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Pa. O.C. mule 6.12 ST ~.TUS REPOT
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REGISTER OF WILLS OF y/7 ~~' ~// COtTiv'TY, PEN~ISYLVANI.~1.-~---^~--- -
lv'ame of Decedent: ; ~~/J~~//l/~ L . ,D~~W~"
Date of Death: ~ ~'~~~! ~ File Number: ~~~~ w ~ ~O~
Pursuant to Pa. O.G. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :.................... Yes Q No
2. If the answeris No, state when the personal representative
reasonably believes that the ad:ninistrationvill 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? ....... Yes ~(No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
info:nzally to the parties in interest? .............:..........:........ ~I'es ~ No
d. Copies of receipts, releases, joinders and appror•als of fo:-mal or informal accounts maybe
filed with the Clerlc of the Orphans' Court and maybe attached to this report.
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Si,,mature oJPerson Filing this orm
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Capacity: ,Personal Representative ]Counsel
Name of Persmi Filing ibis Form
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Address
7/7 737-s~~8
Telepho»e
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