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CERTIFICATION OF NOTICE
UNDER RULE 5.6(a)
Name of Decedent: !I~ L~ AI E GoSAJ-€ Lt..-
Date of Death: 5 - I if -- 0 fo
Will No: 00 0 Vb L Admin No:
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans'
Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on S - 3 (- 0 0 :
Name
YHI!LfY I1I1NSDILJ
C:P/.IJ J'c~tVutfb), t_L
Address
90Q J1! IlN () rc IY... /, er L r~ IV PIl / 7 I ) 3
/
iflz- &Clf~Ckj{t Rd, //J'7/(I</sbU;1b! P/1 j 7; 09
Notice has now been given to all persons entitles thereto under Rule 5.6(a) except:
c__
~~1- L--
(Signature)
Name: ;1; !)J11IU J~ f)f/ ((EJJJ
Address: S"r;ZI {',4teLl SLf 1ft
M~CIl AA-/LSb uA.t. rA J)O SD
Telephone ( 717) 097 - / {uu
Date: :;"'-:5 / - 0 0
C)
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Capacity:
v-
Personal Representative
Counsel for Personal
Representative
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