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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA CLARK ~~
ORPHAN'S COURT DIVISION ~~~~~~~ ~, ~~"~ ~A
EMMA B. HENRY cl1P~~~r~?~ "' ~""~ ~'~
N0.20-10-00769
FAMILY SETTLEMENT AGREEMENT
Date of Death: June 27, 2010
Accounting Period June 27, 2010 to
May 31, 2011
Gross Estate $8,134.68
PRINCIPAL ACCOUNT
PNC Bank, decedent's checking account
AARP, refund
DISBURSEMENTS
Messiah Village, nursing home bill
Messiah Village, return AARP refund
Miller/Sekely Funeral Home
Weaver Memorials, Inc., headstone
Register of Wills, Letters Testamentary
Cumberland County Register of Wills, filing fee for inheritance tax return
Cumberland County Register of Wills, filing fee for account
Gingrich, Smith, Klingensmith & Dolan, attorney fee
PA Department of Revenue, inheritance tax
TOTAL PRINCIPAL BALANCE
TOTAL BALANCE FOR DISTRIBUTION
$7,922.68
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Total $8,134.68
$4,145.14
212.00
222.86
670.00
96.50
30.00
20.00
475.00
343.23
Total $1,919.95
$1,919.95
$1,919.95
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PROPOSED SCHEDULE OF DISTRIBUTION
TO: IRENE HEISEY -One-half (1/~) of the residue
X959.98
TO: GERALDINE SHUMAN -One-half (1/~) of the residue $959.97
IRENE HEISEY, Executrix of the Estate of Emma B. Henry, hereby declares under oath
(penalties of perjury) that she has fully and faithfully discharged the duties of her office; that the
foregoing First and Final Account is true and correct and fully discloses all significant transactions
occurring during the accounting period; that all claims against the estate have been paid in full; that,
to her knowledge, there are no claims now outstanding against the estate; and that all taxes due from
the estate have been paid.
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Irene Heisey
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF LANCASTER
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Subscribed and sworn to by Irene Heisey before me this ~ ay of ~' '~^`'`~' ; 2011.
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Notary Public
NOTARIAL SEAL
CHAD M ~80YER
pJotary f ublic
ELIZABEI"HTOWIV BORO., L,r,~CASTER CN~Y
My Commission Expires Oct t 7, 2f?~3
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
EMMA B. HENRY
N0.20-10-00769
RECEIPT, RELEASE, REFUNDING AND INDEMNIFICATION AGREEMENT
The undersigned, IRENE HEISEY, a beneficiary of the EMMA I3. HENRY ESTATE, does
hereby:
Acknowledge that she has examined and approved the attached Final Accounting and
Schedule of distribution;
Acknowledge that she waives the filing of an Account in any Court;
Acknowledge that she will receive the sum of $959.98 in cash the amount shown on the
Schedule of Distribution, a copy of which has been provided to it, upon the execution of this
document;
Agree to indemnify and hold harmless John M. Smith, Esq. and Gingrich, Smith,
Klingensmith & Dolan, attorneys, of and from any claims including tax claims or demands ever
made against him and the law firm by any heirs in the estate.
Declares that this instrument shall be legally binding upon her, her personal representative,
successors and assigns.
SIGNED this ~~r ay of ~, , 201:1.
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Irene Heisey
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
EMMA B. HENRY
NO. ZO-10-00769
RECEIPT, RELEASE, REFUNDING AND INDEMNIFICATION AGREEMENT
The undersigned, GERALDINE SHUMAN, a beneficiary of the EMMA B. HENRY
ESTATE, does hereby:
Acknowledge that she has examined and approved the attached Final Accounting and
Schedule of distribution;
Acknowledge that she waives the filing of an Account in any Court;
Acknowledge that she will receive the sum of $959.97 in cash the amount shown on the
Schedule of Distribution, a copy of which has been provided to it, upon the execution of this
document;
Release IRENE HEISEY, her heirs and assigns, from all Liabilities, whether due to her
negligence or otherwise, which she may have by reason of her administration of the Estate;
Agree to indemnify and hold harmless John M. Smith, Esq. and Gingrich, Smith,
Klingensmith & Dolan, attorneys, of and from any claims including tax claims or demands ever
made against him and the law firm by any heirs in the estate.
Declares that this instrument shall be legally binding upon her, her personal representative,
successors and assigns.
SIGNED i ~~h~
th s Day of , 201 u.
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Geraldine Shuman
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