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CERTIFICATION OF NOTICE UNDER F�. O.C. Rule 5.6(a)
REGISTER OF ��ZLLS
��C�'yI/�"'�''�G��COLTNTY, PE�'S'�'LVANIA
Name of Decedent: C�y I� 1� 5 YZ�,O�e� 1/V - �C=�I�� �,�r,�-�� ���'
Date of Death: ��c7�0���/� File Number:_�,��� �Q �� �
Date Letters Granted: p�l� �
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C.Rule �.6(a)of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
a�s�,�_�
Name: Address:
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r r �'-e L-��-�a s Lo�,�x�r��-+� ��::>��-�
1 � .� �'L'����n /..� ,�; . .,.��.� � ��ri C�
�1�P���I���-�1�PL
(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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Pnle (�/��1�� �:.. -�
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Sigrtn re af Pr� a,z Fili�a�thrs F'orm
Capacity: �'j Personal ltepresentative ❑Counsel '
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a _ i _ Nnme of ers�his For�,r�
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Form RW-08 rev. IOJ3.0G ��
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