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Family 8 Creditor Agreement-Waiving Filing of Account
This Agreement is by and between Donald P. Osborne of 9 East Linder„
Drive, Carlisle; .Pennsylvania 17013; in his capacity as Administrator p~ ant tom
Small Estate Petition of the Last Will and Testament dated April 12, 1 f Mari
Elizabeth Osborne, a/k/a Mary E. Osborne, Deceased, ~ ~ '~
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and ~~~ ,,.
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Donald P. Osborne of 9 East Linden Drive, Carlisle, Pennsylv~era'1701~
the residuary and only legatee of the estate of Mary Elizabeth Osborne, a/k/a
Mary E. Osborne, Deceased pursuant to paragraph Second of the said Last Wilr
and Testament. "` ""
And
Commonwealth of Pennsylvania, Department of Public Welfare,
Estate Recovery Program, of P.O. Box 8486, Harrisburg, Pennsylvania 17105-
8486.
For purposes of this agreement, when Donald P. Osborne is referred to in
his fiduciary capacity, the term, "Administrator" will be used and, when he is
referred to in his individual capacity, he will be referred to as "legatee" or
"beneficiary."
BACKGROUND
1. Mary Elizabeth Osborne, a/k/a Mary E. Osborne ("Decedent') died
on November 30, 2009, a resident of South Middleton Township (1 Longsdorf
Way), CumbSerland County, Pennsylvania, leaving a Will dated April 12, 1993.
2. Donald P. Osborne was empowered to settle the estate of Mary
Elizabeth Osborne, a/k/a Mary E. Osborne pursuant to a Petition for Distribution
of Small Estate (pursuant to 20 Pa. C.S.A. §3102) that he filed on January 7,
2010 to Cumberland County number 21-10-00011. A Decree was entered by the
Court on January 8, 2010.
3. In her Will, Decedent made no specific bequests and in paragraph
SECOND named Donald P. Osborne as the sole residuary legatee. A copy of
the Will is attached as Exhibit "B" to the aforementioned Petition for Distribution
of Small Estate.
4. The Administrator has not advertised the entry of the Decree
pursuant to the Petition for Distribution of Small Estate. The Administrator has
filed a Pennsylvania Inheritance Tax Return. Federal and state income tax
returns, if required, will be filed and the appropriate taxes thereon paid.
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Family & Creditor Agreement -Estate of Mary Elizabeth Osborne Page 1 of 5
5. The Administrator has paid all .the taxes, Attorney's fees,
Administrator/Executor's fees, debts and expenses of the estate known to him, to
the extent that funds are available, and pursuant to the said Petition for
Distribution of Small Estate. The Administrator has no knowledge of any unpaid
claims, absolute or contingent, which may be asserted against the estate nor
does he have any reason to believe that there are any such claims, except for
the unpaid balance due the Commonwealth of Pennsylvania, Department of
Public Welfare, Estate Recovery Program, the total amount of which is
$222,267.19. A copy of the cover letter for the Estate Recovery Program Claim
is attached hereto as Exhibit "A."
6. The Administrator has liquidated the assets of the Decedent.
7. An account of the principal and income received by the
Administrator, his disbursements, and a Schedule of Distribution, is attached
hereto as Exhibit "B." The funds available for the Estate Recovery Program are
$300.11. The net value of the estate available for distribution to the beneficiary
of the estate is $0.00.
8. All parties hereto desire that this Family & Creditor Agreement
make unnecessary the filing an accounting in the Orphans' Court Division of the
Court of Common Pleas of Cumberland County.
NOW THEREFORE, intending to be legally bound, the parties do hereby:
1. Waive the filing of an account of the administration of the estate in
any court, at the discretion of the Administrator.
2. Declare that the undersigned have examined the Account and
Proposed Schedule of Distribution which are attached hereto as Exhibits "B" and
find them to be true and correct in all particulars; accept and approve them with
the same force and effect as if they had been prepared and filed with, audited,
adjudicated and confirmed absolutely by a court of competent. jurisdiction; and as
if the balance of principal and income had been awarded by the Court in
accordance with the Proposed Schedule of Distribution.
3. Warrant that the beneficiary named in the Proposed Schedule of
Distribution, and the Pennsylvania Department of Public Welfare, Estate
Recovery Program, are the sole remaining parties in interest in the estate and
that the Pennsylvania Department of Public Welfare, Estate Recovery Program is
entitled to receive a distribution of the remaining funds in the estate as shown on
Exhibit "B" attached hereto, to wit: $301.11.
4. Warrant that the undersigned know of no outstanding and
unsatisfied claims against the estate, except for the Pennsylvania Department of
Public Welfare, Estate Recovery Program.
Family & CreditorAgreement-Estate of Mary Elizabeth Osborne Page 2 of 5
5. Approve the distribution of the balance of principal and income
shown in the Account and Proposed Schedule of Distribution which are attached
hereto as Exhibit "B" to the persons or parties set forth therein.
6. Absolutely and irrevocably release and discharge the Administrator,
and his heir8, personal representatives, successors and assigns of and from any
and all actions, liabilities, claims and demands relating in any way to his
administration of the estate and distribution in accordance with the Account and
Proposed Schedule of Distribution which are attached hereto as Exhibit "B" and
without a caurt accounting and adjudication.
7. Agree to refund to the Administrator any amount of the payment or
distribution which exceeds the amount to which the undersigned are entitled as
may hereafter be determined in accordance with law.
8. Agree to indemnify and hold harmless, the Administrator, and his
heirs, personal representatives, successors and assigns, from and against any
claims, liabilities, loss or expense (including costs and counsel fees) arising from
any cause whatsoever, which the Administrator may incur as a result of the
administration of the estate and its distribution in accordance with this agreement
including, but not limited to, any liability for any federal estate taxes,
Pennsylvania Inheritance tax or any other death taxes, and any federal or
Pennsylvania income taxes, and Pennsylvania personal property taxes, together
with any interest and costs incidental thereto, relating in any way to the estate
and also including, but not limited to, any assets received or payments or
distributions made by reason of any negligence or mistake of law or fact.
9. Agree that this Agreement shall be binding and effective as against
each party upon execution (signing) by that party and the Administrator.
that:
10. Agree that notwithstanding any other provision of this Agreement
.This Receipt .and Release constitutes a release of the
claim of the Pennsylvania Department of Public Welfare only to
the extent of those assets of the decedent as set forth in the
accounting attached hereto, and shall not constitute a release
of any claim of said Department in and to any other assets
presently in the hands of the Administrator, in the hands of any
other person, or which may be hereafter discovered.
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IN WITNESS WHEREOF, and with intent to be le ally bound hereby, the
parties hereto have set their hands and seals this day of March,
2010.
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Witness: ~ / ~ ~ (Seal)
~ Donald P. Osbome, Administrator
Witness: Sea!)
Donald P. Osbor e, residuary legatee
Witness: ~• (Seal)
C on Ith of Pennsylvania
D rtm f Public Welfare
Estate Recovery Program
Commonwealth of Pennsylvania
}ss.
County of Cumberland
On this, the ~~ day of March, 2010, before me, the
undersigned officer, personally appeared Donald P. Osborne, known to me (or
satisfactorily proven) to be the Administrator or residuary legatee whose name is
subscribed fo the within instrument, and acknowledged that he executed the
same for the purposes therein contained.
IN WITNESS WHEREOF, 1 hereunto set my hand. and official seal.
`- (SEAL)
NarMUti s~
RO~ERf G. ~Rl14 NCMRY PU~LK
~aiagn d Cate uwear~d Cwil~r M
My to~.~itfla+ f~pYes ho+. 4, 2010
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Commonwealth of Pennsylvania
}ss.
County of Dauphin ~ I
On this, the ~ (o day of Meth, 2010, before me, the
undersigned officer, personally appeared ~~~lV ~ ~~c3- ~. ~ ~ ~-n ,
known to me (or satisfactorily proven) to be the C t ,L}
whose name is subscribed to the within instrument, and acknowledged that
he/she is the G~ IA- of the Commonwealth of
Pennsylvaniia, Department of Public Welfare, Estate Recovery Program and that
he/she executed the same for the purposes therein contained.
IN IMITNESS WHEREOF, 1 hereunto set my hand and official seal.
~ G~C~C'LU" ~ ~ (SEAL)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
NICOLE L. LIPSCOMB, Notary Public
City of Harrisburg, Dauphin County
My Commission Expires July 29, 2010
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