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REGIS T FR 0 ~;VILLS GiG ._.._+.:~ r~ 1'> 4..1Z l a~ d COliNT :', PEti~`: SYL`/.`:N i ~.
Name of Decedent: ~"~~ ~ 1~ ~ h~ ~ ~ A ~ S ~ ~ cat,
_ ~~ ~„~ Q ;zaG ~ File Number: ~ fi Q ~ •-C~ / ~ 7 7
Date of Death: -
D,,.-,..,.,,,, ~„ ~„ n ~ D„lo ~ 17 T Le,-,n,-t the f0110 ;z;vino ~z;ifh ,-a~~,er.t to rmm~lP,tini] of tale ad1111111$trat1011 Of
file above-captioned estate:
1. State whether administration of the estate is complete :.................... es L-I No
2. If the answe>~is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? ....... Yes [~ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
.-
informally to the parties in interest? ............................... Yes No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerlc of the Orphans' Court and maybe attached to this report.
Date ~~~ J/ ~ /~ ~ Cl~
Signature of"?erson ding this Form
Capacity: Personal Representative ~ Counsel
~ w Name of Pzrson Filing this Form
~. yct~ iJ c1 ?
Address
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