STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF:
) ) ) ) ) )
IN THE PROBATE COURT PROOF OF DELIVERY CASE NUMBER:
On the
day of
, 20
, I mailed or delivered the following document,
A copy of which is attached hereto and incorporated herein, or The original of which is on file with the court and incorporated herein, Delivery was accomplished by the following method (check appropriate box): personal delivery certified mail ordinary first class mail registered mail
to each of the following persons at the address shown: NAME ADDRESS
SWORN to before me this , 20
day of
Signature: Name: Address: Telephone (O): (H): E-mail: Signature: Name: Address: Telephone (O): (H): E-mail:
Notary Public for South Carolina My Commission Expires:
FORM #120PC (2/2004) 62-1-401, 62-3-1003, general