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CERTI~'I~A~~~i`d ~~' N~~~~~ U1~t~~P. P~. ~.C. Rile 5.~(a)
REGISTER OF WILLS
COU:~ITY, PEivti'SYLVA:VIa
Name of Decedent: ~i~4-s~~ ~ . ~ i1 ~ ,~ ~~
Date of DeaL`t: q~ ~Zei'/ File Number: ZOl/ - D// ~ Z
Date Le~-ers Granted:
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 beneficiaries of the above-captioned estate on
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Notice has now been given to all persons entitled thereto under Pa O.C. Rule 5.6(a) except:
S~ e o Person Filing this Forts
c, , ""• Capacity: ~esonal Representative 0 Counsel
Name o~Person Filing this F//orm/ _ ~ I
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