HomeMy WebLinkAbout05-30-12
CREDITOR'S CLAIM FORM
ATTORNEY OR CREDITOR WITHOUT ATTORNEY (Name and Address). TELEPHONE NO: FOR COURT USE ONLY
888-715-4315
WELLS FARGO BANK
F.O. BOX 5347b ~,
PHOENIX, AZ 85072 trP
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ATTORNEY FOR (Name): ~~ ev
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STREET ADDRESS: CUmberlend COUnty Orphans COart ~~
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MAILING ADDRESS: 1 COUrthou3e SQuare ((
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CITY AND ZIP CODE: Carli$le, PA 17013 ..ZZ v `"
H NAME: Probate Division ~~~-, - , ~,
NAME: ~
Thomas A Wildman ~'-~
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DECEDENT ~"~
CREDITOR'S CLAIM cASE NUMBER.
(for administration proceedings filed after June 30, 1988)
2t-2012-0282
You must file this claim with the court clerk at the court address above before the LATER of (a) four months after the date letters
(authority to act for the estate) were first issued to the personal representative, or (b} thirty days after the Notice of Administration was
given to the creditor, if notice was given as provided in Probate Code section 9051. Mail or deliver a copy of this claim to the personal
representative. A proof of service is on the reverse.
1. Total amount of the claim: 559,574.44
2. Claimant (name): Wells Fargo Bank, PO Box 53476, Phoenix, AZ 85072
a. ^ an individual
b. ^ an individual or entity doing business under the fictitious name of (specify):
c. ^ a partnership. The person signing has authority to sign on behalf of the partnership.
d. ®a corporation. The person signing has authority to sign on behalf of the corporation.
e. ^ other (specify):
3. Address of claimant (specify):
Wells Fargo Bank
P.O. Box 53476
Phoenix, AZ 85072
4. Claimant is ®the creditor ^ a person acting on behalf of creditor (state reason):
5. ^ Claimant is ^ the personal representative ^ the attorney for the personal representative.
(Claims against the estate by the persona! representative and the attorney for dhe personal representative must be
fried within the claim period allowed in Probate Code section 9100. See the notice box above.)
6. I am authorized to make this claim which is just and due or may become due. All payments on or offsets to the claim
have been credited. Facts supporting the claim are ^ on reverse ®attached.
I declare under penalty of perjury that this creditor's claim is true and correct.
Date: 05!29!11 ~~/
Kimberly Dee,VP, Loan Admisnistration Manager ~ ~~• _~ ~
(TYPE OR PRINT NAMt ANp TITLFj (SIGNATURE OF CLAI T)
INSTRUCTIONS TO CLAIMANT
A. On the reverse, itemize the claim and show the date the service was rendered or the debt incurred. Describe the item or
service in detail, and indicate the amount claimed for each item. Do not include debts incurred after the date of death, except
funeral claims.
B. If the claim is not due or contingent, or the amount is not yet ascertainable, state the facts supporting the claim.
C, If the claim is secured by a note or other written instrument, the original or a copy must be attached (state why original is
unavailable). If secured by mortgage, deed of trust, or other lien on property that is of record, it is sufficient to describe the
security and refer to the date or volume and page, and county where recorded. (See Probate Code section 9152.)
D. Mail or take this original claim to the court clerk's office for filing. If mailed, use certified mail, with return receipt requested.
E. Mail or deliver a copy to the personal representative. Complete the Proof of Mailing or Personal Delivery on the reverse.+
F. The personal representative wilt notify you when your claim is allowed or rejected. O R 1 G 1 N A L
(Continued on reverse)
1 jAME: CASE NUMBER:
Thomas A Wildman 21_2012-0282
DECEDENT
rexa, t ~ aurrvl(l IPIG t liE I;KEllI'I VK'J CLAIM
® See attachment /if space is insufficient)
I . I am the creditor or a person acting on behalf of the creditor. At the time of mailing or delivery 1 was at least 18 years of age.
2. My residence or business address is (specify):
WELLS FARGO BANK
P.O. Box 53476
Phoenix, AZ 85072
3. I mailed or delivered a copy of this Creditor's Claim to the personal representative as follows (check either a or b below):
a. ®First Class Mail. I deposited a copy of the claim with the United States Postal Service, in a sealed envelope with postage
fully prepaid. 1 used first-class mail. I am a resident of or employed in the county where the mailing occurred.
The envelope was addressed and mailed as follows:
(1) Name of personal representative served: Margaret A Gilhooly
(2) Address on envelope: c/o Wayne Pecht
1205 Manor Dr Suite 200
Mechanicsburg, PA 17055
(3) Date of mailing: 5/29/12
(4) Place of mailing (city and state): Phoenix, AZ
b. ^ Personal delivery. 1 personally delivered a copy of the claim to the personal representative as follows:
(1) Name of personal representative served:
(2) Address where delivered:
(3) Date delivered:
(4) Time delivered:
I declare under penalty of perjury that the foregoing is true and correct.
Date: 5/29/12
Kimberly Dee,VP, Loan Admisnistration.Manager ~ I
(TYPE OR PRINT NAME AND TITLE) (SIGNA E OF CLAIMANT)
CREDITOR'S CLAIM
Page 2
PROOF OF ®MAILING ^ PERSONAL DEL/VERY TO PERSONAL REPRESENTATIVE
(Be sure to mafl or take the original to the court clerk's ofJlce for filing