HomeMy WebLinkAbout05-19-10 (9)~~~ ~~~
Thi receipt, r 1 ase, and indemnity agreement (hereinafter called the "RELEASE") is
given this~9 day o 2009, by:
Holy Spirit Hospital
(hereinafter lied the "CLAIMANT") to and in favor of KEYSTONE
GUARDIANSHII' S VICES, (ADMINISTRATOR) of the CYNTHIA N. STAGER
ESTATE (hereinafter lied "ADMINISTRATOR").
For the purpos~ Of inducing the ADMINISTRATOR to make the distribution described
herein, and intending t ~e legally bound, the Claimant hereby represents, warrants, convenants
and agrees as follows:
1. Acknowledgment Receipt -The Claimant acknowledges that he will receive of and from
the Fiduciary the f llowing securities upon returning this Receipt & Release document
properly signed, wi essed and notarized to the department.
In the form of a check in the amount of $16,739.30
2. Release - AND T BEFORE, the Claimant hereby does by these presents remise, release,
quit-claim, and for er discharge the said Administrator, their heirs, successors and assigns of
and from the said p yments to me and of and from all actions, suits, payments, accounts,
reckonings, claims nd demands whatsoever, for or by reason thereof, or of any other act,
matter, cause or thi whatsoever.
3. Indemnity Agreem t -The Administrator has indicated a willingness to make a distribution ~,
without the adjudi tion by the Court. Accordingly, the Claimant agrees to indemnify 'the
Administrator and Id them harmless, to the extent of any funds or assets received by the
Claimant from the 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 i
which the Admini for may be subjected by reason of its administration of the account. In
connection with th' greement, the Claimant agrees to:
a) Refund or retu ,promptly upon the Administrator written demand, any funds or assets
distributed by h Administrator to the Claimant, if the distribution thereof is determined
at any time to ve been an erroneous or negligent distribution to the Claimant, whether ',
such error or a ligence was or was claimed to have been premised upon a mistake of
law or of fact.
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b) Modify and di~~lace any otherwise applicable period limiting the time within which the
Administrator ! ction to collect an erroneous or negligent distribution must be
commenced, sp ias to provide that the Administrator need not commence an action to
collect an erro ous or negligent distribution to the Claimant until two (2) yeazs after
such time as ~ Administrator shall have obtained actual knowledge of such error or
negligence.
4. Miscellaneous - construction, effect, validity and performance of this Release shall be
governed in all res cts by the laws of the Commonwealth of Pennsylvania.
The provisions o is Release shall be deemed severable in the event that one or more
thereof shall be erred invalid or unenforceable, with the effect that the remaining
provisions shall r ist as if such invalid or unenforceable provision had never been a part
hereof.
This Release sha 1 bind the Claimant his heirs, representatives, successors, and assigns
together with any )lildren with respect to whom the Claimant is a natural guardian.
IN WITNESS I REOF, the Claimant has executed and sealed this Release on the date
first above inscri and the presence of at least two (2) witnesses.
BY:
Holy Spirit Hospital
orized Represe ive of Claimant
(WITNESS