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IN RE: ESTATE OF
JULIA A GARCZYNSKI
STATE OF Pennsylvania
IN THE REGISTER OF WILLS
CUMBERLAND
CASE#: 21-12-0094
STATEMENT OF CLAIM
American InfoSource as agent for Cavalry Portfolio Services,
1. , , ,, . -_-, ~__.:.. _ hereby presents for filing against the above
estate this statement of claim in the amount of $ $7,102.43
2. .The basis for the claim is account number OONBVS98444 Which was open on
10/9/1996
3. The name and address of the claimant is American IaroSoarce as agent for ca~airy Par[rolio services LLC-Legal
P.O. BOX 248$94, Oklahoma City, OK 73124
4. This claim IS NOT contingent
5. This claim IS NOT secured
6. The last payment made on the account was $ $55.00 on 4/30/1999
7. Please Send payments t0 American InfoSource as agent for Cavalry Portfolio Services, LLC-Legal
P.O. BOX 248894
Oklahoma City, OK 73124
]-Sb6-083-5139
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 11 day of Mav 2012
American InfoSource as agent for Cavalry Portfolio Services, LLC-Legal
Claimant Name: Jon McCleske
Claimant Signature:
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CASE #:21-12-0094
IN RE ESTATE OF: ~~ A GARCZYNSKI
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 and/or services in the amount of $ $7,102.43
evidenced by account number OONBVS98444
Further your affiant sayeth not
American InfoSource as agent for Cavalry Portfolio Services, LLC-Legat'
By:
One of its Authorized Rep entatives:
Subscribed and sworn
This 11
Notary Public
Printed Name: Jon McCleskey
American InfoSource as agent for Cavalry Portfolio Services, LLC-Legal
P.O. BOX 248894, Oklahoma Ciry, OK 73124
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1-866.483-5139
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