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HomeMy WebLinkAbout10-11-06 .. . .~ . J' PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: RUTH E. STINE Date of Death: JANURY 9. 2006 Will No.: 21-06-00248 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orp.hans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes! No 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.1 is yes, state the following: A. Did the personal representative file a final account with the Court? Yes No ! 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! No D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Ten (10) Releases attached. Date: 11//1010(. ~'4~.( ))~ Signature Edmund G. Mvers. Attornev Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemovne. PA 17043-0109 Address .-"'~ .'--" ,',j 1\,./ (717) 761-4540 Telephone No. Capacity: Personal Representative ! Counsel for Personal Representative go: I Hd I I 1:JO SOOZ - - "...1 , r.'-l(",',~ ~ \r, t'-r=":(;~,~l('!J("'J'~i :AJ j...);JJV \,J~\..J~.h.J -:-..J ~ ) l' . iN THE ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-06-00248 ~(Q)~~ R E eEl PT. R E LEA S E AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Two Thousand One Hundred Twenty-one and 48/100 ($2,121.48) DOLLARS, being the amount shown as distributable to the Pennsylvania Department of Conservation and Natural Resources in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. The Pennsylvania Department of Conservation and Natural Resources also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to the Department of Conservation and Natural Resources had been duly awarded to DCNR by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, the Department of Conservation and Natural Resources agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, the Pennsylvania Department of Conservation and Natural Resources does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to DCNR arising out of his administration of the Estate. IN WITNESS WHEREOF, the Department of Conservation and Natural Resources has caused the execution hereof by its duly authorized officer this a I day of ~ . 2006. PENNSYLVANIA DEPARTMENT OF CONSERV AnON AND NATURAL RESOURCES By: ~~~ EINNo.: 25-1773197 Deputy Secretary of Administration , l' t COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN On this, the a ( day Of~2006, before me, the undersigned officer, personally appeared 'R t({;.~ tt, (\ rJJ lJ (} ilL , a duly authorized officer of the Pennsylvania Department of Conservation and Natural Resources known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. l1JolKrirL..~ N'OTARtAL' SEAl- WC!NDY L. SWE'G!:R, Notary PubIJo _ of Harrisbu,',l, [)auphin Cot.antr. PIl .., COiInIulon Expires January." .. ! (") 't- (;-~ :""" .~) . c , . .. .~ ,.... ) .. ,,~. ~':"::.. -;---,/ t t. . IN THE ESTATE OF RUTH E. STINE LATE OF CAMP mLL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION NO. 21-06-00248 ~(Q) U~VV RECEIPT. RELEASE AND REFUNDING AGREEMENT \,t KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Four Thousand Two Hundred Forty-two and 96/100 ($4,242.96) DOLLARS, being the amount shown as distributable to The Salvation Army in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. The Salvation Army also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to The Salvation Army had been duly awarded to The Salvation Army by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, The Salvation Army agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, The Salvation Army does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to The Salvation Army arising out of his administration of the Estate. IN WITNESS WHEREOF, The Salvation Army has caused the execution hereof by its duly authorized officer this 1Sf ~ r\L-'f/V\J....~:..... .-1---- day of ~ 2006. By: EINNo.: 13-55lo23~ ''" . " I , STATEOFNEWYORK COUNTY OF ~O c..f1( and : ss. On this, the ~ day of ~ 2006, before me, the undersigned officer, personally appeared Richard D. A11en , a duly authorized officer of The Salvation Army known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged thc{ji/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public a IAISTINA NAR10WICZ ...., PubIic..... d No. O1NM133021 QuIIIIed In Orange County V],.'tJ> Comntlulon ExpIres Sept8rnber os. ~ .,. . ,~ ) l ~ f I' IN THE ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-06-00248 ~cQ)\fV'V R E eEl P T. R E LEA S E AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Two Thousand One Hundred Twenty-one and 48/100 ($2,121.48) DOLLARS, being the amount shown as distributable to American University in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. American University also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to American University had been duly awarded to the University by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, the University agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, American University does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from. all further liability of any nature to the University arising out of his administration of the Estate. IN WITNESS WHEREOF, American University has caused the execution hereof by its duly authorized officer this S l$. day of g yk""~ . 2006. By: AMERICAN UNIVERSITY Douglas Kudravetz Assistant Vice President Qf Anance ) I. ( " DISTRICT OF COLUMBIA : SS. COUNTY OF On this, the ~1lI day of ~/fqJ ~ . 2006, before me, the undersigned officer, personally appeared ~1Is ,ftfJ/LLI/rrz. . a duly authorized officer of American University, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. A.(~uJ~ Notary Public PaIrIcfa l. Kslshlan ~ Public. DistrIct of Columbia My COmmission Expires oe.14-2O(>> ,~ >> l. , I STATE OF GEORGIA : SS. COUNTY OF r=tL/..-fO^J gl{J~ ~ 2006, before me, the undersigned officer, personally appeared . a duly authorized officer of CARE USA known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. ~t/ On this, the _ day of LA)b~( . IN WITNESS WHEREOF, I hereunto set my hand and official seal. /) . eiu IV~ C- ( _n. Notary Public DENISE E. BERRY . NOTARY PUBLIC FULTON COUNTY, GEORGIA My Commission Expires C-19-09 ... ) ~ J I IN'THE ESTATE OF RUTH E. STINE tATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION NO. 21-06-00248 ~(Q)~'V R E eEl PT. R E LEA S E AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Two Thousand One Hundred Twenty-one and 48/100 ($2,121.48) DOLLARS, being the amount shown as distributable to Boston University in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. Boston University also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to Boston University had been duly awarded to the University by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, the University agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, Boston University does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to the University arising out of his administration of the Estate. IN WITNESS WHEREOF, Boston University has caused the execution hereof by its duly authorized officer this 7tk. day of '5.tr /tIM~ ,2006. BOSTON UNNERSITY By. Martin J. Howard, Assistant Tr EINNO.: t'V- :?-/# 3f>5/',/ # ) \. f f STATE OF MASSACHUSETTS SS. COUNTYOF SuffolK On this, the 7~ day of Sepfpmher. 2006, before me, the undersigned officer, personally appeared mar ;"'/l <J: No (,U 12,- d . a duly authorized officer of Boston University known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Lrko fi~ ~ Public MARY L MORRIS NoIIIJ fltIIIIIc alii If .~rrr ch 1 nl ..,a....iIwiun~_13,_ oJ . .. . iN THE ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-06-00248 ~ cg G:-iJ V RECEIPT. RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Four Thousand Two Hundred Forty-two and 96/100 ($4,242.96) DOLLARS, being the amount shown as distributable to The American Red Cross in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. The American Red Cross also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to The American Red Cross had been duly awarded to The American Red Cross by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, The American Red Cross agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, The American Red Cross does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to The American Red Cross arising out of his administration of the Estate. IN WITNESS WHEREOF, The American Red Cross has caused the execution hereof by its duly authorized officer this 8"'-I!: day of ~ .2006. THE AMERICAN RED CROSS By: ~ ~.~, EINNo.: ~3- /3S~:L() .# . 1 I . I COMMONWEALTH OF PENNSYLVANIA : SS. cOUNTYOF DAUPt-\T..Y-0 On this, the ~ day of .'5e ~ \:, U . 2006, before me, the undersigned officer, personally appeared j l'A..rv\ P .oS '\-l e..c. k Mavn . a duly authorized officer of The American Red Cross known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~f&:~!I ' N blic NOTARIAL SEAL TROY ROHRBAUGH NOTARY PUBLIC CITY OF HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES JUNE 30, 2007 # ) \ IN 1IIE ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED . ',J IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION NO. 21-06-00248 ~@~'V RECEIPT. RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Six Thousand Three Hundred Sixty-four and 44/100 ($6,364.44) DOLLARS, being the amount shown as distributable to Trinity Evangelical Lutheran Church in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. Trinity Evangelical Lutheran Church also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to Trinity Evangelical Lutheran Church had been duly awarded to the Church by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, the Church agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, Trinity Evangelical Lutheran Church does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to the Church arising out of his administration of the Estate. IN WITNESS WHEREOF, Trinity Evangelical Lutheran Church has caused the execution hereof by its duly authorized officer this J \ it- day of <6ttot<"",Ll/V , 2006. TRlNITY EVANGELICAL LUTHERAN CHURCH By: ~ S~"' ~ ~~lkl-.t-V( flt ~.lt ~ ,I ) ~, r , COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF .:vtttJfrl'^, r4 On this, the ~ day of ~~lf . 2006, before me, the undersigned officer, personally appeared rh IJU1 {{ f, Slt\. hA..u U" . a duly authorized officer of Trinity Evangelical Lutheran Church known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~~.~. Notary Public W :rH f PENN YLVANIA Martenne NofM8JS811 OllYcf~~PubIc MyCornmfulon eiPI~ no ~ ) I , I IN TIB ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-06-00248 cg; (Q) U~~ ~ RECEIPT. RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Two Thousand One Hundred Twenty-one and 48/100 ($2,121.48) DOLLARS, being the amount shown as distributable to WITF, Inc. in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. WITF, Inc. also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it ifhad been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to WITF, Inc. had been duly awarded to WITF, Inc. by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, WITF, Inc. agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, WITF, Inc. does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to WITF, Inc. arising out of his administration of the Estate. IN WITNESS WHEREOF, WITF, Inc. has caused the execution hereof by its duly authorized officer this I '1)';1.. day of 5 t f + f 'Ih b ~ Y'" , 2006. WITF, INC. By: ~~ -~~ EIN No.: 2.. 3 - I/' 2... q 0 " ~~~ q It 11 Q (., NOTARIAl SEAL TERESA J. KURTZ Notary Public CITY OF HARRISBURG, DAUPHIN COUNTY My Commission Expires JU/8. 2000 .. >> . , . f COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF Dau..fhi'(\ On this, the ~ day of Jp.~ . 2006, before me, the undersigned officer, personally appeared L1-r ~ \ru-J ... . a duly authorized officer of WITF, Inc. known to me (or satisfuctorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~IaIy~ Qp1/f\1p NOTARIAl. SEAl. TERESA J. KURTZ Notary PubUc CITY OF HARRISBURG, DAUPHIN COUNTY My CommissIon expires JuJ 8, 2009 . .. I ,I' IN THE ESTATE OF RUTH E. STINE tATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION NO. 21-06-00248 cg (Q) U~D 'Y! RECEIPT. RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Two Thousand One Hundred Twenty-one and 48/100 ($2,121.48) DOLLARS, being the amount shown as distributable to the Amelia Given Library in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. The Amelia Given Library also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to the Amelia Given Library had been duly awarded to the Library by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, the Amelia Given Library agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, the Amelia Given Library does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C.T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to the Amelia Given Library arising out of his administration of the Estate. IN WITNESS WHEREOF, the Amelia Given Library has caused the execution hereof by its duly authorized officer this ~ 9"" day Of~/J( ~ . 2006. NOTARW. SEAl. CHERYL D SMI1H Notary PublIc Mt HOU.Y~8ORO. cw.wERlNC)CNIY My CommIssIon expires Feb la, 2010 AMELIA GIVEN LffiRARY By: l~ ~ ---rt;;:~", Di~ ElNNo.: 1-~- 'L'O'2. '\Gf\1 t ,. I .~ I COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF /, On this, the ~ay Of~ti /11 /'U)L 2006, before me, the undersigned officer, personally appeared l~l-kl,^ --rt:;;"'t" . a duly authorized officer of the Amelia Given Library known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. {lj, ''tLn.xhn < b{, Notary Public NOTARIAL SEAl. CHERYL D SMt1H Natafy PubIc Ml HCllLYSPRIGS I0IO, CUl.EfU.NC)CNIY My CommIIIIon ElcpIfeI F.a> 11, 2010 . . . . .. ,. IN THE ESTATE OF RUTH E. STINE LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-06-00248 ~ cQ) Ll2) V RECEIPT. RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that receipt is hereby acknowledged of Cash in the amount of Four Thousand Two Hundred Forty-two and 96/100 ($4,242.96) DOLLARS, being the amount shown as distributable to The Bethesda Mission in the First and Final Account and Proposed Distribution to Beneficiaries attached hereto and made a part hereof. The Bethesda Mission also hereby waives the filing of a Formal Account with the Court, and accepts and approves the Informal Account as stated with the same force and effect as it if had been duly filed in the Office of the Register of Wills, adjudicated and confirmed absolutely, and the amount distributed to The Bethesda Mission had been duly awarded to the Mission by the Court. In consideration of such payment and in consideration of the same promise of the other heirs, The Bethesda Mission agrees to refund to the Administrator of the Estate, any portion of the distribution to which it may not properly be entitled, or pro rata, any portion of its distribution which may be necessary in the future to discharge any liabilities of the Estate or claims against the Estate not known to the Administrator during the period of administration. In further consideration of which payment, The Bethesda Mission does hereby remise, release, exonerate and discharge the said Richard E. Shambach, both individually and in his capacity as Administrator, C. T.A., as well as his heirs and personal representative, of and from said payment and of and from all further liability of any nature to the Mission arising out of his administration of the Estate. IN WITNESS WHEREOF, The Bethesda Mission has caused the execution hereof by its duly authorized officer this ~- day of 6 C TOB If ~ .2006. THE BETHESDA MISSION By: ~~I:?/ EINNo.: 213 13 'iI 7 377 ,: . . . . ;' COMMONWEALTH OF PENNSYLVANIA : SSe COUNTY OF DAUPHIN On this, the f11L day of tJcA-o &4 L~a" IQ.,~ LlJIAiG:A--T~ ~ a duly . 2006, before me, the undersigned officer, personally appeared authorized officer of The Bethesda Mission known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. {dh'" )j, ~~A/JY;;" < Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL DONNA M. WIERMAN. Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 28, 2009 I F'"'''' ll:\..A RE(:i1:.; ; ") OFFICE OF 1 OF WILLS 2005 OCT II Ptll: 08 - ir\ OF tRT ,,', ("'\1 ," I ~ \"~;\),,J I CF:' Cl,l" 'I. 0.....0;0 >ocm ;oO~G) .....Cr:Den cn;om-e .....-e;om m:I:S:;o -"'OOZO >CC'" .....eno:E oooJmO_ ~enC~ wOzen w~-eO w -<." 0);00'" oooJmOO .. cm ~ :I: o C en m ~ ~ 00; C:Co ~~: ~O~, .......... '" mZcn "'l:l <J.l :::; ~ 0 := ~===a: <J.l 51 0 > .:, Z >< E:! .... I:'fj ~ r;; o:-o~ <C .,;: <C en ~ ~ m ~ II i: 0 0 U/IfJt~""" )> Of\) ~ ~ rl> ;.ii; ~ ~~ !~'I ~ f\)~ i OO~ t ~ CI