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� OF NOTICE UNDER Pa. O.C. Rule 5.6(a) _
CERTIFICATIOI _
REGISTER OF WILLS =
Ic�c� COUNTY,PENNSYLVANIA =
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of Decedent� _
Name � p / � - 0 b 9 `�� —
Da te o f D e a t h: l� - �� - j °�' File Number: _
Date Letters Granted: �� � �' �`� � _
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To the Register:
I certif that Notice of Estate Administration required by Pa.O.C.Rule 5.6(a)of the Orphans'Court
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Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
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N_: Address: .
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(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:
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Date Signature oJ erson Filrng this Form
— Capacity: �Personal Representative �]Counsel
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_ � � � „ Name ojPerson Filing th�s Form
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