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1?.ECISTER OF WILLS OF COL>;~~TY, :°LNTtSYLVA:tiI~
Name of Decedent:
Date of Death: ~,~ /d ~l b ~ File Nu:nber:_~Q/1D - Q ®~-~
D...•....•..r t,. D., (1 (` D„1, ~ 17 T ,•ar~n,+ the f.~~ilrnziino~ u;ith t•_ena;.; to rmm~letinn of tl,e a~1111n1~t1'at?011 Of
the above-captioned estate:
~ ~ fthe estate > com lete: .................. • • es (~ loo
1. State wh.ther admmistrata.on o p.
2. If the answeris No, state when the personal representative
reasonably believes that the adlministratioliwitl be complete:
3. If the answer to No. 1 is YES, state file 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: r
~J~lJ
c. Did the personal representative state an account
informally to the parties in interest? ............................. .
es Q No
~'es [~ No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may Ue
filed with the Cleric of the Orphans' Court and mays be attached to this report.
Dare 4~I17 /o
-~ Sign~fure ers Filing his Form
Capacity: ~ ersonal Represe ative Counsel
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c. _
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t.ts = ' ~ ~ ~ Nnme ojP rson Filing this Form
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