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T~IFICATIO~ ®~' NO ~IC~ U --=-------------------------_-_ __
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~~ ~ COUNTY, PE~+`+SYLVAtiIA .
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Name of Decedent:-~,~, .- -
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---_-- -- Ry,GISTER. OF bVILLS
Date of Death: ~d'
Date Letters Granted:
To the Register: of the Orphans', Court
e of Estate Administration required by Pa. O.C. Rule ~•6(a) on
I certrfy that Not~c
'led to the following beneficiaries of the aboVe"captioned estate
Rules was served on or mai .
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Name: L~~'~ Q.Ci ~ ~ '~~L.~ S ~'
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(If more space is needed, attach separate sheet.)
to all ersons entitled thereto under Pa. O.C. Rule 5.6(a) except
Notice has now been given P ~
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Name of Person Filing this Form < ~n
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