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11-02-10
1 , ; ,rte ff ~~; _ i~ "c~:~. ?i7, tJ.s~.'. ~`_'ii~ ~.~.~ v.:.?3 '7i ~ir`i .it%~--~~ ' F.EC1STEr.O;= ~^i .' LS Gr ~i'hBr2LRN.~ CGUvTY, P~~~ISYL•~,- ~,\a, Tvame of Decedent: ~ S2t ~ Date ~: Death: I/~3 0 ~ File ~~u:::v~::~s2o2--dam P .. • ~.. D.. Cl !` D. la h 1'Ir T ,•~wt t-'e •1 :Yti/!r.' ~ r ui~u3iu w . ~. .... ,..:,.. ~.._ ~ . f.,_ - a anti, r?c;,?:,, t.~ !'rrr. ~1~`i~n n{th2 2~1ri: i9t!',ation of tine above-captioned estate: i 1. State whether ad!ninistration of the estate is complete :.................... ©'~'~s No I 2. if the ans~veris ;v'o, state when the personal representative ~ ', reasonably believes that the ad!rini~tration will Ue complete: ', 3. If the ai~s.ver to 1~'0.. l is YES, state die iollowinj: ', a. Did the ersona~ re resen~at:ve ~!.e a fnal account with the Court........ ~Y P ' P `~ ~ ~ ~ s ' T° i b. The separate Orphans' Court No. (if any) for the person: l representative's account is: • i c. Did the ersonal re !-esentative state an account Y P A niforn,al:y to the parties !n n:t,.rF~t. ~ ~ ~s Va d. Copies of receipts, releases, joinders and approvals of fom!zl or in filed with the Cleric of the 0-ph~ns' Court and tr ~ a~.a hed t Dnrc /" ~ l l `r S' ncr.:re of ?zr;on Fairg riiit !'nrm ~~3~, ~'. ~ ' ~ ~~ u '" i v°, ~, <:!3 -; ~ ~ :Y ~~.a: ~. c ac cs. N t O 0 c° g b !al account' miry L-e repo Capacity: QPeau^.al Represe;~i3live Caluns2i ~LL~,tI ~~ ~E,/cfl ~ -t--- P%m::e oj?zrsa: Fili/:; rh.:r rm•m ~d_a•ts Tefz~Snnz