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RECEIPT AND RELEASE
BLACK
AND
DAVISON
ATTORNEYS AT LAW
82 W. QUEEN STREET
CHAMBERSBURG, PA
17201
717.264.5194
FROM: Constance Lee Ericksen, of 2926 Constellation Drive,
Chambersburg, Pennsylvania 17202
TO: Constance Lee Ericksen, Executrix of the Last Will and
Testament of Janet Codv, ~ ate of West Pennsboro Township,
Cumberland County, Pennsylvania, deceased
WHEREAS, Janet Cody died testate on March 9, 2009, and Letters Testamentary were
duly issued by the Register of Wills of Cumberland County, Pennsylvania, to Constance Lee
Ericksen on March 26, 2009; and,
WHERF,AS, the First and Final Account of said Executrix, together with the Schedule
of Proposed Distribution, was filed in the Office of the Register of Wills of Cumberland
County, Pennsylvania, and confirmed by the Court of Common Pleas of the 9th Judicial
District, Pennsylvania, Cumberland County Branch, on June 22, 2010.
NOW, THEREFORE, I, Constance Lee Ericksen, do hereby acknowledge that I have
had and received of and from said Executrix of the Estate of Janet Cody, deceased, all items
~! and all sums distributable under the Schedule of Proposed Distribution to Beneficiaries in
the aforesaid First and Final Account filed in the Office of the Register of ~JVills for
', Cumberland County, Pennsylvania, as aforesaid.
AND, THEREFORE, I do, by these presents, remise, release, quitclaim and forever
~' discharge the said Constance Lee Ericksen, Executrix of the Estate of Jane? Cody, deceased,
of and from the legacy or legacies a:;cordi~tg to the laws of the Common~ti~ealth of
Pennsylvania and according to the Schedule of Proposed Distribution and of and from all
'~ actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by
'' reason thereof, or of any other act, matter, cause or thing whatsoever touching ups or
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concerning the same. c. _ £-~, ;~
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,/ IN WITNESS WHEREOF, I hereunto set my hand and seal the ~7 ___ day of
' ,,~.,..~,.~, , 2010.
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Witness:
Constance Lee Ericksen
STATI-~, OF ~ ~ - - --~ ------
COUNTY OF ~ Q~\- ~ 1 r^~
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On this, the `~ ~r day of __ ~~~ -- ____, 2010, before me, the undersigned officer,
ersonall a eared Constance Lee Ericksen, known to me, or satisfactorily proven) to be
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the person whose name is subscribed to the within instrument and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Title: '~C~~C~-C ___ _
M commission x Tres: ~ ~'r~f. ~ 11 __
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COMMONWEALTH OF FENN51'L'~l~,rvtA
NOTARIAL SEAL
DEBRA K. N~CRRGW, NOT,~~~;Y r=~.J3L!C
GIJiLP"ORD T1iVP., FRANK.LI~ COUtiTY
MY COMMISSION EXPIRES JUNE 7, 2011
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