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REV-346 EX (03-09
3460009101
ESTATE INFORMATION
SHEET
FOR REGISTER’S OFFICE USE ONLY
County Code Year
File Number
DECEDENT INFORMATION:
Enter data as it will appear on all
documents submitted to the Department.
Decedent’s Social Security Number
Date of Death
Date of Birth
Last Name
Suffix
First Name
MI
TYPE FILING:
Fill in oval to indicate the nature of the return to be filed with the department.
Probate Return
Joint Assets Only
Non-probate Assets Only
Litigation Purposes (no other assets)
LETTERS GRANTED:
Fill in oval to indicate the nature of the proceedings at the Register of Wills Office.
(Attach additional sheets if explanation is necessary.)
Testamentary
Administration
No Letters
Other (Please Explain.)
ATTORNEY/CORRESPONDENT INFORMATION:
Enter all information for the attorney or individual to receive tax
information and correspondence.
Last Name
Suffix
First Name
MI
Supreme Court I.D. #
Telephone Number
Attorney/ Correspondent’s e-mail address:
First Line of Address
Second Line of Address
ENTER ZIP + 4
City or Post Office
State
ZIP Code
PERSONAL REPRESENTATIVE INFORMATION:
Enter all information for the personal representative(s) of the estate
authorized by the Register of Wills.
Executor/Administrator
Social Security Number
Telephone Number
Last Name
Suffix
First Name
MI
First Line of Address
OFFICIAL USE ONLY
Second Line of Address
TRANSACTION COUNT
ENTER ZIP + 4
City or Post Office
State
ZIP Code
Complete general estate information questions and indicate additional personal representatives on reverse side.
PLEASE USE ORIGINAL FORM ONLY
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3460009101
3460009101