STATE OF SOUTH CAROLINA	)	IN THE PROBATE COURT
)
COUNTY OF GREENVILLE	)
)	RECEIPT AND RELEASE WITH WAIVER
IN THE MATTER OF:	)
)	CASE NUMBER: ____________________
(Decedent)	)

The undersigned hereby acknowledges receipt from the Personal Representative in this matter of the following property:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

In consideration of the above listed distribution, the undersigned hereby releases and forever discharges the Personal Representative and the Estate from any and all rights and claims, which the undersigned may have against the Personal Representative and the Estate, and waives right to demand a hearing on all Accountings (if applicable), Proposals for Distribution (if applicable), and the Application for Settlement.

Executed this _____ day of ________________________________, 20_____.

Recipient Signature:
Print Name:

*Witness Signature:
Print Name:

*The Personal Representative is not allowed to serve as the witness. The witness must be a disinterested party--not related to decedent, beneficiary or personal representative.