STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF: ) ) ) ) ) IN THE PROBATE COURT RECEIPT AND DISTRIBUTION AGREEMENT CASE NUMBER:
The undersigned hereby acknowledges receipt from the Personal Representative(s) in this matter of the following property:
If the other assets of the Estate are insufficient to pay all the debts, administration expenses and taxes of the estate, then the undersigned, in consideration of the distribution made at this time, agrees to pay over an amount equal to the value of the distribution or such lesser amounts as will fully satisfy all of the debts, expenses and taxes, to the Personal Representative(s).
Executed this
day of
, 20
.
Witness:
Beneficiary:
FORM #402PC (7/87) SCPC administrative