HomeMy WebLinkAbout09-13-06
INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-06-0174
ESTATE OF
WILLIAM F.S. ORNER, JR.
Deceased
RECEIPT AND RELEASE
I, ELAINE M. ORNER, the undersigned, being a beneficiary under the Estate of
William F.S. Orner, Jr., 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 property to which I am entitled as a
beneficiary of the Estate of William F.S. Orner, Jr.;
4. To the extent of said distribution, release Elaine M. Orner, Executrix of the Estate of
William F.S. Orner, Jr., 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 Elaine M. Orner, 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 'P1~~,~~~ : ,_:;j~'61J
~:~) );:',:J:rl:;
representatives, and assigns.
6 I : I ~':d r. I d3S gaOl
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this C;S day of
AUb
, 2006.
~IY\ ~ (SEAL)
ELAINE M. ORNER
COMMONWEALTH OF PENNSYLVANIA
COUNTYOFCU~AND
On this, the day of , 2006, before me, the
undersigned officer, personally appeared E~A E M. ORNER, known to me (or satisfactorily
proven) to be the person whose name is sub' c . ed to the within instrument and acknowledged
that she executed same for the purposes therein contained.
~,Q,l1", ,i!"":'~.\"'''''1'l(,j'~.._~''~''~...:aA.:.~~...s.,
· OTA.~t.A!. SEAL
WE~tt)Y S. CHESBRO, Nc4srj p~c
l.owIr AlIGn Twp., CumbeMnd Co'JOiy
My CuR.mI8Iktn ExpIrIs May 10, 2007