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IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS
HELEN T. COOVER, :CUMBERLAND COUNTY, PENNSYLVANIA
Deceased, :ORPHANS' COURT DIVISION
No. 21-11-1292
AFFIDAVIT OF SERVICE
I, Debra A. Evangelisti, Paralegal to Steven J. Schiffman, Esquire, being duly sworn
according to law, depose and say that I served, upon the parties in interest in the above captioned
matter, a copy of the Petition for Adjudication, First and Final Account of the Estate of Helen T.
Coover, Deceased, by Vance C. Coover, Jr., Executor and Schedule of Proposed Distribution by
depositing copies of said documents in the United States mail, certified, return receipt requested on
August 21, 2012, addressed as follows:
Lois Keller
820 Lisburn Road, Apt. 704
Camp Hill, PA 17011
Abigail Hume
408 Classon Avenue
Brooklyn, NY 11238
PA Department of Public Welfare
Recovery Section
PO Box 8486
Harrisburg, PA 17105-8486
ATTN: Nicole L.Lipscomb
Vance C. Coover
PO Box 845
Pocono Pines, PA 18360
Lacy Hayes, Esq.
2216 Walnut Street
Harrisburg, PA 17103
Messiah Village
100 Mount Allen Drive
Mechanicsburg, PA 17055
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All return receipt cards are attached hereto.
Dated: ~'J ~~ Z-y
Debra A. Evangelisti, P e 1 to
Steven J. Schiffman, Esq.
SERRATELLI, SCHIFFMAN &
BROWN
2080 Linglestown Rd., Suite 201
Harrisburg, PA 17110
(717) 540-9170
Sworn and Subscri ed to
before me this
day of ~C i" , 2012
NOTARY PUBLIC _
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^ Print your name and address on the reverse
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^ Attach this card to the back of the mailpiece,
or on the front H space permits.
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If YES, enter delivery address below: ^ No
3. Type
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^ ^ Return Receipt for Merchandise
^ insured Mail O C.O.D.
4. Restricted Delivery? (Extra Fee) ^
2. Article Number Yes
(nc~rrraaNb.Nrr~,J 7005 311 0002 1866 3807
PS Form 3$11, FebruArY' 4 Domestic Rratun Fieesipt '
102595-02-M-1540
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^ Complete items 1, 2, and 3, Also complete
item 4 H Restricted DelNery is desired.
^ Print your name and address on the reverse
so that we can return the card to you.
^ Attach this card to the back of the mailpiece,
or on the ircrrt if space permits.
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D. Is delivery address different from item 1?~ ^ Ye:
If YES, enter delivery address below: O No
3. type
Certified Mail 0 Express Mail
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D Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number
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PS Form 3811, February 2004 Domestic Rearm Receipt ,o25s5-oz-M-,sac ;
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^ Complete items 1, 2, and 3. Also complete
Item 4 ff Restricted Delhrery I.s desired.
^ Print your name and address on the reverse
so that we can return the card to you.
^ Attach this card to the hack of the mailpiece,
or on the front ff space permits.
1. Article Addressed to:/ ~ -^^ ^
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4. Restricted Delivet)/1(Extra Fee) ^ Yes
2. Article Number
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Ps Form 3811, Febru»ty 2ooa Domestic Return Receipt 102595-02-M-1540 ;
^ Complete items 1, 2, and 3. Also complete
ttem 4 ff Restricted Delivery is desired.
^ Print your name and address on the reverse
so tnat we can return the card to you.
^ Attach this card to the back of the mailpiece,
or on the front ff space permRs.
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1. Article Addressed to:
B. Receiveb'tlSr(Pdn Name)~i~-C Cv`l~
D. Is delivery address different from Item 1? ^ Yes L
If YES, enter delivery address below: ^ No
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Certified Mail ^ Express Mail
Registered ^ Return Receipt for Merchandise
^ Insured Mall ^ C.O.D.
4. Restricted Delivery? (Exha Fee) ^ Yes
2. Article Number
(TrarrsJbr from se-viw ~ 7005 311 0002 1866 3777
PS Form 3811, February 2004 Domestic Return Recbipt to2ss5-a2-M-t5ao
^ I,^,omplete ffems 1.2, and 3. Also complete
ffarrt 4 ff Restricted Delivery Is desired.
^ Print your name and address on the reverse
so that we can return the cans to you.
^ Attach this card to the back of the maiipiece,
or on ttte front ff space permits.
1. Article Addressed to:
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g. ReCel ~g C. Date of Delivery
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D. Is delivery address different from Item 1 ? ^ Yes
It YES, enter delivery address below: ^ No
3. Senrk:e type
L~ Certified Mall ^ Express Mail
^ Registered ^ Return Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Deliver)/? (Extra Fee) ^ Yes
2. Article Nrxnber 7 D p 5 311 D D D 0 2 18 6 6 3 814
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PS Form 3811, February 2004 Dorrlestlc Return Receipt t ozsss-oz-n~-t sao
^ Complete items 1, 2, and 3. Also complete
item 4 ff Restricted Delivery is desired.
^ Print your name and address on the reverse
so that we can return the card to you.
^ Attach this card to the back of the mailpiece,
or on the front ff space permits.
1. Article Addressed to:
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D. Is delivery address different from item 1 T ^ Yes
If YES, enter delivery address below: ^ No
3. Service Type
,~Certifled Mail ^ Express Mail
^ Registered ^ Return Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number 7DD5 311D DDD2 1866 3784
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PS Fonn 38l 1, February 2004 Domestlc Return Receipt