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REGISTER OF WILLS OF l '. ~.~~~J~ `l~-L~ COUNTY, PENI~iSYLVANi~
Name of Decedent: ~~0 ~ ~ - I~~~~ ~~.5 ~ _
Date of Death: ~ J' ` ~`~ 200 File Number: ~-V~t~ ~ y~ ~ " 1
Piirsuaiii tv Pa. i.i.C. mule v.i?, i repCrt tl:e fOllntztinj ezrith racsner•.t to rnmpletinn Qf the aCi1117T11$tratlon Of
the above-captioned estate:
1. State whether administration of the estate is complete :.................... `~] Yes ~] No
2. If the arisweris 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 finahaccount 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 oPformal or informal accounts maybe
filed with the Cleric of the Orphans' Court and maybe attached to this report.
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Signature ojperson Filing this orrrt
Capacity: Personal Representative ~] Counsel
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Name ojPerson Filing this Fans
Addres
Telephone
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