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09-16-09
CERTIFICATION Off' NOVICE UNDER Pa. O.C. Rule ~.~(a) REGISTER. OF tiVILLS ~~t,t -y~ ~1y r ~ : ~ COUNTY; PENNSYLVAiv`IA Name of Decedent: ~ ~ ~~ ~ a n. ~~ Q yJ~ Ge-- Date of Death: ~'ti'1 ~.,7____~ ZI r Z O O ~1 File Number: ~ O 0 - D © ',775 Date Letters Granted: ~ Ju,~~` / q , ZO ©9' To the Register: I certify that Notice of Estate Administration required by 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 Name: Address: _ 1 ~- e ~ ~-~ad ~~ so.,) ~1 (Al,~.~.r~ r~ w ~ -~ r ti,~h or o e , ~~ i~rZ Z 9 5-~-a ~~-~e r- s.~..~_ / S r n to 1~-~ 1.1~! ~ r n p n e r~ ~~ o~i3~ (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: Date ~ ~~ .(su ~. _/ 9 Signature of Person Filing this .Form -='~ . ; , ~ ' Q f-~- Capacity: ~ Personal Representative ^ Counszl . _., c ~ cc._ ~ l`7 ;.+ G. ~ ~ L~ Name o Person Filing this Form -~ '-'~ mss! Gf~ <'' --~ .-~ ~ (, ~- _ Address o n ~ O ~ ~ ... ; ~ . y O ~./ ,C~ ~ I.~L b L.i.~.',... ~.~ 1 N ~ ~ ~7/ / q~y ~ ~ 7 - Telephone