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REGISTER O Vv"ILLS Or C~-n°-~~-~-~1~!-~CC•~ COL`I~~TY, PE;v~SYL~~':~NI~
Nance of Deceden
Date of Death: ''-~ - 1~-- ~ ~ File Number::~C~G 7- C~C`.J7~
D..,- ,++„ D., n n D 1 ~ 1'7 T ,- n,-` the fnlin.znno ~zrith recrier.t to ! mm~lP,tinll Qfthe adil117115trat1011 Of
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the above-captioned estate:
State whether administration of the estate is c.<~n~plete :.. . ................. ~~ Yes ~ No
2. If the answeris No, state when the personal representative
reasonably believes that the administration will be complete:
3. Ifthe answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? .... , ..Yes
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
No
c. Did the personal representative state an account
._
info>n~ally to the parties in interest? ............................... Yes ^No
d. Copies of receipts, releases, joinders and approvals of fo>znal or informal accounts may be
filed with the Clerlt of the Orphans' Court and may be attached to this report.
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Si~nah e ofPerson iin~ this Form
Capacity: ]PersonalhR~epresentative 0 Counsel
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