STATE OF WISCONSIN, CIRCUIT COURT, 1815 PR

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STATE OF WISCONSIN, CIRCUIT COURT,

COUNTY
Amended

IN THE MATTER OF THE ESTATE OF

Estate Receipt
Informal Administration
Formal Administration
Case No.

1. I received from the

personal representative

special administrator of this estate the following:

Describe items of property or monies received

2. This is a

partial

full

distribution of my share of the estate.

3. This is a full satisfaction of the claim filed by

in the amount of $

.

4. This is a distribution of funds to trust. [Identify Trust]

.

5. Other:

.


Signature

Name Printed or Typed

Form completed by: (Name)

Address

Telephone Number

Address

Bar Number (If any)
Date

PR-1815, 03/12 Estate Receipt (Informal Administration or Formal Administration)

§§863.41, 865.21, and 867.21, Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.



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Title                           : STATE OF WISCONSIN, CIRCUIT COURT,
Author                          : Terri Borrud
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Create Date                     : 2017:04:06 14:42:14-05:00
Modify Date                     : 2017:04:06 14:42:14-05:00
Producer                        : Microsoft® Word 2010

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