NOTICE OF CLAIM (Filed Pursuant to 20 Pa.C.S. § 3532) COURT OF COMMON PLEAS OF COUNTY, PENNSYLVANIA ORPHANS’ COURT DIVISION , DECEASED ESTATE OF 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) Form OC-07 rev. 10.13.06 American LegalNet, Inc. www.FormsWorkflow.com