HomeMy WebLinkAbout09-13-13 ESTATE OF DOROTHY M. DURHAM, DECEASED
NO. 21-12-1269
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS, that FOREST PARK HEALTH
CENTER hereby acknowledges that it has this day had and
received of and from ARLENE M. KOSER, Administratrix C.T.A. of
the Estate of DOROTHY M. DURHAM, deceased, the sum of $7,125. 00
in full satisfaction and payment of its claim as set forth in
the Notice of Claim dated June 19, 2013, and subsequently filed
with the Register of Wills of Cumberland County, Pennsylvania.
AND THEREFORE, the said FOREST PARK HEALTH CENTER,
creditor as aforesaid, does by these presents remise, release,
quit-claim and forever discharge the said ARLENE M. KOSER,
Administratrix C.T.A. of the Estate of DOROTHY M. DURHAM,
deceased, her heirs, executors, administrators and assigns, of
and from the claim described in the aforesaid Notice of Claim
and of and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever, for or by reason
thereof, or any other act, matter, cause or thing whatever,
from the beginning of the world to the day and date of these
presents.
And the said FOREST PARK HEALTH CENTER, hereby consents
and agrees that the Orphans Court of Cumberland County,
Pennsylvania, may discharge the said ARLENE M. KOSER,
Administratrix C.T.A. of the Estate of DOROTHY M. DURHAM,
deceased, upon application, without further notice to it.
The undersigned understands that false statements herein
are made subject to the penalties of 18 Pa. C.S. , Section 4904,
relating to unsworn falsification to authorities.
The said FOREST PARK HEALTH CENTER, has caused this
Receipt and Release to be executed on its behalf by its
and signed officer who is authorized to do so this ')M day
ofpf�1� Y l"�'�, 2013 .
FOREST PARK HEALTH CENTER
By: 2!� VUr7l C
Auth
,o Yizdd Officer —
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Print Name: AJQYT A. Sbod el
Title: Aok)iil'7 sbodp)l-
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