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CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
~,..~~~-x~i` D~s~_ COUNTY, PENNSYLVANIA
Name of Decedent: ~/i~,~~~~~~~~~~~~,.~~/~1,,.,
Date of Death:_ ri' _~!~- File Number: ~~~~ - C.~' Z /
Date Letters Granted:_ ~ ~;~~-~~~l}
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 ~n
Name:
Address:
(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 of Person Filing this Form
Capacity: rsonal Representative Q Counsel
Name~oJ'Person Filing this Form
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Ad~fress
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Telephone
Form RW-08 rev. 10.13.06
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NOTICE OF EST
PURSUANT
YORP
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Whether you will receive any money
the decedent's will. If the decedent
money or property will be deter
BEFORE THE REGISTER OF WILLS, CO
IN RE: ESTATE OF _~
File Nun:
TO:
Please take notice of the death of the Decedent
below. The Decedent died on the cry of
r _
The Decedent died: testate (with a
You may have a beneficial interest in the estate
(If additional space is needed, use separate sheet)
The name(s), address(es) and telephone numbers
NAME ADDRESS
If the Decedent died
the will has been file ~ Tfte ~
If the Decedent died intestate, a Petition for the
Register of Wills of ~ ~. ___ /_. .
The Register's address is ~,~~.-_ ,~ ~.~ n,1 l..
~ ~ ~_ ~~rt
F ~ .. ~ c ~y-.. -..:_~
y~e` , r n..
jyH, ~~ _
~: ~.,~>°
` ,and telephone number is ~ ~~
A copy of the Will or Petition maybe obtained by contacting the Register of Wills and paying the char es for
duplication. g
Date ~ Z-
Signature of Person Filin this Form
Name of Person Filing this Form
Ca acit - ~~ ~~' ~~
P y: ersonal Representative Address
OCounsel for Personal Representative ~ r~/
Telephone
Form RW-07 rev. 10.13.06