Free Microsoft Word - 120PC.dot - South Carolina

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