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Home My WebLink About11-29-05 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CLARK BETH M 870 GRANDON WAY MECHANICSBURG, PA 17050 -------- fold ESTATE INFORMATION: SSN: 204-30-6762 FILE NUMBER: 2105-0395 DECEDENT NAME: MILLINGTON JOHN THOMAS DA TE OF PAYMENT: 11/29/2005 POSTMARK DATE: 11/29/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2005 NO. CD 006036 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $385.82 I I I I I I I I TOTAL AMOUNT PAID: $385.82 REMARKS: B CLARK CHECK#104 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS I '-,. -I r:;c( /- r ,.... 0.' -: ~ .~ l r~ ~ ...:::;. il > ,-_ f.,,"'.!-..; . ,'"-" INRE: ESTATE OF JOHN THOMAS MILLINGTON, a/k!a J. THOMAS MILLINGTON, DECEASED r"" I : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYL VANIA : ORPHANS' COURT DIVISION : NO. 21-05-0395 RECEIPT, RELEASE, REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE THIS AGREEMENT, based upon the family circumstances outlined, is entered into with the Administrator by each beneficiary, from the date of formalization of his separate Consent: 1. JOHN THOMAS MILLINGTON, a/k!a J. THOMAS MILLINGTON died Testate on April 19, 2005. 2. Decedent's Will, dated February 23,2000, provided for various specific and general bequests, and designated Beth M. Clark, as Executrix. 3. Said Will was accepted by the Register of Wills of Cumberland County for probate on April 27, 2005, and steps necessary to complete the administration were undertaken by the Executrix. 4. The beneficiaries desire that the distribution of the assets of the Estate be made without the formality of an Accounting in the Orphans' Court Division of the Cumberland County, Pennsylvania Court of Common Pleas, and the Executrix is willing to make this distribution upon the execution of this Agreement. \}t- \ I.. " 5. The beneficiaries desire to forever settle and compromise any and all claims and rights which they may possess, now or hereafter, in the Estate and to confirm their acceptance of the distribution in satisfaction of the bequest contained in the decedent's Last Will and Testament. 6. The beneficiaries wish to release the Executrix and to indemnify her against any and all claims that may be asserted against the Estate with the Executrix after the date hereof. 7. The Executrix is willing to make a distribution of informal settlement of the Estate in consideration of the indemnification and agreements hereinafter provided by the beneficiaries. NOW, THEREFORE, in consideration of the foregoing and intending to be legally bound hereby, jointly and severally, the Beneficiaries do, for themselves, their heirs, personal representatives, successors and assigns, agree as follows: A. Represent and warrant that they have read and they understand this Agreement and confirm that the facts set forth above are true and correct, to the best of their knowledge, information and belief. B. Declare that they have sufficient information to make an informed waiver of their right to a formal accounting with the Court, and do hereby waive the filing and auditing of said formal accounting. C. Acknowledge that the distributive share or amount set forth on the "Accounting" shall be in satisfaction of their respective entitlements under the Will. D. Release, remise, quitclaim and forever discharge the Executrix, her heirs, personal representatives, successors and assigns, from and against all " " claims that they, as residuary beneficiaries of the Estate, had, now have, or may in the future have in connection with the Estate. E. Agree to refund, on demand, all or any part of their proportionate share of any aforesaid distribution, which has been determined by the Executrix, or by the Court, or by any court of competent jurisdiction, to have been improperly made. F. Agree to indemnify and hold harmless the Executrix, her heirs, personal representatives, successors and assigns, from and against any and all claims, loss, liability or damage (whether or not related to the negligence of the Executrix) that may hereafter be asserted against the Estate or against the Executrix. G. Agree to execute such additional documents as may be necessary to effectuate the agreements set forth herein. H. Acknowledge that this Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania. 1. Consent to the Court exercising personal jurisdiction over them in any suit or action arising out of the enforcement of this Agreement. IN WITNESS WHEREOF, the beneficiaries have set their hands and seals to the Consents attached hereto, to be effective as of the date first above written. ~ CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, BRIAN R. CLARK, a beneficiary of the Last Will and Testament ofJOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased, hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to him. The undersigned also acknowledges receipt of his share of the Estate, as more particularly described in the aforesaid Agreement, including the Accounting, subject to all the terms and conditions specified therein. rb~ '2 CLl BRIAN R. CLARK COMMONWEALTH OF VIRGINIA COUNTY OF r 11 )' (2.)~ A ~ SS. On this, the ().( day of Vu L- / , 2005, before me, a Notary Public, the undersigned officer, personally appeared BRIAN R. CLARK, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set~hand)nd Not~ ~~ NOTARY PUBLIC State of Virginia, C ty of Fairfax Gerald Bonnes Notary Public MyComm. Exp. Aug 312009 CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, STEVEN M. CLARK, a beneficiary of the Last Will and Testament of JOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased, hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to him. The undersigned also acknowledges receipt of his share of the Estate, as more particularly described in the aforesaid Agreement, including the Accounting, subject to all the terms and conditions specified therein. dJ;!ti STEVEN M. CLARK COMMONWEALTH OF VIRGINIA F~I't--t~~ SS. COUNTY OF On this, the ~ S day of J It Iv , 2005, before me, a Notary Public, the undersigned officer, personally 'ppeared STEVEN M. CLARK, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. \\,,11 1111" tIll ",\\\~~ E. Hl./""'~ .,' ...:<..~ ........ '~A.~, ,.... iV.. -. '..v;. '" .~ ~ .....~p.y p, ;.... Q ~ .- . " v~.,... ., . . ,., .:::- .. 0 "/'.::' ~ : y-. :: :: : ~ MY (): = ~ g ~ COMMISSION j 1 ~ % ,\'" EXPIRES ./ f5 j '';,:; 0...... 4/30/06......~~ ~'. "Vi-I, ............ ~ ~ ,~ "" "'~AL TH 0 "", 11111 It It" II \ \ \ \ \ \' ~ ~.~---- NOTARY PUBLIC CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, DORA MEGONNELL, a beneficiary of the Last Will and Testament of JOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased. hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to her. The undersigned also acknowledges receipt of her share of the Estate, as more particularly described in the aforesaid Agreement, including the Accounting, subject to all the terms and conditions specified therein. J)MA '-/J1ttN~ DORA MEGONNE - COMMONWEALTH OF PENNSYLVANIA 'I () r L 55. COUNTY OF On this, the 2 I day of ,J u I, j , 2005, before me, a Notary I Public, the undersigned officer, personally appeared DORA MEGONNELL, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. / ( 1 { ,l ^ ' ,+i L', I. " 'j~~y ~UBLiguI6'Y'>'- NOTARIAL SEAl Mm L UPDEGROft"IIOTMYPtaII FAIRVlEW TWI'., _ COUII1Y MY COMMISSION EXPIIEJ NOV. 10. _ I JA,~ J '. ,~ :'JlU"n'll''''!'I Ji' r"~ll 1 ~~ Ytv.~.~r" y..("-'~,' '.~' 1j J ~ ';!'iMO! ,II"";' "'~\' ,'- ~ .. V'I -"' CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, J. THOMAS MILLINGTON JR. and RUTH L. MILLINGTON, beneficiaries of the Last Will and Testament of JOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased, hereby consent to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to them. The undersigned also acknowledge receipt of their share of the Estate, as more particularly described in the aforesaid Agreement, inclllding the Accounting, subject to all the terms and conditions SP~~fi,1}hgi:~ J. ,rn6~~~k&rJN,F /J4: ;(.' . v~ ,. ih' - STATE OF CALIFORNIA COUNTY OF V 8 N\VL~f\ SS. On this, the cQ,"'"t."n day of 005, before me, a Notary Public, the undersigned officer, personally appearedJ. OMAS MILLINGTON JR. and RUTH L. MILLINGTON, known to me to be the rsons whose names are subscribed to the within instrument, and acknowledged at they executed the same for the purpose therein contained. IN WITNESS WHEREOF ave hereunto set my hand and Notarial Seal. NOTARY PUBLIC ( -$e~ ~kJ.. ~~k~(:~~") ...... ~ -.... ~ - --- -- ~ .r-~ ~ __ - -- - -- CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~AX'.,c<>c<?..<:X..c<>c<><x"-G<'..c<'.C<><X'R<>C<?'..c<'-<X'-<X'-<X'..e<'-<X'..Q('RX>(X><x>o<>c<,~..<:XR,('-<X'-<X'~~-<X'~..e<'AX'~~~~ ~ ~ ~ ~ g State of califOrnia} ~ g V - ~ \ ss. ~ ~ County of . e--f\n..r....rCZ g % g ~..,. On <-l--..:J-'-~DC>;5 beforeme,h -1'-Ne~ ~~LtYL<..b\~c, ~.'.',: ~ peo;o,"II, appea,.; ~~~ Ii\ \\~,,~::i;'~:G-~C"ht\ \~"4--1zl.1 ~ ~ ~oftigner(S).-.-J ~ ~ - D personally known to me ~ ~ ~roved to me on the basis of satisfactory ~ ~ evidence ~ ~ g ~,'..;;' to be the person(s) whose name(s) oi&Iare ~.',.', ~, subscribed to the within instrument and .~ ~ acknowledged to me that ~/they executed g ~ the same in ~/their authorized g ~ capacity(ies), and that by ~r/their g ~ signature(s) on the instrument the person(s), or ~ ~ the entity upon behalf of which the person(s) g ~ acted, executed the instrument. g ~ J -- -. ~ -. :: ~ -. -. -. -. J WITNESS my hand and official seal. g ~ . SlCEAlE ~ g "Ca.........#1591862 ~ ~lJi4n ~ g ~ Nolary PubIc - CaIf~ J ~ slg1tu~tary Public g ~ VantI.wa County - ~ g M,Corrrn. ExpIres Jun 27, 2009 g 2 OPTIONAL ~ ~, '.'. ..... Though the information belOw. is ndot, required bYI,aw.d, it may Phrove vaf'uhabl: to personShre'y~ng on the document and could prevent X.~.I " ~; ,rau u ent remova an reattac ment 0 I IS ,orm to anol er uocument. .~ ~ Description of Attached Document ~ ~ Title or Type of Document: g ~ g ~ Document Date: Number of Pages: g ~ ~ ~ Signer(s) Other Than Named Above: g ~ ~ g Capacity(ies) Claimed by Signer ~ ~ ~ ~ Signer's Name: ~ ~ D Individual Top of thumb here ~ ~ D Corporate Officer - Title(s): g ~ D Partner - D Limited D General g ~ D Attorney-in-Fact g ~ D Trustee ~ ~ D GOuhardian or Conservator g ~ D t er: ~ ~ @ ~ Signer Is Representing: g ~~'<X,~~~~'<X.~~,%'<:''<:;''Q(,~''C<i'<X,~''C<i,%'<X,'Q(,'Q(,'Q(,~~'<X.'Q(,'Q(,''C<i''C<i~~~~~~~'<x:9.1 @ 1999 National Notary Association. 9350 De Soto Ave., P.O. Box 2402. Chatsworth, CA 9t313-2402. www.NationaINotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 t --... ... ... ...... ...... ... ~ ~ ~I 3;t.~ltZ .8 fj >:Mr~~: f, ~m:> ,~ ~ "'.- ~ ?. r ",1110;.,. ...J'.N v1Pl(~ .'.. -.:;,1 '. . y.t"".C:J.i..'.V'l!W . .~}t ~ _ "'''''.,-, ~ ",y,'er,' ". ',jv1 ~,!', l';', , ,.".....~~.1Qf/r,~.......................... ~,., . ~ CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, RICHARD P. CLARK, a beneficiary of the Last Will and Testament of JOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased, hereby consents to the Receipt, Release. Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to him. The undersigned also acknowledges receipt of his share of the Estate, as more particularly described in the aforesaid Agreement, including the Accounting, subject to all the terms and conditions specified therein. ~-/~ ~ RICHARD P. CLARK COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS. D On this, the ~dNU day of ;JULV ' 2005, before me, a Notary Public, the undersigned officer, personally appeared RICHARD P. CLARK, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. ~~ ~ ~~/7UJl NOT PUBLI EAlTH OF PENN NOTARIAL SEAL Mary Ann C. Garbar1no. Notay PlJ)IIc $Uvef Spring Twp.. ClrnberIand ~ My CM\ffltsslon Expret Dee. l~ RoAN .~. ..-"'...,........---.---..,--...- . CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, BETH M. CLARK, a beneficiary of the Last Will and Testament ofJOHN THOMAS MILLINGTON, a/k/a J. THOMAS MILLINGTON, Deceased, hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to her. The undersigned also acknowledges receipt of her share of the Estate, as more particularly described in the aforesaid Agreement, including the Accounting, subject to all the terms and conditions specified therein. ~ (' /oJ( BETH M. CLARK COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~U~R.UWJD SS. On this, the ~ ND day of :::J LlL'1 ' 2005, before me, a Notary Public, the undersigned officer, personally appeared BETH M. CLARK, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. COMMONWEALTH Of PENN :vANIA NOTARIAL SEAL Mary AM C. GarbarIno. Notay Public SlIver Spring Twp.. cunberland County My comm\s$lOn~.~~~