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Home My WebLink About04-08-13 NOTICE OF CLAIM {Filed Pursuant to 24 Pa.C.S. § 3532} SCOURT OF COMMON PLEAS OF eurn& , / All COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE,OF i3W�6 l'6L ��-1 DECEASED No. 02! To the Clerk of the Orphans' Court Division: tt^^ Enter the claim o//f �-ome� Setzier ratt&- in the amount of$ � 17, (Claimant) against the entitled Estate. T� The Decedent, who resided at jy q z /�lo�d od Dl'l ke., &aa) �}� / � l4�SgeetAddre s) 1t Yl � i�"�, died on/ �py fl . Written notice of said claim was given to i2o- , �7 �/�C(" 11al Gba e7le of era ct) k 4 , - at L (/ 7 [f l y (personal Represent 've or by/fi��unsef) /J�� on O ! / C C./ (Address) Cp [Ifn f/ {pate} L...Z c (Claims UJ CL �; - �C>O� Lerr het- SQL fe /Dl t> ^." ` O C> (Srre vtAA�ddddre Lo (City,Sfate.Zip) o L>_ CC) (Clalmu Counsel) U Z (Supreme Court J.D.Na.) Uj (Addrexej LLf (Telephone) Form OC-07 rev. 10.13.06 DETAILED INVOICE Service For : Barbara Lane(2) Billed To : Mrs. Barabra Lane 5002 Mechanicsburg,Street Invoice#: 1656-0512-1 Mechanicsburg,PA 17050 Invoice Date : 5/15/2012 (717)731-9984 Service Period : May 01,2012 -May 15,2012 www.Homelnstead.com 5111 4:00pm 8:00pm Normal Lesha Hourly Service,Level 2 4.00 $20.95 $83.80 5/12 10:30am 1:30pm Weekend Cristina Hourly Service,Level 2 3.00 $23.05 $69.15 6:00pm 7:00pm Linda 2-Hour RS or TI 0.50 $63.80 $31.90 5/13 10:30am 1:30pm Weekend Stephanie Hourly Service,Level 2 3.00 $23.05 $69.15 5/14 10:45am 1:15pm Normal Natalie Hourly Service,Level 2 2.50 $20.95 $52.38 6:00pm 9:00pm Stephanie Hourly Service,Level 2 3.00 $20.95 $62.85 5/15 10:30am 1:30pm Normal Bonnie Hourly Service,Level 2 3.00 $20.95 $62.85 6:00pm 8:00pm 2-Hour RS or TI 1.00 $58.00 $58.00 I it i Miles: 0.00 $0.59 $0.00 Miscellaneous Charges: _ $0.00 Additional Charges/Credits: $0.00 Service Deposit Applied: _ $0.00 Current Invoice Total: $490.08 Total Amount Due: $490.08 Due Date: April 18,2013 -All overdue Invoices are Subject to an 18%Annual Service Charge Please Retain For Vow Records Please Detach And Return This PostionW ith Yow Payment Payable to Home Instead Senior Care Each Home Instead Senior Care Franchise Office is independently owned and operated. , Invoice#: 1656-0512-1 Service For: Barbara Lane(2) Service Period: May 01,2012-May 15,2012 Mrs.Barabra Lane Current Invoice Total: $490.08 1499 Maplewood Drive New Cumberland,PA 17070 Total Amount Due: $490.08 Due Date: April 18,2013 i DETAILED INVOICE Service For : Barbara Lane(2) Billed To : Mrs. Barabra Lane Invoice#: 1656-0512-2 5002 Lenker Street Invoice Date : 5/31/201.2 Mechanicsburg,PA 17050 (717)731-9984 Service Period: May 16,2012-May 31,2012 www.Homelnstead.com Page#1 5/16 10:30am 1:30pm Normal Bonnie Hourly Service,Level 2 100 $20.95 $62.85 6:OOpm 8:OOpm Stephanie 2-Hour RS or TI 1.00 $58.00 $58.00 5/17 10:30am 1:45pm Normal Elly Hourly Service,Level 2 3.25 $20.95 $68.09 6:OOpm 9:OOpm Kristen Hourly Service,Level 2 3.00 $20.95 $62.85 5/18 10:30am 1:30pm Normal Janet Hourly Service,Level 2 300 $20.95 $62.85 6:OOpm 9:OOprn Stephanie Hourly Service,Level 2 100 $20.95 $62.85 5/19 10:30arn 1:30pm Weekend Stephanie Hourly Service,Level 2 3.00 $2105 $69.15 6:OOpm 7:45pm Tuck-In Shift 1.00 $47.85 $47.85 Miscellaneous 0.50 $15.95 $7.98 5/20 10:20arn 1:20pm Weekend Jackie Hourly Service,Level 2 3.00 $23.05 $69.15 5:45pm 8:45pm Stephanie Hourly Service,Level 2 3.00 $23.05 $69.15 5/21 10:30am 1:30pm Normal Stephanie Hourly Service,Level 2 100 $20.95 $6185 6:OOpm 9:OOprn Bonnie Hourly Service,Level 2 3.00 $20.95 $62.85 5/22 9:30am 12:30prn Normal Elly Hourly Service,Level 2 3.00 $20.95 $62.85 5:30pm 9:OOpm Bonnie Hourly Service,Level 2 3.50 $20.95 $73.33 5/23 10:30am 1:30pm Normal Elly Hourly Service,Level 2 3,00 $20.95 $62.85 6:OOprn 8:30prn Stephanie Hourly Service,Level 2 2.50 $20.95 $52.38 5/24 10:30am 1:30pm Normal Bonnie 9.00 Hourly Service,Level 2 100 $20.95 $62.85 6:OOpm 9:06pm Kristen Hourly Service,Level 2 3.00 $20.95 $6185 5/25 10:30am 1:30pm Normal Jackie Hourly Service,Level 2 3.00 $20.95 $62.85 6:OOpm 9:OOprn Cristina Hourly Service,Level 2 3.00 $20.95 $62.85 5/26 10:45am 1:30pm Weekend Jackie Hourly Service,Level 2 175 $23.05 $63.39 6:OOprn 9:I5pm Bonnie Hourly Service,Level 2 3.25 $23.05 $7431 j 5/27 10:30am 3:45pm Weekend Jackie Hourly Service,Level 2 5.25 $2105 $121.01 5:00ptn 7:30pm Hourly Service,Level 2 2.50 $23.05 $57.63 5/29 10:30am 1:15pm Normal Elly Hourly Service,Level 2 175 $20.95 $57.61 5/30 10:30am 1:30pm Normal Elly Hourly Service,Level 2 100 $20.95 $62.85 5/31 11:30am 3:30pm Normal Elly Hourly Service,Level 2 4.00 $20.95 $83.80 i i i i DETAILED INVOICE, Service For : Barbara Lane(2) Billed To : Mrs. Barabra Lane Invoice#: 1656-0512-2 5002 Invoice Date ; 5/31/2012 Mechanicsburg,PA 17050 Lenker Street (717)731-9984 Service Period : May 16,2012-May 31,2012 www.Homeinstead.cotn Page#2 Miles: 9.00 (a $0.59 = $5.27 Miscellaneous Charges: _ $0.00 Additional Charges/Credits: $0,00 Service Deposit Applied: - $0.00 Current Invoice Total: - $1,795.73 Total Amount Due: $1,795.73 Due Date: April 18,2013 -All Overdue Invoices are Subject to an 18%Annual Service Charge Pkase Retain Per Your Records Please Detach And Rel m,This PortionW itb Yom Payment Payable to Home Instead Senior Care Each Time Instead Senior Care Franchise Office is independently owned and operated. Invoice#: 1656-0512-2 Smice For: Barbara Lane(2) Service Period: May 16,2012-May 31,2012 Mrs. Barabra Lane Current Invoice Total: $1,795.73 1499 Maplewood Drive New Cumberland,PA 17070 Total Amount Due: $1,795.73 Due Date: April 18,2013 DETAILED INVOICE Service For :Barbara Lane(2) Billed To : Mrs. Barabra Lane Invoice#: 1656-0612-1 5002 Invoice Date : 6/15/2012 Mechanicsburg,PA 17050 Lenker Street (717)731-9984 Service Period : Jun 01,2012-Jun 15,2012 www.Homeinstead.com 6/4 11:30am 3:30pm Normal Elly Hourly Service,Level 2 4.00 $20.95 $83.80 6/5 11:00am 3:00pm Normal Elly Hourly Service,Level 2 4.00 $20.95 $8180 6/6 11:30am 3:30pm Normal Corinne Hourly Service,Level 2 4,00 $20.95 $83.80 6/7 10:30am 3:00pm Normal Bonnie Hourly Service,Level 2 4.50 $20.95 $94.28 6/8 11:00am 3:00pm Normal Jackie Hourly Service,Level 2 4.00 $20.95 $83.80 6/9 11:05am 3:05pm Weekend Shondell Hourly Service,Level 2 4.00 $23.05 $92.20 6/10 11:00am 3:00pm Weekend Amber Hourly Service,Level 2 4.00 $23.05 $92.20 6/11 12:15pm 4:15prn Normal Beverly Hourly Service.Level 2 4.00 $20.95 $83.80 6/12 10:30arn 130pm Normal Bonnie Hourly Service,Level 2 3.00 $20.95 $62.85 6/13 11:00am 3:00pm Normal Nancy Hourly Service,Level 2 4.00 $20.95 $83.80 6/14 11:15am 3:15pm Normal Bonnie Hourly Service,Level 2 4.00 $20.95 $83.80 6/15 10:00am 1:30pm Normal Amber Hourly Service,Level 2 3.50 $20.95 $73.33 Miles: 0.00 Im $0.59 - $0.00 Miscellaneous Charges: _ $0.00 Additional Charges/Credits: - $0.00 Service Deposit Applied: _ $0.00 Current Invoice Total: - $1,001.45 Total Amount Due: $1,001.45 Due Date: April 18,2013 -All Overdue Invoices are Subject to an 18%Annual Service Charge Please Remin For You Rereads Please Detach And Return This PonionW ith Yew Payment Payable to Home Instead Senior Care Each Ham Instead Senior Care Franchise Office is independently owned and operated. Invoice#: 1656-0612-1 Service For: Barbara Lanc(2) Mrs.Barabra Lane Service Period: Jun 01,2012 -Jun 15,2012 1499 Maplewood Drive Current Invoice Total: $1,001.45 New Cumberland,PA 17070 Total Amount Due: $1,001.45 Due Date: April 18,2013 Kay LLC dba Horne Instead Senior Care Invoice 5002 Lenker Street Mechanicsburg, PA 17050 Date Invoice - 5l1512412 1656-05(2-i Bill To Lane,Barbara P.Q.No. Terms Project Quantity Description Rate Amount 0 RISC Servioes 490.08 490.08 Finance Charges on Overdue Balance up through April 30,2013 1630% 80.86 Total $570.94 Kay LLC dba Home Instead Senior Care Invoice 5002 Lenker Street Date Invoice# Mechanicsburg, PA 17050 5/31/2012 1656-05124 Bill To Lane,Barabra P.O. No. Terms Project Quantity Description Rate Amount 0 HISC Services 1,790.46 1,790.46 0 Client Miles 5.27 5.27 Finance Charges on Overdue Balance as of April 30,2013 296.34 296.34 Total $2,092.07 Kay LLC dba Home Instead Senior Care Invoice 5002 Lenker Street Date Invoice# Mechanicsburg, PA 17050 61/5/2012 1656-0612-1 Bill To Lane,Barabra P.Q. No. Terms Project Quantity Description Rate Amount 0 RISC Services 1,001.45 1,001.45 Finance Charges on Overdue Balance as of April 30,2013 15.00% 150.22 Total $1,151.67