NOTICE OF CHARITABLE GIFT 

(In  Accordance  with  Pa.  O.C.  Rule  4.4) 

COURT OF COMMON PLEAS OF  

ORPHANS’ COURT DIVISION 

ESTATE OF 

 SETTLOR 

DECEASED 

,

No. 

Chief, Charitable Trusts and Organizations Section 
Office of the Attorney General 

Dear Sir or Madam: 

Notice is given of a charitable gift as follows: 

1. The nature of the present proceeding is an Account:         Yes  

              No      If no, please

proceed to Question 2.
(a)  The Account is filed in a court with a separate Orphans’ Court Division and has
been or will be listed for Audit on __________________,

in_________________________________________________________________. 

(State name of Courthouse and town/city.) 

The time and place of the Audit is Court Room _____________ at __________ o'clock. 
If not provided herein, the time and location will be provided upon request when that 
information becomes available. 

(b) The Account is filed in a court without a separate Orphans’ Court Division, and the 

last day for filing written objections is __________________, at 
__________ o’clock.   

Any objection shall be filed with __________________________________________
on or before the date and time above.

                     (State name of Courthouse and town/city.)  

(c)  The Account concerns an estate or trust in which a charity has an interest or is a 

potential distributee.         Yes               No         

If NO, the Account concerns an estate or trust in which all or part of the balance of 
assets remaining on hand will be distributed to:     

an estate in which a charity has an interest; or

         a trust in which a charity is named as a qualified beneficiary as defined in 
         20 Pa.C.S. § 7703. 

* If  more space is required, attach additional sheets.

Form OC-06  eff. 09.01.16     

     Page 1 of 4 

Estate of 

,        SETTLOR

DECEASED

2.

If the proceedings are other than an Account, state the nature of the proceedings and the
place, date and time fixed for hearing:

3. Charitable gifts are made as follows:

(a)  Give full names and addresses of charities, and the names and addresses of counsel 

for any charity who has received notice or has appeared for it: 

(b) If pecuniary legacies, state exact amounts and indicate whether legacies will be or have 

been paid in full; if not, give reasons therefor. 

(c)  If the charitable interest is a future interest and the estimated present value of the charity's 

future interest exceeds $25,000, a brief description thereof including the conditions 
precedent to its vesting in enjoyment and possession, the names and ages of persons 
known to have interests preceding such charitable interest, and the approximate market 
value of the property involved. 

Form OC-06  eff. 09.01.16

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Estate of 

SETTLOR

DECEASED

,

(d) If residuary gift, state nature and value of share. 

4. Provide a brief statement of all pertinent questions to be presented to the Court for

adjudication or other disposition,  including unresolved claims and any material questions
of interpretation or distribution which may affect the value of the charitable interest.

5. The names and addresses of the fiduciaries are (state whether Executors and/or Trustees):

6. The names and addresses of counsel for the fiduciaries:

Form OC-06  eff. 09.01.16

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Estate of 

SETTLOR

DECEASED

,

7.

(a)  A copy of the instrument creating the gift is attached hereto.

(b) If the gift is other than a pecuniary legacy which will be paid in full, there is attached hereto:

(1) A copy of the Account, if one has been filed 

(2) A copy of any other relevant documents 

________________________   
Date

Signature 

Very truly yours, 

Name of Counsel 

Supreme Court I.D. No. 

Name of Law Firm

Address 

Telephone 

  Email

Form OC-06  eff. 09.01.16

Page 4 of 4