4.2
Certification of Notice under Rule 5.6

 
 
 
 
CERTIFICATION OF NOTICE UNDER RULE 5 6(a)
 
NAME OF DECEDENT:   [Decedent Name]    
DATE OF DEATH: [Date of Death]  
WILL NO.   [Register's File Number]   {as appropriate}
ADMINISTRATION NO.   [Register's File Number]   {as appropriate}
 
 
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 [Date of service or mailing].

 
NAME ADDRESS
 
 
 
 
 
 
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
 
 
 
 
 
Dated:  
 
   
Signature
 
Capacity: _______ Personal Representative
  _______ Counsel-ID#
 
[Attorney Name]
[Address, City, State]
[Telephone]
 
 
 

 
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