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01-12-11
..rr-1~ ~~jj t~ 1 i~l, tJ.`~ Ate.:i° i7.~..j ~1~~^,~+.~ ti.~i i~.~.I lei 1. . i~FC!STzi;L;: Cv'_,LSGr Cumberland~C~L; ,,.,,,;~Y'L'4'~.?~. r .vT':', P~.. . N3n;e of Decedent: Dst~ o: D.~:tlt: Flo W. Smith January 25, 2009 Fiieieu:-:be:: 2009-00180 D~.. ~ r,. ~.. r+.C. C`...!~ i. 17 S ~2....:-t t :.°, f~11.~:N:"a Et; tth _s~ya:. to ('Qrt`jC.lt.',if1.} f?~L1iC wliliilh! the above-captioned estate: 1. Stn*.~ wl:cthe. aeri.iis ;anon of tale estate is coaiple;e: ................... • ~Y~~s 2. if the ar:'sweris No, sta;z wh~n tl~z Fersenal representative reasonably L•elieves that the zd:rir~ist<ation Fill be completa: I: cf D ~~.~ 3. If tl:e a• saver to No. 1 is YES, stn;e tae fc'ao1.4•in,: ~I '~ a. Did tl.e perser_al represe:i:atve ::le a f aal~acceunt with t.':c Cou:'t? ....... ©Ye~ i,~:~o I b. The sepzrate Orphans' Court Ise. (if any for tl:e persa::l rerresenta;ive's account is: • C. Lld ll'ie pCfSOP.al 1'epre5et:;at:~'C s;3iC 2:1 aCCOllnt in.om:ally W the parties in i:ae,est? .:............................. ~`:es', Iva d. Capes c: receir ts, re;ra,es, }oi::ders and ao royals of fo:mzl or i^fonnal aocounts nlaylt~ fired with the Clerk of tl:a Or':7ara' Cass' i. a f be at:ac to this ; e !i i I January 11, 2011 ~~ o~+~ _ ~~ , j:;nrr,:mot of r Cr:Ln F.;u:j snit Form • i ~ - ~ ~ u... ~ ~. ~ %r ~. i~~~r ~ ~Cn n ~ ~' is ~ O g .,T.,-~ Capacity: Q?trsoral Rc~~•rsentative ~Cair.;s~:l I~, David A. Baric, Esquire l%a.•a c' Ft+mn FiLr; rh.r Fo:•n+ ~~ 19 West South Street~I, ,,»_ Carlisle, PA 17013 (717) 249-6873