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C~RTIFICATI~`d Q~ hC7C~CE Ul~'~~P. P~. Q.C. R~~'_~-(a) ~ ~`=~'~_~=;
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REGISTER OF ~VILLS
~ er CC+U:~1TY, PE~+~rSnVAVI.~
Name of Decedent:,~Q~N ,E• Sti o urc ~-~
Date of Deatlt: o l File Number: ' ~ ~'~ - 0 0 9 a ~
Date Le-~ers Granted:
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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 mailed to the following be~~n~~efppiciaries of the above-capti//oned//estate on -- /I / /
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{If more stwce is needed, attach separnre sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule S.ti(a) except:
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iync of Pcrson Filing this Form
Capacity: ~ Personal Representative ~ Counsel
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