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REGISTER OF WILLS OF t-,L,r jV1_~ y ~~%/~c~ COU~i~ITY, PENiv-SYLV ~Nl.~
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Nance of Decedent: ~l~t,f~'f i cZ- ~ ~ C ~! ~l~C'r~
Date of Death: ~'~ I ~~ I "~
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File Number: o~ Cl~ ~ " C i ~ ~=~
D.,.-.,,.., ,,++., D., (1 ~` D.,lo ~ 1 7 T ,-o.-.n -t ll1P f~llOtiznna ~Xntll t'PCnP.tli" t(1 (lflnlTll P_,Yloll Qf the 3.dlll]r11St1"at1011 Of
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the above-captioned estate:
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i. Stag, vVhether aUllliili~traiioii of t.le cS~atc i~ CU111pic;ic: .... ~ e5 ~ ivv
2. If the answer°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:
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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
infoin~ally to the parties in interest? ............................... 1'es [] No
d. Copies of receipts, releases, joinders and approvals of foi~rial or informal accounts may be
rued with lice Cieric oz the Orphans' Court and maybe attached to this report.
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gnatur of Person fling this Form
Capacity: [Personal Representative OUnsel
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Name dfPzrson Filing this Form
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