HomeMy WebLinkAbout12-27-12RFCORCFa 0=1''C,F OF
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Cumberland
NOTICE OF CLAIM
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Filed Pursuant to 20 Pa.C.S. § 3 )
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COURT OF COMMON PLEAS OFC U M B E R !. A Fi ~ ~ i~' . , ~ ,;
COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF Henry Malis DECEASED
No. 21-12-1189
To the Clerk of the Orphans' Court Division:
Enter the claim of Pinnacle Health Hospitals in the
200,110.08 (Claimant)
amount of $ against the above entitled Estate.
The Decedent, who resided at 218 North 29th Street, Camp Hill, PA 17011
(StreetAddress)
said claim was given to William Adler
died on 10/3/12
(Date of Death)
Written notice of
(Personal Representative or his/her counsel)
at 4949 Devonshire Road Harrisbur PA 17109
on 12/13/12 (Address)
(Date)
Pinnacle Health Hospitals
(Claimant)
409 S. Second Street, P.O. Box 8700
(Street Address)
Harrisburg, PA 17104
John DeLorenzo 72190 (city, scare, zip)
(Claimants Counsel) (Supreme Court LD. No.)
Pinnacle Health, 409 S. Second Street, Suite 2C
(Address)
Southgate Building, Harrisburg, PA 17104
717-231-8210
(Telephone)
Form OC-07 rev. 10.13.06
Mailing Address:
P.O. Box 8700
Harrisburg, PA 17105-8700
Location:
409 S. Second Street
Harrisburg, PA 17104
717 231-8210
717 231-8157 Fax
December 21, 2012
VIA REGULAR MAIL
Cumberland County Register of Wills
1 Courthouse Square, Room 102
Carlisle, PA 17013
Re: Estate of Henry Malis, deceased
No. 21-12-1189
Dear Sir/Madam:
PINNACLEHEALTH
Enclosed for filing in the above-referenced matter please find the original and one (1) cop of a
Notice of Claim Against Estate. Please file the Claim and return atime-stamped copy in the
self-addressed, stamped envelope.
Also enclosed is a check in the amount of $10.00 which represents the required filing fee. If
you should have any questions or require anything further please feel free to contact me at the
above number.
Thank you very much for your assistance with this matter.
Sincerely, ~ I
Wt~ - I
ennifer W dford
Legal Assistant
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