HomeMy WebLinkAbout12-04-13 (2) NOTICE OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532) .
c o M n
M , C> c,
COURT OF COMMON PLEAS OF rn ca c-D -4 �
NY'I l COUNTY, PENNSYLV r �r
7)
ORPHANS' COURT DIVISION �s
►- F rn
ESTATE OF cC�+l, y`-- `U � ;-PECVAED
No.
To the Clerk of the Orphans' Court Division:
Enter the claim of �SU.9 \ l�''V`{� a n the
�. (Claimant)
amount of$ -� , against the above entitled Estate.
The Decedent,who resided at J�C7 i L lCtq-a-� a
(Street Address)
j ?0 , died on 10~C 7 ' 010 E---2, . Written notice of
�� �� (gate of Death)
said claim was given to A
(Perso Representative or is/her counsel) _
at ,SEA 8�� . A 5
(Address)
on
(Date) �1L1 LJ�:�✓(Y'C.t/l� ��IVYV�[/ `-'�'r^-�-
(Claimant)
(Street Address) �
(City,State,Zip)
(Claimant's Counsel) (Supreme Court I.D.No)
C
(Address)
(Telephone)
Form OC-07 rev.10.13.06
5 �
Griswold
HOME BARE Statement
fx Pdanalselvkeforever30Years Date
Griswold Home Care, Cumberland County 2/0FA2'03
6 West Main Street , Shiremanstown, PA 17011
G O
(717)975-0540
rn :X: rn m
Bill To Client rrl S �10
Barbara Beward Barbara Beward y U? --n n
501 Ricky Road
c �. r= rn
Mechanicsburg, PA 17055 � a
Quantity Description Rate Amount PAID
10.00 41-1: 9/20/2013- Ruth Taylor 4.50 $45.00 UNPAID
1.00 12H O/N: 9/20/2013-Leslie Cordero 27.50 $27.50 UNPAID
12.00 41-1: 9/21/2013- Ruth Taylor 4.50 $54.00 UNPAID
1.00 12H O/N: 9/21/2013- Leslie Cordero 27.50 $27.50 UNPAID
12.00 41-1: 9/22/2013- Marjorie Paul 4.50 $54.00 UNPAID
1.00 12H O/N: 9/22/2013- Leslie Cordero 27.50 $27.50 UNPAID
1.00 24H LI: 10/7/2013 - Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/8/2013- Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/9/2013- Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/10/2013 -Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/11/2013-Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/12/2013- Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/13/2013- Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/14/2013-Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/15/2013-Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/16/2013-Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/17/2013 -Fataba Swaray 30.00 $30.00 UNPAID
1.00 24H LI: 10/18/2013-Fataba Swaray 30.00 $30.00 UNPAID
Sub Total $595.50
Payment(s)Applied
Total $595.50
c
Printed 12/4/2013 11:40 AM