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RXHO,U>>fi<\ ,/Ill SIINON 1,1,1'
ATTORNEYS AT LAW
ONt': SouTHMARKtr SQl!MHC:
P.O. Box 1146
HA'~HI"r.URO, F,lA 17'08.,,46
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. Complete items 1,2, and 3, Also complete
Item 4 It Restricted Oollvety Is desired,
. Print your namo and address on the reverse
SI,) that we oan return the card to you.
. Attsch this csrd 10 the bsck of the ""lIplece,
or on the iront If space permits,
\\11\ LTLK.')
I~Al<:.p:,IP/1r~ U-J
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D lJ~I{lIIV6ry addreJ'l different from !tOm 1" 0 '(os
11 YES, enlm delivery Rddross hf)low: 0 No
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Article Addressed \0:
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f1u'itn';Wd f.l"Ii'INy 1-'1"
II:n<l,_",;"!IIO'1\ H'lquiW(!1
3, ~lCe'Ty -
...f'J Certified all 0 [)(pross Mal ""_:,'_U:~;1"
. 0 Regi,lme" l,lfJHel4!(\ R~""j "I'.',e
o InsuredMnll ~ --
..' .~---
4, Restricted Delivory? (f:"xtra Foe) 0 Yes
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TolftlPOSIIl\"JlIdo fllllS $
1______..
'ReoIPlopi-~riN:"Tlie iPi~;;;i(J 1;";I-'--6ionr"ivi' (!{;.i;~co(J)j;I;.)fI;{Ti;vni'l;IQ~--_.'
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2, Artlole Number (Copy from sorvlce/sOO/) - ...' r::- () . - n. (./ (I
100{) . OloOO -U02-S- 1':>14 -IU
PS Form 3811 , July 1999 Dome,tlo Relllrn Rece,pl
10259!HI9.M.t1t'9
d, Copies of t"eceipts, releases, joinders and
approvalS of formal or informal accounts may be filed with the
:0.::,0' ;~ ~::;' CO"" ."d .., bOQ"" d 0 <h" ,opo<<
Signat-ure - ---
~ -;;;t rt-1 !va 1hz (.5
Name (~lease type or print)
A.7dA;zZrj%tI~ ~ /7$"
Un} 7;;2' /:;"3?2- -
Tel. No.
Date
ST^TU~ REPORT UNDER RULE_~~
l k 5~e_1-1-.<kilk ( 5
of Deathl cO ~ 9'- Cf,5
.;.-------------
No. ).1- l~tr'7~ O(Yl5.f..--_~ Admin. No. :JI
/9'17. r!>15'?
--
Name of Decedent 1
pursuant to Rule 6.12 of the Supreme Court orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estatel
Will
1. State whether administration of the estate is complete I
Yes_ ><,_. No_---
2. If the answer is No, state when the personal
representative reasonablY believes that the administration will be
complete 1_
3. If the answer to No, I is Yes. state the followingl
a. Did the personal representative file a finnl
account with the court? Yes____. No_~p'
b. The separate orphans' Court No. (if any) for
the personal representative's account is: tJ/~
c. Did the personal representative state an
account informally to the parties in interest? Yes No ><
capaci ty:
X personal Representative
____counsel for personal
representative
(MAHlrmf/1\M3)