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HomeMy WebLinkAbout01-12-15 C�i�TIFICA,TiO'�i C)� i�i O�'ICE d�TN�E�t �a. O.C. Rul� 5.�(a) REGISTER OF `VILLS °V���1��COINTY, PE��ISYLVANI.A Name of Decedent:��P../'`� W� �� !.t S P� J^ �' Date of Death: _�-��6J� y File Number:_ 0`2. '" 020/ �d G���5� Date Letters Granted: 9'�/ a O/'� To the Register: I certify that Notice of Estate Administration reauired by Pa. O.C.Rule.5.6(a)nf the Orphans' C���rt Rules was served on or mailed to the follo�ving beneficiaries of the avove-ca�tioned estate an J�G.o� // , a/ : Name: Address: ��eq� � O�'S�°r /�/�'' �iir! �a��r� /Y�.k/ C c.� I»�i� aho/ /�f�J7d (If more space is r..eeded, attach separate sheet.) Noticc has now Ueen given to all persons entitled theretu under Pa. O.C.Rule 5.6(a) except: � '-� � Dnre �' � gnnttrre of Person Filiny(his Form � C� � N W _...� g.._ ',�. c.� w- N r.=�: Capacity: "�Personal Representative [_]Counsel La.. `` F- ta : . �» � � ' c�".> �'.� °— { ' ' E �� � n _��=_.�_V d N S G r'' , Anme of Person('ilin�Ihis Form C� CS;; N 4 La I i�,:� [ J ��� �J �� �-. .-j .� K E-: ��/�_��o n ��rrY�c� c�= us � �' � �.�� nd�i,�ss � r,� � � r:,� �/ / A w � —,/—l� �.t/ C��� r �1�'I ���flJ 7d � '� � �' � �7 � --�.1 -- � ?��.��-� - Tc(eplronc Form RGf%OS rer. lOJ3.0G �.i'\