HomeMy WebLinkAbout12-17-10NOTICE OF CLAIM ~_
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(Filed Pursuant to 24 Pa. C . S . § 3532) ~ " ~'
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COURT OF COMMON PLEAS OF ~~ =~
COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
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ESTATE OF DIANE PALOVITZ ,DECEASED
No. 21-10-0912
To the Clerk of the Orphans' Court Division:
Enter the claim of Phillips & Cohen Associates, LTD on behalf of US Bank
(Claimant)
amount of $ 5,643.15 ,against the above entitled Estate.
The Decedent, who resided at STONE MOUNTAIN, GA 30083
(Street Address)
died on 05/16/2010 .Written notice of
(Date of Death)
said claim was given to Dawn Heilman
(Personal Representative or his/her counsel)
at _ 111 N Front Street Harrisburg, PA 17101
(Address)
on December 10, 2010
(Date)
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(Cl ant)
1 02 Justison Street
(Street Address)
Wilmington, DE 19802
(City, State, Zip)
(Claimant's Counsel) (Supreme Court I.D. No.)
(Address)
(Telephone)
Form OC-07 rev. 10.13.06
Cumberland
in the
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STATEMENT AND PROOF OF ; FILE NO:
CLAIM
21-10-0912
STATE OF PA
PROBATE COURT
Cumberland COUNTY
Estate of DIANE PALOVITZ
Cumberland County Register of Wills
One Courthouse Square
R nnm 1(17
Carlisle, PA 17013
Phillips & Cohen Associates, LLC, on behalf of US Bank located at 425 Walnut Street,
15th Floor, Cincinnati, Ohio 45020 submit the following claim against the estate fir the
sum set forth.
DESCRIPTION
ount #: XXXXXXXXXXXX8133
t Due:
CA File #: 17538825
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There is now due on the claim, above all legal set-offs, the sum of 1 _ _ $564i.15J
It is declared that this claim has been examined by one of Phillips & Cohen Associates,
Ltd. representatives and that its contents are true to the best of our information,
knowledge, and belief.
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uthorized Signature
hackie Adams
Phillips & Cohen Associates, Ltd.
The Creditor's Rights & Bankruptcy Group
A Division of Phillips & Cohen Associates, Ltd.
1002 Justison Street
Wilmington, Delaware 19801
Telephone: (866) 907-6832
.special form
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PROOF OF SERVICE OF CLAIM
I served upon the Estate of DIANE PALOVITZ , a copy of this claim on 12/10/2010 via
United States Postal Service to:
Dawn Heilman
111 N. Front Street,
Harrisburg, PA 171 O 1,
I served upon the Estate of DIANE PALOVITZ , a copy of this claim on 12/10/20110 via
United States Postal Service to:
Cumberland County Register of Wills
One Courthouse Square
Room 102
Carlisle, PA 17013
It is declared that this claim has been examined by one of Phillips & Cohen Associates,
Ltd. representatives and that its contents are true to the best of our information,
knowledge, and belief. .,~
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12/10/2010 ~ ~ ~~
Date S~ ature
kie Adams
ACCEPTANCE OF SERVICE
Service of the attached claim is accepted.
Date
Signature
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To whom it may concern:
Due to the voluminous nature of the documentation supporting this claim, the following
account summary is provided:
SUMMARY OF ACCOUNT
1. ACCOUNT NUMBER: XXXXXXXXXXXX8133
2. NAME IN WHICH CARD ISSUED: DIANE PALOVITZ
3. PRIMARY CARD HOLDER(S): DIANE PALOVITZ
4. OPEN DATE: NiA
5. CREDIT LIMIT: $ N/A
6. FINAL BALANCE: $ 5643.15
7. PRIMARY USE OF CARD: Purchases
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