Rule 2.4 - Medical Assistance(a) For decedents who died after August 15, 1994, and were over 55 years of age upon their demise, the provisions of 62 P.S. § 1412(b) apply. Attached to the petition for adjudication shall be either:(1) the notice sent to the Department of Human Services and the Department's response; or(2) the Affidavit of the fiduciary, that he has reason to know the financial affairs of the decedent prior to decedent's death, and the fiduciary affirmatively represents that decedent did not receive any medical assistance during the five years preceding decedent's death.Penn. Wash. O.C. Rule 2.4