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REGISTER OF WILLS --~~
COU:~iTY, PE~~'Sn-VAVIa ~ . `= j
Name of Decedent: OQV I C1 C~, y 0 YIeS .
Date of Death:,.~~ ,_ File Number: 2 ~ ~ ~ _ ~ 0 ~ ~ Jt:'
Date Le-~ers Granted: ~o / I ~ ~~~~
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C. Rule S.ti(a) of the Orphans' Court
Rues was served on or mailed to the following beneficiaries of the above-captioned estate on
Name.
ddress
(If mare space is needed, anach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule S.ti(a) except:
Dorc
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SigncQert~JPason Fdine lhts Form
C-apacity: ^ Pe;sonal'Representative ~ Counsel
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Namc ojPcrson Filin, this Form
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