Form OC-07 rev. 10.13.06
NOTICE OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532)
COURT OF COMMON PLEAS OF
COUNTY, PENNSYLVANIA
ORPHANS’ COURT DIVISION
ESTATE OF , DECEASED
No.
To the Clerk of the Orphans’ Court Division:
Enter the claim of in the
(Claimant)
amount of $ , against the above entitled Estate.
The Decedent, who resided at
(Street Address)
, died on . Written notice of
(Date of Death)
said claim was given to
(Personal Representative or his/her counsel)
at
(Address)
on .
(Date)
(Claimant)
(Street Address)
(City, State, Zip)
(Claimant's Counsel) (Supreme Court I.D. No.)
(Address)
(Telephone)
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