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C~.RTIFICATI~~i ®~' NOT'ICIJ UNI~IJ'R JP.a. O.C. Rile ~.~(a)
REGIS ER. OF WILLS
~1n r ~ ~ COUNTY, PE~v~TSYLVAV'IA
Name of Decedent: (CY(at ~ ~ ~~~~((,~rj?~---
Date of Death: L- " Ls--~I File Number: Z~ ~l ° CI~33 ~ _
Date Letters Granted: 3 " ~ ~ ~ ~
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
~ '~~ III
Name: Address:
-~:.~
L~ ~~"
(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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ts.... ~ Date ~ ~~ ~ ~ ~._ c,'~~.
Q G'~ ~ "3 R Sio azure of Person Filin, This .Form
t..a_ : _ .~ t-r l1. .
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«` ~ L~ ~-~ ~ -.:; Capacity: Personal Repr ati 'e L7 C;ounsel
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---- ~_t..t -=--- _=_ ;Name of Person Filrn~ this Form
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~~ ;,'_-~ ,._ c ] =. t '=,' Address ~
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Form RW-OS rev. 10.13.Ob _ _ _ _ _
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