HomeMy WebLinkAbout11-03-06
INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYL VANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-05-1114
ESTATE OF
JACQUELINE H. FREAM
Deceased
RECEIPT AND RELEASE
I, KATHY J. POWELL, the undersigned, being a beneficiary under the Estate of
Jacqueline H. Fream, 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 Jacqueline H. Fream;
4. To the extent of said distribution, release Kathy J. Powell, Executrix, of the Estate of
Jacqueline H. Fream, 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 Kathy J. Powell, Executrix, any portj.Qp of
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the distribution to which I am not properly entitled, and, to the extent of said disftion, t~
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indemnify her and the Estate for claims made against her and to reimburse her m!~~~sta~ll
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expenses and costs incurred in connection with any such claim; and (--3 c -n ;;g
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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
day of
No\feJY\rx ('
, 2006.
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KATHY~LL
E)C2:c.
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND ~ I )
On this, the ~ day of) ~ ,2006, before me, the
undersigned officer, personally appeared KATHY J. POWELL, 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.
SEAl.
WEII)Y I. OfESBRO, NotIIy NIII
loww". Twp., Cumberland CaIIIJ
My ~hl', IlIlukf'l Expirrnt May 10, 2<<fI
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