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09-26-14
C�'RTIFI��TI�;`v C��' iv OT'�CE �,T�il��l� �'a. O,C. �u�� 5.5(a; REGISTER GF �VILL� _ Cumber_land _CCjtJ�;TY,PE��SYLV��IA Name ofDecedent: Rebecca J. Kohl Date ofDeath: 02 1 7 1 4 File Number:_ 201 4-00601 Date Letters Granted: 0 6/2 6/2 01 4 To the Register: i certiiy iizai ivuiice oi Esiate ��dministration required by Pa. U.C.Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the follo�ving beneficiaries of the above-captioned estate on September 25 2014 , Name: Address: Garth James Kohl 9386 S. Heywood Court,Su�nmerville, SC �9485 Donna Lea Eaken 31207 N. 60th Street,Cave Creek, AZ - - '-�£�5331 Karen Kathleen Hoerner 757 Pine Street,Steelton,PA 17113 (If more space is r..eeded, attach sepc�rate sheet.) NOt1C���:25 ne�,�L-•:.•_.:�giveri tO 811 pPrcpl?S Prillt�e�t1.:erett� under Pa. O.C.Rule 5.C�3��XCe�?!: tx. O p C!) C..r LS.! �'�j r� � � � _ --- ^`(�'!r--���C'�/Ti!/C _(�� �� � n�,�.. ��p��mjber 25, 201 4 �-' �''° Sisnnurre of Person Filiny t6is Form � ,_ � �=' <., � ,.. °rf .' �aW ��,.� � �..� = �i Capacity: �nersonal Representative ��Counsel � �._.. � ..� �[ � � cra � c� � �,, • o � � � � _ Robert 3. Koh1�II � �W � � � Nn�ue ojPerson Filing�his l�ori�i � � 501 _Mohn Street, Apt.404 .idd��ss� _�tePlton, PA 17113 , _ 71 7-9 3 9-7 4�.�_.�---- -- �� Tcic-phvne �\(� �\