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04-05-11 (3)
~~. ©.~. Ttiule 6.1? ST~TU~ ~P~~~ T r, T-~ R OF ~'JILLS Or ~..~ ~,~.tv~~~ ~=- ~e-- ~ ct_ ~~-~ c ~~ COL~iTY, PE~`~i ~YLV ?.'.~L~ ~G_~TE 1i . N3.~1e of Decedent: 1 ~ \ ~•._.. v~-C, 4 ~ ~~. ") L- l ~ ~ ire Number: ~~ ~~' `_ Date of Death: i.-- ~-'_~~:~ ir-i~~z_r- ~f ~t~>>~ ~ -- 2 Ire ort the following with respect to completion of the administration of Pursuant to Pa. O.C. Rule 6.1 p the above-captioned estate: ~~-,~s; . , ............... [`r'est" J No 1. State whether administration of the estate is complete:... . 2. If the answeris N~, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: ~] No -e resentative file a f~nal account with the Court? ....... Yes a. D.d the. per~onal i p U. The separate Orphans' Court I~To. (if any) for the personal representative's account is: c. Did the personal representative state an acco,~:nt []Yes ~No ....... ..... i.nfoi-mally to the parties in interest . ........... ~ •. ~ • • - E.~.._ ~ G• :'~ ~ 1 ~ __~ _ f ^` __ c ,~~ t_e_~ ~ ;`-1- (.%.. 'o ies of recei ts, releases, joinders and approvals of formal or informal accounts nzay be d. C p P filed with the Clerlc of the Orphans' Court and maybe attached to this report. ~., ~~~ . ~,. ~n[e~ ~ `~~ ~~ ~~~ ~- i--~~ ,S'i~ia~ure Persvn Fifin~ t/tis Forn1 ,' J 4 ~ - c ~_ .r ,, . , _ . ?~ .~ {`/ ~~. ~. ,< _'~ ~, ~~; ~ ~ ,., -x: iZ C r . - C.~ Capacity: '[.personal Represe~ltative ~] Cou~~sel Y` - _ ~~ ~ ~~ Z t . ~~~<<~ TJame'~" Filingllus corm ....\ Address +q`. -.,~ , _....`~ 4. -_._---- 5\\ I { +0... ..~. ~' Telephone