HomeMy WebLinkAbout10-15-13 _ _ � _ _
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STATE OF Pennsvlvaaia
IN RE: ESTATE OF IN THE �GISTER OF W LS
KAY I BRENNEMAN CUMB AND COUNTY
CASE#: D13-01023
STATEMENT OF CLAIM
Boek of Amerko
1, hereby presen for filing against the above
estate this statement of claim in the amount of$ �,016.22
2. The basis for the claim is account number �z906o473754718 �y, �ch was open on
5/19/1993 .
3. The name and address of the claimant is e.or orn��.Fu c.m se..�«�i n
P.O.Box 982239 EL Paeo,TX 79998-2238
4. This claim IS NOT contingent
5. This claim IS NOT secured
6. The last payment made on the account was$ $1�•� on 3
7. Please send payments toBaekotnmerica
P.O.Box 982238
EL Paso,TX 7999&2238
1-888-221-4299
Please write the above acconnt number on your check
�
Under penalties of pequry,I declaze that I have read the foregoing,and t�' faFts alleged ai`satrue�o�e
best of my koowledge and belief. � ° �-; `"� �
v, %o
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Executed this 11 day of Octo6er , 2013 � ';;;`. r� F-' 'i �
r ;,: �.;;
Baak of America FIA Card Services NA r ;;, . ; v � c�
ClaimantName: Crai� Smith �? , ' , � '; �;
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Claimant Signature: ! .n ""� _s �' °
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