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III :::J '< ID ID N !l! n '" c, >-' m >-3 o :Y (]) :;;: ('] Ul 'U rt o '" 3 rt '"" (]) " Cl 0 rt '"" :n f--" (]) 'U )> ....J (j) " rt (]) (]) o f--" W n 3: o c, ,., f-"- Ul o :J -lIo ~ -lIo ~ I C I co L-...--...._-----.J m1M&TBank 499 Mitchell Road, Millsboro, DE 19%6 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 December 28, 2006 Law Offices Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 ~~~~aw~~ :- ',.);J r:.. '..-.' ',- ',..' Re: Estate or Lee C Morrison Social Securitv: 202-20-3984 Date of Death: December 11, 2006 IP .l...J. \. r\~ i'i;> t(~.T i[~ r...:p' " ':I <........... _."! "'__~~ ~ J. ''',jt 1. of il Dear Sir or Madam: Per your inquiry dated December 20, 2006, please be advised that at the time of death, the above-named decedent had on deposit with this bank the follo\Ving: 1. Type of Account Checking Account Account Number 1058002 Ownership (Names of) r\ /'!v (;' ,J Jean E Morrison * ,t',.\:_l.t~ Lee C Morrison * Opening Date 12/08/90 Balance on Date of Death $3,340.72 Accrued Interest $ 0.00 Total $3,340.72 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Spring Garden Office # 717-240-4525. Sincerely, v1L/i:/f.J'{/(;~-:J/' Nancy Clagett Records Management IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF LEE C. MORRISON, DECEASED No. 21-2007-30 NOTICE OF CLAIM FILED PURSUANT TO 20 Pa. C.S. ~3532 OF THE PROBA TE, EST A TES AND FIDUCIARIES CODE To the Clerk of the Orphans' Court Division: Enter the claim of HCR ManorCare - Carlisle ("Claimant") in the amount of $3,971.91, against the above entitled Estate. The Decedent, who resided at 1 Clifton Terrace, Carlisle, Pennsylvania 17013, died on December 11,2006. Written notice of said claim was given to Roger Irwin, Esquire, at 60 West Pomfret Street, Carlisle, Pennsylvania 17013 on August 3, 2007. Respectfully submitted, SCHUTJER BOGAR LLC Dated:B / ~/ 0 ::;- ( I By!r?tWJ1~ Bradley A. SchutJer , Attorney J.D. No. 75954 (717) 909-5924 Maria G. Macus-Bryan Attorney J.D. No. 90947 (717) 909-8640 305 N. Front Street, Suite 401 Harrisburg, PA 17101 Claimant's Information HCR ManorCare - Carlisle 940 Walnut Bottom Road Carlisle, PA 17015 (717) 249-0085 Attorneys for Claimant ~(Q)[F?)W K x U ate !II me HI L - j II - L LlIJ I '11 U ~ I l ~ 'J 4 Jul 30 2007 2:49PM HP LASERJET FAX .J. U U L p.2 MAY 03 HCR*ManorCare MANORCARE CARLISLE 372 940 WALNUT BOTTOM ROAD CARLISLE, PA 17013 (717)-249-0085 PRIVATE MORRISON, LI STATEMENT ROOM 214 A 3/1/2006 PRIVATE PORTION $1,141.50 -$88.50 4/1/2006 PRIVATE PORTION $1,14150 -$88.50 5/1/2006 PRIVATE PORTION $1,141.50 -$88.50 6/1/2006 PRIVATE PORTION $1,141.50 -$88.50 7/1/2006 PRIVATE PORTION $1,141.50 -$88.50 7/1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 8/1/2006 PRIVATE PORTION $1,141.50 -$88.50 8/1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 9/1/2006 PRIVATE PORTION $1,141.50 -S88.50 9/1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 10/1/2006 PRIVATE PORTION $1,141.50 -$88.50 10f1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 11 f1/2006 PRIVATE PORTION $1,141.50 -$88.50 11f1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 12/1/2006 PRIVATE PORTION $1,141.50 -$88.50 12/1/2006 PAYMENT SOCIAL SECURITY -$1,053.00 2/26/2007 PAYMENT -$240.09 Payment Due Upon Receipt Amount Due $3,971.91 Page 1 CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Notice of Claim was served first-class, United States mail, postage prepaid, upon the following: Roger Irwin, Esquire Irwin & McKnight 60 West Pomfret Street Carlisle, PA 17013 ~ I "5 I O:r Dated:~ Vv---- By: William Keslar, Paralegal . CHRYSLER FINANCIAL CHRYSLER FINANCIAL FARMINGTON HILLS MI 48333-9223 PAYMENT SERVICES April 12, 2007 LEE C MORRISON 1 CLIFTON TER CARLISLE PA 17015 1,"11111,111111,"11.1.1.1,"1,11"11. " ,1,1,11111 " .11111,11 ~"' /- / . I . J' f 1.'~.' '('-€(I,i .", ( V) ,l J,-( n Cl (ylJZ l, ~Y'l c V y \ .~ (,y\ 0+ ,-tl + L( t\( I d ---------- DESCRIPTION OF BILL PAYMENT: Bank: Bank Account Number: Date of Transaction: PNC BANK, NATIONAL ASSOCIATION ******6944 Apr12,2007 DESCRIPTION OF WESTERN UNION PHONE PAY SERVICE FEE PAYMENT: For the Transfer of Money Payable To: CHRYSLER FINANCIAL (RETAIL) r Amount of Payment: $7926.85 "'~.{tA CC{~ CtJf 't;v I f1 yt} 'vt..- ycu {;ctve- tYUL. Jol/ Customer Reference: 010172071026572834 Bank: Bank Account Number: Date of Transaction: PNC BANK, NATIONAL ASSOCIATION ******6944 Apr 12, 2007 Payable To: Amount of Payment: WESTERN UNION $7.00 Customer Reference: 010172071026572834 Dear LEE C MORRISON: Based on your authorization during our telephone conversation at 08:54 A.M., on Apr 10,2007, Western Union has initiated an automated clearing house (ACH) debit to withdraw the bill payment amount described above from your specified bank account to make the bill payment that you requested. In addition to the bill payment amount and based on your separate authorization that you provided during that telephone conversation, Western Union has initiated an ACH debit for the Western Union@ Phone Pay@ service fee as described above. The Western Union Phone Pay Service is provided on the terms and conditions set forth on the back of this letter. If you have any questions or wish to make corrections to the information listed above, please call 800-556-8172 or write to us at the address listed above. CHRYSLER FINANCIAL CHRYSLER FINANCIAL FARMINGTON HILLS MI 48333 004702A3677445 This is not a bill. Do not mail payment. Retain this letter for your records. . ~~\S~uw~~ JAN -4 2007 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 6486 HARRISBURG, PA 17105-6486 IR\\ f, _..I. \. r .. _. . -..... .,'. l\lcKi'IIGHT January 2, 2007 IRWIN & MCKNIGHT ROGER B IRWIN ESQUIRE WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE PA 17013 Re: LEE MORRISON CIS #: 830164168 SSN: 202-20-3984 Date of Death: 12/11/2006 Dear Mr. Irwin: Please be advised that the Department of Public Welfare maintains a claim in the amount of $37,243.05 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $26,733.64, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $1.0,509.41., is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, -, ~t'~)llJ.'--~ ~f-~b'-L l !L.. Jessica L. Strawbridge TPL Program Investigator 717-772-6238 717-772-6553 FAX Enclosure