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10-30-09
REGISTER 0~' WILLS OF J 1~ Pr2 h+~}VJ t%~, COL~tTY, PENNS~'LVANIA Name of Decedent: ~~~ ~ f~ 1 ~~ ~~ ~ ~~~ X12 / S l Date of Death: IV ©U~ ~ ~©©~ File Number: a~~~ 8' ©~ ~ ~ 7 D,..•,,...,,,++„ D~, (1 r~ D„la ~ 1 ~ T ,-o,,,,,-t tho fO110zz,inv ~z;ith racner.t to rmm~lP,tio11 (lf tale a171111T11Strat1011 Of 1 ULJLLC1:ll ~V 1 (1. V•L~• l~.l.~ly v.1., . 1vNvl~ ~iiv „ ..b r'-- t"' the above-captioned estate: 1. State whether administration of the estate is complete :.................... Yes ~ No 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: a. Did the personal representative file a final account with the Court? ...... . b. The separate Orphans' Court No. (if any) for the personal representative's account is: flYes ~No c. Did the personal representative state an account - - inforn~ally to the parties in interest? ............................... (Yes ^ No d. Copies of receipts, releases, joinders and approvals of fo>.rnal or informal accounts maybe filed with the Clerlc of the Orphans' Court and may be attached to this report. Dnre ~L'~~~(':2 ~C1 !t'om'/ _ / Si~nahtre o on Fil' g this Form Capacity: Personal Representative ]Counsel 4 `~ Nmne ojPerson Fi n, this Fm~m L i "~ - Addres ,, jj~ ~ ~- ~ Lt~n~~iCS~uQ~ ~!~ 17oSrS r ,~:, t :. _,. n-, ~--''' Telephone C`C ~~"'~.. C~ c~-+ ro,,nRbY-JD rev. J0.J3.0/ /~