The undersigned, ____________________________, having being appointed as the personal representative for the estate of ______________________________, in Cause Number _____________________________, does hereby acknowledge that the undersigned has received and had the opportunity to review LRI 8-ARO1-DLR-0008 regarding personal representative's and attorney's fees for probate matters in Delaware County, Indiana.

Executed this ______ day of ________________________, 20___.

I affirm under the penalties for perjury that the forgoing representations are true.