IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON

IN AND FOR COUNTY

In re Estate of , Deceased.	NO. RECEIPT AND REFUNDING AGREEMENT AND WAIVER OF NOTICE OF FILING DECLARATION OF COMPLETION OF PROBATE

The undersigned hereby acknowledges receipt of full settlement of the undersigned’s distributive share of said estate. The undersigned also acknowledges receipt of a copy of the Declaration of Completion of Probate and the personal representative’s accounting for the estate, and hereby approves of the personal representative’s accounting waiving any right to challenge the accounting. In consideration of the foregoing distribution, the undersigned hereby releases Ohana Financial Services, as personal representative of said estate, and the above captioned estate from any further claim the undersigned may have as an heir or beneficiary of said estate.

The undersigned further agrees upon written demand by Ohana Financial Services, or its successor, to (i) refund, to the extent of the amount distributed to the undersigned, and not otherwise, any amount which Ohana Financial Services or his successor certifies is due and payable by the undersigned with respect to any estate obligation resulting from over-distribution of the undersigned’s share of the residuary estate, and (ii) pay the reasonable attorneys’ fees and costs, if any, of the personal representative which are incurred to enforce the obligations of the undersigned which are contained in this paragraph.

The undersigned hereby waives notice of the filing of the Declaration of Completion of Probate in the above estate.

The undersigned further hereby acknowledges and understands that the personal representative does not intend to submit a formal accounting to the Court or to obtain an order approving the fees of the personal representative, attorneys, appraisers, and accountants, or to otherwise obtain Court approval of any of the personal representative’s actions in administering and distributing the assets of the estate.

DATED: ____________________________.