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CERTIFICATION OF NOTICE UNDER RULE 5.6(a\
NameofDecedent:Jh~ell'"C- K' ~/'~"i'r Ml{'s. Mo.n/ {j. /(evse,
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Date ofDeath: fv111 rch 31 a ov..s-
Will No.
Admin. No. ~OOS--OO ;}..()..9
To the Register:
I certify that notice of (beneficial interest) estate admini.tration required by Rule 5.6(a) of the Orphans' Court Rules was
served on Of mailed to the following beneficiaries of the above-captioned estate on
Name
Address
J$ruce- G.Keyser BM5L5, Reve.re)PA INS3
Ala...... C. Keyser ,,10/1. refry Fa,.../'vl~ I2d~AMYll1.polisJ fiJlD..:1-/oL/.:z..
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
fo/9/o.s-
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:::r~L' ii;j~M/
Slgnatu e
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Name ~_ J( Sfmyer-
Address cl N. r:hfSfnu+ sl
bi/Ishurg J fA /7v11
Telephone (717 - t.f 3 2 - if ;;L'IO
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Capacity: _ Personal Representative ~~~ur
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_Counsel for personal representative
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