HomeMy WebLinkAbout06-08-15 NOTIC� OF CLAIM
(Filed Pursuant to 20 Pa.C.S. § 3532}
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF �OYCQS �"�,• �Y�2���1�YO1P� , DECEASED
No. ?1J��,'OOtO'!�I
To the Clerk of the Orphans' Court Division:
Enter the claim of �C,�f1Pir�n� ��'c in the
(Claimant)
amount of$ 35�c�•� , against the above entitled Estate.
The Decedent, who resided at 2�� w00d s�. �C4►� ���, �;"� �'1�1�
(Streez Acla'ress)
, died on .�VIxKC 1lQ���,� . Written notice of
(Date of.Dearlri
said claim was given to Jaca►u►e�tn� �• ,L4�l�y
(Personal Representative or his laer co+msel)
at 4'hL�S S�Ir ��rY1GtS �uY�' SV�1� 12. �lYY1Sb�V�YC�, . Q� 1�1��
(Address) ��
on ,�VrY� 2� 'Zr01�
(Date)
�.rn�e.rl���un� us�
(Claimant)
1� �� P�Yic�yard �d•, Su�tQ bab
(Street Address)
S�11� 1�1� C1'1� , V�.h �t�lOb
(Ciry,State,Zip)
(Claimant's Counsel) (Supreme Court LD.No.)
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Form OC-07 rev. 10.13.06 ` F---" ��'� ^�"1
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E gTAT��E�T
�(�T� &ptiSCL�SUR G1au5e�
�bitration �,;�u�N""'b� o�41
t�nctudin9 D�of 1.oaT�-
Est�ma� �fi/�8�11 _...
�etic to�R6'� n(Bo�<<5�� raer
�Nae �nddre� M 5hP11eri�=-�
of�oa�c p8�11�201 Nat�
D11 y�3op3 ST�A y�p11
pnna�pzlAmou� D�9.p0 �a�P gill,
��ender. ��rm�ncier ide��
�me&Address � ,,.ou�and You�
12�East BrickYaT��oad,Suite ed a� and��ie`Nor�s �
Ener6ank tSSA ve;
GitY,�T gq106 orroN'erlsl�detrtfi ��andlof sertices
Salt t.ak� ,tY . me"and`Le�{reFer�ee. � pUrchase r.ertai i undeasbndthatthis is��°e ms�oss
m1��•�. t's ass 9
1n this EJote,�e wDrds ent of th�s N�, � }�is Note r,Gontsactor') . hJote,l am a9Teein9 e �e and,'rf
above or��P°�ass�9�m �T �e loan ev�dpA� Fotm to tha Rrom Gontra�ct You tD�CTOR.1F
�hed
� have aPPlied to YII a� Centra e PaY�ent A�or¢�dtor sem�Purc o��tio oRR, ER AN�C��1 TNE
1. L� b Anderse�� $y S�g�in9�' oods,e4��pment a�e pa�ent A�p�,B �w 11 1'1/-
from Renewal loan Ptoce �edgm9{�y�tt'e 9 pre hy�gnin9 MVgT BESIGN R BEFORE aPl�
ich 1 maY�se 1h�e ackn� �on FuttherT�' ��-pON FOftM �pN 0 EGT. � e•pnndP
d 1 am s(a �p,UTh1OR F�B HA E NO F�RC�p'ND EFF
for�. ofth�N�tean $ � p59.00
installed tD ORl7���FORM IS NO�R�C TE
aPP��b� h�ebeen or.Tf-fEPA TWSN� WILL � piom+SetoA�U.S. n
ronisack �ub i
ds ofthe loan to � AU-�H ��B�VOtDD�an Form,t,SoaoweeloW. .+con[muin9�� � oth befY°e a d
procee pR17ATION FORM edule b c�or an.. isthe ratethir�PaY P .
THE SiGNED PAYME erttA�' entsch Cortr�
PA�'MEM AV� pa .BY �e�e�s sho�on the��bursed bY�ender 10 TK�s interest race al Whicfi has not been ai
s�gnin9 p 0 0 °h Pe�annum the p°nc1P
prom�se to due P
2. �e e loan proceeds on�y� a�
��s interest,to Yout order°on the date tt� ra1e eres�� e da�Y n S
t geyinnin9 s�ofe����. Irrt
In�� interest�!aP of PaYme t
DisciosuTe Statem�t
�en Paid ����U P yed in para9 h ndin9 T0�81
�er anY�ult d Trut6�n t-e Finan��d Ii have paid after 1
�pOL+rlt -�he atnounY I`� all scheduled
{�,}oed to have matle
rrINANC� The amount of cre3�P ��e�ts.
p�I�ilIAL- GHARGE me ot on mY behalf.
¢ERCENTp`GE tt'e c� e
-�e do11'ar amou�rt $ ?,p5��
�,TE �,ri11 costme. $ �,05� I
The cos'� of mY c{ed'd � a ,
yeacN�e. $ _0��e} drsII�e ' are�S���tD
p�°� 1��'��e�an P�pCee� month thereaftei
eTrt schedule v�n'll ba O d� me�y o{each
u1e MY P� ��-' 3
� Pay�nerd Sched ents ��'utJY"crfi P?Y� 7,17.65 � s and on thQ sa
Contra�
�urt+tie�flf i'�� e uaNn 5°k
6 0 30 oT�n an amount q
ed a late char9e ot$ e�tin
e to paY a Pe�a11Y• 1 will be char9 t��qui2�eP�'
1 v+;��ot ha� af the date i��due, tt and Your ri9h
laan ear1Y, ��pnP��ertk detau
menC If 1 paY ofl th� �wid�in���feater. iion o
PraP� mentls notm ��,er is 9 d�ional in��a
�d amo❑of the paYrt'errt'`� �s N�e for a
�G���' er of th
oftheunpd ��adtheremama � 05 .00
Terrts:lshould d�e. �AmountF�nancea! $ �,�59.00
Other ote the sc heduled m�T� �t i on $
full bef �n,ate l�` rinted on mY
�e�means an ent date H^Il be p R��Pa1 and
�on mY�ha�" 5 vahen due. MY first Pa� ��be aPP�P�a d�efe
Contra� ot��d nt
p�ourd P�d to ed: 11 amou� order rf 1 am n nts
To�AmOUnt Financ �m�that I wnll Pay Sied in th a��n�,mor�thN PaYme maY
eduls aboVe ase e��11 be aPP e in of tt�e last PaYmeAo�a�vurhs under
ent sch on1hN P� unP�P a1 balance,tt1e a�e�Matuci�Y Q�e on as You Sha➢designate-
en1s.The��ai1 tn me. MY rt' ave b� nncip ule abov�
4. P��ch Y�U ►t 1 have Pa�d�daiN un the a�entsched you atsn c alocab
coupon �harge'� ru shov�m on the P monll�ly P�erds out Pa`P g �y�ls d
e intere5t�ent d� Ue,I will p�'Y°�a� e
otl�e��on-defaultf�on�Becaus ��make mY an time� �the date , e onh'°�Ce°n
put� ot late• �,on the final Pa Mafa�ll�' Tyal prepaYR1e�t at £t W�hin�fl daY� a th�s IaYe char9
o{der at Y eady full on th errt oT a� morrth�Y Pa`�. i is 9�eater.1 v�nll P�u hatis d�shono�ed°r retumed
increase ii I p�Y e amount'in fl repaYR' U�of mY g Y
ote�.�fi�7o Pre�.�Ym�a e not rece^'ed the ful'd amount of the P�e oth�qO�Payment 1 ive
this N Tm
5. ou h ��o/of the unp� check or anY �of�e loan.
p�er Cba �afee of 5�for a� at final paY°
6. an amount eq�� nded
charge of 530 oi m��ona�N��sha9 PayY°��c 0�shall be __-_�-
any late Pa1`me�' ovetPaymet�t in ex� _
aid. AnY J-_"._.____, -�
to Yo�unP � _ .
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14.0�09 agre �e a9�0eme c��1 ass\9�y�son��e�a� ��,;,aec Uem,,�a�0 oWet�a P� e aetalla�.
` y�iden e��Sa n�e��p�°��h�ets°�Pecson om`a�2`N�e��te�cAYd rna��5 ,u�9rnetft ag�e bytFlp°da a�d� �B�R�w�
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cs��b gin�pPN fO�se�m�e t,: B°��S ed lPaa��enaas umet teP°��goR�we the name�d ad a 1'�czf�on and
goRp`Ne� �T F,o�da�a�yched°�g maY te4���d tendet v� �� � �a ae PP dad�
o��ssm9 ��mc�a�
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gisPfl o�,ceiot�'�'�o Sutne�t d�rt �eP°�'marl��et�t p�� make c�edR qu+�.The c
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tes��n9�sumes�eP e�+ts� "Che oclin8 age 1aw. ��d'm conne aRo�t 5 fe4 e�ep��- �
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hts tR � d,� 5O� am
R�9 cefotve�ens�ons (e4�esteda� �` -
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Notice f�r Wisconsin Residenfs:Wisconsin law provides th�t no pravision of any marital praperiy agreemerrt,unrlaterafstatemerR,or
court decree applying to marital properfy wili adversely affe^t a credEtor's interests uniess the cred'itor,pdor to the time credit is granted,is
fumished wi[h a copy of the agreement,statemeai,or decree,or has actual knowledge of the adverss provision when the obiigation to the
cr�tor is incurred.
ARBffRATION:All disputes,claims,or controversies arising from or relating to this Note or tfie relationships which resuRfrom th'�s Note and/or
any guaranty of this Note,or the vafidily of this arbitr-afion clause or the entire Agreement,shalt,at the elecfien of either party,be�esoived by
binding arbitrafion by one arbitrator selected by me with your consent,or appointed by a court if I faml Yo select an arbitretor or we cannot agree
upon an arbitrator. Any arbitration under ihis provision sha�be conducted according to tfie rules afi either the Plational Arbitration Forum,
JA.Af.SJEndispute,or the American Arbitration Assoaatioa I have the right to select which af these arSRration forums to use;but if I do not
make a timely selection,you may choose one.Thisarbitration agreementis made pursuanttn atransacfion in interstate commerce,and shall
be governed by the Federal Arbitration Act at 9 U.5_G.Section 1,et seq. Judgment upon the av�rard rendered may be entered in any court
having jurisdiction. The parties agree and understand that they choose arbitration instead of litig3tion to resolve disputes. The parties
understand that they have a right or opportunity to 65gate disputes through a couR,but that they prefer to resolve their disputes through
arbitraUon,except as provided herein. THE PLlRT1E5 dOLUM"ARILY AND KNOWIN6LY WANE,ANY RIGH7 THEY HAVE TO A JURY
TRIAL EITHER PURSUAN7 TO ARBiTRATION UNDER THIS CLAUSE OR PURSUANT TO A CDURT�4CTiON BY YOU(AS PROVIDED
HEREIN).The parties agree and understand that alf d'sputes arising under case law,str[utory law,and atl other laws including,but not fimfted
to,all contrac[,fort,and property disputes,win 6e subjectto bindmg arbitration in accord with this Note. The parties agree and understand that
the arbitrator shall have all powers provided bythe law and fhis Note. These powers shalt indude ail legal and equifable remedies,induding,but
not limited to,money damages,declaratory relief,and mjunctive reGef. The irts[itution and mairrtenanae of anp action for judicial relief in a court
to obtain a monetary judgment or to enforce this Note,shall not constitute a waiver of the right of any party to compel arbRration regarding any
dispute or remedy subject to arbitration in this Note.
ANY HOLDER OF THlS CONSUMER CREINT CONTRACT IS SUBJECT TO ALL CLAIMS E11VD DEFENSES WHICH THE
DEBTOR COUlQ ASSERT AGAIM1lST THE SELLER OF GOODS OR SERVICES OBTAIf�lED WITH THE PROCEEQS
HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUMS PAID 8Y THE DEBTQR
HEREUNDER.
BY SIGNING THE ATTACHED PAYMEN7 AUTHORIZA'iION FORPA, IfWE, TH� liBOWE-NAMED BORROWER(S},
ACKt�OWLEDGE TFiAT l/WE HAVE REEID ANI� UNDERSTAND ALL TERNtS ANfU COhl�wiT'iONS OF THtS RlOTE &
dtSCLOSURE STATEAfiENT, INCLUD►NG THE ARBiTRAT10N CLAIlSE,A►JD INVfE k4CKNC?WLEDGE RECEIRT OF A
COMPLETELY FtLLEB-IN C�PY OF THlS NOTE.
DD N�D' PRESEhIT TQ CONFRACiOR BEFORE PRO]ECT ZS COMPLETED TO YOlJ6t SAFLSPACTION
PLEASE DE7pCt1 BEFORE PRESEP[7ING TO CANTRACTOR
�' ��"������ PAYMEN'I' AUTHORI ZAT ION �ORI� ^�T"o�►rion NUMa�
iQ149785
DATS: 08/11/2011 . NOT VALFSi AF^TsR: November 17, 2011
By signing below, I/we (the 3oizower(s)}
I, aclmoa�ledge receipt of the attachen&ote � nieclosure Statemeat £or my Loan with ENFsRBANR USA
and agree to be legally bound by the terms and conditions of the Note.
2. confi� that there has beea satisEaciory delivery of all eauipment, goods �d/or sexvices by
the Contractor, and if any installation was included in the contxact, tY�er�e Las been
satisiactory completion of such installatioa.
3. i-nstxvct the Lender to disburse to Contractoz Yhe proceeds oE this :.ozn in the amvuat
� of 6even Thousand Fifty SZine end Ro/100 Dollaz's_
Boz-rowei BORROiQSR f S? hCCOIIFT.T NLII�ER: �0141
Dorcas M Shelle.-iberger
Bo��,� $7 , �5 9 . 0 0
By signing below, Contractor represents and warrants to the Lender:
1. that Contmetor has delivered al.l equipment, goods and/or service and camF��leted any
;*+�tallation included in the contract to the satisfaction of the Sorrowerls).
2. that Contractor Las positively identified each Borrwer whose siaaature agpears abwe.
Renewal by Anderaen of Central PS
gy Authorized Signer for Cantractor
CON7RACTOR,PLEASE F/IXCOMPLE7ED PAYMENTAUTHOftIZAiION FORM TO 1-�00-399-6259
ENERBANK USA,t245 E BRICKTAR�RD SUITE 6�W,SALT LAI�CIiY,lJ'P£3410b
S.I:I1'lllllld{I��IfI. 1
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ifl149785
AA3`�: 0 8/11 f 2 0II bi�T VAi� A-FTSB: Navember 17, 2 011
3y si�n;nq beloW; Ifwe (the Borrowsr(s3l
1. aclmowledge receipt of the attac$ed liote & Diealosv.re Str.:�t far rry i,��a sci.��'RRA"'� USA '
znd agree ta be legal2y�m3 by the tezms and a�itians a� � �ote.
2, canfixm that there lsae be�n satisfac;axy delivery a£ a11 ec�.zipa+ent. 3�ods �f°= 8�'ices hy —
the Contractar, and if any iastallati�vas inalude3 in the c��act, t�iere �s he�n
satisfa�tary cear�letion af suc3 iastailatiaa.
3_ i,assuct the Leader to diernirse to Cactractor the Psoaee3s of `�$ �`a i-n �e awvuat
:'tf Sevea �+„A�d Fifty N,:.ae snd Eia/IDO D�Zlara.
R _ a
�f'9 � ' gasraever BOR80WE&(�3 ACCOIIf�'T Nffi48�� �OI41 �
Dorcas M Saellenberger (}
9arrawer
� 1 j ��J • L!O '
By si3ning below, Coatractor rspresents a.nd wa.rrants Lfl the L���' •
l. that C�ntractor has delivered all �m*ipme�st. 400ds aad/� service an3 ccnp2ete3 asy
iasta2lation included in the conriact to the satis�actiaa af thQ Barrowezts).
2. t?�t Cont=aator has gcsi:.ively z3entified �.;h Bo=rowet w�se simatare a�aars above. —
Renewal by Aadersen o C �tra1 PA . -
BY . - tda'�'ized Signet far Coatract�r
c�xxrRn���P�s�,�i���a�� �saa�r��r�ur s��a.a��