HomeMy WebLinkAbout05-01-14 �,W:.��.��� ��� sa.�.�,�...r� . _ _.
NOTICE OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532)
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DNISION
ESTATE OF JACK E BERTOLETTE , DECEASED
Na. 2114-0228
To the Clerk of the Orphans' Court Division:
Enter the claim of Phillips & Cohen Associates,Ltd. on behalf of Citibank,N.A. in the
(Claimant)
amount of$ 647.97 , against the above entitled Estate.
The Decedent,who resided at 1600 HEMLOCK LN, DAUPHIN, PA 17018-9391
(Street Address)
, died on 03/03/2014 . Written notice of
(Date ofDeath)
said claim was given to Michael L. Ban�s Esq. &Jack I. Bertolette
(Personal Representative or his/her counsel)
at 429 S 18th St Camp Hill PA 17011 & 1600 Hemlock Lane Dau hin PA 17018
(Address)
on 04/25/2014
(Date)
' an t)
1004 Justison Street
(Street Address)
Wilmington, DE 19801
(Ciry,State,Zip)
(Claimant's Counsel) (Supreme Court LD.No.) �
rv
�,� �
C? � �-j �
(Address) � G7 � �;°)� C7
�:7 O
� -� � —�c LI� �
�3 � r_ .....�
' s�:t �'Y'1
= r 1 ~' :;'7 q
'=.� �,..i �`": �
_ _.... �..a
(Telephone) ;�� � ' � -� --�-� --r�
C� �-� 't'!
C� f-a ".il � �
� C: .-: CJi
, �a ►—• r- m
-c� � crr, o �
Form OG07 rev. 10.13.06 '� CI1 �
������.�, ���.m�,
. � � � ,a �,� _
STATE OF PA I STATEMENT AND PROOF OF FILE NO:
PROBATE COURT CLAIM i 2114-0228
CUMBERLAND COUNTY
E�T qT'F nF TP Cu F���rrnLETTE
Cumberland Countv Re�ister of Wills
One Courthouse Square Room 102
Carlisle, PA 17013
Phillips & Cohen Associates, Ltd., located at 1004 Justison Street, Wilmington, Delaware 19801
on behalf of Citibank, N.A. submit the following claim against the estate for the sum set forth.
! DESCRIPTION I VALUE I
�Account#: 9386 I
Amount Due• � $647.97'
�
�PCA File#: 19762740 �
i
�
i � Ji
� i �
There is now due on the claim, including applicable legal set-offs, the 'I $647.97I
sum of: �
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 i contents are true to the best of my information, knowledge and belief.
orized Signature
Chakeya Smith, Manager
Phillips & Cohen Associates, Ltd.
The Creditor's Rights & Bankruptcy Group
A Division of Phillips & Cohen Associates, Ltd.
1004 Justison Street
Wilmington, Delaware 19801
Telephone: (866) 342-4270
Fee$10
k. ,-�. � � . �,.:_:....�.� �� �..-.�,. �- �. ��.� .� xy� �. .�. �, � r�-�,..�, .�... . �w
PROOF OF SERVICE OF CLAINI
I served upon the Estate of JACK E BERTOLETTE, a copy of this claim on 04/25/2014 via
United States Postal Service to:
Michael L. Bangs Esq.
429 S 18th St
Camp Hill, PA 17011
Jack I. Bertolette
1600 Hemlock Lane
Dauphin, PA 17018
I served upon the Estate of JACK E BERTOLETTE, a copy of this claim on 04/25/2014 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 o ' formation, knowledge, and
belief.
04/25/2014
Date Signature
Chakeya Smith, 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: X���:��XX��XX9386
2. NAME IN WHICH CARD ISSUED: JACK E BERTOLETTE
3. OPEN DATE: 10/24/2012
4. REGARDING: EXXONMOBIL
5. FINAL BALANCE: $647.97
6. PRIMARY USE OF CARD: Purchases for goods and/or services