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IN RE: THE ESTATE OF
MARIE H. GOUDY, LATE OF
NORTH MIDDLETON TOWNSHIP
CUMBERLAND COUN'T'Y
PENNSYLVANIA
CLERK 0
. THE COURT OF
CUMBERLAND CO ~ ]~~~~L,VANIA
ORPHANS' COURT DIVISII,OI~1
N0.21-10-00598
RECEIPT, RELEASE, REFUNDING AND INDEMNITY AGREEM~IT'
CONCERNING DISTRIBUTION FROM ESTATE
THIS AGREEMENT, based upon the family circumstances outlined, is ent~rekl into with the
Executor by each beneficiary, from the date of formalization of her/her separate Consents
1. MARIE H. GOUDY died Testate on May 23, 2010.
2. Decedent's Will, dated July 19, 2005 provided for various bequests, and ~ieslignated Richard
E. Goudy as Executor.
3. Said Will was accepted by the Register of Wills of Cumberland County fbr probate on June
10, 2010, and steps necessary to complete the administration were yinc~ertaken by the
Executor.
4. The beneficiaries desire that the distribution of the assets of the Estate b~ nj~ade without the
formality of an Accounting in the Orphans' Court Division of the C~nl~erland County,
Pennsylvania Court of Common Pleas, and the Executor is willing to make'' this distribution
upon the execution of this Agreement
5. The beneficiaries desire to forever settle and compromise any and all clai$nsjand rights which
they may possess, now or hereafter, in the Estate and to confirm thei I~ acceptance of the
distribution in satisfaction of the bequest contained in the decederbt's'' Fast Will and
Testament
6. The beneficiaries wish to release the Executor and to indemnify him against 2u~y and all claims
that may be asserted against the Estate with the Executor after the date l~er$of.
7. The Executor is willing to make a distribution of informal settlement Ilof the Estate in
consideration of the indemnification and agreements hereinafter providedby~lthe beneficiaries.
NOW, THEREFORE, in consideration of the foregoing and intending to be le~al~y bound hereby,
jointly and severally, the beneficiaries do, for themselves, their heirs, personal representathve'~, successors and
assigns, agree as follows:
T I
A. Represent and warrant that they have read and they understand this Agre~m~nt and confirm
that the facts set forth above are true and correct, to the best of their kno a e, information
and belief.
B. Declare that they have sufficient information to make an informed waived o~ their right to a
formal accounting with the Court, and do hereby waive the filing and aud~tir~g of said formal
accounting.
C. Acknowledge that the distributive share shall be in satisfaction of their resp~ec~ive entitlements
under the Will. II,
D. Release, remise, quitclaim and forever discharge the Executor, h~s I~eirs, personal
representatives, successors and assigns, from and against all claims tha ey, as residuary
beneficiaries of the Estate, had, now have, or may in the future have in c~O ection with the
Estate.
E. Agree to refund, on demand, all or any part of their proportionate share f any aforesaid
distribution, which has been determined by the Executor, or by the Cout~, o~by any court of
competent jurisdiction, to have been improperly made. ',
F. Agree to indemnify and hold harmless the Executor, his heirs, perso~al~ representatives,
successors and assigns, from and against any and all claims, loss, liability ~r ~amage (whether
or not related to the negligence of the Executor that may hereafter be $ss rted against the
Estate or against the Executor.
G. Agree to execute such additional documents as maybe necessary to effect~-at{e the agreements
set forth herein.
H. Acknowledge that this Agreement shall be governed by and construed in ~cc~ordance with the
laws of the Commonwealth of Pennsylvania.
I. Cohsent to the Court exercising personal jurisdiction over them in any sluitl or action arising
out of the enforcement of this Agreement.
IN VVl'TNESS WHEREOF, the beneficiaries have set their hands and seals to the Consents attached
hereto, to be effective as of the date first above written. ''
CONSENT TO RECEIPT, RELEASE
REFUNDING AND INDEMNITY AGREEMENT
ONCERNING DISTRIBUTION FROM ESTATE ''
The undersigned, DONALD R, GOUDY, a beneficiary of the Last Will and Tesltar~ent of MARIE
H. GOUDY, Deceased, hereby consents to the Receipt, Release, Refunding and Ind$minity Agreement
Concerning Distribution From Estate, a copy of which has been provided to him. Th~ dersigned also
';
acknowledges receipt of his share of the Estate, as more particularly described in the afdre .aid Agreement,
subject to all the terms and conditions specified therein. n /~ /'
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COUNTY OF ~~ II1 5~~~~,______ ;
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On this, the _ ~~1'____ day of ~ Y _, 2010, before me, a;Ndtary Public, the
undersigned officer, personally appeared DONALD R. GOUDY, known to me to be the eon whose name
is subscribed to the within instrument, and acknowledged that he executed the same for ~hepurpose therein
contained.
IN WITNESS IiER~C?F, I have hereunto set my hand and Notarial Seal,
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CONSENT TO RECEIPT, RELEASE
REFUNDING AND INDEMNITY AGREEMENT
CONCERNING DISTRIBUTION FROM ESTATE ''
The undersigned, LISA GOUDY PEIRANO, a beneficiary of the Last Will band Testament of
MARIE H. GOUDY, Deceased, hereby consents to the Receipt, Release, Refunding land Indemnity
Agreement Concerning Distribution From Estate, a copy of which has been provided to he~1. ~ undersigned
also acknowledges receipt of her share of the Estate, as more particularly described in the af~re~aid Agreement,
subject to all the terms and conditions specified therein.
STATE OF FLORIDA
COUNTY OF /~/G~
On this, the ~~__ day of _,~lT/ ~ , 2010, before me, a', Notary Public, the
undersigned officer, personally appeared LISA GOUDY PEIRANO, known to me to bje t~e person whose
name is subscribed to the within instrument, and acknowledged that she executed the sa~ne~ for the purpose
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therein contained. !, '~
IN WITNESS THEREOF, I have hereunto set my hand and Notarial Seal. ~-
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CONSENT TO RECEIPT, RELEASE i
REFUNDING AND INDEMNITY AGREEMENT
CONCERNING DISTRIBUTION FROM ESTATE
The undersigned, PAMELA GOUDY ROMAN, a beneficiary of the Last Will aid Testament of
MARIE H. GOUDY, Deceased, hereby consents to the Receipt, Release, Refunduhg 'and Indemnity
Agreement Concerning Distribution From Estate, a copy of which has been provided to herf. '7~'he undersigned
also acknowledges receipt of her share of the Estate, as more particularly described in the af~re$ad Agreement,
subject to all the terms and conditions specified therein. ._,`
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PAMELA GOUDY RO
STATE OF FLORIDA
l _ SS.
COUNTY OF \ Cpl
On this, the _ ~ ~ day of , 2010, before me, a, Notary Public, the
undersigned officer, personally appeared PAMELA GOUDY ROMAN, known to me to be dhe person whose
name is subscribed to the within instrument, and acknowledged that she executed the sakne~ for the purpose
therein contained. ! j
IN VVI'i'NESS WHEREOF, I have hereunto se~my hand and Notarial Seal.
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~ TAM~IYM.,IOFNrgpH ~~~
~., My copN ~ ~ NOTARY PUB C
5a~sa ~
ExPIRES: Septe~iber 26, 2010 '~
CONSENT TO RECEIPT, RELEASE
REFUNDING AND INDEMNTII' AGREEMENT
CONCERNING DISTRIBUTION FROM ESTATE
The undersigned, RICHARD E. GOUDY, a beneficiary of the Last Will and Te~tament of MARIE
H. GOUDY, Deceased, hereby consents to the Receipt, Release, Refunding and Ind~mnity Agreement
Concerning Distribution From Estate, a copy of which has been provided to him. Th~ Wndersi~ned also
acknowledges receipt of his share of the Estate, as more pazticulazly described in the afc~re~aid Agreement,
subject to all the terms and conditions specified therein.
RICHARD E. GOUDY
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF ~~'
On this, the Z ~ day of , 2010, before me, ai Nbtary Public, the
undersigned officer, personally appeared RIC E. GOUDY, known to me to be the ~e>Fson whose name
is subscribed to the within instrument, and acknowledged that he executed the same for ~d purpose therein
contained.
IN WTTNE.SS WHE1t~OF, I have hereunto set rryy-lf"and and Notari~'S~al/~
N
Notarial Seal ~
Janet S. core, notary Public
pYlsbug Boro, York CourAY
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