Fill and Sign the Executor Release Form

IN THE _____________ (Name of Court) OF ______________ (County) OF _____________ (State) IN THE MATTER OF THE ESTATE OF ____________________ (Name of Decedent) , Cause NO. _____________ DECEASED Release and Waiver I, __________________ (Name of Beneficiary) , acknowledge that _____________________ (Name of Executor) as the Executor of the Estate of _____________________ (Name of Decedent) , Decedent, late of ________________ _____________________________________ (street address, city, state, zip code) , has fully and satisfactorily accounted to me as beneficiary under the Last Will and Testament of ____________________ (Name of Decedent) , for all moneys and property held by said Executor. Now, therefore, in consideration of the sum of $__________ (dollar amount) paid to me, the receipt of which is acknowledged, I release, exonerate, and discharge ___________________ (Name of Executor) , as Executor and his/her sureties from any and all liability and accountability to me, and I consent that Executor may have a decree entered discharging him from any and all claims, demands, liability, and accountability to me without further accounting. I waive the issue and service on me of a citation to attend the judicial settlement of the accounts of Executor or any other proceedings taken by him/her in ______________ (Name of Court) of ___________________ (Name of County) , pertaining or relating to the Estate of Decedent. Witness my signature this the _______ day of ________________, 20_____. ______________________________ (Printed Name of Beneficiary) ______________________________ (Signature of Beneficiary) STATE OF ______________________ CITY OF ______________________ Personally appeared before me, the undersigned authority-at-law in and for the jurisdiction aforesaid, the within-named _________________ ( Name of Beneficiary) , who, being by me first duly sworn, stated under oath that he/she signed, executed, and delivered the above and foregoing instrument on the day and year therein stated for the purposes therein mentioned as his/her own act and deed and that the things contained therein are true and correct as stated therein. ______________________________ (Printed Name of Beneficiary) ______________________________ (Signature of Beneficiary) SWORN to and subscribed before me, this the _______ day of _____________, 20_____. ____________________________ NOTARY PUBLIC My Commission Expires: ___________________