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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYVLVANIA
ORPHANS' COURT DIVISION
In Re: Estate of HOW ARD FULLER, Deceased
No: 21 - 07 - 0095
CLAIM
To the Clerk ofthe Orphans' Court Division:
Index and make proper entry in your official records of the claim of GOLDEN GATE
NATIONAL SENIOR CARE, LLC d/b/a WEST SHORE HEALTH AND REHABILITATION
FACILITY (formerly BEVERLY HEALTHCARE), CLAIMANT in the amount of $ 2,380.80
against the estate of the above-named decedent
This claim is filed under Section 3532(b)(2) of the Probate, Estates and Fiduciaries Code.
The said decedent, who resided at 37 Meadow Brook Court, New Cumberland, PA
17070-2507, died on)anuary 21 sl of2007.
Written notice of this claim was given to GERALD FULLER, Executor, at 37 Meadow
Brook Court, New Cumberland, PA 17070-2507, on December 17,2007.
Written notice of this claim was given to Lisa Coyne, Esq. at 3901 Market Street, Camp
Hill, PA 17011-4227 on December 17, 2007.
Claimant
West Shore Health and Rehabilitation Center
770 Poplar Church Road
Camp Hill, P A 17011
A~jlr71
Nathan T. Chase, Esq.
Attorney ID# 200295
Dodson, McCaffrey & Associates
9800A McKnight Avenue, Suite 332
Pittsburgh, PA 15237
Phone: 412-635-9314
Fax: 412-635-9358
Email: Nathan_Chase@dodsonmccaffrey.com
DODSON, MCCAFFREY & ASSOCIATES
BY: Nathan T. Chase, Esquire
P A ID# 200295
Suite 332 Building A
9800 McKnight Road
Pittsburgh, PA 15237
412-635-9314
Attorneys for Plaintiff
ESTATE OF HOWARD FULLER, DECEASED
CUMBERLAND COUNTY
ORPHAN'S COURT DIVISION
Case No.: 21 - 07 - 0095
CERTIFICATE OF MAILING OF NOTICE LETTER
I, NATHAN T. CHASE, ESQUIRE, hereby certify that on December 17, 2007, I sent
notice of the presentation of the foregoing Notice of Claim to GERALD FULLER, EXECUTOR,
37 Meadowbrook Court, New Cumberland, PA 17070, by first-class and certified mail, together
with copy of the Notice of Claim. A copy of the foregoing Notice of Claim was also sent to Lisa
Coyne, Esq. 3901 Market Street, Camp Hill, P A 17011.
Date: December 17, 2007
DODSON, MCCAFFREY & ASSOCIATES
~
NATHAN T. CHASE, ES