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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND
Name of Decedent: ~Y A• ~Y
COUNTY, PENNSYLVANIA
Date of Death: 9-10-2010 File Number: 2010-00998
21-10-0998
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :.................... ®Yes ^ No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? ....... ^Yes C~ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ...... .
........................ C~ Yes ^ No
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d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may be attached to this report. cam, of
Agreement for Approval of Account, lease and Indemnif' ion attached
Date 8-17-2012
Si azure o Person Filing this Form ~-
Cap ity: ^ Persona] Representative ~ Counsel
`~ Joseph A. Macaluso
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N ~ Q. Name of Person Ftlmg thts Form
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Q A n RnX 8 ~
-) Address
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~'" '- "'~ Orrstown PA 17244
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FormRW-10 rev.lO.liG6
-(?17) 5~2-4832
Telephone
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IN THE COURT OF COMMON PLEAS OF THE 9TH JUDICIAL DISTRICT OF
PENNSYLVANIA -CUMBERLAND COUNTY BRANCH
ORPHANS'COURT
Estate of Ray A. Coy } File No. 2010-00998;
PA File No. 21-10-0998
AGREEMENT FOR APPROVAL OF ACCOUNT, RELEASE
AND INDEMNIFICATION
The undersigned, Lota L. Cohick, of 472 McCulloch Road, Shippensburg, PA _ _
17257; Victoria J. Mozingo, of 1025 Leroy Drive, Newport, PA 17074; and
Dennis Coy, of 1105 South Spring Garden Street, Carlisle, PA 17015,
being all the beneficiaries under the will of the decedent in connection with the
above-referenced estate, desire that the estate be distributed without the
formality of a court accounting, and Lola L. Cohick, of 472 McCulloch Road,
Shippensburg, PA 17257, as Executrix of the Estate of Ray A. Coy, is willing to
consent to such distribution upon receipt of a proper release and indemn~cation,
which it is the purpose of this Agreement for Approval of Account, Release, and
Indemnification ("Agreement"} to provide.
In consideration of the willingness of the Executrix to distribute and terminate the
estate in accordance with the terms of the will without the protection afforded her
by a formal adjudication of the account, each of the said undersigned
beneficiaries, their heirs, personal representatives, successors and assigns,
hereby:
1. Acknowledge that he/she has read this Agreement and represents that the
facts set forth herein are true and correct to the best of his/her knowledge,
information and belief. The undersigned beneficiary further acknowledges that
he/she is familiar with the provisions of the will of the decedent;
2. Waives the filing of a formal account of the administration of this estate, with
respect to the income and principal thereof, in any court which has jurisdiction, in
particular, the Orphans' Court of the Court of Common Pleas of the 9th Judicial
District of Pennsylvania, Cumberland County;
3. Declares that he/she has been advised of an informal accounting which the
Executrix has communicated to him/her, and finds it to be true and correct in all
particulars; understands that the distribu#ion may be still subject to the payment
of certain administration expenses; and accepts and approves it with the•same
force and effect as if it had been prepared and duly filed with, audited,
adjudicated and confirmed absolutely by such court which has jurisdiction over
this estate, and, as if the balance of principal and income had been awarded by
said court in accordance with this Agreement and the account;
4. Warrants that he/she knows of no outstanding and unsa#isfied claims against
the estate and approves the distribution of the balance of principal and income
shown on the informal account as set forth above;
5. Absolutely and irrevocably releases and discharges the Executrix, her
personal representatives, heirs, successors and assigns, from any and ail
actions, liabilities, claims and demands, including specifically but not limited to
liability arising in connection with any mistake of fact or law, or negligent or
careless act or omission by the Executrix, in connection with the administration
and distribution of assets pursuant to the informal account, without a formal court
accounting and adjudication;
6. Agrees to refund to the Executrix such part or all of the distributive share
which is being distributed to him/her which may at any time be determined to
have been an erroneous distribution to him/her regardless of the cause of such
error, even if attributable to negligence;
7. Agrees that any period of limitation of actions for the collection for any
erroneous distribution to him/her shall commence only at such time as the
Executrix has obtained actual knowledge of such erroneous distribution and that
in no event shall the obligation to collect any erroneous distribution start earlier
than the actual discovery thereof by the Executrix.
8. With respect to any distributions of income or principal, which he/she has
received, or will receive upon execution of this Agreement, agrees to indemnify
and hold harmless the Executrix, her personal representatives, heirs, successors
and assigns, from any liability, loss or expense (including but not limited to costs
and counsel fees), arising from any cause whatsoever, which may be incurred by
the Executrix as a result of the administration of this estate or distribution in
accordance with this Agreement including, but not limited to, any liability for any
federal estate tax, Pennsylvania inheritance tax or any other death taxes and
federal and state income taxes, together with any interest and costs incidental
thereto, relating in any way to the estate and also including, but not limited to,
any assets received or payments or distributions made by reason of any
negligence or mistake of fact or law;
9. Understands that this Agreement may be signed in coun#erpart originals, aA of
which together shall be deemed to constitute one original;
10. Agrees that this Agreement shall be governed by the laws of the
Commonwealth of Pennsylvania;
11. Agrees that this Agreement is the entire and only agreement between
him/her and the Executrix, and any changes or additions to this Agreement must
be made in writing and executed by the parties hereto;
12. Agrees #hat this Agreement is binding on the parties hereto, their heirs,
personal representatives, successors and assigns, as the case may be;
13. Agrees that in the event any part of this Agreement is construed as
unen#orceable, the remaining provisions of this Agreement shall be in full force
and effect, and en#orceable as though the unenforceable part or parts were not
included;
14. Acknowledges that he/she has received from the Executrix the entire and
final distribution of the devise, or bequest, or legacy to him/her in the last will and
testament of the decedent will as set forth in Schedule A attached hereto and
made part hereof.
iN WITNESS WHEREOF, we agree to be bound hereby and have signed this
Agreement this day of July, 2011.
Witness:
Lola L. Cohick
al)
Vi oria J. Mozin
~~~~„~! ~t (Seal)
Dennis Coy
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