LACKAWANNA COUNTY APPLICATION FOR GENEALOGY SEARCHES WILLS/ESTATES 1878-Present Signature of Person making the request:_______________________________________ Signature required on all requests. PRINT or TYPE your name and address: Name: _________________________________________________________________ Relation to person named on the certificate: ____________________________________ Address: ______________________________________ City: _____________________ State: ________________________ Zip: ____________ Phone: ____________________ PRINT or TYPE the information below with regard to the person named on requested certificate. Number of Copies: ______ Name of Decedent: ______________________________________________________ File Number: ________________________ Date of Death : _______________________ IMPORTANT: PLEASE NOTE The fee for Estate Genealogy searches is $ 25.00 per search. All searches are non- refundable. Please enclose a self-addressed envelope along with a check made payable to The Register of Wills in the applicable amount. Mail requests to: Register of Wills Clerk of Orphans' Court The Scranton Electric Building Suite400 507 Linden Street Scranton, PA 18503-1632 570-963-6702 FRANCES KOVALESKI American LegalNet, Inc. www.FormsWorkFlow.com