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03-02-10
RECISTEr, OF titiiT LS OF Cyi~r°(~I ~ rl (J~. COUNTY, PE?v`?vSYL~V:~NI~ Name of }~ .U~ 1" 1 ~O~-lG~erS Deceden~.~ C' Date o~ Death: ~ ~ 2 ~~ ~ File Iv'u:mber: ~OU .~ ~ ~ 2 ~- ^„* + ,-'nr„-+ t~,a f.,11n1z~i.,o~ Zuith r~cr~a;~t n rrmnletiQn of the adn nitra ion of Dill Jll :111 LV PCL. v.C. Di.il~ V.i?, 11..1..va~ .,... y•,; .av .~ t ~ t r- r the above-captioned estate: 1. State whether administration of the estate is complete :.................... ~ Yes [] No 2. If the answei is No, state when the personal representative reasonably believes that the administration will be complete: . 3. If the answer to I~To. 1 is YES, state the following: a. Did the personal representative file a fnal~account with the Court? ....... es ~ 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? .:.................:........... ~ ~~.'es L~'No d. Copies of receipts, releases, joino'°rs and approvals of formal or informal accounts nlay be filed with the Cleric of the Orphans' Court and maybe attached to this report. Dn~e ~' °2'a / ~ c~ Ci © ~ '~ ~l..~K_ t ~ .~. ~ ~ ~ N ~. ~:>> c ~. .x,.t f_c.s c 1 °~ . 4 ~ ~..:;~ ~.,....: ;. ~ s ~ ['T:. 4 Form RBI'-/0 rev. lOJ3.06 SiJnc~ture of Person Filin,;this Form Capacity: ersonal Representative []Counsel UGC n ~ ~~ ~ 1~ ~0 2 [Q,0 vJS~ 1 1Vmne of Person Filing this Form Address Telephone