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C~RTIFIC~,TIfl~v ®~' PTO :i ICE U~iI~P'I~ P~. O.C'. I',ule 5.~(a)
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REGISTF_,R OF `VICES
~~~/ZLA~tI,I~ COtTNTY, PE~+~'SYLVA~IA
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Name of Decedent:^~E ~-~-~,.~ _~~1 /~R~~, _--_-_._----^-q-- - - / --
Date of Dead.:. -~yLT 2-5 ~_~~ File dumber: ~ ~~ L ` ~U~Q ~° _
Date Letters Granted: ~ - ~ ~ ~" U
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
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Name:
~Es ~ ~~~ i QV~-
Address:
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~jitld BEf4GN ~'(_r ~' , g0~l~ly
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(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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Sio arure ojl~on Fifing this Fonn
Capacity: Personal Represzntative ^ Counsel
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;Name ojPerson Filing This Form
Address
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Tzlephone
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Form RW-08 rev. 10.13.06