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NOTICE OF CLAIM o
(Filed Pursuant to 20 Pa.C.S. § 3532) m
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COURT OF COMMON PLEAS OF
COUNTY, PENNSYLVAN�
ORPHANS' COURT DIVISION '
ESTATE OF X C A-k- � ,DECEASED
No. c To the Clerk of the Orphans' Court Division:
Enter the claim of 1--C� O �-�- in the
(Claimant)
amount of$ t 11 �4 0, 0 ,against the above entitled Estate.
The Decedent, who Wside d at 0
ft died ( reet Address)on C�J�- - ( Written notice of
(Date of Death)
said claim was given to �1-
rsonal Representativ or his1her coun 1)
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on � � �� (Address)
(Date)
(Claimant)
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(Street 4 ddre`s
(City,State,Zip)
(Claimants Counsel) (Supreme Court I.D.No)
(Address)
(Telephone) l✓l v �Lni p-Y� l�
Form OC-07 rev.10.13.06 ��
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November 20, 2013
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Sue Leach C> G'
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217 Shafferstown Road 0
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New Cumberland, PA 17070 ;~ 7` -ro -n
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Dear Sue, ` cn
The check you wrote for$ 1,740.00, dated October 17, 2013,which was made payable to Fataba
Swaray,was denied by PA Central Federal Credit Union,because the account had insufficient funds.
Unless full payment of the check is received by cash within 10 days after the date this demand letter was
mailed,together with$ 25.00 in bank fees, and$ 6.00,the cost of mailing this demand letter by certified
mail, I will file a small claims court claim against you.
The claim will also request damages for the amount of the check,$ 1,740, plus$ 500.00damages,for a
total claim of$ 2,240.00 against you.
You may wish to contact a lawyer to discuss your legal rights and responsibilities.
Please send your payment to:
Fataba Swaray
3021 S.72"d. Street Apt.#1
Philadelphia, PA 19153
(215) 789-8452
Fataba Swaray
NOCGR
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