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HomeMy WebLinkAbout10-21-10IN RE: ESTATE OF STATE OF_ _ Pennsylvania DALE A DAVENPORT IN THE REGISTER OF WILLS CUMBERLAND COUNTY CASE#: 10-549 STATEMENT OF CLAIM 1. American Infosource as agent for Bank of America estate this statement of claim in the amount of $ hereby presents for filing against the above 2• The basis for the claim is account number 414736001408073 1/S/_ ~ 999 7 which was open on 3• The tax identification number of the claimant is (if available) 5 ~ 033 ~ 454 4• The name and address of the claimant is American Infosource as agent for Bank of P.O. Box 248852, Oklahoma City, OK 73124 America 5• This claim IS NOT contingent 6• This claim IS NOT secured 7• The last payment made on the account was $ $1,0`28 on 10/13/2010 8. Please send payments to American Infosource as agent for Bank of America P.O. Box 248852. Please write the above o ount n tuber on our check. Under penalties ofperjury, I declare that I have read the foregoing, and the facts alleged are true best of my knowledge and belief. , to the Executed this 15 day of October 2010 American Infosource as agent for Bank of America Claimant Name: Crai Smith Claimant Signature: State of Oklahoma , County of kl h _ a ~...~ IN WITNESS WHEREOF, I have set my hand and notarial se 15 d l thi ~ a s ay of October 2010 c ~ ,,.,,,,.,~,,,,,,,,,, ,,, ~ D KING ~~ ~ -n 1Z ~ ~ o ~-, ---1 ' • ~~ ~ ~ ~ Notary Public N. ~ = -^ ~~ ~ ..~ ' ,, . P \G of °~`a'`;, My Commission Ex i °~., - _ p res: , rv , _ ~ • ~ ~-;. w w ASE #:10-549 IN RE ESTATE OF: DALE A DAVENPORT AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1 • 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 $ $1,325.00 evidenced by account number 4147360014080737 Further your affiant sayeth not American Infosource as ent 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 1-877-767-9383 Subscribed and sworn before me This 15 day of October 2010 D. K/,~ :'~ Notary Pub is =_ 5az , n ' ~(P. 081C`3~~'' i g