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05-12-15
�E��IFIL:�T�(�� C��' 'ti��'�CE ��UI.R T'��. �,�'. F�ule �.5{a; r2��','J1'_=� C�1' ���.I�U� �irin�'�12��v _ COL'�T'Y", �':�\"ti�YLti'a`�?_� Name of Decedent: �� �� ' � .S Ca'�)'.1 Date of Death:�1—/� --,��J� � File �'�.r„�;�e,:_��S'�� /SS Date Letters Granted: ��–// �,�C�/--�`"� Ta the P.egister: I ceriify that Notice of Estate Administration required by Pa. O.C.Rule 5.6(a) of the Orpha�ls' Court Rules w�as served on or mail�d to the follo�ving beneficiaries of�he aLove-captioned estate on _ U�7�'—�-5 Name: Address: �d � �e� �� , � �., C:�;�, t��'-(� � 1"7��� � ,uP �-.� �'. ,,,� ����,� ���-�- � s s .� � -cF�,� ;-:,% ,� � y���6- . � _ �L_-� ��s_ � � �� (If r�zore space is r.eeded, altacl2 sepnrate sheet.) Notice has now Ueen given to all persons entitled tlzereto under}'a. O.C.Rule 5.6(a)except: J�l�� /� 2-�i 5� ��. 'f�� Le:» �Dnle _ ._,i'.� _._ � ��j � � Sisnniirt Person Filuig ILis Form t,+-+ ....I � , �.� � '� Capacity: �Persor,al Representative ��Counsel �� =� �— ' - � _ ;�. . !/ � '°- G���,�G. ,�:: _��� _ , Nmr,�ojPerso� i ,uii� d�u l�orm L J � i ��� � % � C � �.• � W � /C �!��.1'��< � r—i i . C.._" t,:, �-- '�-� �- a _ J __.�_�_ G�.- 4-� r.d���esa' � � �1 � f�/ � ,,t � 4 «.� •+� � � �. � � �/�L.�.�_�'.�4�= �_. ��7����--- � �., --- ---�- �� --- `�l� -_:'_,�,,;3,�... - S�y,�� ��c�ct,i��,�� �