InfoSub - Regarding Refunds

www.OGMHognj.com
InfoSheet SubPage - Refunds

Ocean Grove Memorial Home
118 Main Avenue, Ocean Grove, New Jersey 07756

Thomas J. Saragusa, Manager
N. J. License No. 4036

VOICE 732-775-0434 - - OGMHognj@aol.com

Occasionally, we find ourselves in possession of funds in excess of what we are entitled, often because of the accrual of interest on trusted prepaid funds or because of a credit granted for prompt payment.

This is our policy regarding:

Refunds

(After our services are rendered, no contract will be renegotiated.)

All refunds made by the Ocean Grove Memorial Home will be made payable to the order of:

the sole payor of all funds received (if living)

or to

the Estate of the decedent.

or ONLY IF a Release and Refunding Bond is executed and filed with us.

Another individual who is reasonably due the refund.

Release and Refunding Bond

IN THE MATTER OF THE ESTATE OF

NAME OF THE DECEDENT, deceased.

________________________________________________

KNOW ALL MEN BY THESE PRESENTS, that I,

Name of the Recipient of the refund

residing at
in the City of
in the County of
in the State of

herein designated as the Obligor, hereby hold and bind myself to the

OCEAN GROVE MEMORIAL HOME
118 MAIN AVENUE, OCEAN GROVE, N. J.

herein designated as the Obligee, in the sum of

$

lawful money of the United States of America, to be paid to the Obligee or to the Obligee’s certain attorney, successors in office or assigns. I bind myself, my heirs, executors and administrators firmly by these presents.

Signed and dated this DATE

The condition of the above obligation is such, that whereas the Obligor has received from the Obligee the sum of

$

representing the balance of funds from the

NAME OF THE DECEDENT, irrevocable prepaid funeral trust fund

the refund being withdrawn and forwarded to

Name of the Recipient of the refund

And in consideration therefor, the Obligor by these presents releases and forever discharges the Obligee from all claims and demands whatsoever, in law or in equity, on account of or in respect to the estate of the said decedent and of Obligor’s interest therein.

Now therefor,
If the Obligor be a legatee, then if any part or the whole of such legacy shall at any time hereafter appear to be wanting to discharge any debt or debts, legacy or legacies, or any other just claim which the Obligee may not have other assets of the decedent to pay, the Obligor will return said legacy or such part thereof as may be necessary for the payment of the said debt: or

If the Obligor be a distributee, then if any debt or debts, truly owed by the decedent via the Obligee, shall be afterwards sued for and recovered or otherwise made to appear, and which there shall be no other assets to pay, Obligor shall refund and pay back to the Obligee, the Obligor’s ratable part of such debt or debts, then the above obligation to be void, or else to be and remain in full force and virtue.

The words “debt or debts” wherever used herein, shall be deemed to include all taxes imposed upon or chargeable to the estate via the Obligee or owed by the decedent, including but not limited to Federal, New Jersey or other State or Sovereignty transfer inheritance, estate, death and income taxes, or any other value determined as due any of the State of New Jersey Public Assistance programs (including Supplemental Security Income program of the federal Social Security Act, Medicaid, Work First New Jersey or the “Work FIrst New Jersey General Public Assistance Act” or any successor program under N.J.S.A. 2A:102-20) together with interest, penalties, costs, expenses and counsel fees, if any.

Signed, Sealed and Delivered _____________________________________L.S.
Name of the Recipient of the refund

Signed, Sealed and Delivered _____________________________________L.S.
X

Notarized Statement

State of New Jersey }
County of Monmouth }

Be it remembered, that on Today’s Date

before me, the subscriber, personally appeared

Name of the Recipient of the refund

who, I am satisfied, is the person named in and who executed the within Instrument, and thereupon he acknowledged that he signed, sealed and delivered the same as act and deed, for the uses and purposes expressed therein.
(Seal) _____________________________________L.S.

If more than one person executes the within instrument, then words used in the singular shall be considered to include the plural, and wherever herein any particular gender is used, it shall be inclusive of the masculine, feminine and neuter gender, where the text so requires.

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