HomeMy WebLinkAbout03-19-10_ NOTICE OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532)
COURT OF COMMON PLEAS OF
a
(,~ u/n ~,~,~~ COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF ~ ~ N C ~ ~ l O b~~' S , DECEASED
No. ~ !--/ d ~- d ~~~
To the Clerk of the Orphans' Court Division:
Enter the claim of ~ ~' ~~ ~ ~'1
in the
(Claimant)
amount of $ S ` ~ , `S~ ,against the above entitled Estate.
The Decedent, who resided at C~ S ,/,_~ ~ ~ ~ ~2 ~ ;
1, ~ ~ 9~~3
Street Address) ~ '
~ v z ~ ,died on ~ 0 ~ ~ 7- ~ ~ .Written notice of
~~ (Date o Death)
said claim was given to T, ~ C ~ n ~
(Personal Representative or his/her counsel)
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on
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(Clai~t)
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(Street Address)
(City, State, Zip)
(Claimant's Counsel) (Supreme Court I.D. No.)
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Form OC-07 rev. 10.13.06