HomeMy WebLinkAbout01-17-13
IN RE: ESTATE OF FLORENCE E. STONE
LATE OF TOWNSHIP OF MIDDLESEX
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
N0.21-12-0135
AFFIDAVIT OF SERVICE
I, Bradley L. Griffie, counsel of record for the Estate of Florence Stone, state that a true
and correct copy of the Petition for Settlement of a Small Estate Pursuant to 20 Pa.C.S.A. §3102,
and a copy of the Order of Court and Rule to Show Cause, dated January 9, 2013, was sent to
Karen L. Tyler, Claims Investigation Agent, at her address of the Department of Public Welfare,
Bureau of Program Integrity, Division of Third Party Liability, Recovery Section, P.O. Box 8486,
Harrisburg, Pennsylvania, by certified mail. A copy of said receipt is attached hereto indicating
service was made on January 11 , 2013.
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Attorney for etitioner -
Supreme Court ID No. 349 `~'
GRIFFIE & ASSOCIATE P.~.
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200 North Hanover Street
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Carlisle, PA 17013 r :;~ !~ F--~ r
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^ Complete items 1, 2, and 3. Also complete
item 4• if 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 if space permits.
A. Signature r
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B. Receive I>~r ~'~ns ~ANt 1 ~ ~Q~.a
D. Is delivery address different from item 1 ? ^ Yes
1. Article Addressed to: If YES, enter delivery address below: ^ No
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Nr+ r ~i S buLi' ~ A L' 4. Restricted Delivery? (Extra Fee)
^ Express Mail
^ Return Receipt for Merchandise
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2. Article Number ~' 7p11 297 0000 469, 9858
(fransfi~r from service label)
PS Form 3811, August 2001 Domestic Return Receipt
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^ Yes
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