HomeMy WebLinkAbout10-22-10IN RE: ESTATE OF
ROY COY
CUMBERLAND COUNTY
CASE#: 10099
STATEMENT OF CLAIM
1 American Infosource as agent for Bank of America
hereby presents for filing against the above
estate this statement of claim in the amount of $ $669.00
2. The basis for the claim is account number 4264287460804756 which was open ort
7/24/1.996 .
3. The tax identification number of the claimant is (if available) 510331454
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 $ $79.00 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: Craig Smith
Claimant Signature:
State of Oklahoma ,County of Oklahoma ~_~ , ~~:
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IN WITNESS WHEREOF, I have set my hand and notarial seal this ~~
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15 day of October 2010 ~ T'
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STATE OF Pennsylvania
IN THE REGISTER OF WILLS
ASE #:100998
IN RE ESTATE OF: ROY COY
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
1.
2
3
Your Affiant is authorized by the Claimant as its Authorized Representative to
make this Affidavit.
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.
The Decedent purchased merchandise in the amount of $
evidenced by account number
Further your affiant sayeth not
X669.00
4264287460804756
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
1-877-767-9383
Subscribed and sworn before me
This 15 day of October 2010_
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