HomeMy WebLinkAbout07-02-07 (2)
On behalf of the claimant, I do solemnly declare and affirm under the penalties of
perjury that they Information and representations made herein are true and correct
to the best of my knowledge, information and belief. J
~ oshua 1: Patrick
Dated: CD -ll- 0 t .. I~ Authorized Representative
Claimant I
Representative and/or his/her couns~
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COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
NOTICE OF CLAIM
In Re: The Estate of:
Court File No: 21-07-0147
DANIEL KAHLEY
Deceased
TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by
creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries
Code, 20 PA.C.S.A. ~3532(b)(2).
1) Claimant's name: FIA CARD SERVICES NA
2) Claimant's address: ESTATE UNIT DE5-014-02-03 1000 SAMOSET DRIVE,
WILMINGTON DE 19884
3) Creditor listed below is the owner and holder of a claim in the amount of
$1,652.74.
4) The facts upon which this claim is based is an account for credit evidenced by
the attached Affidavit of Account Stated.
5) Decedent's address: 7073 CARLISLE PIKE, CARLISLE PA 17015
6) Date of Death:
7) That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by
Written notice of claim was given to Person
as stated below:
DANIEL E KAHLEY
Name
727 WOODBROOK LN
Address
PLYMOUTH MEETING PA 19462
City/State/Zip &"'1""'\
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Date notice maile
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IN RE ESTATE OF: DANIEL KAHLEY
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
1. Your Affiant is authorized by the Claimant as its Authorized Representative to make this
Affidavit.
2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent.
Your Affiant is familiar with these records and accounts and reviews them as a regular part of
his/her duties.
3. The Decedent purchased merchandise in the amount of$I,652.74 evidenced by account number
74981995828516
Further your affiant sayeth not
FIA CARD SERVICES NA
By:
One 0
Printed Name: Joshua 1: Patrick
Authorized Representative
FIA CARD SERVICES NA
ESTATE UNIT DE5-014-02-03 1000 SAMOSET DRIVE
WILMINGTON DE 19884
Subscribed and sworn before me
This JL day of ~JOVU ,2oill
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DIANA KIRCHNER
NOTARY PUBLIC. MINNESOTA
MY COMM. EXP. 01/31/2011
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