Preview
KETC E
San Francisco Superior Courts
Information Technology Group
Document Scanning Lead Sheet
Nov-01-2006 11:22 am
Case Number: PES-06-288306
Filing Date: Oct-25-2006 11:20
Juke Box: 001 Image: 01585048
CREDITOR'S CLAIM
THE ESTATE OF ANDREW THOMAS MEAD
001P01585048
Instructions:
Please place this sheet on top of the document to be scanned.ATTORNEY OR PARTY WITHOUT ATTORNEY {Name, state bar number, and address), TELEPHONE AND FAX NOS.
lichele Mehan, Authorized Agent for Claimant
175 South Third Street, Suite 900
Columbus, OH 43215
800/325-9965 WWR #05575497
ATTORNEY FOR (Name): HOUSEHOLD RECOVERY SERVICE
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO J D
STREETADDRESS: 400 McAllister ST. RM103 San Francisco Covmty Suneror Court
MAILING ADDRESS: OCT 2 5 2006
* CITYANDZIPCODE: San Francisco, CA 94102
BRANCH NAME: Probate
ESTATE OF (Name):
ANDREW T MEAD
DECEDENT
You must file this claim with the court clerk at the court address above before the LATER or (a) four months after the dale letters (authority to act for the
estate) were first Issued to the personal representative, or (b) sixty days after the date the Notice of Administration was given to the creditor, if notice was
given as provided in Probate Code section 9051. You must afso mail or deliver a copy of this claim to the personal representative and his or her attomey.
A proof of services is on the reverse.
WARNING: Your claim will in most instances be Invatid If you do not property complete this form, fite it on time with the court, and mail or deliver a copy to
the personal representative and his or her attomey.
Il vs
‘1, Total amount of the claim: $7,712.25
Ciaimant (name): HOUSEHOLD RECOVERY SERVICE
a. Clanindividual
b. [Jan individual or entity doing business under the fictitious name of (specify):
c. [lapartnership, The person signing has authority to sign on behalf of the partnership.
a. (lacorporation, The person signing has authority to sign on behalf of the corporation.
e. (other (specify): Authorized Agent for Claimant
Address of claimant (specify):
175 South Third Street, Suite 900
Columbus, OH 43215
4, Claimant is [1] the creditor J a person acting on behalf of creditor (state reason):
t Authorized Agent for Claimant
5. [1 Claimantis 11 the personal representative Othe attomey for the personal representative.
tam authorized to make this claim which is just and due or may become due. All payments on or offsets to the claim have been credited.
+ Facts supporting the ctaim are [J on reverse DJ attached.
I declare under penalty of perjury under the laws of the State of California that the forgoing is tre and correct.
1
woo
Date: October 13,2006
Michele Mehan, Authorized Agent for Claimant oO Lf ;
(TYPE OR PRINT NAME AND TITLE) (SIGNATURE OF CLAIMANT)
INSTRUCTIONS TO CLAIMANT
A. On the reverse, itemize the claim and show the date the service was rendered or the debt incurred. Describe the item or service in detail,
and indicate the amount claimed for each item. Do not include debts Incurred after the date of death, except funeral claims.
B. If the claim is not due or contingent, or the amount is not yet ascertainable, state the facts supporting the claim.
C. Ifthe claim Is secured by a note or other written instrument, the original or a copy must be attached (state why original is unavailable). If
secured by mortgage, deed of trust, or other lien on property that is of record, it is sufficient to describe the security and refer to the date
or volume and page, and county where recorded. (See Prob. Code 6 9152).
Mail or take this original claim to the court clerk's office for filing. !f mailed, use certified mail, with retum receipt requested.
Mail or deliver a copy to the personal representative and his or her attorney. Complete the Proof of Mailing or Personal Delivery on the
reverse.
The personal representative or his or her attomey will notify you when your claim is allowed or rejected.
™ moi G. Claims against the estate by the persg=' representative and the attomey for the person representative must be filed with the claim
{ :i._, Period allowed in Probate Code sectid§_ .00. See the notice box above.
(Continued on reverse)
Foam Avoroved by the CREDITOR’S CLAIM Probate Cade H 9000 ot ea D189
Juckelal Counc of Cattomia: (Probate)
DEATE oy Jom 1, 1008)
ESTATE OF (Name):
ANDREW T MEAD
DECEDENT
CASE NUMBER:
tN sy
PES-06-288306
FACTS SUPPORTING THE CREDITOR'S CLAIM
0 See attachment (If space is insufficient)
Date of item Item and supporting facts Amount claimed
October 13,2006 The balance due on a Loan account. $7,712.25
Account # 21181800623846
Due and owing to: HOUSEHOLD RECOVERY SERVICE
‘.
j ot
1 $7,712.25
il . 4», PROOF OF x] MAILING |] PERSONAL DELIVERY TO PERSONAL REPRESENTATIVE
per (Be sure to mail or take the original to the court clerk’s office for filing)
"4. am the creditor or a person acting on behalf of the creditor. Atthe time of mailing or delivery | was at least 18 years of age.
2. My residence or business address Is (specify):
| 175 South Third Street, Suite 900
Columbus, OH 43215
3. I mailed or personally delivered a copy of this Creditor’s Claim to the personal representative as follows (check either a or b below):
* a. Bd Mail.1 ama resident of or employed in the county where the mailing occurred.
(1) lenctosed a copy in an envelope AND
(a) oO deposited the seated envelope with the United States Postal Service with the postage fully prepaid.
(b) EX] ptaced the envelope for collection and mailing on the date and at the place shown in items below following
our ordinary business practices. | am readity familiar with this business’ practice for collecting and
processing correspondence for mailing. On the same day that correspondence is placed for collection and
Maiting. Itis deposited In the ordinary course of business with the United States Postat Service In a sealed
envelope with postage fully prepaid.
(2) The envelope was addressed and mailed first-class as follows:
(a) Name of personal representative served: REBECCA J MEAD , PERSONAL
: (b) Address on envelope: REPRESENTATIVE
{ " . 880 WISCONSIN ST
SAN FRANCISCO,CA 94107
{c) Date of mailing October 13,2006
{d) Place of mailing (city and state): Columbus, OH
b. (Personal delivery. | personally delivered a copy of the claim to the personal representative as follows:
(1) Name of personal representative served:
: (2) Address where delivered:
. (3) Date delivered:
| Bi (4) Time delivered:
' : | declare under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct.
Date: October 13,2008 4, Lh, 4
Michele Mehan, Authorized Agent for Claiman 0 t
(TYPE OR PRINT NAME CF CLAIMANT) (SIGNATURE CF CLAIMANT)
eee
J) D472 gtev darumry 1, 186 CREDITOR'S CLAIM Page Two
| (Probate)
Preview
KETC E San Francisco Superior Courts Information Technology Group Document Scanning Lead Sheet Nov-01-2006 11:22 am Case Number: PES-06-288306 Filing Date: Oct-25-2006 11:20 Juke Box: 001 Image: 01585048 CREDITOR'S CLAIM THE ESTATE OF ANDREW THOMAS MEAD 001P01585048 Instructions: Please place this sheet on top of the document to be scanned.ATTORNEY OR PARTY WITHOUT ATTORNEY {Name, state bar number, and address), TELEPHONE AND FAX NOS. lichele Mehan, Authorized Agent for Claimant 175 South Third Street, Suite 900 Columbus, OH 43215 800/325-9965 WWR #05575497 ATTORNEY FOR (Name): HOUSEHOLD RECOVERY SERVICE SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO J D STREETADDRESS: 400 McAllister ST. RM103 San Francisco Covmty Suneror Court MAILING ADDRESS: OCT 2 5 2006 * CITYANDZIPCODE: San Francisco, CA 94102 BRANCH NAME: Probate ESTATE OF (Name): ANDREW T MEAD DECEDENT You must file this claim with the court clerk at the court address above before the LATER or (a) four months after the dale letters (authority to act for the estate) were first Issued to the personal representative, or (b) sixty days after the date the Notice of Administration was given to the creditor, if notice was given as provided in Probate Code section 9051. You must afso mail or deliver a copy of this claim to the personal representative and his or her attomey. A proof of services is on the reverse. WARNING: Your claim will in most instances be Invatid If you do not property complete this form, fite it on time with the court, and mail or deliver a copy to the personal representative and his or her attomey. Il vs ‘1, Total amount of the claim: $7,712.25 Ciaimant (name): HOUSEHOLD RECOVERY SERVICE a. Clanindividual b. [Jan individual or entity doing business under the fictitious name of (specify): c. [lapartnership, The person signing has authority to sign on behalf of the partnership. a. (lacorporation, The person signing has authority to sign on behalf of the corporation. e. (other (specify): Authorized Agent for Claimant Address of claimant (specify): 175 South Third Street, Suite 900 Columbus, OH 43215 4, Claimant is [1] the creditor J a person acting on behalf of creditor (state reason): t Authorized Agent for Claimant 5. [1 Claimantis 11 the personal representative Othe attomey for the personal representative. tam authorized to make this claim which is just and due or may become due. All payments on or offsets to the claim have been credited. + Facts supporting the ctaim are [J on reverse DJ attached. I declare under penalty of perjury under the laws of the State of California that the forgoing is tre and correct. 1 woo Date: October 13,2006 Michele Mehan, Authorized Agent for Claimant oO Lf ; (TYPE OR PRINT NAME AND TITLE) (SIGNATURE OF CLAIMANT) INSTRUCTIONS TO CLAIMANT A. On the reverse, itemize the claim and show the date the service was rendered or the debt incurred. Describe the item or service in detail, and indicate the amount claimed for each item. Do not include debts Incurred after the date of death, except funeral claims. B. If the claim is not due or contingent, or the amount is not yet ascertainable, state the facts supporting the claim. C. Ifthe claim Is secured by a note or other written instrument, the original or a copy must be attached (state why original is unavailable). If secured by mortgage, deed of trust, or other lien on property that is of record, it is sufficient to describe the security and refer to the date or volume and page, and county where recorded. (See Prob. Code 6 9152). Mail or take this original claim to the court clerk's office for filing. !f mailed, use certified mail, with retum receipt requested. Mail or deliver a copy to the personal representative and his or her attorney. Complete the Proof of Mailing or Personal Delivery on the reverse. The personal representative or his or her attomey will notify you when your claim is allowed or rejected. ™ moi G. Claims against the estate by the persg=' representative and the attomey for the person representative must be filed with the claim { :i._, Period allowed in Probate Code sectid§_ .00. See the notice box above. (Continued on reverse) Foam Avoroved by the CREDITOR’S CLAIM Probate Cade H 9000 ot ea D189 Juckelal Counc of Cattomia: (Probate) DEATE oy Jom 1, 1008) ESTATE OF (Name): ANDREW T MEAD DECEDENT CASE NUMBER: tN sy PES-06-288306 FACTS SUPPORTING THE CREDITOR'S CLAIM 0 See attachment (If space is insufficient) Date of item Item and supporting facts Amount claimed October 13,2006 The balance due on a Loan account. $7,712.25 Account # 21181800623846 Due and owing to: HOUSEHOLD RECOVERY SERVICE ‘. j ot 1 $7,712.25 il . 4», PROOF OF x] MAILING |] PERSONAL DELIVERY TO PERSONAL REPRESENTATIVE per (Be sure to mail or take the original to the court clerk’s office for filing) "4. am the creditor or a person acting on behalf of the creditor. Atthe time of mailing or delivery | was at least 18 years of age. 2. My residence or business address Is (specify): | 175 South Third Street, Suite 900 Columbus, OH 43215 3. I mailed or personally delivered a copy of this Creditor’s Claim to the personal representative as follows (check either a or b below): * a. Bd Mail.1 ama resident of or employed in the county where the mailing occurred. (1) lenctosed a copy in an envelope AND (a) oO deposited the seated envelope with the United States Postal Service with the postage fully prepaid. (b) EX] ptaced the envelope for collection and mailing on the date and at the place shown in items below following our ordinary business practices. | am readity familiar with this business’ practice for collecting and processing correspondence for mailing. On the same day that correspondence is placed for collection and Maiting. Itis deposited In the ordinary course of business with the United States Postat Service In a sealed envelope with postage fully prepaid. (2) The envelope was addressed and mailed first-class as follows: (a) Name of personal representative served: REBECCA J MEAD , PERSONAL : (b) Address on envelope: REPRESENTATIVE { " . 880 WISCONSIN ST SAN FRANCISCO,CA 94107 {c) Date of mailing October 13,2006 {d) Place of mailing (city and state): Columbus, OH b. (Personal delivery. | personally delivered a copy of the claim to the personal representative as follows: (1) Name of personal representative served: : (2) Address where delivered: . (3) Date delivered: | Bi (4) Time delivered: ' : | declare under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct. Date: October 13,2008 4, Lh, 4 Michele Mehan, Authorized Agent for Claiman 0 t (TYPE OR PRINT NAME CF CLAIMANT) (SIGNATURE CF CLAIMANT) eee J) D472 gtev darumry 1, 186 CREDITOR'S CLAIM Page Two | (Probate)