HomeMy WebLinkAbout04-28-10C... ~!' . t •. • ' I .. V ..L u :i.. 1 ~..
R~C1ST%R 0~ tiViLLS OF~I~ber-lcun~ 00VvTi', PL=vT1SYLV.~N?.~
Nall7e Gi Deced~nt:_ ~--x~ ~ ~~~r~~~-~" ~, ~`._---_.- - -
~~ 3 2~0 ~ rile Iv'n:Tber: ~ ~ ~ ~ _ ~ ~ 3 Z ~
Datz a Death:
D•.. _t •.. D.. r, ~^ D, In <. 17 T , r~~-t th f~-,l!n~ini~a \:;!th ~ yCpPf-t to rnmpl~tinii of tl,e aljlllilllitl'at!on Of
1 ui Ji.i;a.u •v i u. v.~.~. i~ua., v. <, a. ae~ ... .. .. ..J _
the abo•~•e-captioned estate: .
1. State whether admul!5trat!on of t~~e esta~e is compl
2. If the a!is:~~er is ~ 10, 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:
-~~ ...... ( I'es ~~No
a. Did the personal representative file a final account withthe Cout~.. .
b. The separate OtThans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representati~~•e state an account
.......,..~'~ 1'es ~No
info,r:~ally to the parties in interest? .:... . .............. .
_ d. Copies of receipts, releases, joinders and approvals of fotlr!al or infonraal accounts nlay be
Bled with the Clerlc of the Orphans' Court and i y be atiacl:ed o this re rt.
Si~n~ture ojPerson riling us rorm
~ Capacity: ~ersonal Representative ^Counsel
W O ~ ~ Nnn;e of Parson riling this rorm ,,
-_' - C_~ ~ lJi-tL.~
~- ~ .~, ~ n .,.,~ n
fv .,.... ~ Fe(enhone
t~.+