HomeMy WebLinkAbout09-21-11C~R~'IFIC~~I~`d ~~' h~~C~C~ U~i~~P. ~'~. ~.C. ~~~'_e ~.~(?)
REGISTER OF ~VIT..LS
COU?~1TY, PEN~rSY1-VANI~+
` ~ ~
Name of Decedent: ~ n t ~ - (j U 7
~_ _~ et ,, ~_~ ~ \ File Number:
Date of Death:
Date Letters Granted:
To the Register: bans' Court
I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orp
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
9 Z/-ZG~
Name: Address: l ~~-
~ 11 ~ 3Z~ ~ .~~o -
L~tn~~~ tc ~~~ .
I more space is needed, attach separate shoe
(f en iven to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except:
Notice has now be g
t
Y.
rr ~2_ 2 ~ l l
__
~, a w
~~-
-:;
U
~en+rt eJPerson Filing thtt Form
Capacixy' ^Pe;sonalRe resentativ~~/oun~
ihr,/a~ D ~ c 5ti
Z _
JJamt ojPerson Filin, this Form
SCE
3-Z-1 w IN a t t-~`« -
,~ddrtts
^Z1~ 335 vc t ~
Telepi;ont
V
~2,