HomeMy WebLinkAbout03-18-13 (3) IN RE: ) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
} PENNSYLVANIA
ESTATE OF )
JOSEPH ZEDLAR, ) ORPHANS' COURT DIVISION
Deceased )
NO. 21-12-1106
RECEIPT AND RELEASE
I, JAN M. LEIB, the undersigned, being a beneficiary under the Estate of Joseph Zedlar,
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deceased, do hereby:
1. State and acknowledge that I am an adult individual;
2. Waive the filing of an Account or Schedule of Distribution by the personal
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representative of the Estate;
3. Acknowledge that I have received the sum of$26,000.00 as a partial distribution to
which I am entitled as a beneficiary of the Estate of Joseph Zedlar;
4. To the extent of said distribution, release Amy G. Yovanovich, Executrix, of the
Estate of Joseph Zedlar and her heirs and personal representatives, from all liabilities, whether
due to her negligence or otherwise,which she may have by reason of her administration of the
Estate;
5. Agree to refund to the Estate and to the said Amy G. Yovanovich, Executrix, any
portion of the distribution to which I am not properly entitled, and,to the extent of said
distribution, to indemnify her and the Estate for claims made against her and to reimburse her
and the Estate all expenses and costs incurred in connection with any such claim; and rn
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6. Declare that this instrument shall be legally binding upon me, my PX� c
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representatives, and assigns. c:> a
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
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(SEAL)
JAN M. LEIB
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STATE OF NEW JERSEY )
( SS!
COUNTY OF )
On this, the /d day of 91)OW4� 20L9before me, the
undersigned officer, personally appeared JAN M. LEIB, known to me (or satisfactorily proven)
to be the person whose name is subscribed to the within instrument and acknowledged that she
executed same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
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Notary Public
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