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12-10-08
~i;ra~~a~~.1y.a~`lyiL ~a _`i'L'.L'~'l~~ ~i9u~ z~~oG.:o~.oy';b.;,~o`u~ U.c,~1`TEP, OF ~'~'ILLS ~G~YN~JE'N~~~~/) U/COli~ 1~~, Pr~~iS~,VAI~IL~ Name of Decedent: ~ ~ i ~ 6 / Ct: iy~_ __ _ ~_ Y_ Date of Death: ~ _ ~ ~ = ~ ~ Fiie Numbe : ~ ~ ©C~ r~ "' ~ C~ F~~ Late Letters Granted: ~ ~ Q •" To the Registe, . I certify that Notice of Estate a dministration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Dame: _ ~ ~~ ~ea~~ s~e~~' /,~, h h ~~~~~s _~~c~ f2r1 f'h ~r~~ ~ Address: r ~ r L`~ fit. , ~ ~ /~ ~ ;~- /L°G ,2 k' 7/(, ~~ c~~~ ~~~ ~;~~1~ ~~~~~~~~-~~~~,~1 ~~~~~ .z 3 3 ,~ 3 ~,f~ 1 taw (If more space is needed, attach separate sheet.) 1V~t1Ce 11aS nGW beers gi"yeti i~ all p er",Ci:S el.t:tled tl?ere10 UIld~'r Pa. O.C. Rule J.6(,a) except: Dale J~, Cf ~J ~~l/ ~ ~. - :•,, ' ,~. t ,u~~J~d~O. 1r;-(~( i SL ~i;i bid Q 13~~ 80~c' i "", , t f ~; ~, J / ` J / i a Signa:rre ojPzrson riling t .s a-m Capacity: ~ ®Personal Representative ^ Counsel Name ojPerson Filing this Form r ~l~ L /~ej ~~Y1CZr1 CI rC:- ~ Address Telepnane E~