HomeMy WebLinkAbout07-16-13 (2) IN RE: ) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
ESTATE OF )
HAZEL B. Hi7NN, ) ORPHANS' COURT DIVISION
Deceased )
) N0. 21-13-0202
RECEIPT AND RELEASE
I, CHARLENE S. COSTANTINI,the undersigned, being a beneficiary under the Estate
of Hazel B. Hunn, 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
representative ofthe Estate;
3. Acknowledge that I have received the sum of$25,000.00 as a partial distribution to
which I am entitled as a beneficiary of the Estate of Hazel B. Hunn;
4. To the extent of said distribution, release Cynthia A. Sell, Executrix of the Estate of
Hazel B. Hunn 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 Cynthia A. Sell, 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
6. Declare that this instrument shall be legally binding upon me, my personal
representatives, and assigns.
-�.
c� �: � �
io ``' m �
Co � � � O
ms � � ,n �
�7 �, �— ..� c'3
r z �-r� �-' rr; r-;
Yti � A O'� s,. O '
2 • �� Gy C7
� G� c Z' -r� 'rf
� c -r� � ,,,� '�'�
. :a �--' _` �
� ,� n� � rn
y�, s U� O
� � �W
_ . . __ . . .. . . ... ___.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this I 0 day of
WC, 2013.
i�'� i> ��_
-�_�4n� � �U' ��w'v�h> (SEAL)
CHARLENE S. COSTANTINI
STATE OF FLORIDA )
( SS:
COUNTY OF �U�,G� )
On this, the /�� day of 2013, bef e
undersigned officer, personally appea�d CH RLENE S. COSTANT , known to me or
satisfactorily proven)to be the person whose name is subscribed to the wi m ms rument and
acknowledged that (s)he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
_yp"'�'�;: JANICE E OILES ��� � �i��
: MV COMMISSION#EE74174• Ot3I'}' PUbI1C
'-,,,4. „�' EXPIRES October 26,2015 ; �.p �� �(/�5
11011 3 9 8-015 3 FbriOeNdarySerrKe.com ��jyl/W , r �OGZ(p /�,�
/')7 y GOmr�riss�ot�r �LK/�IY�S' � !
/ �