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ItiTame of
REGISTER OF WILLS
COUNTY, PE~,~TSYLVA~II_~
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Date of Deat'~: / ~ 9 ~ d / ~ File Number: y 2 /~
D ate i,e«ers vrdnted: a~ ~ 3 ,~ a O//
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 ma.-l~evd to tlZe following beneficiaries of the ~.b~vP-capt~io :ed estate or.
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N=: Address:
~` i 'I'a htr ~- to ~ li 2 ~` ~ ~ ~ ~' rte /G`~G
~i~-~•.~J V . ~~e d,P _76 ~ ~ /~ u rhm e j v i . ~ ~ Mr ~/a t P~- /.?G •j/ 3
/'n r ;1 S Q ~/ nkt-l~o-~-'~*'K Q /'7 2 G G
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(ff more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule S.6(a) except:
Datr_ 10/~i ~ 7., ~ ~'~ /J
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S' rare ojPerson Filing this Form
Capacity: ^ Personal Representative ^ Counsel
Name of Person Filing this Form
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Telephone
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~Orm r"rr=GB rev. lD.11.G6