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REGISTER OF WILLS
OtJNTY, PEiv~'SYLV.A~1I A
Name of Decedent: ~Q~ A
Date of Death: ~ ~i,~~?CD File Number: - Q~,~`
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Date i.cttePs vrdnted:=. - ~ ~ ..... ~ ~ ~
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To the Register:
I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a'i of the 0 bans'
rp Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
Name: Address: •
(Ifmore space is needed, attach separate sheet.)
Notice has now been given to all perso ns entitled thereto under Pa. O.C. Rule 5.6(a) except:
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:~ Signcturt ojPerson Filing lhis Form
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