HomeMy WebLinkAbout01-14-10r
Date: 12/21/09
In the estate of:
LOTS G. TAYLOR
Estate No: 21-09-1016
Date of Death:-T/ ~ g
CLAIM AGAINST DECEDENT'S ESTATE
The Claimant certifies that there is due and owing by the LOTS G. TAYLOR
deceased,
in accordance with the attached statement of account the sum of $ so3.6s
together with interest at the rate of
until paid.
from
On behalf of the claimant I do solemnly declare and affirm under the penalties
of perjury that the information and representations made herein are true and correct
of the best of my knowledge, information and belief.
MILITARY STAR
Name of Claimant
Mark E. Bennett, Agent
Signature of Claimant or person
authorized to make verification
on behalf of creditor
9441 LBJ Freeway
Lock Box 30
Dallas, TX 75243
Address of Claimant Address
972-644-6360 ~
Phone Number
Phone Number ~ ~~~
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FILED: ~ G_ .~' ,~" e~ ;
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THIS FORM MAY BE FILED WITH THE ORPHANS COURT UPON
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FILING FEE OF $10.00. PAYN
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A COPY MUST ALSO BE SENT TO THE PERSONAL FD
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REPRESENTATIVE.
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PROBATE COURT
Cumberland County, State of Pennsylvania
Lois G. Taylor, Deceased
Case #21-09-10'16
Proof of Mailing
I mailed the creditors claim to the fiduciary (and attorney, if applicable) as
follows:
I deposited a copy/copies of the claim with the United States Postal Service in
a sealed envelope with the postage fully pre-paid. I used first-class mail. I
am employed in the county where the mailing occurred. The envelope(s) was/were
addressed and mailed as follows:
Mr. John Taylor Jr.
c/o Bradley L. Griffie, Esq.
200 N. Hanover St.
Carlisle, PA 17013
Date of Mailing:
County of Mailing: Dallas, Texas
I declare under penalty of perjury that the foregoing is true and correct.
Date:
Mark E. Bennett, Agent for
Military Star
P.O. Box 741026
Dallas, TX 75374
• 9441 LBJ FreeH~ay Suite 605 Dallas, Texas 7:243
'~ 972-b44-6360 Fax 972-544-A660
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Deceased Account Referral from AAFES/1~1ilitarv Stai• ~ ~~
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New Referral 0 Addition to Prior Referral ~~Date: ~ o~ ~~r
*Decedent: ~. ~ % .~
,social Security #. ,~~ ,,~~ ~~ ~jr
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Next of Kin or Executor:
Address:
Phone #: _
Date of Death: ~ G-~- ~'} ~' *County and State of Death:
~~tate in Probate? ~-es or no
If Yes: Case Numher:
Date betters Issued: ~C~ ~~
Attorney: ~
Attorney's Address: _ ADO -~. l-~ p ~ ~~~ ~ 5~ '
rvo ~~~ .~ ~ ZO49
Attorney's Phone #: (~71 ~ L y _ ~-~- J
Account Number *Balance
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* Designates essential information