HomeMy WebLinkAbout11-03-06
lNRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-06-0290
ESTATE OF
DOROTHY A. WERTZ,
Deceased
RECEIPT AND RELEASE
I, MARY ANN WERTZ-METCALF, the undersigned, being a beneficiary under the
Estate of Dorothy A. Wertz, 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 Dorothy A. Wertz;
4. To the extent of said distribution, release John T. Wertz, Executor, of the Estate of
Dorothy A. Wertz, and his heirs and personal representatives, from all liabilities, whether due to
his negligence or otherwise, which he may have by reason of his administration of the Estate;
5. Agree to refund to the Estate and to the said John T. Wertz, Executor, any portion of
the distribution to which I am not properly entitled, and, to the extent of said distribution, to
indemnify him and the Estate for claims made against him and to reimburse him 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 personal
representatives, and assigns.
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this
C~tio~'~r- ,2006.
day of
#~~1;/~l (SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
On this, the 3 D day of CJJtf6er~- , 2006, before me, the
undersigned officer, personally appeared MARY ANN WERTZ-METCALF, 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.
~Vud1t OUjl;no
Notary Publi<V
NOTAAW. SEAt
WENDY S. CHESBRo, Hotmy Ptbtic
t..o.r Allen Twp., ~ Ccut(r
My Commtaebl ElCpires May 10, 200t
BANEiS LAW OFFICE
4-29 SOUTH 18TH STREET
CAMP HILL, PA 17011
E-mail: mikebangs@verizon.net
PHONE: 717-730-731l
FAX: 717-730-737'
MICHAEL L. BANGS, Attorney-at-Law
WENDY K. STRAUB, Paralegal
WILLIAM E. MILLER, JR
Of Couns€
October 31, 2006
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Dorothy A. Wertz
File No. 21-06-290
Dear Ms. Strasbaugh:
Enclosed you will find the following:
1. Two Receipt and Releases;
2. A check in the amount of $1 0.00 to pay the filing fee; and
3. A Status Report Form.
Please file these accordingly. The estate administration is now concluded.
Kindly return a paid receipt to me in the enclosed, stamped, pre-addressed envelope. If you have
any questions or require anything further, please contact me.
Very truly yours,
V\J\~
Michael L. Bangs
wks
Enclosures
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cc: Mr. John T. Wertz
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