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C~RTI~'~CA~~~i`d Q~ ~~7C~C~ ITN~~P. ~'~. ~.C. ~eli2 j.~(2~
REGISTER OF `VICES
~nni~-er~t.~nd COUNTY, PENti'SYLVA:~IIA
Name
Date of DeaL'~: q " ~ y ~ ~~, File Number: ?+ ~ ~ ~ " C7 i ~ ?-~P
Date Leilars Granted: j ~ ' Z ~ "~ j
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court
Rues was served on or mailed to the following beneficiaries of the above•captioned estate on
~~, ~~ -:
~~: ddress• .
~eu.l ~ GQrc~.h~C~'~ S ~ ~eJe~ ~, d ~ ~ ~~- x'7257
(If more space is needed attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except:
Daa f . ~~~
"'r ~ ~ ,~ yam' ~ SIgRCtLrf Of P SOR FAJR~ f FOrR7
:a~ - ~ Capacity: Personal Representative D Counsel
Q t~G 3. ' Name of Perton Filing rm
~~ _ ~ 2ov -~~ ~ ~ R oa
.4ddress 1
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re~eP~Re r~
corm r•.w-G8 rev. i0.13.G6