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HomeMy WebLinkAbout08-22-11 (11),. IN RE: IN THE COURT OF COMMON ]PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ~ --. ,'.-; .- C.~ ESTATE OF ANNA MAE MCCOMBS, :,--. ~= _~ Deceased :ORPHANS' COURT DIVISI(~$~ f r' FILE N0.21-10-0572 {_T ` ~? ~~,- -, ,.- ; _ _ 1 ~~ } RECEIPT -~~--~~ •~• ~r,_~ FINAL AND COMPLETE RELEASE ~ AND INDEMNIFICATION AGREEMENT KNOW ALL MEN AND BY THESE PRESENTS, that I, DANIEL MCKENZIE, do her;;by acl::~owledge receipt, from G~~'El'~TDCLY°ti I i. MILLEP., Executrix (hereinafter referred to as "Fiduciary"), of the Estate of Anna Mae McCombs, deceased, the sum of Fourteen Thousand Two Hundred Ninety-Three and 54/100 Dollars ($14,293.54) in satisfaction of all claims, distribution, shares and property, (personal, tangible and/or intangible) due the undersigned from the Estate. The undersigned acknowledges receipt of Notice Beneficial Interest in Estate, a final accounting and timely information from FIDUCIARY when requested by the undersigned. IN CONSIDERATION WHEREOF, the undersigned does hereby remise, release, quitclaim and forever discharge the FIDUCIARY and the respective heirs, personal representatives, successors and/or assigns thereof as weii as said decedent's estatf~,, of and from all manner of actions, cause or causes of action, debts, dues, claims and derriands whatsoever, both in law and in equity, against the FIDUCIARY, individually, corporately and/or in a fiduciary capacity, and against said decedent's estate, whether as legatee under the Last Will and Testament and/or as heir-at-law of said decedent and/or as claimant/creditor and/or in any other capacity which the undersigned has had or now has 5 ~ • • or ought to have had for or by reason of any act, matter, cause or thing from the beginning of the world to the day of the date of these presents. AND IN FURTHER CONSIDERATION WHEREOF, the undersigned does hereby expressly stipulate, covenant and agree, in consideration of the aforesaid distribution and payments, to indemnify and hold harmless said FIDUCIARY and the respective heirs, personal representatives, successors and assigns thereof against loss from any and all further claims, demands and actions, in law or in equity or otherwise, teat may hereafter at any time be made or brought by the Commonwealth of Pennsylvania, or anyone in its behalf, for any unpaid Pennsylvania Death Transfer Inheritance Taxes or by the Internal Revenue Service, or anyone on its behalf, for any unpaid Federal Gift or Estate Taxes on the gross taxable estate of said decedent and the undersigned hereby waives any and all rights of exemption, both as to real and personal property, to which the undersigned may be entitled under the laws of this or any other state as against such claim for reimbursement or indemnity. The undersigned does hereby consent to the discharge of the FIDUCIARY' without notice to, or necessity of joinder of, the undersigned. IN WITNESS WHEREOF, the undersigned has duly executed this Receipt, Final and Complete Release and Indemnification Agreement the day, month and year set opposite the signature of the undersigned. .~ ~ Witness Da e ~~~~- -- DANIEL MCKENZIE ~ ~. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~~c-~Nr=ur,~- ~-,E,- ;~'- - - ~c~C'~c~~~C~.~~Y~~4Y~_`.,r`~r, M.rY~~cv~. ~F+s=A~.r.~~,n~,n,~n,-:nr.,~,-,r. - t` ~~..~'~'.G`S>:F=l` State of California County of ~ ~~~ ~ tN On ` ~~~ ~ ~/ / before me, i~ ~ / ~~ ~ D Here Insert me and Title of th Offic r ' personally appeared ,~~/Jj-P f ~ ~eJC ej~ ~Q ~ ~--- 1-----~~ Name(s) of Signer(s) --- M NtCA 1. MITH Commissions 1809214 Notary Public - Calfforeia San Oiepo County Come. who proved to me on the basis of satisfactory evidence to be the person(.a~ whose name('} is/ate subscribed to the within instrument and acknowledged to me that he/s~tf~ executed the same in his/h~r/ti7.eit~authorized capacity(i~), and that by his/Y~flt~signature(~ on the instrument the person(', or the entity uK~ori behalf of which the person(,g) acted, executed the in;>trument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing piaragraph is true and correct. WITNESS my ha an ici Ise Signature ___ Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached/~Document ~~ / Title or Type of Document:/[ ~~'P,//J~ ~(lAD~ ` ~,_~~~~ ~ l~ ~ __ Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name:. __ I`1 Individual J Corporate Officer -Title(s): J Partner - __ Limited ~J General J, Attorney in Fact -~ Top of thumb here I_ Trustee i_ Guardian or Conservator I Other: Signer Is Representing: Number of Pages: Signer's Name:__ ___ L~ Individual ~ Corporate Officer -Title(s): _ - C' Partner - =1 Limited _ 1 General L7 Attorney in Fact ~J TrUStee Tcp of thumb here i 1 Guardian or Conservator I Other: Signer Is Representing: _ _ _ _ - - _ s ©2007 National Notary Association • 9350 De Soto Ave., RO. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.org Item k5907 Reorder: Call Tol -Free 1-800-876-6827