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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Mary Tasseff,
No. 21-05-0160
Deceased
Date of Death: April 12, 2002
Social Security No. 180-07-2995
FAMILY SETTLEMENT AND FINAL RELEASE
ESTATE OF MARY TASSEFF. DECEASED
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KNOW ALL MEN BY THESE PRESENTS, that Mary Tasseff, late of Cumbexj1&nd
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County, Pennsylvania, deceased, died on April 12, 2002.
WHEREAS, Letters of Administration on the Estate of the said decedent were duly issued
by the Register of Wills of Cumberland County, Pennsylvania, to Mary Goetz, as Administrat~r of
the Estate, hereinafter called personal representative, on February 17,2005;
WHEREAS, the personal representative has gathered the assets of the Estate of the said
decedent and the assets consist of personal and real property with the total net value of $24,795.94
as set forth in an Accounting which the undersigned acknowledges she has received;
WHEREAS, the undersigned, the daughter of decedent, is the sole heir of the said dece(lent;
WHEREAS, the primary obligations of the Estate include obligations to the
Commonwealth of Pennsylvania, Department of Public Welfare, and to the undersigned;
WHEREAS, as a result of the said obligations, the undersigned hereby acknowledgd that
said estate is insolvent and that no proceeds will be distributed to the heir of said decedent;
WHEREAS, the Commonwealth of Pennsylvania, Department of Public Welfare I has
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accepted a settlement of its claim against the Estate as represented by the correspondence attdched
as Exhibit "A" hereto; and
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WHEREAS, the undersigned hereby acknowledges that, as the estate is insolvent and that
the obligations to the Commonwealth of Pennsylvania have been settled, there will be no benefit to
the sole heir of the estate to the filing of a formal accounting with the court.
NOW, THEREFORE, the undersigned does hereby stipulate that in order to avoid the
expense and time involved in filing of a formal account and schedule of distribution, she agrees: that
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no account is necessary and does hereby agree that she consents to the estate being resolved without
the filing of an account and schedule of distribution, the same to be with the same force and erfect
as if they had been filed and confirmed by the Orphans' Court Division of the Court of Comlmon
Pleas of Cumberland County, Pennsylvania.
THEREFORE, the undersigned, individually and on her own behalf, hereby releases the
estate of Mary Tasseff from any further claims she may have individually for funds paid on b~half
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of the decedent prior to her death, except as additional assets of the estate, unknown at this time,
may become available in the future.
THEREFORE, the undersigned does hereby remIse, release, quitclaim and fo~ever
discharge the said personal representative, Mary Goetz, her heirs, executors, administrator$ and
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assigns, of and from the said estate and from all actions, suits, payments, accounts, reckorlings,
claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or
thing whatsoever, touching upon the Estate of the said decedent.
IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year hoted
below.
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Date
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 8486
HARRISBURG, PA 17105-8486
June 10, 2005
KLINE LAW OFFICE
ROBERT P KLINE ESQUIRE
714 BRIDGE ST
PO BOX 461
NEW CUMBERLAND PA 17070
Re: MARY TASSEFF
CIS #: 940143036
SSN: 180-07-2995
Date of Death: 04/12/2002
Dear Mr. Kline:
I am in receipt of your correspondence dated May 19, 2005 regarding
above-referenced estate.
The Department has reviewed the information presented and agrees
the accounting of the estate. Please notify us of any change in
circumstances as they may change this agreement.
Thank you for your cooperation in this matter. If you have any
questions, please contact me.
Sincerely,
(j,Mt,;,/~dU
Carol J. Zellers
TPL Program Investigator
717-772-6266
717-772-6553 FAX
Exhibit "A"
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