HomeMy WebLinkAbout05-29-13 IN THE CIRCUIT COURT IN AND FOR CUMBERLAND
COUNTY PROBATE DIVISION
IN RE: Estate of ]EANNE P ROSAS
Claimant: See attached claim detail
Case No: 2012-00023
Account No: See attached claim detail
SATISFACTION AND RELEASE OF CREDITOR'S CLAIM
The Claimant(s) listed on the attached claim detail has/have received the sum of $ 1 132 00 as
payment in satisfaction the Claim filed in the above-referenced matter and hereby releases the
Estate and Personal Representative from any and all indebtedness relating to the Claim.
Dated: � � day of l;'"� , 20��
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Signature: �L J
One of Claimant(s)'s Authorized Representatives
Printed Name: �-("�fl-� ����a '�� ��` I
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KEY: BERWICK HOSPITAL COMPANY Case Number:
Line 1 —Account No
Line 2—CreditodClaimant LLC DB/A BERWICK HOSPITAL 2012-00023
Line 3 —Balance CENTER
CLAIM DETAIL
IN RE ESTATE OF:JEANNE P ROSAS
Claim detail is as follows:
***9634
BERWICK HOSPITAL COMPANY LLC DB/A BERWICK HOSPITAL CENTER
$1,132.00
UNSECURED.
THIS CLAIM IS BASED ON AN ACCOUNT FOR GOODS AND/OR SERVICES IN THE
AMOUNT OF $1,132.OQ EVIDENCED BY ACCOUNT NUMBER ***9634.
Claim Balance: $],132.00