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03-05-09
REGISTER OF ~TJILLS C~~ M 13r±1'~.L..I=t i~.; r~ COUNTY, PEI~"I~TSY`LVANIA Name of Decedent: ~! ~,( Pt I~(~ ~ y~,~; ~ - f~ !~ f~ Date of Death: 1~,~~~ .C~~ 13 - U/_)O ~ File Number: ~GG ~~ ~ C;7 '~~_~ Late icilGl-S Grd.IlLed:__. ~ ~.1 ~ L ~, ~j -- ~~ ~C% ~'j To the Register: I certify that Notice of Estate Administration required b~~ Pa. O.C. Rule ~.6(a} of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~~ Da y ~' (~~ A f2C -~ c~~~ Name: Address: r ~c~c. ~- ~--v~~~; ~ i J ~ t 3i o ~~- ?~~2R~;~T q ~~: , -~~~ cun~ ~Fr~~ti~ -~>`~ 47c~ 7c 4'~t ti rvC~ - ~ i tJ H ~ ` i RA rr 13i c; t ~- ,~l'<~Ar` ~r?t ~ y r . tiEw C'. c a-r r5 -7~' L!~ ~J7 rJl~ .f 7"C'-IC ' r r~ i tiE .y ~i.tl:(t~~i<'~-N t~~ 1~~ ~7c''7~. (If more space is needed, attach separate sheet.) 1 Noti ce has n ow been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except: ~ / /~ Date ~-~l~~C~ U~ -' ~~©~ Signature ojPerson Filing this Fore ~p Capacity: ~ Personal Representative ^ Counsel ~ ~ ° `_- ~ ~- - (~`,~~ C. - HUH ~l r ~' u " ]~ '~ ~.-. tom. r~ - ' Name ojPerson Filing this Form t.,- ;, a- ~ z ~ = ~- ~ ,. ~ ~c% I ~. ~~ N ~ ; A y is ti~l - ~_ ~ ~v~.- ~.l Address ' ' N U Telephone FormRiv=GB rev.ID.IS.06