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West Virginia University Hospitals
P.O. Box 8031
Morgantown, WV 26506-9903
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STATE OF West Vir inia C.....~~-,~ ~
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TO WIT: Q ,
This day personally appeared before me, the undersigned authority in an for
the County and State aforesaid, lnr~ ,who, being by me
first duly worn, deposes and says that the claim filed by _ WVU Hospitals
for the amount of $ 3 ~ 1 Z, , ~ ip , is herby released against the Estate of
,said claim having been paid in full.
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Taken subscribed and sworn to be ~~h
fore me this ~ da of
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My commission expires ~, ~ ~(~
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OFFICIAL SEAL
'" NOTARY PUBLIC
., ~~, STATE OF WEST VIRGINIA
` 3~ NATALIE D. HALL ~' y
U4ESTVIRGINIAUNIVERSITYHOSPITALS,INC.~~"~i?`:` Notary Public
*,, P. o. aox soar ~~~°
+.w, ~,.~ MORGANTOWN, WV 26506-8031
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,,,,,1~~ ~.~~Y ~mmission expires August 2, 2012
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RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH Receipt Date: 12/11/2009
Cumberland County - Orphans Court Receipt Time: 09:03:16
One Courthouse Square Receipt No.: 1041236
Carlisle, PA 17613-3387
BUTTORFF LOUISE S
File Number: 2008-01130
Paid By Remarks:
JN
------------------------ Receipt Distribution ---------____
-----------
Fee/Tax Description Payment Amount Payee Name
RELEASE 5.00 CUMBERLAND COUNTY GENERAL FUN
---------$5.00--
Check# 240640
Total Received......... $5.00