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Iv3nle of Decedent:- (.:E~ELI A ~ • ~LCi;Z.EptS~ ___. _~_
Date o`D°atll:____91 8 0$ File i`iu::?oeT.. abb g -D ! l $'~ ' _
n•r~uaiit tv i~ic./^+f C. 1~1. 77 ~r.'.wv:tt:.~. '~ ~It:l Y: ~. ~~~~. 7~•~i; f ~
a i, li.i.. a":a., v.ai., fill:Y;xr;, 1:, r~ct~ • to [lsiT~ ,Ir_l c?f tllZ c.v+l 1! a'3~1d!? Oi
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the above-Capt1011ed estate:
1. State whether adlnintstrahon of file estate is coriplete: ................... . ~ 1'e$ ~ No
~. If the answel-is lv'o, state when the personal representative ~ .
reasonably believes th at the adlrinistrat/on w1I1 be complete:
lcl~-~TiN"b oR. Nvu.SE '~ i~D b mca .
3. If the ailswer to 1'0..1 isYES, state the following:
a. Did the personal representative fi?e a fnal~account with the Coup? ...:..:" ~Y s ~No
b. The separate Orphans' Court lv'o. (if any) for the personr:l .
representative's account is:
-- -~
c. Did the personal representative s~at~ an account
. infornlally to the. parties in interest? .:.................:........... • dY~s E]No
. d. Copies of receipts, releases, joinders and"approvals of folmzl or inforlna] account may i;e
filed with the Clerlc of the Oip':lans' Court and may be aiached le this repots:.
• Signr .re of?eca++ FdIL:,; ri+is F'nrm
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£, ; ~ Capac;y: .Personal Re~rrsentative [~Clounsel
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