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
On this, the ~ day 0 A fIll , 2007, before me, the
undersigned officer, personally app:~H S. HEMPT, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that (s )he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I ha e