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HomeMy WebLinkAbout09-16-10 Li S ~.5. / V t.."+. J. tJJ J.S. fl , F.ECI~TEi:OF ~^iiT LS Gr ~ ~~1~~1~}N~ COU:vTY, PL~~iSYi ~~'~,~~a >.. . Name of Decedent:_~_[ r I 1 ~C~,,~.~ ~ ~~r _ *~_ Date o: D_at'~. ~- G~~ --ZQ~ F File Nu::'? zY• o~ ~` (~'.•~~ ~~' ' ~ -*-7-- D • • D !l /~ P. to ~. 17 i ~ v:~t t:1'. f~l:::.t=r;r. ' n ~ ••le f tl?,'. ~di~?i';?IStI•at101? Of • ui~u3iu w ~ v. v.~,~. i.L:.., v.a_, et, „~ ;'tin r. c7~a^: t~ ('rTT:.~ .;~(!t] (? the above-captioned estate: 1. Sta±e ~* rte a h h r dministration of the e..tate is com fete :.................... ~ es ~] No P 2. If the ans~veris Iv'o, state when the personal representative ICI reasonably believes that the administration will be complete: 3. If the ai?seer to I~'o..l is YES, state tie followinj: a. Did the ersonal re resentative file a f:lal•account with the Court? ....... ~ ~es- ~No P P ~ / ``''' b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account iufotm?ally to the parties in intzrest? .:............................. 'es Ovo d. Copies of receipts, releases, joit.ders and approvals of formal or informal accqui~ts may Ue filed with the Clerlc of the Orphans' Court and maybe ar..ached to thi~~,~•eport. ', `i • ~ ~ ~ VGA , Q ~ _ L~ -~. N ~ OC Li _.. C ' ecC O -..J ~ €~~~ ~' 4 m _ ~, N Si~nnrur of"? :on Filir~~(iti: Form Capac~y: QPersoral Representative ~C~ounsel '~p.Y Ld K :P ~1V'~¢.~WS ~I ~-^ - tb'nr::e ocjPzrsat FilDir.~tha rur-nt _~d W 1 ~~~ d.icrreSS - Te7zp;rarz L ~ i