HomeMy WebLinkAbout05-19-10~~ - ~3s
Thi re,MCeipt, r 1@~ nd ' demnity agreement (hereinafter called the "RELEASE") is
given this ~ day o II,~C~~C-'1~ ~ 2009, by:
Carlisle Digestive Disease
(hereinafter Iled the "CLAIMANT") to and in favor of KEYSTONE
GUARDIANSHIP S)~~VICES, (ADMINISTRATOR) of the CYNTIIIA N. STAGER
ESTATF, (hereinafter shed "ADMINISTRATOR'.
For the purpos bf inducing the ADMINISTRATOR to make the distribution described
herein, and intending t~ ~ legally bound, the Claimant hereby represents, warrants, convenants
and agrees as follows. I;
1. Acknowledgment o iXteceipt -The Claimant acknowledges that he will receive of and from
the Fiduciary the dllowing securities upon returning this Receipt & Release document
properly signed, wi ~ssed and notarized to the department.
- In the form of a check in the amount of $73.8
2. Release - AND T BEFORE, the Claimant hereby does by these presents remise, release,
quit-claim, and fore r discharge the said Administrator, their heirs, successors and assigns of
and from the said yments to me and of and from all actions, suits, payments, accounts,
reckonings, claims d demands whatsoever, for or by reason thereof, or of any other act,
matter, cause or thi g whatsoever.
3. Indemnity Agreeme ~ -The Administrator has indicated a willingness to make a distribution.
without the adjudic t on by the Court. _Accordingly, the Claimant agrees to indemnify the
Administrator and ~d them harmless, to the extent of any funds or assets received by the
Claimant from the c~ministrator hereunder, from and against the Claimant's pro rata share of
any and all liabili (including attorney's fees and other costs or expenses of defense) to
which the Adminis ~or may be subjected by reason of its administration of the account. In
connection with this greement, the Claima~t.agrees to:
a) Refund or retu ,promptly upon the Administrator written demand, any funds or assets
distributed by a Administrator to the Claimant, if the distribution thereof is determined
at any time to h ~e been an erroneous or negligent distribution to the Claimant, whether
such error or n #igence was or was claimed to have been premised upon a mistake of 'i
law or of fact. o ',
n
', ~ o =',?
:
"~
Page 1 of 2 Pages ~~ rn ~
"< _
n,
< ,-U '
~T ~
- t~~
-`
~o ~
~ --~ rn
aa'.:J
Z -
-p -I ~ _
r ~ rn
a ~ ~ ~ ~,
N ~
4.
b) Modify and di p ace any otherwise applicable period limiting the time within which the
Administrator tion to collect an erroneous or negligent distribution must be
commenced, s to provide that the Administrator need not commence an action to
collect an erro ous or negligent distribution to the Claimant until two (2) years after
such time as Administrator shall have obtained actual knowledge of such error or
negligence.
it
Miscellaneous - ~~ construction, effect, validity and performance of this Release shall be
governed in all res its by the laws of the Commonwealth of Pennsylvania.
The provisions of this Release shall be deemed severable in the event that one or more
P ereof shall b P ~e~med invalid or unenforceable, with the effect that the remaining
rovisions shall e s st as if such invalid or unenforceable provision had never been a part
hereof.
This Release shall ind the Claimant his heirs, representatives, successors, and assigns
together with any c i dren with respect to whom the Claimant is a natural guardian.
IN WITNESS W OF, the Claimant has executed and sealed this Release on the date
first above inscribe~nd the presence of at least two (2) witnesses.
BY•
li a Digestive Dise
l
Authorized Representative of Claimant
WITNESSES:
.~. ,
(WITNESS ONE)
i
Page 2 of 2 Pages