STATE OF SOUTH CAROLINA COUNTY OF: ___________________________ IN THE MATTER OF: (Decedent) ) ) ) ) ) ) ) IN THE PROBATE COURT PROOF OF DELIVERY CASE NUMBER: ____________________ On the _____ day of ________________________, 20_____, I mailed or delivered the following document(s): _________________________________________________________________________________________________ _________________________________________________________________________________________________ A copy of which is attached hereto and incorporated herein, or The original of which is on file with the Court. Delivery was accomplished by the following method (check appropriate box): personal delivery certified mail commercial delivery ordinary first-class mail registered mail electronic message (Article 7, Trust matters only) to each of the following persons at the address shown: NAME ADDRESS SWORN to before me this , 20 day of Signature: Print Name: Address: Notary Public for South Carolina My Commission Expires: Telephone (Work): (Home): (Cell): E-mail: Relationship to Decedent/Estate: FORM #120PC (1/2014) 62-1-401, 62-3-706, 62-3-1001, SCRCP 4(d)(9) American LegalNet, Inc. www.FormsWorkFlow.com