HomeMy WebLinkAbout10-25-11NOTICE OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532)
COURT OF COMMON PLEAS OF
C-~~"n,~+~"~.-~.~ COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF _ ~0~.'(~L.~.( ~ ~ (.S~.il~,~-~~c-ct ~'~
No. 2.l -11't5~?vS
To the Clerk of the Orphans' Court Division:
DECEASED
Enter the claim of Sir ~¢, ~2~a~ C.~„« ~, `~~ ~ ~{~ ~~ in the
(Clatmant)
amount of $_~;~{~ against the above entitled Estate,
The Decedent, who resided at IBS S 2F
(Street Address)
died on _ cam{ ~ Z-j ~ ~ ~ .Written notice of
(Dale Death)
said claim was given to ('r~~ Lc:~~r
(Personal Representative or his/her counsel)
on
(Dare)
(Claimant's Counsel]
(Supreme Court L D. Nn.)
(Address)
(Telephone)
(Address)
(c.tatmarlt)
(Street Address) -"`'
i .~ ~
(City, State, Zip) ~.-~ ~ ~-~
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r~e.
form OC-07 rev. 10,13.06
Glenda Farner Strasbaugh
Register of wills &
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq.
Solicitor
One Courthouse Square
Carlisle, PA 17013
Phone: 1-888-697-0371 x 6345
717-240-6345
Fax: 1-888-697-0371 x 7797
OFFICES OF
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
RESPONSE TO RESEARCH REQUEST
October 13, 2011
AN ESTATE WAS LOCATED
Decedent Name:
Estate No.
Date Filed:
Date Granted:
Personal Representative:
Address:
City, State, Zip:
Attorney Name:
Address:
City, State, Zip:
Telephone:
NO RECORD OF PROBATE
RODNEY D LANKFORD JR
21-11-0535
05/03/2011
05/03/2011
FRED L LAVER
407 PINE GROVE ROAD
GARDNERS PA 17324
NEELY E MEALS
2331 MARKET ST
CAMP HILL PA 17011
7177631383
NEED MORE INFORMATION TO CONDUCT SEARCH
FEE REQUIRED.
Please forward a check in the amount of $4 per name to be searched. Make check
payable to ,Register of Wills and included aself-addressed stamped envelope.
;`
® YOUR RECEIPT IS ENCLOSED.
^ COMMENTS:
NOTE: The fee to file a claim against an estate is $10. See our website for the Notice
of Claim form. (www.cc a.net -search for Notice of Claim)
Spring Cree~
`~~ ~ ~ RehabiliNation & Health Care' Center
f
Daryl Aleksiewicz
Spring Creek Management, LP
1205 South 28~' Street
Harrisburg, PA 17111
October 21, 2011
Fred Lauer
407 Pine Grove Road
Gardners, PA 17324
Dear Fred Lauer:
Spring Creek Rehabilitation & Health Care Center
1205 South 28~' Street • Harrisburg, PA 17111
Telephone: 717-565-7000 • Fax: 717-558-8138
I am writing this letter to give you written notice of the claim we are filing with the Register of Wills on the
Estate of Rodney D. Lankford, No. 21-11-0535, for the amount owed for services rendered at Spring Creek
Rehabilitation & Health Care Center in the amount of nine thousand two hundred forty dollars and forty-six
cents ($9,240.46). Enclosed please find a copy of the bill from our facility for the services provided. To have
this claim removed please send payment to the following address:
Spring Creek Rehab & Health Care
Business Office
1205 S 28th Street
Harrisburg, PA 17111
If there are any questions and/or concerns please contact me at (717)745-9015.
Sincerely,
Daryl Aleksiewicz
Finance Director
cc:
Glenda Farner Strasbaugh Neely Meals
One Courthouse Square 2331 Market Street
Carlisle, PA 17013 Camp Hill, PA 17011
SPRING CREEK REHAB & HEALTH CARE CENTER
1205
SOUTH 28TH ST
HARRISBURG PA 17111
TELEPHONE:
FRED LAUER
407 PINE GROVE ROAD
GARDNERS, PA 17324
717 565 7000
BILL FOR: RODNEY LANKFORD
RESIDENT NO 2888 DATE: 10/21/ 2011
DATE DESCRIPTION
REFERENCE UNITS PRICE CHARGES/ BALANCE
______ _________________ PAYMENT DUE
PREVIOUS BALANCE
04/01/10
PAYMENT THANK YOU .00
04/01/10 PAYMENT THANK YOU PMNT
PYMNT 1 1000.00- 1000.00-
04/01/10 PAYMENT THANK YOU
PAYMNT 1 1000.00- 2000.00-
04/05/10 COMM INS TRF TO PVT
FREED BL 1 667 71-
2667.71-
FREEDOM BLUE CO-INS+ DEDCT APR 1 2667.71 .00
05/01/10 COMM INS TRF TO PVT FREED BL
FREEDOM BLUE CO-PAY 5/2010 1 250.00 250.00
05/01/10 PAYMENT THANK YOU PAYMNT
05/01/10 PAYMENT THANK YOU
PAYMENT 1 306.11- 56.11-
05/01/10 PAYMENT THANK YOU
PAYMENT 1 1023.22-
1079.33-
05/11/10 05/20/10 NURSING CARE 004-2 1 1014.12- 2093.45-
05/21/10 05/25/10 NURSING CARE 004-2 10 246.00 2460.00 366.55
05/26/10 05/27/10 NURSING CARE 004-2 5 82.00 410.00 776.55
06/04/10 06/09/10 NURSING CARE 004-2 2 82.00 164.00 940.55
06/10/10 06/15/10 NURSING CARE 010-1 6 246.00 1476.00 2416.55
06/15/10 COMM INS TRF TO PVT
FRDM BL 6 246.00 14"I 6.00 3892.55
FREEDOM BLUE COPAY 6/2010 1 131.91 4024.46
06/16/10 06/30/10 NURSING CARE 010-1
07/01/10 COMM INS TRF TO PVT
FB 15 246.00 3690.00 7714.46
FREEDOM BLUE COPAY 7/2010 1 50.00 7764.46
07/01/10 07/06/10 NURSING CARE 010-1
CONTINUED NEXT PAGE 6 246.00 1476.00 9240.46
SPRING CREEK REHAB &
1205 SOUTH 28TH ST
HARRISBURG pA
HEALTH CARE CENTER
17111
TELEPHONE: 717 565 7000
FRED LAUER
407 PINE GROVE ROAD
GARDNERS, PA 17324
BILL FOR: RODNEY
RESIDENT NO 2888 LANKFORD DATE:
10/21/2011
DATE DESCRIPTION CURRENT
----- REFERENCE UNITS PRICE CHARGES/ BALANCE
___________________________________________________ PAYMENT
---------- DUE
BALANCE FORWARD
9240.46
BALANCE DUE
9240.46
Payment is due 10 days from the Statement Date, payable to Spring
Creek. Contact us at (717) 565-7000 Pat x7178
If income payments are not prompt income WILL BErchanged to23.
come directly to Spring Creek_