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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COL~T~,
PENNSYLVANIA
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ORPHANS' COURT DIVISION
1N RE: ESTATE OF HAZEL R. CALHOUN,
Deceased.
No. 21-11-0573
Cumberland County No.: 2011-00573
RECEIPT, RELEASE, AND INDEMNIFICATION AGREEMENT
WHEREAS, HAZEL R. CALHOUN died testate on Mach 31, 2011, a copy of her
Last Will and Testament being of record in the Register of Wills Office of Cumberland County,
Pennsylvania; and
WHEREAS,. Letters of Testamentary were granted on May 13, 2011 by the Register of
Wills of Cumberland County, Pennsylvania to KAREN L. MOVER and TERRY E. CALHOUN,
who are now acting in said capacity; and
WHEREAS, the decedent, Hazel R. Calhoun, in her Last Will and Testament dated May
31, 2005, devised and bequeathed her entire estate as follows:
Terry E. Calhoun 50
Karen L. Moyer 50
WHEREAS, the remaining assets in the estate after all debts and expenses have been paid
will be distributed equally between Terry E. Calhoun and Karen L. Moyer; and
WHEREAS, the granting of Letters Testamentary was published in the Carlisle Sentinel
and Cumberland Law Review; and
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WHEREAS, an original Pennsylvania Inheritance Tax Return for a Resident Decedent
was filed with the Register of Wills Office, Cumberland County, Pennsylvania on October 31,
2011; and
WHEREAS, a Notice of Inheritance Tax Appraisement, Allowance or Disallowance of
Deductions and Assessment of Tax dated April 23, 2012, was received accepting the return as
filed with no additional tax due in this matter; and
WHEREAS, an Inventory was filed for the Estate of Hazel R. Calhoun on September 12,
2011; and
WHEREAS, the Executrix and Executor have affirmed that they have no knowledge of
any assets or liabilities of the Estate of HAZEL R. CALHOUN, Deceased, not previously
reported; and
WHEREAS, the parties hereto desire that the Executrix and Executor shall not be
required to file a First and Final Account with the Court of Common Pleas of Cumberland
County, Pennsylvania, Orphans' Court Division, and no fmal audit is required.
NOW, THEREFORE, the parties hereto, intending to be legally bound hereby, mutually
agree as follows:
1. The Parties agree and acknowledge that they have fully and carefully examined
the records of the Executrix and Executor of the estate and find them to be true, correct and
acceptable to the parties hereto. The parties further acknowledge that they have received a copy
• of the Will and Notice of Inheritance Tax, Appraisement, Allowance or Disallowance of
Deductions and Assessment of Tax.
2. The parties do hereby release, remise and forever discharge the Estate of HAZEL
R. CALHOUN, Deceased, and the Executrix and Executor of and from ali manner of acts, suits,
claims, accounts, accountings, debts, dues and demands whatsoever which they or any of their
legal representatives or assigns or heirs may aY any time hereafter have against said Executrix
and Executor, the Estate of HAZEL R. CALHOITN, Deceased, or the assets thereof, from, for or
concerning any of the assets and property of the estate and/or claim or interest thereto or therein,
and the administration, management, collection, sale or distribution of any of the said assets and
for or on account of any money, interest, income, assets or proceeds out of the same, from the
time of the death of said decedent to and including the date of this Receipt, Release and
Indemnification Agreement.
3. This instrument is a full and final receipt, release and indemnification agreement
by the parties hereto, both fiduciary and individual, the same having been arrived at, concluded
and executed after full and complete disclosure of the assets of the said estate and the rights of
the parties, and the parties hereto agree to abide by the terms of this Agreement.
5. The parties agree, and each will at all times in the future and whenever necessary,
appropriate or convenient, make, execute and deliver to the said Executrix and Executor and/or
to the other parties or to other persons as may be required any and all instruments, documents,
conveyances, deeds, releases or other instruments of any kind necessary or convenient to carry
out the intentions of this Agreement and/or to permit, assist and enable the said Executrix and
Executor to fulfill their duties with reference to this estate and all of the assets thereof.
6. This Agreement constitutes the entire understanding among the parties hereto and
they acknowledge that no representations or statements of any kind, written or oral, have been
made to them prior hereto by the Executrix and/or Executor or by any other person or party upon
their behalf.
7. This Agreement shall inure to the :benefit of and shall be binding upon the parties
hereto, and each of them, their heirs, executors, administrators, successors and assigns.
IN WITNESS WHEREOF, the Executrix and Executor and all beneficiaries of the
remaining assets of the estate have hereunto set their hands and seals on the day and year set
forth below.
Date: p f
Date:
Date:_ ~/y ~, z
Date:
(SEAL)
K en L. Moyer, Execu '
of the Estate of HAZEL R. CALHOUN
(SEAL)
Karen L. Moyer, Individually
E L)
Terry E. C un, Executor
of the Est f HAZEL R. CALHOUN
(SEAL)
Terry E. Calhoun, Individually
VERIFICATION
I, TERRY E. CALHOUN, individually and as Executor of the Estate of HAZEL R.
CALHOLIN, Deceased, have read the foregoing Receipt, Release and Indemnification
Agreement. The statements therein are correct to the best of my personal knowledge or
information and belief.
This statement and verification is made subject to the penalties of 18 Pa. C.S.A. § 4904
relating to unsworn falsification to authorities, which provides that if I make knowingly false
statements, I may be subject to criminal penalties.
Dated: G/~~~~Z
Terry E. un
VERIFICATION
I, KAREN L. MOYER, individually and as Executrix of the Estate of HAZEL R.
CALHOUN, Deceased, have read the foregoing Receipt, Release and Indemnification
Agreement. The statements therein are correct to the best of my personal knowledge or
information and belief.
This statement and verification is made subject to the penalties of 18 Pa. C.S.A. § 4904
relating to unsworn falsification to authorities, which provides that if I make knowingly false
statements, I may be subject to criminal penalties.
Dated: 6 /t 5/ a O 1 a ~~
Karen L Moyer