HomeMy WebLinkAbout10-21-10STATE OF_ Penn~vania
IN RE: ESTATE OF IN THE REGISTER OF WILLS
RAY A COY CUMBERLAND COUNTY
CASE#: 100998
STATEMENT OF CLAIM
l , American Infosource as agent for Bank of America hereby presents for filing against the above
estate this statement of claim in the amount of $_ $(89.00
2. The basis for the claim is account number 5329020419159562 which was open on
8/17/1994 .
3. The tax identification number of the claimant is (if available) Sto331454
4. The name and address of the claimant is American Infosource as agent for Bank of America
P.O. Box 248852, Oklahoma City, OK 73124
5. This claim IS NOT contingent
6. This claim IS NOT secured
7. The last payment made on the account was $ $25.00 on 8/17/2010
8. Please send payments to American Infosource as agent for Bank of America
P.O. Box 248852.
Oklahoma City, OK 73124
Please write the above account number on your check,
Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the
best of my knowledge and belief.
Executed this 15 day of October 2010
American Infosource as agent for Bank of America
Claimant Name: rai Smith
Claimant Signature:
State of Oklahoma ,County of nklahnma
IN WITNESS WHEREOF , I have set my hand and notarial seal thi "~
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ASE #:100998
IN RE ESTATE OF: RAY A COY
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
Your Affiant is authorized by the Claimant as its Authorized Representative to
make this Affidavit.
2. Your Affiant has reviewed the account records of the Claimant with respect to
the decedent. Your Affiant is familiar with these records and accounts and
reviews them as a regular part of his/her duties.
3. The Decedent purchased merchandise in the amount of $ $689.00
evidenced by account number 5329020419159562
Further your affiant sayeth not
American Infosource as agent for Bank of America
By:
One of its Authorized Representatives:
Printed Name: Craig Smith
American Infosource as agent for Bank of America
P.O. Box 248852,
Oklahoma City, OK 73124
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