Fill and Sign the Chapter 28a Administration of Decedents Estates Article 1 Form

IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI IN THE MATTER OF THE ESTATE OF NO. REPORT OF DISBURSEMENT OF ESTATE ASSETS COMES , Administrator/Administratrix With Will Annexed of the Estate of and files this his/her Disbursement of the Estate Assets pursuant to the Estate Disbursement Plan of record in this matter.A drawing was held on , at the office of , Mississippi and was attended by . The drawing distributed the assets as follows: SHARE 1 consisting of $ receivable and $ cash to .SHARE 2 consisting of $ receivable and $ cash to .SHARE 3 consisting of $ receivable and $ cash to .SHARE 4 consisting of $ receivable and $ cash to .SHARE 5 consisting of $ receivable and $ cash to . The assets of each share have been disbursed to the heirs making up that family group. Accounts Receivable have been transferred to the heirs as tenants in common. Cash has been paid to each family member in accordance with their share of the Estate.Respectfully submitted, ________________________________ , Administrator/Administratrix With Will Annexed Prepared and presented by: Telephone: MSB # Attorney for STATE OF MISSISSIPPICOUNTY OF PERSONALLY appeared before me, the undersigned authority in and for the county and state aforesaid, the within named , who acknowledged to me that he/she signed and delivered the above and foregoing instrument on the date and year therein mentioned. GIVEN under my hand and official seal, this the day of , . _________________________________NOTARY PUBLIC MY COMMISSION EXPIRES: