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REGISTER OF WILLS OF Cuv~~JeV`~q t-~~ COUNTY, PEN-NSYLVANI~
Name of Decedent: 1 ~i (~~ ~'~~ ~~ ~r ~~~ TI (~
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Date of Death: q!'G~ 7 File Number: ~ ~ - ~ ~ - ~ 3 ~
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the above-captioned estate:
. Yes ^ No
State whether administration of the estate is complete :.................. .
2. If the answe>~is No, state when the personal representative
reasonably believes that the administration will be complete:
3. T ~'', ~~ 'vTo. 1 is YES, state the following:
._. D1d the personal representative file a final account with the Court? ....... C~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 fol~nal or informal accounts maybe
filed with the Cleric of the Orphans' Court and maybe attached to this report.
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~ Signature of Person Filing this Form
Capacity: Personal Representative Counsel
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l~ Nmne- ofP~n lling/~this Form y
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