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CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
^ f) _ A REpISTER OF WILLS
~ COUNTY, PENNSYLVANIA
Name of Decedent: [1~~ m, '1~
Date of Death: ~ .3 o.c .;:t tn (,J File Number: c!:l NJ 6 - ~ 1 f? 'I
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To the Register:
I certify that Notice of Estate Administration required by Pa. D.C. Rule 5.6(a) of the Orphans' Court
~rv~d on or mailed to the following beneficiaries of the above-captioned estate on
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Name:
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(If more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. D.C. Rule 5.6(a) except:
Date
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Capacity: ~rsonal Representative 0 Counsel
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Name of Person Filing this Form ~ '
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Form RW-08 rev. 10.13.06