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REGISTER OF WILLS
C,.UM'~ bQr IAJh cC._COUNTY, PENNSYLVANIA
Name of Decedent: N ~ ~- ~ t- ~ l ~ • tJ'e tJ ~ a Se' .---
Date of Death: li DR ~ ~- ~ + l2'-~~'' ~ ~ File Number:, ~~d~.~~ ~ U ~.~ _~_
Daic ictiGl S GI AIlted: ~ ~~ ~ `'' ~ ~ ~~ o
To the Register:
I certify that Notice of Estate Administration 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
Name: Address: ~ 3 ~_ ~'~'
1~~6o2Ai~ S ~31A5~ ~lal ~ Cc~.~~ ~ y a ~`, r, 5 i Pty 1~-~f~ l-~ 1- tr
DIN N l E W , D~~~ l P~-~ ~1~ ~ `1 C~~ ~ v a C i r, ST P~~ /~A ~ t-~- ~ ~-
33~70~
(If more space is needed, attach separate sheet. )
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except:
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Signature ajPerson Filing this Form
Capacity: ~ Personal Representative ^ Counsel
Name ojPerson Filing this Form
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Address
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Telephone
corm ni~'v=08 rev. iQ13.G6