Fill and Sign the Wisconsin Personal Representative 497431329 Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF THE ESTATE OF       Amended Personal Representative’s Statement to Close Estate (Informal Administration)       Case No.       I VERIFY THAT I, OR A PRIOR PERSONAL REPRESENTATIVE WHOM I HAVE SUCCEEDED : 1. Gave notice to interested persons and to creditors as required by law and that the time for filing claims expired prior to the date of this statement. 2. Fully administered the estate by making payment, settlement, or other disposition of all claims presented, expenses of administration, reasonable funeral and burial expenses, death and other taxes, except as otherwise specified below. 3. Inventoried the assets of the estate, furnished a copy of the inventory to interested persons and distributed the assets to the persons entitled to them. 4. No unpaid claims, expenses or taxes are outstanding. Made the following detailed arrangements to accommodate any unpaid claims:       See attached 5. Sent a copy of this statement to all distributees of this estate and to all creditors or other claimants of whom I am aware whose claims are neither paid nor barred. 6. Furnished a full account of the administration, in writing, to all persons whose interests are affected. 7. Paid attorney fees of $       . 8. Understand that i f no proceedings challenging this statement or otherwise involving me as personal representative are pending in the court 6 months after this statement is filed, my appointment as the personal representative terminates. State of       County of       Subscribed and sworn to before me on       Notary Public/Court Official       Name Printed or Typed My commission/term expires:       ► Personal Representative       Name Printed or Typed       Address             Telephone Number       Date PR-1816 , 03/12 Personal Representative’s Statement to Close Estate (Informal Administration) §865.16, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Personal Representative’s Statement to Close Estate (Informal Administration) Page 2 of 2 Case No. State of       County of       Subscribed and sworn to before me on       Notary Public/Court Official       Name Printed or Typed My commission/term expires:       ► Personal Representative       Name Printed or Typed       Address             Telephone Number       Date PR-1816 , 03/12 Personal Representative’s Statement to Close Estate (Informal Administration) §865.16, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2