HomeMy WebLinkAbout06-07-13 � f
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ORPHANS' COURT DIVISION
PAULINE K. COVER , No. 179 of 2013
An Incapacitated Person
AFFIDAVIT OF SERVICE
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF CUMBERLAND) } SS
Before me, the undersigned authority, personally appeared Brenda Hall who, being duly
sworn according to law, deposes and says that on the�day of 2013, at
S O'clock,P.m., she served the certified copy of the Order of Court Appointment
Permanent and Plenary Guardian of Person with Statement of Rights dated the 31st day of
May, 2013, and upon the alleged incapacitated person, PAULINE K. COVER, at the following
address Golden Living Center-West Shore with an address of 770 Poplar Church Road, Camp
Hill, PA 17011 by making known the contents thereof to the alleged incapacitated person and
handing to and leaving with the alleged incapacitated person a copy of the Order and Statement
of Rights.
This Affidavit is made subject to the penalties of 18 Pa. C.S. § 4904 relating to unswom
falsification to authorities.
Dated: .S _' 2013
Print Name: e c .aut
Title: tyuc r ranrc9, c�
m ' c
rn
� rn --J
zn
x
o c>
vna o n -n
C3 c 17 t
rn
zr F n
r—
a x u1 a
N �
Ob
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ORPHANS' COURT DIVISION
PAULINE K. COVER, No. 179 of 2013
An Incapacitated Person
AFFIDAVIT OF SERVICE OF FINAL
ORDER/STATEMENT OF RIGHTS
Filed on behalf of:
GOLDEN LIVING CENTER, Petitioner
Counsel of Record for this
Party:
Aaron C. Jackson
Pa. I.D. #200490
Nora Gieg Chatha
Pa. I.D. #200446
Tucker Arensberg, P.C.
Firm #287
2 Lemoyne Drive, Suite 200
Lemoyne, PA 17043
(717) 234-4121