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HomeMy WebLinkAbout11-20-13 STATE OF PA STATEMENT AND PROOF OF FILE NO: PROBATE COURT CLAIM 21-13-0804 CUMBERLAND COUNTY ESTATE OF NATHAN MUSSER SR Cumberland County Register of Wills One Courthouse Square Room 102 Carlisle, PA 17013 Phillips & Cohen Associates, Ltd., located at 1002 Justison Street, Wilmington, Delaware 19801 on behalf of Department Story r:`ational Bank (DSNB) submit the following claim against the estate for the sum set forth. DESCRIPTION VALUE Account#: XXXXXXXXXXXX0526 Amount Due: $283.08 PCA File#: 19389624 There is now due on the claim, including applicable legal set-offs, the $283.08 sum of: III Notice to interested parties: This is a claim for services rendered and/or goods provided. This claim will be allowed unless notice of an objection by an interested person is delivered or mailed to the court,personal representative and creditor at below address. I declare that this claim has been examined by a representative of Phillips & Cohen Associates, Ltd., and that its contents are true to the best of my information, knowledge and belief. Co M 4? o -�, A .thorize Signature -„ . 'i lizabeth Hansen,Manager a M O ; C> ° Phillips & Cohen Associates, Ltd. The Creditor's Rights & Bankruptcy Group A Division of Phillips & Cohen Associates, Ltd. ) ,, Co 1002 Justison Street Wilmington, Delaware 19801 Telephone: (866) 342-4270 Fee$10 PROOF OF SERVICE OF CLAIM I served upon the Estate of NATHAN MUSSER SR, a copy of this claim on 11/15/2013 via United States Postal Service to: David Musser 133 Old Stonehouse Rd South Carlisle, PA 17015 I served upon the Estate of NATHAN MUSSER SR, a copy of this claim on 11/15/2013 via United States Postal Service to: Cumberland County Register of Wills One Courthouse Square, Room 102 Carlisle, PA 17013 It is declared that this claim has been examined by a representative of Phillips & Cohen Associates, Ltd. and that its contents are true to the best of our information, knowledge, and belief. 11/15/2013 616' -XIL Date ature izabeth Hansen, Manager ACCEPTANCE OF SERVICE Service of the attached claim is accepted. Date Signature The following account summary is provided: SUMMARY OF ACCOUNT 1. ACCOUNT NUMBER: XXXXXXXXXXXX0526 2. NAME IN WHICH CARD ISSUED: NATHAN MUSSER SR 3. OPEN DATE: 01/09/2009 4. REGARDING: FDS Bank/Macy's or Department Stores National Bank 5. FINAL BALANCE: $283.08 6. PRIMARY USE OF CARD: Purchases for goods and/or services NOTICE OF CLAIM (Filed Pursuant to 20 Pa.C.S. § 3532) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF NATHAN MUSSER SR , DECEASED No. 21-13-0804 To the Clerk of the Orphans' Court Division: Enter the claim of Phillips & Cohen Associates,Ltd. on behalf of Department Stores National 11 i he (Claimant) amount of$ 283.08 , against the above entitled Estate. The Decedent,who resided at 133 Old Stonehouse Rd., South, Carlisle, PA 17015 (Street Address) died on 06/19/2013 Written notice of (Date ofDeath) said claim was given to David Musser (Personal Representative or his/her counsel) at 133 Old Stonehouse Rd South Carlisle PA 17015 On 11/15/2013 (Address) (Date) (Cl a' nt) 1 r02 Justison Street (Street Address) Wilmington, DE 19801 (City,State,Zip) (Claimant's Counsel) (Supreme Court LD.No) (Address) (Telephone) Form OC-07 rev. 10.13.06 $ WOl- I m N O I ©00 O _ LJL(o r-4 cn W %Nn a "' o ca CE © c, Q N uj -a cv w Z '� ca f% r i `i} e a ® at 0)i �.? CO w dd a Lu0 COO cq < _ �