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12-30-10
F.Eti>jTciti LF t^i'_LS Gr ~~t-•~~Jr/s•-~.~lb~ CGL~:vTY, PP. ~~~SYL'l~' ~.~1?. ""~ C itianle cf Decedent: „~~,~~~ e.•9. ~~ D7te n°il°at'1:~~,~s~ ~~ ~,2,c2~`7,~ File i`iulrbe~.. .... (~~- ~ /,i_. i 'ila a Dn /1 !~ P.,!~ ti 17 T .•~~ ~.t ::~ F.111.~itrir. :•~ _ r.r1T... a`I(~il Q~•T ~ J• , tct ~ i~ir si.in ' w - c:. v.~,. a~~.. u, as, . a v:.a ..~ h'ltll .. c~ ?aYt fn ~.t•:s L .I i~'. a~::l?:.1 ... ~'~~101. C1 the above-cautioned estate: . Stnt~ Wll~tller adr11ir11Sirat10r1 Of Cile estate 15 Cu:llplete: .................... ©~'eS~ a c~ 2. if the an'sweris l~'o, StdtB When the personat representative reasonacly believes t; at the administration will be con;pl~~~: ~~.,c ~ JD ~D // - 3. If the als~~er to ?vo. 1 is YES, state tale fo';lo«•ing: z. Did file personal represelltativa file a fnal~accolint wi`al the Cotlrt? ....... [:~Y~s ©No b. The sepzrate Orphans' Court ;~e. (if Gny) for the persoi/al • representative's account is: ' c. Did the personal representative state an account in.oiti,aliy to the parties in i:aerest? .:............................. {~,~{des ~yo d. Copies e; receipts, releases, jei~:ders and app:ovals of formal or illfonnal acco>~nls may be fired with the Cleric of the Orphans' Ccvrt slid ir:3y be at»aolzad to tl!is repott. ~~ Qnm `:"r 4L^i' ~ ~~ ' C.~, .raj ' $,~nCr:rr GJ ~rf".7q f:iu:j ri,i! I• orn, Cayaeiry: QPerso^.all?eprrse,itati~~c (~~"Coii;:sel • s ~- ~~ ~ Cis '_~ (~'~ (3'S H- ~ ` ~ ?':^r:t c'Ft FifirFtk:: i•~:•a, ~ ~ LG~ /Kirf'~L-d+~~ + i~~' ~ ti..> QQ ~ V n . !Ga ~. f~-l~_:L_ 'L'rr:5 // l~ _ G©. ca U c ~ ~ ~ ~~' `7i ~~ ~ W L~ L;.J ~ . ~ _ 7clr~l,o,er t :~ CV