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10-04-12
CERTIFICATIO~i OF ~; OTICE UDDER Pa. O.C. Rule ~.6(a) Name of DeceCent: Date of Death: ~ ' - ] ~~)) 1 °~ Fllz 1~jrimhPr' ~V~~-DD ~a ~ Date Letters Granted: - 7~ .- a~ To the Register: t certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules was s rv d on or mailed to the following beneficiaries of the above-captioned estate on ~...(~ Nam _ Address: ~ ~ ~t l r (IJ'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: ~'~"` Date ~ ~ ~~'~~ ~ - --~ v ~ ~=~ cU , r..,..v. ... CX. ~~, 1 t ~~ ~+ ~- ~ J ~ Cr .. ~'.. ~~ ~~ Signature ojPerson FiJrng this Foirn Capac ~sona epr 5entative ^ Counsel Name ojPerson Ft urg thrs Form Addre s ` ,1 ~~© Telcahoare V h~