HomeMy WebLinkAbout02-14-06
INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-05-0673
ESTATE OF
LLOYD CARL ZEMBOWER
Deceased
RECEIPT AND RELEASE
I, DONNA LORRAINE ZEMBOWER, the undersigned, being a beneficiary under the
Estate of Lloyd Carl Zembower, 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 of the Estate;
3. Acknowledge that I have received all sums and personal property to which I am
entitled as a beneficiary of the Estate of Lloyd Carl Zembower;
4. To the extent of said distribution, release Donna Lorraine Zembower, Executrix of the
Estate of Lloyd Carl Zembower, 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 Donna Lorraine Zembower, 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
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6. Declare that this instrument shall be legally binding upon me, my personal
representatives, and assigns.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this .J l !f-i" day of
l"~/\UJ-c:.l.A_-'1 ' 2006.
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STATE OF FLORIDA
COUNTY OF J-rE.c...
)
( SS:
)
On this, the d.-1 TL day of ~N....l.....-'-.C:\.'2..~ ,2006, before me, the
undersigned officer, personally appeared DONNA L RRAINE ZEMBOWER, 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.
Q.~~~
Notary Public
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.h~ .:u!~~~.~
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
N f D d t Lloyd Carl Zembower
ame 0 ece en :
Date of Death: April 9, 2005
Estate No.: 21-05-0673
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
I. State whether administration of the estate is complete:
Yes [8] NoD
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No {gl
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes 0. No 0
)
c. Copies of receipts, releases, joinders and approval of formal or informal
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accounts may. be filed with the Clerk Ofth.. e Orphans' co. u..,~,. n.7d. ay be
attached to thIS report. /] '1" ....
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Signature v'/
Date:
J..I~6&
I
Michael L. Bangs, Esquire
Name
429 South 18th Street
Camp Hill, PA 17011
Address
(717) 730-7310
Telephone No.
Capacity: 0 Personal Representative
~ Counsel for personal representative
, 1'1/
\1"C
BANGS LAW OFFICE
429 SOUTH 18TH STREET
CAMP HILL, P A 17011
E-mail: mikebangs@verizon.net
PHONE: 717-730-7310
FAJ{: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY K. STRAUB, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
February 13, 2006
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Lloyd Carl Zembower
File No. 21-05-0673
Dear Mrs. Strasbaugh:
Enclosed you will find the following:
1. A Receipt and Release together with a check in the amount of $5.00 to pay the
filing fee.
2. A Status Report Form.
This concludes the administration ofthe above-referenced estate. Kindly send me a filing receipt
in the enclosed, stamped, pre-addressed envelope.
If you have any questions or require anything further, please contact me directly.
\V' ery truly yours,
\ f\ 1\
\ ;' \JG'\
\,
Michael L. Bangs
wks
Enclqsures
cc: Mrs. Donna L. Zembower
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