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' C~RTIFTCATIO~ QF 1~OT~CE U~~~P. Pa. O.C. R~!'_z 5.~(a)
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~.~ ~~~,~ N ~~ ~ REGISTER OF WILLS
~~ ~ ~~ COUNTY, PE~1'SYLVA~I.~ .
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~ ~ame of Decedent: ~r. v,n >° ~ ~, ~c~. r r e.~ ~
Date of Deat'~:_S=l T t ~. b 11~ File Number. a, a 1 ! -- t c~ ~ cs
Dar Lti-tcs Crranted:
To the Register. ~ .
I that Notice of Estate Administntioa nquind by Pa. O.C. Role 5.6(aj of the Orphans' Court
Rules was served on or mailed to the following beneficiaries oftheabove-captioned estate on
a ~: dA dress
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(IJmore space ~s needed anach aeparote stiee~)
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Notice has now been given to al! persons entitled thereto under Pa. O.C. Rule S.ti(a) except:
Silnenvt q/Pcrton Fili,~ chit Form
Capacity: 0 P~sonal Represenutive 0 Counsel
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Namr of Pcrton Filinr chit form
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