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Appendix K:       Notification of Retention of Lack of Counsel Under Rule 14, Section (3)

  Date of Letter
The Honorable                                          
Court of Common Pleas of Allegheny County
Orphans' Court Division Courtroom           
1700 Frick Building
Pittsburgh, PA 15219
  

RE:    *10                                 , an alleged incapacitated person
Docket Number                 of                
Date of Hearing:                                    

Dear Judge                                :

With regard to the above-captioned matter and in accordance with Allegheny County Local Orphans' Court Rule 14 Section 3(b), this letter is to inform you that to the best of my knowledge, information and belief, *                                    is not presently represented by counsel in *his/her own right in regard to the above referenced proceedings.

OR

With regard to the above-captioned matter and in accordance with Allegheny County Local Orphans' Court Rule 14 Section 3(b), this letter is to inform you that to the best of my knowledge, information and belief, *                                    is presently represented by counsel in *his/her own right in regard to the above referenced proceedings.  An appearance has been entered on *his/her behalf by *                                    whose address is *                                             and whose telephone number is *                        .
  Very truly yours,

*                                                
 Attorney for Petitioner

10Sections denoted by asterisk (*) must be completed by counsel before Court presentation.

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