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iV 3111e GI Decedent: ' I~ tli. ~ 1~ 1`.Q-~ ~P _
Dade e`D_ath: ~~~, ~l G' ;~! Fil~ h;ut:^ber:
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tine above-captionzd estate:
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•.. t f •1 P r III es LJ l ~ `~
1. Sate whether adrlinistratioa of the e.,tate >s co~apl..~e :............ .:
2. if the answeris iv'o, state when the personal representative
reasona~ly L-elieves t hat the administratio?i will be complete:
rte- ~{.,+ C e'"~-~ if~1. ,~'~. S ~ - -
3. If the answer to iV'o.. l is YES, state the follo«•in~:
a. Did the perser_af repre,en~at:ve ~t.e a f..lal~aecolint with the Court? ....... [~~'~s ~ No
b. Thy separate Orphans' Court No. {if any) for the personal
representative's account is:
- ~ _~
c. Did the personal representative state an aCCOl111t
infornlaliy to the parties in iraerest? .:............................. ~ ~,~~'es E]No
d. Copies of receipts, releases, joinders and approvals of folTrlal or informal accaun~s maybe
filed with the Cleric of the O>phan s' Court d a•• be a~a~hed to thi~ repot~~
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Capacity: ~'ersollal Representative ~]C~ ounlsel
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ddc~ress
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