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CERTIFICATION; OF ~ OTICE t~j`tiDER Pa. O.C. Rule 5.6(a)
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Date of Death: '~~~
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Date Letters Granted:
To the Register:
1 certify that Notice of Estate Administration required by Pa. O.C. Rule 5.b(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 S.6(a) except:
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S~grrature ojP ~san Frlurg drys Form v
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Capacity: .personal Representative ^ Counsel
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CERTIFICATI~~; OF ~ pT.ICE ~,~`tiDER Pa. fl.C. Rule 5.6(a)
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Vame of Decedent: __a~- ~/ ~=~ ~ ~~<~
Date of Death:_ i~ ~ t c~ ~ ~~~ ~ ~ .Z
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Date Letters Granted:
To the Register:
i certify that Notice of Estate Administraiian required by Pa, O.C. Rule 5.6(a) of the Orphans' Court
Rules was s rved,on or mailed to the following beneficiaries of the above-captioned estate on
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Name: Address:
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(l~rrrore 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:
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