HomeMy WebLinkAbout95-00426
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A Yes. In fact, she would only see me that one
time. She wouldn't even see me in follow-up. I
recommended that she come up to our inpatient unit, Dr.
Martin recommended it and the daughter was in support of
it as well as long as the mother would agree, but Mrs.
Baum flatly refused any type of psychiatric care.
o Did you then see her again following that?
A Yes. She came in again a few weeks -- or not
even a few weeks later admitted again medically because of
complications of not being dialyzed. I saw her at that
time and strongly encouraged her again to come up to our
inpatient unit. She again flatly refused.
Dr. Martin then saw her and stated to the
14 patient that he would not continue to follow her for her
15 medical care if she would not agree to psychiatric
16 placement because he saw this essential and necessary as
17 welJ. as possibly life preserving. She, therefore,
18 reluctantly agreed to come up to our unit and signed in
19 voluntarily. That was on April 14th.
20
21
o
How long did she stay?
A
She stayed one week very reluctantly. She did
22 not participate at all with her treatment program. She
23 basically stayed in her room, went to dialysis and would
I..,.)
24 not cooperate with any of the treatment guidelines or
25 programs.
C.P.C.R.S.
(717)258-3657 or (800)863-3657
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IN RE: NETTIE R. BAUM
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 0)/ - q~ - tI--~ ~
DECREE OF COlJRT
AND NOW, this ?' day of ~v....., 1995, after hearing on the within Petition for
Appointment for Emergency Guardian, the same is granted and the Cumberland County Office of
Aging is hereby appointed as Emergency Guardian for the limited purposes of I) making all general
and health care decisions for the incapacitated and providing all consents necessary therefore, and
fA ~) lIu~kin5 All luaintensne", "lid Gttstody dGcision] regarding Ih"" ;1It.:upiu.::batea person, and J)
_ designAling An "pprnpnAIP p1allu for tile iRrap.r;t"l"c! In IiVl' Said guardian shall serve in that
capacity until J'l- """ , .:rIM.. /'f', 1995, which period may be extended by further Order of
Court. :rf' a- 5,/1 r-h'h~ ..... F.'1.. .J -t4... D...... ~I 1',_ e.r,. ~
{.. It.. MI<<ul '..c.,.....nt::tI 1'1/),...
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BY THE COURT,
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IN RE: NETTIE R. BAUM,
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. d./ .cr.<;.1/ c? {,
DECREE OF COtJRT
AND NOW, this S~1. day of~~ . 1995, upon consideration of the Petition of Carlisle
Hospital for Appointment of Emergency Guardian Pursuant to 20 Pa. C.S. ~5513, a hearing on the
Petition is scheduled for tv/al. , 9! 7U 1, 1995, at ~: c/5Qn, ,in (2K -# Lj
Cumberland County Courthouse, Carlisle, Pennsylvania; and
IT IS FURTHER ORDERED AND DECREED that , Esquire is
appointed to represent the alleged incapacitated person; and
IT IS FURTHER ORDERED AND DECREED that Petitioner shall make good faith effort
to give actual notice of the said Petition and hearing, either oral or written, to all persons and entities
specified in Section 5511(a) of the Probate, Estates and Fiduciaries Code; All other requirements
under Section 5511, such as the twenty day notice, are deemed to be unfeasible in view of the
emergency allegations set forth in the Petition.
BY THE COURT, ~ I
4' /lbI--
J.
IN RE: NETTIE R. BAUM
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
PETITION FOR APPOINTMENT OF EMERGENCY GUARDIAN
PI JRSlJANT TO 20 Pa C S 65513
AND NOW comes CARLISLE HOSPITAL, Petitioner, by and through their counsel,
MARTSON, DEARDORFF, WILLIAMS & OTTO, and petitions This Honorable Court for the
appointment of an Emergency Guardian under 20 Pa. C.S, ~ 5513 for Nettie R, Baum, an alleged
incapacitated person, and in support therefore represents and avers as follows:
I. Petitioner, Carlisle Hospital, is a Pennsylvania nonprofit corporation with a principal
place of business at 246 Parker Street, Carlisle, Cumberland County, Pennsylvania 170]3.
2. The alleged incapacitated person, Nettie R. Baum, is domiciled in Cumberland
County, Pennsylvania, with a residence at 2 West Penn, Apt # 20], Carlisle. Pennsylvania 17013.
She is currently 68 years of age, having been born on January 29, 1927.
3. Nettie R. Baum, the alleged incapacitated person, was recently admitted to Carlisle
Hospital, suffering from. illler alia, delirium, The alleged incapacitated person is suffering from
renal failure and requires regular kidney dialysis and other treatment. Such care is necessary to
preserve her life.
4. The alleged incapacitated person is incapable of understanding that she must maintain
regular compliance with her dialysis treatment program and has refused treatment when she feels
well.
5. Nettie R. Baum also suffers from a history of poor memory such that it affects her
ability to seek and continue the medical treatment and care necessary to preserve her life.
6. As a result of the alleged incapacitated's inability to comprehend the nature of her
medical condition and the required treatment therefor, she has suffered numerous episodes of
delusion and near death circumstances.
7. Nettie R. Baum, the alleged incapacitated, has been examined by Rocco L. Manfredi,
M.D, who has concluded that the alleged incapacitated has lost the ability to receive and evaluate
information etTectively and to communicate her decisions to such a significant extent that she is
totally unable to manage her medical condition to meet essential requirements for her physical health
and safety. A copy of Dr. Manfredi's report leller is all ached hereto and marked as Exhibit "A".
8. The alleged incapacitated persons' mental and physical deterioration impair her from
fully understanding the significance of her actions and the actions and conduct of others around her.
9. The alleged incapacitated has refused to execute a power of allomey.
10. Without the prompt appointment ofa guardian the alleged incapacitated person will
likely sutTer irreparable hann and possibly death.
II. Petitioner believes that the presumptive heirs of the alleged incapacitated, their
relationship to the alleged incapacitated, and their addresses, are as follows:
Arthur Baum: husband (separated); 161 Mulberry Ave., Carlisle, PA 17013.
Arthur Baum: son; 161 Mulberry Ave., Carlisle, PA 17013.
Mary Buckenhower: daughter; 150 Pine Hill Road, Carlisle, PA 17013.
12. Petitioner believes that the alleged incapacitated's husband and son may not be the
most appropriate persons to act as Emergency Guardian. The alleged incapacitated's daughter has
declined to act as Emergency Guardian. Petitioner is aware of no other presumptive heirs.
13. The Cumberland County Office of Aging with offices at 16 West High Street,
Carlisle, Cumberland County, Pennsylvania 17013, is an agency who may be appointed a guardian
under 20 Pa. C.S. ~5511 (I).
14. Petitioner requests that the Cumberland County office of Aging be appointed
Emergency Guardian for the alleged incapacitated and said office has consented to so act. The
Consent ofthe Cumberland County Office of Aging to act as Emergency Guardian is attached hereto
as Exhibit "B".
15. The proposed Emergency Guardian has no interests adverse to the interests of Nettie
R. Baum, the alleged incapacitated.
16. No other Court has assumed jurisdiction in any proceeding to determine the
incapacity of Nettie R. Baum.
17. Petitioner believes that the alleged incapacitated has not executed any living will or
health care directive.
WHEREFORE, Petitioner, Carlisle Hospital, respectfully respects that this Court appoint the
Cumberland County Office of Aging to be the Emergency Guardian of the person of Nettie R.
Baum.
Date: Maf~ 1995
Respectfully submitted,
MARTS ON, DEARDORFF, WILLIAMS & OTTO
By -r~~) AJJ.. ~
Thomas J. Williams, Esquire
LD. #17512
W. Darren Powell, Esquire
LD. #68953
Ten East High Street
Carlisle, PA 17013-3093
(717) 243-3341
Attorneys for Petitioner
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CAI<L H:J5P UR 50e SER
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PAGE 02
717 '4::1 ::I:'4HI# ';I ,;
VlUUPfCA110N
I, Dianl O'NIU. Senlnr Snclal Worker. Depnmeot or SociAl Work Service., Carll.l,
HoIpIlII, do veril1....11hc tl&Ienulnl. made In lho Pelltion for Appointment ofEmerllency Guardian
Purauant to 20 PI, C,S. 1"13 are tNe and correa, I undermnd that ~IIC atatancntl herlin Iro
made IUbJeot to the plllahltl or" PI, C,S, 4904, retatina to u",worn fAI.iflcltion to IUlhoridca.
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Diana O'N.II, SlmIor SoQaI Wodlll',
lJcpartmentllrSoclal Work S'M.:e.
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TEL:
Ila~ 26,95
10:27 ~o.OOl P.02
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MUM, NETTIE R.
318.W
MR 11022228
CONSULTATION TO:
AmNDING PHYSICIAN:
DATe:
TYPE CONSULTATION:
IDENTIFYING INFORMATION: Mil, Nettie Baunlla a 67-year-old whllo leplrllad womln from
Carlisle. Pennsylvania where shu lives alono, She h.. e prior psychiatric history for 110 Inpallent psy_
ch/ollie admlsllon last monlh lIthe Carll.le HOlpllal for delirium, She was referred for consultation fOI
usassmont of mental oompotency.
Or. Rocoo L. Manfladl
Or. Glrald B. Mlrtln
05117111/1/5
Mre. Baum I. well known 10 ma from hsr provlous Inpellenl psychiatric edmlBSlon. She hat boen
conlllltsntfy uncooperltlvl With har madlcal tleatmsnt program Har lack of compllancalelds thl
pallent 10 severe physlClI dablll18l1on IIOd has resulled In nuar death on sevarel ocClslons. The psllont
appears 10 hive I poor Und.ralanding of her IIlluallon Bnd Ihe Imporltlnc. of melntllnlng regular com.
pllance with her dlalYlls Irlatment program. She sllltes thaI when she feels well, she doe. nol feellhe
need to have the dlllylls She tries deaperalaly to avoid lhe post dlaly.ls discomfort Ihal ahe experl-
oncos. The pallent'a leek of lnelghtlead. her to cls.rfy dangerous levels of medical compllcallone,
Wlon the paUant doe. not hive dl.lj.lll. II Iuds to delirium I have seen her on several occasion. In
this state of delirium. I hlva al.o recognized her poor memory thaI has r8sulied nOI only slnca hor
carebro~a9cular accldenl but Iccordlng 10 the daughter's history, even before Ihls OVA oocurred.
BaC8us8 of the pallent's poor Judgemsnt, lack of Insight Inlo her medlcel condition, pOOl compllanco
with her medical treatment program leading 10 sal'eral near dealh episodes and har Impalretl memory
which laads her 10 make errora In schotlullng and following Ihrough wllh the scheduling of hll dl.l)'sls,
I etrongly believe Ihll pltlentls Incapacitated. thaI Is, I believe Mrs. 8uum has loslth. ability II)
receive and evaluate Information effectively anti 10 communlcalB her decisions 10 sUCh I significant
extenllhal aile Is lolally unablo to manage her modical condition to moot ossentla1 requlrelTlllnts for
her physIcal hOllth Ind safety.
I hope thaI this Information 15 helpful to you In your worll Wllh Mill Boum. "I mey of further assis-
tance, please contact my offlca.
RLM/bka
0: 05/17/1996 . 09:35 pm
T; 05118/1996
cc Or. Rocco L. Manfredi
Or. Garald 8, Murt/n
Rocco L Monfrodl, M.O,
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Page 1 of 1
ORIGINAL
CARLISLE HOSPITAL
&pNSULTATION
,Exhibit "A" ,
EXHIBIT B
~I ". '- 9- "f'E 'I' 5" \\1
..."\l-j....- , i.. .' I ^."1
SE.'\T BYllIDlIO
C[~~ C0 C~f!CE C? ftG:H~
I 5-30-85 I 10:36 I
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717240&1161' 21 2
IN 0: NBTnE R. BAUM
III aIIepd Jne.l*illl4ld penon
IN THE COURT OF COMMON PLllAS
CUMBIlRLAND COUNTY. PENNSYL V ANI'"
O'RllHANS' COUR.T DIVISION
NO.
.
l
NlNRRNT nP PDnPnt;1.J;n RUWII(;~N~Y In ,A..niAN
" '- /'.1'/,'1#1 ;::' - ?l,u'"Y: . bclIII A""~fj 1rJ,.. or 1hc
CUIlIborlu.! CowIl)' 0ftIce or A&inc dO ltate \hit the CuIDbatand County Office of Alina IllII
con.Iled ID be appolnlecl and .cc .. ~ ("JIIw.n ohlle per10II ofNetti, R. Bwm, an
aIJe&ed lncapaolWocl petIOli.
CUMBIllU...AND COUNTY OFPlCE OF AGlNO
BY; tf,.J~f1)?~
Exhibit "B"
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',!lFI! J FF' <; HETlJrW
CASE NO; 2195-004~G 0
r:OMMOIIWEALTII OF PEIHlSYLYAUI II;
(OUNTY OF CUMBERLAND
ltLRJ;;.L.JlETT']J;;_J,L!l1iJ.!l:L,j-;.L!i.I,,_...,
YS.
!1!L,Mi.THUH BAU,!L_--,..
.~_T.tlOmQfl Kline ___' Sheriff, "ho b,,'i :el"orn UI:cordinl1
to la.... GlIYS, that h", mad~ ct.tl.i~wnt; >>",,,roh nnd i01uiry. Lor thtl' within
named d.?J'endant, to ...it I BAUM ARTII!JJLJl!JJpBAIIDL
but ...as unable to. locate' Hi";
iO'1)ol' builivick. II~ therefore rll'turns
thl? ?UBPOENA __~
/LQL.E.QJlliP-..:., as to the ...i thin i' named defenclant
BAU1L1RTHUH (jllI~BtUU2..) .. '...__
:it;:VERAL ATTEMPTS ATSWl.QI::' WJ;;li!LJ1tln,&""",PU'tWE __
yJll,ILP__NOT FINDA/lYOIlE' AT 110M!::; __.
-.,,----
'~~.
.
Sheriff's Coati'll
Docketing
Service
Affidavit
Surcharge
6;00
.0D
.N'!
2.00
5.0. .ur)s'We~a.,,:~
~'~/:' .' ..'~
.~ 'W~.</ ~~
. . "Thoma~nnln~';--Slii;FlTI
'H;i';-iiY(ll' TIlOMAS \lII.UhliS
I/JG IQlIJ I t';J',)~j
Sworn nndBubocrib~d to boiol"~ mo
Itd,:" .Lit.t di,Y '.l! ~~~!:!.':.~.____..., ~
19..16 _._ A. D.
-M~r--Cl':'~f'.g~1~I..I!f!'.4 ~6~~fJdj
(Jle.lT ':(,\ . '/,I["(.i,vlfPa ....oui-(~ '~-~r\
, -
tuRK OF THE ORPHANS'COURT DIVISION
CUMDERLANO COUNlY PENNSYLVANIA _
M, eammlullln ElqJir" lbo Arlllbllllr. -, --
,
'JIII'111 FF'" "!'TUrnl
{. 1\:'1' /11.1; :: 1';15 -))0'1;;(. 0
COMMlJIlWEI\I-1'I1 or PElltl~;YLV Alii f,:
COUNTY OF CUMlIEIiLMIlJ
LN __ !lj': I II F,; T T I 1-:"./L.t1, A l111.J';,Lt\ l",~.,..
vs.
!1R...bJ"TllUfLllAUM
_RJ_.JhQ!!Hlli..Ji..U.l1lL______,~_.._, Shc'riU who b",inl'l duly slIorn aocording
to law, saya, thaI;. h", ntad.? dilioent Ii!Hlr<:h tHld inquiry for the lIithin
Sheriff's CostSI
Docketing
Service
Affidavit
Surcharge
namE'd defendant; In lIitIBAU~JiI!H)R (SON)
but wus unable to locale .Jli'l1_ in h~'l' bailiwick.
He th,uefore .returns
the :2.!JBPOEIIA ____~ ,
!illI-.F'OUND , aa to ,the withinnam&d defendant
~AUM ARTHUR <SOH)
SEVERAL ATTEMPT AT SERVICE
COULD NOT LOCATE At/YOllE AT
.,;,,;.;.,,;.--
WERE MAPE.l.-.!)UT
f{OME.
WE
6.00
.00
.00
2~00
50,' u. nSwe1'l:ll.' . .~. . .' . . ......
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4!::~~:-<<~' ~~ ~
Ir. "'Tlloriib-a--trlTn-';'i5Tll?l' ~ i 1.
THOMAS WILLIAMS
0G/0B/1995
sll-:-0'0
Sworn andsubscr~bqd to before me
thiu .,J/j_.__ tj'lY <Of _.~~~
19..95:,.." A, D.
--~P.ab ~~~d-r7-~-r.---'---"---
~~erk o~ Orpll n s ~uur~
~~~""""""""""~,,,_..;".,."
ca-KJ~TH OF PENNSYLVANIA
CCXJNI"{ OF CLt1BERLAND
IN RE:
NETTIE R. BIIUM.
an alleged incapacitated pe~son
I
:
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:
SUBPOENA
File No. 21-95-426
ORPHANS' COURT DIVISION
TO: Ms. Ma~y Buckenhower (daughter)
150 pine Hill Road. Ca~lislc, PII 17013
1. You are ordered by the co~ to come to the Cumberland County Courthouse
at
Carlisle
(Spec~fy co~room or other place)
Cumberland County, Pennsylvania, on
6/7/95
at
8:45
o'clock,
II. M., to testify on behalf of
petitioner
in the above case, and to rerrain until excused.
2. And bring with you the following: iliA
If you fail to attend or to produce the docurents or things requ;Lred by this subpoena,
you may be subject to the sanctions authorized by Rule 234.5 of the Pennsylvania Rules
of Civil Procedure, including but not limited to costs, attomey fees and inprisonrrent.
ISSUED BY A PAR1"fICOUNSEL IN CCMPUANCE WITH Pa.R.C.P. No. 234.2(a)
NAME: Thomas J. Williams. Esquire
ADDRESS: Ten East High Street
C;,,,J j,,]p, PA 1701 '1-10')'1
TELEPHONE: (717) 243-3341
SUPREME COURT IOn 17512
BY THE COURT:
'/rhh.~ c.,. ,:f,,, L:'"
Prot not~, Civil
Division
DATE: June 5. 1995
Seal. of the Co~
12---- e.J, .\),. .,.j.;~
I
Deputy
OFFIC:u.r. NOI'E: This form of subpoena shall be used whenever a subpoena is issuable,
including hearings in connection with depositions and before arbitrators, masters,
COITtT1i.ssioners, etc. in corrpliance W1.th Pa.R.C.P. No. 234.1. If a subpoena for production
of docurents, records or things is desired, caTl'lete paragraph 2.
'.,;.
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C'CM-ONWEAL'll! OF PENNSYLVANIA
CCXJlI1I'Y OF CLMBERLAND
IN RE: NETTIE R. BA~I,
an alleged incapacitated person
File No. 21-95-426
ORPIlANS' COURT DIVISION
SUBPOENA
'ro. Mr. Arthur Baum (husband) (separated)
161 Mulberry Avenue, Carlisle, PA 17013
1. You are ordered by the court to come to the Cumberland County Courthouse
at
(Spec~fy courtroom or other place)
Cumberland County, Pennsylvania, on
6/7/95
Car1isl~
at
8:45
o'clock,
1\. M., to testify on behalf of
Petitioner
in the above case, and to renain until excused.
2. And bring with you the following. N/A
If you fail to attend or to produce the documents or things required by this subpoena,
you may be subject to the sanctions authorized by Rule 234.5 of the Pennsylvania Rules
of Civil Procedure, inclUding but not limited to costs, attorney fees and imprisonment.
ISSUED BY A PARTY/COUNSEL IN COMPLIANCE WI'll! Pa.R.C.P. No. 234.2(a)
NAME. Thomas J. Williams, Esquire
ADDRESS. Ten East lligh Street
C~rl;~1p. PA 1701~-~Oq1
TELEPHONE. (717) 243-3341
SUPREME COURT IOU 17512
DATE. June 5, 1995
Seal of the Court
BY THE OJURT.
'7~. S : ':m:,
P'I or. I.,,.U
R~ PB~vc~t\
,
Deputy
LJ:'9.;.....ion
OFFICIAr. NOl'E. This form of subpoena shalJ. be used whenever a subpoena is issuable,
including hearings in connection with depositions and before arbitrators, masters,
comnissioners, etc. in conpliance with Pa.R.C.P. No. 234.1. If a subpoena for production
of documents, records or things is desired, complete paragraph 2.
(Rev. 1/901
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RmMd ~lQ.""DJ""l)N.1
IN RE: NETTIE R. BAUM
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
AN ALLEGED INCAPACITATED PERSON
NO. 21 . 95 .426
DECREE
AND NOW, this o'"otA day of~, 1995, upon careful review and full consideration
of the within Petition, IT IS HEREBY DECREED that, in accordance with the Order of June 7,
1995, Daniel J. Sodus, Esquire is appointed to represent the alleged incapacitated person.
IT IS FURTHER DECREED that a hearing upon said Petition is to be conducted on the
/ I tIi day of aa y (l '1,:[ , 1995, at .,:/ ; 30 o'clock reI .m., in Court Room No, '/
of the Cumberland County Court House, Carlisle, Pennsylvania, at which time all interested
parties may be heard. Notice of the Petition and hearing shall be given by certified mail to all
persons residing within the Commonwealth who arc sui juris and would be entitled to share in the
estate of the alleged incapacitated person if she died intestate at that time, and to the person or
institution providing residential services to the alleged incapacitated person.
BY THE COURT,
-?<Ct-. 4
/ J.
/
/
r
IN RE: NETTIE R, BAUM
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
ORPHANS' COURT DIVISION
AN ALLEGED INCAPACITATED PERSON
NO. 21 - 95 - 426
DECREE
AND NOW. this day of 1995, upon careful consideration of the
foregoing Petition and after a hearing held on the same. is hereby DECREED that Nettle R. Baum
suffers a mental deficiency such that she is unable to make or participate in any decision relating to
her person and that said Nettie R. Baum is adjudged totally incapacitated and
is appointed plenary guardian of the person of Nettie R. Baum.
"
J.
IN RE: NETTIE R, BAUM
IN TIlE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPIIANS' COURT DIVISION
AN ALLEGED INCAI'ACITATED I'ERSON
NO, 21 - 95 - 426
PETITION FOR ADJUDICATION OF INCAI'A['ITY AND APPOINTMENT
OF A GUARDIAN OF TIlE PERSON UNDER 20 Po C,S ~ 55 II
AND NOW comes CARLISLE HOSPITAL, Petitioner. by and through their counsel.
MARTSON. DEARDORFF. WILLIAMS & OTTO. and petitions This Honorable Court for an an
adjudication of incapacity of Nettie R, Baum, an alleged incapllcitated person, and appointment of
a plenary guardian of her person, In support thereof the Petitioner avers as follows:
I. Petitioner, Carlisle Hospital, is a Pennsylvania nonprofit corporation with a principal
place of business at 246 Parker Street, Carlisle, Cumberland County, Pennsylvania 17013. Petitioner
has provided health carc and counseling to the alleged incapacitated person for several years and is
intcrested in her welfare,
2. The alleged incapacitated person, Nettie R. Baum. is domiciled in Cumberland
County, Pennsylvania, with a residence at 2 West Penn. Apt 11201, Carlisle, Pennsylvania 17013.
She is currently 68 years of age, having been born on January 29, 1927.
3, Ncttic R. Baum, the alleged incapacitated person, was recently admitted to Carlisle
Hospital, suffering from, il/ler CIlia, delirium, The alleged incapacitated person suffers from renal
failure and requires regular kidncy dialysis and other treatment. Such care is necessary to preservc
her life,
4. Ncttie R. Baumalso sutlers Ii-om a history of poor mcmolY such that it atlects hcr
ability to seck and continue thc medicllltrcatmcnt and carc necessary to prcservc her life,
5. Thc alleged incapacitated pcrson is incllpable of understanding that she must maintain
regular compliancc with her dialysis treatment program and has refused trcatment when she feels
well. The alleged incapacitated's compliancc with necessary medical treatment has been minimal
sincc her recent cardiovascular accident.
6. The alleged incapacitated persons' mental and physical deterioration impair her from
fully understanding the significance of her actions and the actions and conduct of others lIround her.
This condition significantly impairs her ability to comprehcnd her mcdical condition, the necessity
of treatment therefore, the consequences of noncompliance with treatment and, therefore, her ability
to make intelligent and informed decisions regarding the same,
7, As a result of the alleged incapacitated's inability to comprehend the nature of her
medical condition, and the required treatment therefor, she has sullcred numerous episodes of
delusion and near death circumstances,
8. Nettie R. Baum, the alleged incapacitated, has been examined by Rocco L. Manfredi,
M.D. who has concluded that the alleged incapacitated has lost the ability to receive and evaluate
information effectively and to communicate her decisions to such a significant extent that she is
totally unable to manage her medical condition to meet essential requirements for her physical health
and safety.
9. The alleged incapacitated ollen reluses to comply with the medical treatment
necessary to maintain the alleged incapacitated. In such circumstllnces, nothing short of physical
force whieh will persuade her to comply with her necessary treatment.
10. Because of the seriousness of the situation presented by the aforestated averments,
Petitioner herein, on or about May 31, 1995, petitioned This Honorable Court for the appointment
of an Emergency Guardianship of Nettie R. Baum, an alleged incapacitated person, A copy of
aforesaid petition ("Emergency Petition") is attached hereto as Exhibit "AU and is incorporated
herein as though set forth at length,
II. A hearing was held on the Emergency Petition on June 7, 1995 before the Honorable
Judge Hess. Subsequent to said hearing, by Order dated even therewith, the Cumberland County
Ollice of Aging was appointed liS Emergency Guardian of the person of Nettie R, Baum, with
limited powers, A copy of this Order is IIttached hereto as Exhibit "B", This guardianship
terminates lit 12:00 p,m, on June 14. 1995,
12. At said hearing, the deposition testimony of Dr, MlInfredi was entered into evidence
IInd Dr. Gerald Martin. the alleged incapacitated's treating physician, testified liS to the IIl1eged
incapacitated's medical condition, her history of noncompliance with treatment and the irreparable
medical harm resulting from such noncomplillnce.
13, Petitioner is of the belief, and therefore avers, that the reasons and concerns which
prompted Petitioner to seek IIppointment of an Emergency Guardian continue in that the alleged
incapacitated person still requires regulur (three times a week) dialysis treatment und that she lacks
the ability to comprehend that the consequence of noncompliance with this treatment is death.
Although the alleged incapacitated has complied with her dialysis treatment since the June 7, 1995
Order, Petitioner believes, and history supports, that such compliance will not likely be maintained.
When such compliance fails, the alleged incapacitated may die, suffer irreparable medical harm and
present a danger to others.
14. Petitioner believcs that it is in the alleged incapacitated's best interest to reside in a
nursing or care home, where dialysis and other medical treatment could be obtained and
administered in accordance with the alleged incapacitated's needs and best interests,
15. Less restrictive measures to ensure compliance with the alleged incapacitated's
medical needs such as having the family assist in getting the alleged incapacitated to treatment and
repeated calls to the alleged incapacitated have been attempted and have failed to secure long term
compliance with the needed treatment, resulting in the alleged incapacitated experiencing near death
situations and irreparable medical harm.
16. The alleged incapacitated has refused to execute a power of attorney.
17. Petitioner believes that the alleged incapacitated's parents are deceased and that the
presumptive adult heirs of the alleged incapacitated, their relationship to the alleged incapacitated,
and their addresses, are as follows:
Arthur Baum: husband (separated); 161 Mulberry Ave" Carlisle, PA 17013.
Arthur Baum: son; 161 Mulberry Ave., Carlisle, PA 17013.
Mary Buckenhower: daughter; 150 Pine Hill Road, Carlisle, PA 17013.
18. Petitioner believes that the alleged incupacitated's husband and son may not be the
most appropriate persons to act as her guardian, The alleged incapacitated's daughter has declined
to act as guardian. Petitioner is aware of no other presumptive heirs.
19. In order that the best interests and welfare of Nettie R. Baum are pursued, Petitioner
proposes that this Honorable Court select an appropriate person or governmental agency to act as
plenary guardian of the person,
20. Petitioner believes that the I1nanclal alTairs of the alleged incapacitated may be
adequately handled with the assistance of her family, as is currently being done, so that a guardian
of the alleged incapacitated's estate is unnecessary and, therefore, not sought herein.
21. No other Court has assumed jurisdiction in any proceeding to determine the
ineapacity ofNeuie R. Baum, other than with regard to the Emergency Petition.
22. Petitioner believes that the alleged incapacitated has not executed any living will or
health care directive.
WHEREFORE, Petitioner, Carlisle Hospital, respectfully respects that this Honorable Court,
after a hearing on the same, adjudicate that Nettie R. Baum incapacitated and appoint a plenary
guardian of her person.
Respectfully submitted,
MARTSON, DEARDORFF, WILLIAMS & OTTO
By -;~~) IIVd ~
Thomas 1. Wffliams, Esquire
1.0. No. 17512
W. Darren Powell, Esquire
1.0. No. 68953
Ten East High Street
Carlisle, PA 17013-3093
(717) 243-3341
Auorneys for Petitioner
Date: June 19, 1995
03/12/1994 14:01
SC'iT BY:/tlDl'lO
\
CARL HaSP CP SO: SER
11:14 ~&o-
FAGE 02
717 2~S 52~9:' 8: 6
717-245"'3~49
: e-19-fl!i
IN IW: NETTIE Jl. BAlM
IN THE COURl OF COMMON PLEAS OF
CUMBERLAND COUNTY, PBNNSYLVAN1A
ORPHANS' COlJRT DIVISION
AN AlLEGED INCAPACITATED PllllSoN
NO, 'J I . 95 . 4U.
VPRIFICATION
I, Diana O'NeU, Seni:!r Social Worker, Depanmcnt nr Social Work 5erv!CIU, Carli,le
Hospital, state thatlhe foregoing Petition i. hued upon intonnation which ~u bMll gathered by
colllllc:l. 1l1e lafliUlSCll ofme doculllellt i~ that oftollnsel and nat my IlWII. 111I"e read the Pelition
and. to the .,llent chat it is based upon information which I hi"" llUpr1ied 10 counsel, it i, llUB and
comet to the be.'llllfmy knowlq.. infonnation Ind b,lief Tn the alllent thlll the conlellC ofche
'cUtilln I>> thllt of counlcl, I have r~licd upon counsel in lIlaklng Ihi~ verification
This Itecemenc aOO \'Cfillcation i. made lIJblC\:tlo rhe penaJties of 18 Pa C, S. ~ 4904 relating
to unswgrn falsification to authorities
,();nntl ((;1.\4'/,
Diana O'NeI~ Senior Social Worker
Dept. Of Social Work Scrvicn
Carlisle Hospilal
EXHIBIT A
NO,
IN RE: NETTIE R. DAUM
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY. PENNSYL VANIA
ORPHANS' COURT DIVISION
PETITION FOR APPOINTMENT OF EMERGENCY at JARDlAN
PIJRSlJANT TO 20 Pa C S SSSI3
AND NOW comes CARLISLE HOSPITAL. Petitioner. by and through their counsel.
MARTSON. DEARDORFF. WILLIAMS & 0TTO. and petitions This Honorable Court for the
appointment of an Emergency Guardian under 20 Pa. C.S. 9 5513 for Nettie R. Baum. an alleged
incapacitated person. and in support therefore represents and avers as follows:
I. Petitioner. Cartisle Hospital. is a P~nnsylvania nonprolit corporation with a principal
place of business at 246 Parker Street. Carlisle. Cumberland County. Pennsylvania 17013.
., The alleged incapacitated person. Nellie R, Baum. is domiciled in Cumberland
County. Pennsylvania. with a residence at 2 West Penn. Apt;; 201. Carlisle. Pennsylvania 17013,
She is currently 68 years of age. having been bom on January 29. 1927,
3. Nellie R. Baum. the alleged incapacitated person. was recently admitted to Carlisle
Hospital. suffering from. IlIll!r alia. delirium. The alleged incapacitated person is suffering from
renal failure and requires regular kidney dialysis and other treatmclIl. Su.:h care is necessary to
preserve her life,
4, The alleged incapacitated person is incapable of understanding that she must maintain
regular compliance with her dialysis tr ,Jlment program and has refused treatment when she feels
well.
5, Nellie R. Baum also sutTers from a history of poor memory such that it affects her
ability to seek and continue the medical treatment and care necessary to preserve her life.
6. As a result olthe alleged incapacitated's inability to comprehend the nature of her
medical condition and the required treatment thereter. she has sutTered numerous episodes of
delusion and near death circumstances,
EXHIBIT "A"
7, Nettie R. Baum. the alleged incapacitated. has been examined by Rocco L. Manfredi,
M.D. who has concluded that the alleged incapacitated has lost the ability to receive and evaluate
infonnation effectively and to communicate her decisions to such a significant el<tent that she is
totally unable to manage her medical condition to meet essential requirements lor her physical health
and safety. A copy of Dr. Manfredi's report letter is attached hereto and marked as Exhibit "A".
S. The alleged incapacitated persons' mental and physical deterioration impair her from
fully understanding the significance of her actions and the actions and conduct of others around her.
9. The alleged incapacitated has refused to execute a power of attorney.
10. Without the prompt appointment of a guardian the alleged incapacitated person will
likely suffer irreparable hann and possibly death.
II. Petitioner believes that the presumptive heirs of the alleged incapacitated, their
relationship to the alleged incapacitated. and their addresses, are as follows:
Arthur Baum: husband (separated); 161 Mulberry Ave.. Carlisle, PA 1701:,
Arthur Baum: son; 161 MUlberry Ave.. Carlisle. PA 17013.
Mary Buckenhower: daughter: 150 Pine Hill Road, Carlisle. PA 17013.
12. Petitioner believes that toe alleged incapacitated's husband and son may not be the
most appropriate persons to act as Emergency Guardian. The alleged incapacitated' s daughter has
declined to act as Emergency Guardian. Petitioner is aware of no other presumptive heirs.
13. The Cumberland County Office of Aging with offices at 16 West High Street,
C.lrlisle. Cumberland County. Pennsylvania 17013. is an agency who may be appointed a guardian
under 20 Pa. C.S. ~5511(O,
14, Petitioner requests that the Cumberland County office of Aging be appointed
Emergency Guardian lor the alleged incapacitated and said office has consented to so act. The
Consent of the Cumberland County Office of Aging to act as Emergency Guardian is attached hereto
as Exhibit "B",
15, The proposed Emergency Guardian has no interests adverse to the interests of Nettie
R. Baum. the alleged incapacitated,
16. No other Court has assumed jurisdiction in any proceeding to detennine the
incapacity of Nettie R. Baum,
17. Petitioner believes lhatthe alleged incapacitated has not executed any living will or
health care directive.
WHEREFORE. Petitioner. Carlisle Hospital. respectfully respects that this Coun appoint the
Cumberland County Office of Aging to be the Emergency Guardian of the person of Nettie R.
Baum.
Respectfully submitted.
MARTSON. DEARDORFF. WILLIAMS & OTTO
By
Thomas J. Williams. Esquire
1.0. #17512
W. Darren Powell. Esquire
1.0. #68953
Ten East High Street
Carlisle. PA 17013-3093
(717)243-3341
Attorneys for Petitioner
Date: May . 1995
" ,--.."L'C ...
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Vl!RIPr~,\TlnN
J, Diana O'Neil, S..-or Sncial Worker, OepanmClll of SociAl Work Service., Carlbl.
HOIpital, do veri~ lhallhc ~l' made in the PelItion for Appointment of'ElnllfllCllll)' Guardian
PUfluantlD 20 Pa, e.s. !5513 Il'll true and corm:l I undcntml !hal filM Blatancn.. herein arc
madelUbJecc to Ihe pllllltin or 18 Pa. C.S. -490-4, rdaling 10 ullIworn lkI.illcation 10 autho1idea,
~ (Q/la'l D
Diana O'Neil, SCIllor Soc;jal Wortcer,
DepanmentllrSocill Worlc 9.MIla
BAUM, NErTlE R
318.W
MR #022228
Or. ~ocoo L, Manlrlldl
Dr. Gerald B. Mlrtln
O15l17'1QQ5
CONSULTATION TO:
ATIENDING PHYSICIAN:
DATE:
TYPE CONSULTATION:
IDENTIFYING INFORMAnON: Mill, Nattla Saum is a 67-vaar-old wnite I8plr.llld womln from
Carlisle. PennsylvaMIII where she lives alone. She hll a poor psychlatrtc history for an Inpatient pay-
cMla\l1c admllllon last month It the Cartllle Hospltlllor aellrlum. She was relemJd lor ccnsullatlon lor
assesament of mental compelency.
Mm. 8aum Is well known 10 me lrom ner previous inpatient psychiatriC admisalon. She hal o"n
conllistenll)t uncooparative With har medlcaltreatmen1 program, Her IlcIe of complllncelelCll Iha
pallent to severe physical debllltlUon and nas reaulted In near deal/1 on sevalll cecallona. Tha patient
appeara to hive I poor undllltlndlng of har situalion and the ImportincI of mainta.nlng IIgular com-
;:lIance with her dlllyall treltment program. She alStes lI1al when shl feell 'oNell. lIha does nOI faeltne
neea to have tha dlllylle, She lrial dalparo1ely to avoid the post dlaly"a discomfort thaI she expen-
encos. The palien~e lack of insight leadl her to clsarty dangerous levels of meoicel compllceho~s,
'MIen tha palienl does 1'101 have allljllll. It laadslO delirium I ~ave seen nar on aaveml occaslona in
Ihle etete 01 delirium. I hlvs allO recognl:ed her poor memol'llhat has re3ulted nOloi'll)' since nor
:erebrov8scular acclaenl bUlaccon:lIng I: :r.1I aaughtar's history. even llefore Ihls OVA occurrad.
gecause ollna patient's poor Juogem,nl. leCK ni Insight into her ",ealcal eondillon. poor compllanco
wlll1 her 'nadlC8l traulment program leading I' several ~ear dealh episodes and her Impaired memory
which leads her Ie; make IIrro" In scnlldullng and fcllowlng tnrough wilh lh'l scnedullng ot har dilly liS,
I strongly balleve thla pltlentls ;r.ca~sCltalad. That I~, I Celleve Mrs. 80um r.aa 1011 me ability I?
receive end evaluate Information er'3C\ivaly snd Ie communlcole hsr aecislona to such a slghlfiearl
exlent that SIle la 101.fly unable to manage her medical condition 10 meet IIsSenlial reqUilemenl9 fcr
har physlcel helllh and salel'f.
I hope Ihallhla Informalion Is helpful 10 you in your WOhl \Vlln Mrs 8a~r11. III may ollurther assis-
tance, please comael my office.
RLM/bka
0; 05117/1996 . 0&;35 pm
T; 06/18/1996
co Dr. Rocco L. Manfraal
Dr. Garald 8, Mun'n
~occo L Manlredl. M,O
~ ' 1 " " ~ ~ . ~. 'I l 7 ... It':
~'.lr~..<l.. .. ^ ~t'1N 'fI-. it
~:.''''''..'I: :!.r:ll~\LL. ilA
II'Q~ l . .r(f.l1~~ ,.
~4~~~~b 022228
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Page 1 01 1
'JRIGINAL
CARLISLE HOSPITAL
CONSUL TATION
evularr a
IN.RE: NBTl'IE R. BAl'M
an a1lepd ~ullld penon
IN THE COUIlT 01 COMMON PLHAS
CUMBEIU.AM) COUNTY, PENNSYLVANIA
OllllHANS' COUllT DIVISION
NO.
fnNRPNT cu: PAnPOC:lin RU)JIl(;~N~Y faJAllnL\N
I, L ;~H'''M ;::- ~ '1""'"'1 . bcJJIa -!Z.,~/! ;",. of tIIc
cumbortlllXi COWI&)' 0IBc0 of Apz do state thlIt lha CwabaIand Counly Office of AJpna haI
co_eel 10 be lIflllolllleo IIId ad U ~ CNwan ollht penoII oiNllttIl R. Baum, 11\
aIIIpd Incapacila&ecl perIOD.
CUMBI!IU..AND COUNTY OFFICE OP AGlNO
~' . ~~ '~
:BY: I ~ "h7A r,::/' Wilj/
ExhlOit. "9"
,.. . .., . ---~--~..-.-. -'-,-~"'~---'-'-"- -. '..'~..,....~
IN RE: NETTIE R. BAUM
an alleged incapacitatcd person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 0)/ - q$ - 1/-~f.t,
-
DECREE OF COURT
AND NOW, this 7' day of 3"...... , 1995, aftcr hearing on the within Petition for
Appointment for Emergcncy Guardian, the same is granted and the Cumbcrland County Office of
Aging is hereby appointed as Emergcncy Guardian for the Iimitcd purposes of I) making all gencral
and health care decisions for the incapacitated and providing all conscnts necessary thercfore, and
Z) "".kit'l> "II nlllinteRBRe.:. A"d ellstod, decisions regarding tl." ;"~lll'lldllllea person, and 3)-
_ dcsirnnling nn npproprinlp plUtO fllr the iR~opo~i'nt~rl 10 livp ~aid guardian shall serve in that
capacity until I'l_ 1.1"", ,.:1"...... /if', ] 995, which period may be cxtendcd by further Ordcr of
Court. fl" a. 5>/1 r-h'h;. .... r,'{. J tt...... 7;;",. ~/ f.cJv. E'1' ..:
10 ./I.... ,u/<<uJ ,.'~...:~eI )'U)~.
'}r,o?';1 '7'J4t.-1- I
BY THE COURT,
.Al-
J.
A T'AUE(X)J'Y FOOM ~
IIlT.vmony~. r ~_ haftd
~ tilt IeeIf t)f 1!Cld C'etort at C8rtIele, ~
.,.",........::~a...PIf 01 9J4lJL.. III 9.d
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VrCll8f1l ot t~ Orphanl Court j-
-'-.--.... . Qllnllerland County
\
IN RE: NETTIE R. BAUM
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. c5) I - q.s - tI- cl ft;
,
DECREE OF COURT
AND NOW, this 7' day of J".....,. 1995, after hearing on the within Petition for
Appointment for Emergency Guardian, the same is granted and the Cumberland County Office of
Aging is hereby appointed as Emergency Guardian for the limited purposes of I) making all general
and health care decisions for the incapacitated and providing all consents necessary therefore, and
:::) ulakino ull J,ulinteRaR'~ ulld GtutoO) d,ti!ioI13 regarding th", ;1l~u}Jadlalea person. and J)
_ design"ling "n "ppropri"tf' pb~g fer the iRr.ppneitnt",1 10 livl' ~aid guardian shall selVe in that
capacity until 12. 1)11 '" ,.:1'...... /'1-', 1995, which period may be extended by further Order of
Court. fr a. 5>11 rh'll't- -'" n'/'.t f1-- 7>'-0, ~I J'..u-. Er" ,.;
10 .J.<.. .u/<<ui I.'~'" :we:eI 1'tJ>~'
'Yr'?;; '7'14<...1- /
BY THE COURT,
.41-
"
J.
,
A TRUE (X)fty FROM fl~
'n T_mony~. , he/OUll1l)"",, tlaftd
MIl tfIt IlIl:Jl ,~ \9;'tld CCI..'ft i1t Car1l$le, PA
1JIM.....Zd, PUt IJI OJ41/l; 1A lid
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'C'~ '7n11.~:. t!.o vr..I.~j"'-~ :"It- ) I' ~ ~..ic
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Q.IInberland ~nly
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EXHIBI'!' liB"
..
CERTIFICATE OF SERVICE
I. hereby certifY that a copy of the foregoing Petition was served this date by hand delivering
the same as follows:
Daniel J. Sodus, Esquire
Sodus & Verney
7 Irvine Row
Carlisle, PA 17013
MARTSON. DEARDORFF. WILLIAMS & OTTO
By Lu.O~~L
William D. Powell. Esquire
Ten East High Street
Carlisle, PA 17013
(717) 243-3341
Attorneys for Petitioner
Dated: June 19. 1995
-""-"~""I~''-~'''''''---''>.~''~' ~.".
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8
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Q And in that capacity have you come to provide
those services for Mrs. Nettie Baum?
A Yes.
Q When did you first become involved with Mrs.
Baum?
A I believe the first time I met her is about
in 1991.
Q Now, you also work with her attending
physicians including Dr. Martin, do you not?
A That's correct.
Q And you are aware of the treatment that she
needs?
A Yes.
Q And what has been your experience with her as
far as getting her to do that treatment?
A As Dr. Martin stated, it has been very
inconsistent. She has been regularly non-compliant over the
last several years, but, as he stated, there has been a
marked change in that since her stroke in March of this
year, in that she has become more non-compliant.
Q Were you involved in her transfer to the
Chambersburg Rehab Center?
A Yes.
Q And would you tell the court how that went
over?
21
~
SHERIFF'S RETURN - REGULAR
CASE NOI 2195-00426 0
COMMONWEALTH OF PENNSYLVANIA I
COUNTY OF CUMBERLAND
IN REI NETTIE R BAUM ET AL
VS.
MR ARTHUR BAUI1
MICHAEL BARRICK . Sheriff or Deputy Sheriff of
CUMBERLAND County, Pennsylvania, who being duly sworn acoording
to law, says, that he served the within SUBPOENA
upon BAUI1 ARTHUR (HUSBAND) the
defendant, at 1707100 HOURS, on the 10th day of Auaust
19~ at 161 I1ULBERRY AVENUE
CARLISLE, PA 17013 ,CUI1BERLAND
County, Pennsylvania, by handing to ARTHUR BAUM
a true and attested copy of the SUBPOENA
and at the same time directing His attention to the contents thereof.
Sheriff's Costs I
Docketing
Service
Affidavit
Surcharge
So answers I ~ ~/~
~ ~ :.e<: (K~
1 ~
H. Thomas K.L1ne, ~her1
18.00
5.60
.00
2.00
$25.60 "ARTSON DEARDORFF
08/14/1995
by
Sworn and subscribed to before me
().~
this J Q day of
19~ A.D~
~r- o!~~1s ~ourt
c
.
SHERIff'S RETURN - NOT FOUND
CASE NOI 2195-00426 0
CO\'l\'lONWEALTH OF PENNSYLVANIAI
COUNTY Of CU\'IBERLAND
IN REI HETTIE R BAUK ET AL
VS.
tlR ARTHUR BAU\'I
R. Thomas Klin9
. Sheriff. who being duly sworn according
diligent search and inquiry for the within
BUCK EN HOWER \'IARY
Her in his bailiwick. He therefore returns
to law. says, that he made
named defendant. to witl
but was unable to locate
the SUBPOENA
N~: :~~~~ . as to the within named defendant
R K __ER MARY
SEVERAL ATTE PTS AT SERVICE WERE \'lADE BUT WE
COULD LaC TE ANYONE AT THIS ADDRESS.
Sheriff's CostSI
Docketing
Service
Af! idavit
surcharge
So answers I......,/, ,. ~tt
~~ .," 1,f.' ,.M,'
R. .lno as 1\.L1ne, 1:ineri.:t%
6.00
.00
.00
2.00
S8.~~ \'IARTSON DEARDORFf WILLIA\'IS
06/14/1995
Sworn and subscribed to before me
this /05 day of aU:JM-nl:
19 q,5- A. D.
(\--; fiAJ~~ ~~~
.~, .lerK 01 rpnBn l.iourt
SHERIFF'S RETURN - NOT FOUND
CASE NOI 2195-00426 0
COMMONWEALTH OF PENNSYLVANIA I
COUNTY OF CUMBERLAND
IN REI NETTIE R BAUM ET AL
VS.
MR ARTHUR BAUM
R. Thomas Kline
to law, says, that he made
named defendant, to witl
but was unable to locate
, Sheriff, who being duly sworn according
diligent search and inquiry for the within
BAUM ARTHUR (SON)
Him in his bailiwick. He therefore returns
the SUBPOENA
NOT FOUND , as to the within named defendant
BAUM ARTHUR (SON)
MR. BAUM NO LONGER LIVES AT ADDRESS STATED.
Sheriff's CostSI
Docketing
Service
Affidavit
Surcharge
So answers I
r:;t~~,.(; 'jdtfr-t.'
R. Thoma' ine, Sheri j;
6.00
.00
.00
2.00
$6.00 MARTSON DEARDORFF WILLLIAMS
08/14/1995
Sworn and subscribed to before me
this J S' day of n.tt '1". "J;
19 q 5" A.D.
~~k'"o~;;'l.. Om'
IN RE: NSITIE R. BAUM.
an alleged incapacitated person
Or~hans' Court Division - NO. 21-95-426
.'
SUBPOENA
Cumberland County, SS:
TO:_-1:!!!:Jlarv B.!!.,*_lillbmLltr
150 Pine Hill Road
Carlisle. PA 17013
GREETING:
We command you and each oC you, that, setting aside all manner oC
business and excuses, you be and appear in your proper person beCore
our Judges at Carlisle, at our County Court oC Common Pleas, Orphans'
Court Division, there to be held in the County oC Cumberland, on the
11th day oC Auqust 19~ at ....L:3{L.g.M.
[prevailing time] oC that day, to testiCy all and singular those things
which you shall know in a certain inCormation Cor the mental caP'l.~i.tYn2!..
Nettie R. Baum.
Failure to appear may result in the initiation oC contempt oC court
proceedings against you and/or issuance oC a bench warrant to secure
your presence.
WITNESS the Honorable Harold E. Sheely,
President Judge, at Carlisle, the 7d
day oC ((.f{~(.d:__ A.D. ONE THOUSAND
~E HUNDRED and -J2Mi.e..li.? '-1~~_
" ,/ (/ /
.. fll.~rJ.",.t..,_~Y~ItYdl~t~-!i/.~dt.mlL2r4~"4I-
CL~RK OF"URPHANS' COURT r/
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IN RE: NE'l'TIE R. MUM,
. an alleged incapacitated person
Orphans' Court Division - No. 21-95-426
SUBPOENA
Cumberland County, SS:
1rO:~~thur Saum, Jr.
161 East Mulberry
Carlisle, PA 17013
GREElrING:
We command you and each of you, that, setting aside all manner of
business and excuses, you be and appear in your proper person before
our Judges at Carlisle, at our County Court of Common Pleas, Orphans'
Court Division, there to be held in the County of Cumberland, on the
11th day of AUQust 19.95- at 2:30 p.M.
[prevailing time] of that day, to testify all and singular those things
which you shall know in a certain information for the mental caJ.Xl",tty.of_
Nettie R. Saum.
Failure to appear may result in the initiation of contempt of court
proceedings against you and/or issuance of n bench warrant to secure
your presence.
WI1rNESS the Hono-ro.hle Harold E. Sheely,
President Judge. al Carlisle, the '1.-cL
day of (1(~.,.c- A.D. ONE 1rHOUSAND
NINE HUNDRED and 7u.',.u."j/' klLJ.!/
3;fi~If~'o16flltifNS~t ci-{(f~~L4J:Y-
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IN REI
I IN THE COURT OF COMMON PLEAS OF
I CUMBERLAND COUNTY, PENNSYLVANIA
I ORPHANS' COURT DIVISION
I
I
I NO. 21-95-426
NETTIE R. BAUM,
AN ALLEGED INCAPACITATED
PERSON
IN RE I TEMPORARY GUARDIAN APPOINTED
ORDER OF COURT
AND NOW, this 11th day of August, 1995, Mary
Buckenhower is appointed emergency temporary guardian of the
person of Nettie Baum, alleged incompetent, until further
hearing in this matter, which is herewith set for August 24th,
1995, at 1130 p.m.
By the Court,
./lIL
W. Darren Powell, Esquire
For Petitioner
Daniel Sodus, Esquire
For Nettie R. Baum
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I N D E X
2 WITNESS
DIRECT CROSS REDIRECT RECROSS
3 MICHAEL S. GREEVY
3/7
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EXHIBITS
DESCRIPTION
PAGE
Curriculum Vitae
7
10
14
2-Pg. Report of Consultation
4-Pg. Report of Consultation
C.P.C.R.S. (717)258-3657
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STIPULATION
It is hereby stipulated by and between the
respective parties that signing, sealing, certification
and filing are waived.
MICHAEL S. GREEVY, Ph.D., called as a witness,
being duly sworn, was examined and testified as follows:
DIRECT EXAMINATION
(As to Qualifications)
BY MR. POWELL:
Q Good morning, Dr. Greevy.
A Good morning.
Q My name is Darren Powell. I represent Carlisle
Hospital in this matter. This matter involves the
appointment of a guardianship for Nettie Baum.
Have you given a deposition before?
A Yes, I have.
Q Then you understand that you've been sworn,
you're under oath and this allows us to ask you some
questions which you will provide the answers to?
A Yes.
Q These questions and answers are being taken
down by the court reporter.
A Yes.
C.P.C.R.S. (717)258-3657
4
~
1 0 Therefore, it's very important that you answer
2 every question verbally rather than with a gesture, which
3 is hard for the court reporter to take down.
4 A Yoo, 1 undorotand.
5 0 If you don't understand or if you do not hear a
6 question, please indicate that to me and I'll be happy to
7 eithor rephrase it, repeat it or whatever should need to
8 be.
9 A I'll do that.
10 0 Could you please state your full name and spell
11 your last name for the record?
12 A Michaol Scott Greevy, G-r-e-e-v-y.
.::. 13 0 And your occupation, Dr. Greevy?
14 1\ I'm a psychologist.
15 0 Are you licensed in any state?
16 A 1 'm licensed in Pennsylvania.
17 0 Could you briefly tell us about your
18 educational background?
19 A I went to Lafayette College as an
20 undergraduate, graduated with a major and honors in
v
21 psychology, cum laude. Then after a year as a house
22 parent in a children's home, went to Ohio University in
23 1973; was on campus there from '73 to '77; got my master's
24 in psychology, clinical psych in '76; and then did my
25 predoctoral internship, which is a requirement for the
C.P.C.R.S. (717)258-3657
1 doctoral degree, at Harvard University from '77 to '78;
2 completed my dissertation while I was working here in
3 Harrisburg, and received my doctorate in clinical
4 psychologist in 1980.
5 0 As part of your Ph.D. program at Ohio
6 University, did you do a predoctoral internship?
7 A Yes, I did a predoctoral internship at Harvard
8 University.
9 0 And what were your areas of focus during your
10 Ph.D. program?
11 A My greatest area of focus, in addition to the
12 broad based background in psychopathology assessment and
13 psychotherapy, was geriatrics. specifically, counseling
14 and psychotherapy, as well as assessment. I did both my
15 master's thesis and my doctoral dissertation on the
16 development of an assessment tool for use with the
17 elderly. My specialty topic for my predoctoral oral
18 comprehensives was an assessment of the elderly.
o And had you received your Ph.D. in 1980?
A That's correct.
o And where did you begin working after that?
A I went to the Harrisburg Hospital Mental Health
Center and stayed there or at sister facilities attached
to Harrisburg Hospital in the Capital Health system until
August of 1992, which would have been three years ago.
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C.P.C.R.S. (717)258-3657
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o And what were your duties or responsibilities
thoro?
A Well, they varied over the years. I began as a
sta(( psychologist, later became chief psychologist, later
became director of the division of psychology services
and, in fact, was involved in the development of the
division of psychology services. I was responsible for
either the supervision of and coordination of or
supervision of all of the psychology services available
through the Harrisburg Institute of psychiatry and Capital
psychiatriC and psychological Associates. I supervised
psychologists in training. I supervised interns and
supervised general staff there, as well as providing the
whole range of clinical services and programmatiC input as
15 well.
16
17 manager
10 system.
19 0
20 A
I did spend a year and a half as the market
for the geriatric services for the Capital Health
21
22
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What did you do when you left there?
I joined the partnership of Commonwealth
Affiliates where I'm continuing to work.
o And in your responsibilities today, or at the
present, do you travel between certain nursing homes in
the area?
A Yes, I do. I have consulting contracts right
c.P.C.R.S. (717)258-3657
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Q
1 now with three area nursing homes, as well as the Area
2 Agency on Aging, as well as United Cerebral Palsy to do
3 their preadmission screening for developmental disorders.
4 But in terms of the traveling, it is to three nursing
5 homes. Typically, if the Triple A has a preadmission
6 admission to do, they come here. But I've gone to the
7 State Hospital to evaluate individuals prior to discharge
8 there.
7
Q Would it be fair to say that a significant part
of your professional time is spent consulting with older
patients for geriatric psychology?
A Yes, it is.
MR. POWELL: I would now offer Dr. Greevy as an
expert in the area of psychology, if you have any cross as
to expertise.
MR. SODUS: No.
MR. POWELL: I have asked Mr. Sodus and he has
stipulated that we will mark thG curriculum vitae of
Michael Scott Greevy into evidence.
(Greevy Deposition Exhibit No.1 was marked.)
DIRECT EXAMINATION
BY MR. POWELL:
Q Now, Dr. Greevy, in your duties as a
25 Baum?
psychologist, when did you first become aware of Nettie
C.P.C.R.S. (717)258-3657
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t"""'\ 1 A The morning of Friday, August 11th.
2 0 And where was that?
3 A At the Leader Nursing facility in Carlisle.
4 0 And could you tell us how you became aware that
5 there was a need for a consultation or a desire for a
6 consultation?
7 A I go out to the Carlisle Leader every other
8 Friday morning. I arrived there about 9:00 or so. I meet
12
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9 with Charlie Lamp who is director of social services
10 there, and he tells me what to expect for the day. And it
11 was at that time that he said that he had a resident that
was actually going to be attending a hearing that
afternoon to determine her competency and he would like me
to see her.
o As part of your visits to these nursing homes,
do you regularly provide consultations to some of the
residents?
A Yes, I do. That is essentially what I do.
o And as part of the consultation process, do you
regularly review the charts or patient files and consult
with staff?
A Typically I meet with staff, either Charlie
23 Lamp, or I also work on their Arcadia unit and speak with
24 their director. I then go to the unit and review the
25 chart and speak with available staff there.
C.P.C.R.S. (717)258-3657
9
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I Q Did you follow this process with your
2 consultation of Nettie Baum?
3 A Yes, I did.
4 Q Did you take notes regarding this consultation?
5 A Yes, I did.
6 Q Dr. Greevy, I'm showing you a two-page document
7 which on the top states, report of consultation, and on
8 the bottom there is a signature. Is that your signature?
9 A Yes, it is.
10 Q The date beside that is what?
11 A 8-11-95.
12 Q And does this two-page document accurately
13 reflect some of the notes that you took during your
14 initial consultation?
15 A These are not the notes that I took. This is
16 my consultation report after my first two attempts to meet
17 with and interview Mrs. Baum.
18 As I meet with the staff and as I review the
19 chart, I scribble some notes down and then use those notes
20 to write the consult report from. So this is the actual
21 consult that goes on the chart.
22 Q So this is something you regularly do?
23 A Yes, in every instance.
24 MR. POWELL: Unless there is an objection, I
25 would have this marked as Greevy Exhibit Number 2.
a
u
C.P.C.R.S. (717)258-3657
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MR. SODUS: Fine.
2 (Greevy Deposition Exhibit No.2 was marked.)
3 BY MR. POWELL:
4
Q
Dr. Greevy, what information did you find
5 regarding your initial review of the chart for Miss Baum
6 and any consultations you may have had with staff at
7 Leader?
8
A
That Mrs. Baum had a history of renal failure;
9 that she had received dialysis treatment; that there was a
pattern of her refusing this treatment; and that she had
had multiple episodes of delirium, supposedly as a direct
result of her renal failure and lack of dialysis
treatment; that she had been admitted to Carlisle Hospital
as well as discharged against medical advice; that she was
seen by a psychiatrist at Carlisle Hospital, Dr.
Manfredi.
I did read what I felt was a brief report on
18 his part where he states that it was his impression that
19 due to her poor memory and mental deterioration, that she
20 was not competent. He also reports that she had a prior
21 stroke, although at that time I did not know when. I have
22 since learned, I believe, that it was in March of '95;
23 that he had also spoken with her daughter and that her
24 daughter had stated that she had shown some mental
25 deterioration and memory impairment prior to that stroke.
C.P.C.R.S. (717)258-3657
11
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1 I was aware that there was a past temporary
2 guardianship, I believe, awarded to Cumberland Perry
J Triple A; that the physicians had recommended a continuous
4 dialysis treatment were she in a nursing home. I also
5 learned that she was separated from her husband; that she
6 frequently refused her medications and her inhaler; that
7 the nurses viewed her to be not oriented to place or time,
8 but oriented to person, and suffering from a memory
9 impairment as well.
10 Q And after your review of the notes and
11 discussions with your staff, did you attempt to actually
12 consult with Nettie Baum?
13 A Yes, I did. I entered her room. She was in
14 her bed, under her covers, lying in the fetal position.
15 In response to hearing her name, she was alert. She
16 opened her eyes. She looked at me and said, leave me
17 alone, go away. I explained why I was there. And over
18 the next ten or fifteen minutes in every instance, she
19 asked me to leave, told me that she didn't want to talk,
20 that no one could help her.
21 At that point an aide entered the room
22 intending to bathe her and dress her, and I left, hoping
2J that after she was up and dressed and bathed, that she
24 might be more responsive.
25 Q Did you approach her later on that morning?
M
w
C.P.C.R.S. (717)258-3657
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1 A About 15 minutes or so later, I went back to
2 the room after I saw the aide leaving the room, thinking
J that she was dressed and bathed. She was still laying in
4 bed, and the aide came back and said that she had refused
5 all care. Her response to me was unchanged. She asked me
6 to leave repeatedly at one time, turned over and faced
7 away from me. At that point I realized that it was not in
8 her best interest for me to continue, nor was I likely to
9 get any useful information.
10 Q At that point you terminated your consultation
11 with her?
12 A I terminated that consultation and went on to a
13 different resident.
14 Q And at some point later that morning did you
15 indeed conduct a consultation with Nettie Baum?
16 A Yes, I did.
17 Q How did that occur?
18 A I was about to move to another resident and
19 Mrs. Baum's attorney approached me and asked me, would I
20 attempt to see her again.
21 Q And had you agreed to attempt this?
22 A Yes, I did.
23 Q And what was her demeanor during this
24 consultation?
25 A As I entered the room, she was sitting up with
--
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a gown on, sitting up on the edge of her bed. She did
look at me initially, said that she was willing to answer
my questions. I would say that her demeanor was gruff,
that she was generally impatient and on edge or irritable.
o Did you take notes regarding this consultation?
A Yes, I did.
o Did you use those notes to prepare a report of
consultation?
A Yes, I did.
o Dr. Greevy, I am showing you a four-page
document which I have previously provided to Attorney
Sodus.
It is the second --
MR. SODUS: Okay.
BY MR. POWELL:
o Is that an accurate copy, a reproduction of
your report of consultation with Miss Baum?
A The first two pages are my -- is my
consultation from the second contact. Really, the only
way to differentiate the two is that you see the first
line of the second consult says, please refer to today's
other consult. And the last two pages of the four are the
Mini-Mental State Examination forms.
o Was that test administered during that
consultation?
C.P.C.R.S. (717)258-3657
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Q
'iI
14
1 A Yes, it was.
2 0 And are the results on there accurate of the
3 results that were given?
4 A Yes, they are.
5 MR. POWELL: If there is no objection, I'll
6 mark this as Greevy Exhibit Number 3.
7 MR. SODUS: No objection.
8 (Greevy Deposition Exhibit No. 3 was marked.)
9 BY MR. POWELL:
10 0 Dr. Greevy, you've just referred to a test
11 which you administered to Miss Baum. Is that correct?
12 A That's correct.
13 0 And you referred to that as the Mini-Mental
14 State Examination?
15 A More commonly referred to as the Mini-Mental
16 Status Examination, yes, but it is the same thing.
17 0 And you administered that test to Miss Baum?
18 A Yes, I did.
19 0 And what's the nature of that test?
20 A It consists of four sections. The first
21 section has to do with orientation; secondly, attention
22 concentration, language comprehension and usage.
23 0 And how did she score on that test?
24 A Out of a possible score of 30 she obtained a
25 score of 10.
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o
15
1
Q
Okay. With regard to the Mini-Mental state, or
2 Mini-Mental Status Test, I have provided to you what I
3 have marked as Greevy Exhibit Number 3. The third page of
4 that document appears to have her results. Is that
5 correct?
6
A
That's correct.
7
o
Could you just briefly go through those results
8 for us, beginning with the first one under orientation?
9
A
The first section under orientation requires
10 her to recall the year, the season, the date of the month,
11 the day of the week and the month itself.
12 She was only able to correctly identify the
13 season. She stated that it was summer. The year she said
14 nineteen and then said she didn't know. In terms of the
15 date, day and month, she said that she didn't know. She
16 doesn't really pay that any mind.
17 She is then asked for information about the
18 state, the county, the town, the hospital, the floor. She
19 stated that she did not know the state or the county we
20 were in. She suggested that the town was Harrisburg or
21 perhaps Camp Hill, knew that she was in a nursing home but
22 did not know the name and did not know her room number.
23 I then asked her to name three objects or
24 repeat three objects that I state. The three objects were
25 pencIl, book and street. She was able to recall all three
. .
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1 of them immediately. In other words, I would say those
2 three and immediately she stated them back. So, out of a
3 possible 13 points in orientation, she obtained 4.
4
And how about under attention and calculation?
Q
5
A
On attention and calculation, the first task
6 can be given in one of two ways. She either is asked to
7 count backwards from 100 by 7, for example, 100, 93 and so
8 forth, or to spell world backwards. I first asked her to
9 subtract 7 from 100, and she stated that she did not know
10 the answer to that. I then asked her to spell world
11 backwards, and her response was w-l-d. I'm not certain
12 that she understood the concept of backwards. So she
,"'"""-..
t" )
_..~..4
13 received no points for that task.
14 The second section of this asked her to recall
15 the three items from the previous test and she could
16 recall none of those three. Interestingly, her first
17 response was 7, clearly a perseveration from the
18 subtraction task previously. So out of a possible 8
19 points for attention and calculation, she received zero.
20
And under languages?
Q
21
Under language usage, I showed her two objects
A
22 and asked her to recall or to state what they were. She
~
23 got one of the three. She recognized the clock. She
24 named a clock and could not name a pen. She is then asked
25 to repeat the following: No if's, an's or but's. She did
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17
I that without error.
2
I asked her to follow a three-stage command;
3 she was able to do that without error. I asked her to
4 read a sentence. The sentence said, close your eyes. And
5 I asked her to do what the sentence told her to do, and
6 she did not close her eyes.
7 I asked her to write a sentence and the
8 sentence she wrote there, interestingly, was, I love you.
9 I asked her to copy a design, and her copy was not
10 sufficiently accurate or complete to receive any points on
II that. So the possible 9 points on language usage, she
12 obtained 6. That led to a total score of 10 out of 30.
13
Q
She scored, again, a total of 10 out of a
14 possible 30?
15
A
That's correct.
16
Q
And I note on the bottom of the Mini-Mental
17 State Exam form it says, non-demented patients usually
18 score between 24 and 30; patients who have Alzheimer's or
19 senile dementia generally score below 20. In your
20 experience, is that statement accurate?
21
A
I think that that's generally accurate. Again,
22 they're talking about usually and generally. But I think
23 that that's accurate, yes.
24
Q
Given Nettie Baum's score on the Mini-Mental
25 State Examination, do you believe that her memory is
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1 significantly impaired?
2
A
Well, it is more than her memory. She does
3 have a significant memory impairment. Her orientation,
4 her attention and calculation is all severely impaired.
5
Q
During that consultation, did you also
6 administer any other tests?
7
A
Yes, I did. I administered two subtests of the
8 Wechsler Memory Scale Revised. Those two subtests were
9 the subtests that comprise the verbal memory subsection of
10 the Wechsler Memory Scale.
11
Q
And what is the nature of that test?
12
A
The Wechsler Memory Scale Revised has four
)
L
13 sections. The first section has to do with attention and
14 concentration, the second has to do with verbal memory,
15 the third has do with visual memory. And then there is a
16 test of delayed recall which involves readministering four
17 of the subtests that had been administered previously.
18 Again, I administered only the verbal memory subtests.
19
Q
Okay. And how did she score on those two
20 verbal memory subtests?
21
A
Do you want her general score, or would you
22 like me to describe the specifics?
23
Q
Why don't you go through and describe the
24 specifics for us?
u
25
A
The first memory task is called logical
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19
v
I memory. It consists of two short stories which are read
2 to her under the instruction for her to listen carefully
3 because I'm going to ask her to recall as much of this as
4 possible.
5 I then recite the first story and ask her what
6 part of that she is able to recall and wIll give some
7 hints if necessary. I note the pieces of information that
8 she recalls accurately.
9 I then read her the second story under the same
10 instruction. And when I'm finished, I asked her what of
II that information she's able to recall and score in the
12 correct pieces of information.
13 Total possible score is 50. Each story has 25
14 what are considered to be discreet pieces of information.
15 She recalled two pieces of information from each story.
16 That led to a raw score of 4 out of 50.
17 The second task is a visual paired associate
18 learning task. This consists of eight pairs of words, two
19 words together, and this is administered under the
20 direction for the individual to listen carefully to each
21 pair because when I am finished, I will ask them to recall
22 the second word having given them first. And in fact, I
23 have residents, subjects, repeat the word pairs just to
24 make sure that hearing is not a potentially compounding
25 variable.
~
t':)
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1
There are four what are considered to be easy
2 associations, things like rose/flower, baby/cries. And
3 there are four difficult or nonsense associations like
4 cabbage/pen.
5 I ask her to repeat each pair after me and then
6 I give her the first word of a pair and ask her to recall
7 the word that went with it. Interestingly, the first word
8 that I gave her was fruit and her response was pear. The
9 correct response being apple.
10 During the testing phase then, I will give her
11 the correct answer if she is incorrect and I will tell her
12 if she is correct, because it is a learning task.
,"'........
)
13
We then study them again, having her repeat the
14 words and I test her again under the same administration
15 directions, correcting incorrect responses, and then we
16 study a third time and I test her a third time. Her score
17 is the number of correct associations that she recalls.
18 On the fir.st time through she recalled zero of
19 the 8. On the second time through, she recalled 2 of the
20 easy associations. And on the third time through, she
21 recalled none of the 8. That led to a score of 2.
22 Q And how does that score relate to, say,
23 others? How is it scaled?
24
That particular subtest is not scaled. We add
A
'-.-J
25 the two subtests together for a total verbal memory score,
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20
21
"'1
1 and it is that score that is then compared to the
2 normative data for her age group.
3
4
o
What were the totals from the two tests?
A
What we come up with then is what is called a
5 memory quotient. And this is done by comparing her raw
6 scores to the normative data for her age group. She is
7 68, so that data would be the 65- to 69-year-old age
8 group.
9
o
What was her memory quotient?
10
A
Her verbal memory quotient was 51. To give
11 that some meaning, you need to understand that all of
12 these scores have a mean of 100 and a standard deviation
OJ
...d'"
13 of 15, just like the 10 test. People are more familiar
14 with 10 tests. So that a 51 would be comparable to a 51
15 10 when it comes to a verbal memory on this task. It's
16 three standard deviations below the mean, greater than
17 that actually, and is reflected by the severe impairment
18 of her memory.
19
o
And were the results from the Wechsler subtests
20 consistent with results from the Mini-Mental State
21 Examination?
22
A
Yes, it is what we would expect, based upon the
23 Mini-Mental Status.
24
o
I see in your consultation report you state
.~
25 that emotional and situational factors may have
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1 contributed somewhat, although you feel that organic
2 factors were the primary contributors?
3
A
That's correct.
4
o
Could you elaborate on that for me, please?
5
A
Yes. Whenever I evaluate an individual, I am
6 aware that their performance could be due to multiple
7 factors. It is part of my task not only to be aware of
8 those factors but to have a sense on how they might be
9 affecting one's performance.
10 Situational factors have to do with the setting
11 in which the tests are administered, as well as the
12 rapport or the relationship that is established with the
(J
0,";..._
13 examiner.
14
The situation with Mrs. Baum was that she was
15 laying in bed in a nursing home. And her rapport with me
16 was not a comfortable one. So certainly I think that
17 those situational factors led to relatively low motivation
18 on her part, and that did concern me.
19 The emotional factors have to do with the mood
20 the individual is in. And I was concerned about possible
21 underlying depression for her. I am aware that there is
22 such a thing as pseudodementia, or false dementia, that
23 when the elderly get depressed, symptoms of that
-.....)
24 depression often can mimic a dementia in that you can have
25 impaired short-term memory.
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1
o
okay.
2
A
So I was concerned that those factors may have
3 played some role in her poor performance. However, my
4 total evaluation of all the data leads to my clinical
5 impression that there are significant and major organic
6 contributing factors.
7
o
And do the tests confirm your opinion of the --
8 that this is primarily based upon organic factors?
9
A
Yes, I believe it is primarily based upon
10 organic factors.
11
o
And is there anything built into the tests that
12 would allow you to perhaps distinguish whether it was -- I
')
.~....
13 think you called it pseudodementia?
14
A
That is an excellent question. Actually, if we
15 go back to the visual paired associate task, which is a
16 learning task, it is believed that individuals with a
17 pseudodementia or emotionally based factors affecting
18 their memory do have the capacity to learn, and that
19 individuals whose primary impairment is related to organic
20 factors tend to not to show improvement across trials. So
21 that is one of the subtests that I always look at to try
22 to difterentiate between emotional and organic factors.
23 Again, that being whether or not they are able to learn
24 with feedback over trials. Her pattern is very
.-.)
25 inconsistent. She got zero of 8, 2 of 8 and, again, zero
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8
9
10
11
12
fi) 13
~
14
15
16
17
18
19
20
21
22
~
.
24
1 of 8.
2
o
And that was on the Wechsler?
3
A
That's on the verbal pairod associate task of
4 the Wechsler Memory Scale. That is consistent with more
5 of an organic presentation.
6
o
Again, her verbal memory quotient was 51. Is
7 that correct?
A That's correct.
o And does that indicate a significant impairment
in her memory?
A That's severe.
o Severe impairment?
A Yes.
o Within a reasonable degree of psychological
certainty, in your opinion does Nettie Baum suffer from a
significant degree of memory impairment?
A Yes, she does.
o Within a reasonable degree of psychological
certainty, is Nettie Baum able to consistently understand
and recall information that is necessary to communicate
competent judgment or decisions?
A It is my opinion that as of the date that I saw
23 her, she was not able to do that.
24
Again, based upon a reasonable degree of
o
25 psychological certainty, upon your review of the patient's
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25
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
file, history and consultation, is it your opinion that
Ms. Baum's mental condition would likely significantly
improve in the future?
A I would hope that were there a depression, were
that to resolve, that there might be some improvement. I
would hope that under better testing circumstances, given
environment and rapport, that there might be some
improvement. I do not think that even under ideal
situational or emotional factors that her memory would
improve to the point where in my judgment her test results
would significantly differ from what I obtained here.
MR. POWELL: That's all I have.
CROSS-EXAMINATION
BY MR. SODUS:
o Dr. Greevy, I am Dan Sodus. I talked to you
before about Ms. Baum, and I do have a few questions on
cross-examination for you relating to your testimony
today.
First, I should note, you are not a medical
doctor.
A No, I am not.
o And have you had an opportunity to review the
medical records for Ms. Baum?
A I reviewed the information that was available
on her chart at Leader Carlisle, certainly not the
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1 complete medical records.
2
o
How far back did those records at Leader go?
3
A
I believe that the oldest thing I saw was from
4 May of '95, that being Dr. Manfredi's consult. He refers
5 within that consult to some earlier information. But,
6 three, four months. There is references back to
7 information, but I didn't see any past medical,
8 specifically original medical reports.
9
o
Now, I noticed in your -- I believe it was the
10 second report that we did
when you went in and talked
11 to Ms. Baum, you asked her about her medical condition,
12 and she stated to you that it was a problem with bad
0)
'~
13 kidneys?
14
A
That's correct.
15
o
And that she also indicated that she understood
16 she would get sick enough to die if she didn't receive
17 treatment?
18
19
A
That's correct.
Q
And then she also made the statement, I'm tired
20 of living this life?
21
A
Yes, she did.
22
o
And just prior to that statement she indicated
23 that maybe it would be better or maybe it would be a good
24 thing. I'm assuming that refers to dying?
v
25
A
That was my interpretation as well.
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1
o
Did you construe this as an expression of Ms.
'.1
2 Baum's desire to commit suicide or at least not to
3 continue living under the same circumstances that she had
4 been living under?
5
A
No, I didn't take it to be an expression of
1
,
,
j
6 suicide or even necessarily of a strong wish to die, but
7 more a growing impatience and intolerance on her part to
8 her suffering. That could certainly develop into more of
9 a wish and desire to die, that she was stating things in
10 an attenuating fashion, maybe and if and I don't want to
11 be a burden and so forth.
12
Q
Okay. Those attenuating type comments as you
~
13 described them, are there other things of that nature that
14 led you to the conclusion that this was not a suicidal
15 expression or an expression of an intent to die?
16
A
It was within the context. It was almost like
17 an afterthought, like a throw-off. She said, maybe I'd be
18 better off dead; I don't want to be a burden; I had enough
19 of this. Again, I would much preferred to have done a
20 more extensive evaluation on her mood and affect and the
21 ideation related to that. This is kind of a gut, quick
22 clinical impression that I would not see her as making a
23 direct suicidal gesture. I would have concerns that her
-J
24 refusal of medications, her refusal to undergo dialysis at
25 times may be also an expression of desperation and giving
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27
28
o
1 up on her part.
2 I would hope that others that have been more
3 consistently involved with her care would have a better
4 handle on this, specifically Dr. Manfredi.
5
o
When you do an evaluation like this of a
6 patient, approximately how much time do you like to spend
7 or what is the typical amount of time to get an accurate
8 evaluation of a patient?
9
A
Of this kind. Are you talking about a
10 competency evaluation or a typical consult that I might
11 do?
12
o
Either.
"J
.....-
13
A
Okay. Typically the consults I do are very
14 problem oriented. There is a specific set of behaviors,
15 either combativeness and agitation or depression that
16 folks are asking me to enter and make some recommendations
17 about.
18
A typical one-time consult takes two hours. In
19 fact, that is kind of the time that I set aside for chart
20 review, discussion with staff, meeting with the resident,
21 discussion with staff after I meet with the resident and
22 writing up my consult; about two hours. Although some can
23 take much longer, and I've done extended evaluations of up
24 to six, eight, ten hours. But the typical discreet
....)
25 behavior problem, my initial consult, two hours, and then
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1 whatever follow-up is needed.
2
o
And you think that amount of time is important
3 not only to get an accurate assessment but also to develop
4 a rapport with the patient?
5
A
Well, sometimes rapport is immediate.
6 Sometimes it is never developed. So, it is really hard to
7 say. If I am unable to develop a rapport, it is my
8 preference to see the person continuously over a period of
9 time, or I may have them come to my office. But I would
10 say in the majority of cases, a consult can be done in two
11 hours with some useful information. I wouldn't claim to
12 have a total understanding of the individual. My
'J
~#
13 goodness, I have been in therapy for two years only to
14 learn after two years something that is fundamentally
15 crucial. So, you know, who knows how much is enough
16 time? You do the best with the time that you have.
17 0 How much time did you have with Ms. Baum?
18 A With her or involved in collecting information
19 as well?
20
o
Let's start with just the amount of time you
21 spent with Ms. Baum and then also --
22
A
I met with Ms. Baum three times. The first two
23 times probably in the neighborhood of ten or fifteen
24 minutes each, so let's say a half hour. The second time
~
25 perhaps 45 minutes, maybe an hour. So, call it maybe an
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1 hour to an hour and a half with her.
2 0 And your first two consultations or your
3 first two meetings with her, I should say, did they yield
4 any productive information?
5 A Well, they yield a lot of productive
6 infor.mation, none of it particularly related to her
7 competency, necessarily. The information that they
8 revealed was that she was distressed, distraught, angry,
9 uncooperative. That's useful information.
I::J
10 0 Okay.
11 A But, again, had I been asked to make any
12 statements about her competency based solely on that
13 information, I would say that I don't know. There are too
14 many factors that could lead to that kind of behavior.
\...,)
15 0 I see. You were asked to give three, what
16 amount to, professional opinions about Ms. Baum. The
17 first was your professional assessment or your
18 professional opinion about her memory, and you indicated
19 that she had a severe memory impairment.
20 Your next professional opinion was whether her
21 judgment was impaired, and the third was whether her
22 mental condition or status would improve over time or
23 could improve over time.
24 We talked a lot about how you developed your
25 opinion about her memory. How did you evaluate her
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12
(") 13
...."'~..
14
15
16
17
18
19
20
31
21 care.
1 ability to make judgments?
2 A Memory is an absolutely crucial component of
3 judgment. We could break down judgment into its component
4 steps, and I could talk about where I think information
5 processing, storage, retrieval, plays a role in that. But
6 memory is a crucial component in judgment. It is also a
7 crucial component in intelligence. Factoring in the
8 studies from the Wechsler Adult Intelligence Scale, memory
9 comes out as a major factor. So that it is such a global
10 underlying ab~lity that, when it is severely impaired, it
11 affects everything, just about.
o I see. And it is your opinion that without an
improvement ~n her memory, her judgment ability would not
improve either?
A Consistently, yes. Folks can wax and wane.
Folks can have moments of clarity. There can be kind of
pockets of retained understanding. But, again, in terms
of consistentl.y over a period of time, I have grave
concerns about an individual with the deficits that these
tests reflect being solely responsible for their medical
22
Q
Let's talk a little bit about less restrictive
23 alternatives.
An alternative to being solely responsible
24 for their own medical care would be a situation where she
v
25 would be less than solely responsible for her own medical
C.P.C.R.S. (717)258-3657
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32
"'1
1 care.
2 Part of -- or at least one part of your
3 testimony today was about her refusing to obtain dialysis
4 and refusing to take her medications.
5
A
That's correct.
6
o
Was she reminded to do those things? Were
7 there people there telling her to do those things or
8 indicating that those things needed to be done?
9
A
Certainly.
10
o
And you also stated that she had an
11 understanding that if she didn't do these things, that it
12 could lead to her death?
........
("""'1''')
13
A
That if she did not take the dialysis. I
14 didn't talk to her about other medications. I might add,
15 interestingly, that she is under continuous dialysis or
16 under frequent dialysis now. There is a machine that goes
17 at her bedside that is responsible for that. And although
18 she talked about her need for dialysis and the
19 consequences if she didn't receive it, she had no concept
20 of what the machine at her bedside was.
21
o
Let's focus on the dialysis then. She had been
22 reminded that she needs to do her dialysis?
23
A
I assume that.
24
o
Okay. She refuses to do her dialysis?
,...)
25
A
I understand periodically that's what happened.
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1 0 And that is what led to her admission at
2 Carlisle Hospital?
3 A That's my understanding.
4 0 Is this a memory problem affecting her medical
5 status, or is this some type of an oppositional, defiant
6 type problem?
7 A It could be both. I wouldn't see that as an
8 either/or in the question. It could well be both.
9 0 Did you do any kind of an evaluation that would
10 assess or identify any kind of oppositional or defiant
11 problem?
12 A Other than my own interaction with her and my
13 own clinical sense of her, I didn't do any other specific
14 testing of her other than the memory testing.
15 0 From your review of the medical records then
16 that you did have a chance to see, had anyone done any
17 kind of an evaluation or testing in any of those types of
18 conditions?
19 A The records that I saw were limited to what
20 were on her chart. The only psychiatric information,
21 direct information there, was a very brief report by Dr.
22 Manfredi.
23 0 Okay.
24 A I would say that I certainly found her to be
25 oppositional, so I wouldn't be surprised if others had
()
w
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33
.~
34
1 that impression as well. We get a little bit into the
2 chicken and the egg question, and I'm not in a position to
3 really say what the interrelationship is between the
4 memory impairment and her oppositional style.
5
6
0 To your knowledge, based on the information
that you were able to gain about Ms. Baum, had anyone ever
done any kind of treatment or therapy relating to her or
trying to alleviate her oppositional or defiant behavior?
A I understand that she had an inpatient
7
8
9
10 psychiatric admission at Carlisle Hospital, and at that
11 time she was delirious, supposedly due to renal failure
12 and lack of dialysis. Is it reasonable to expect that
~) 13 within a psychiatric facility that those issues would be
...,,,,,,,,,
14 addressed? That's a question I'll throw out. I don't
15 know that you want me to make those assumptions. I don't
16 know.
. I
-
17
o
That was going to be my follow-up question.
18 But the short answer is you don't really know?
19
A
I don't know. It would be assumptions on my
20 part.
21
o
If something could be done for Ms. Baum
and
22 here I am asking you for an assumption or at least to deal
23 with a hypothetical. If something could be done for Ms.
24 Baum to, for lack of a better word, fix her oppositional
25 or defiant behaviors
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12
0 13
14
15
16
17
18
19
J
35
1 A What might that be? Is that
2 0 Well, number one, what might that be and,
3 number two, would that be a less restrictive alternative
4 in terms of her being able to care for herself or look
5 after her own medical care with simple reminders and not
6 constantly opposing or acting defiantly towards the people
7 who are reminding her to take medications or reminding her
8 to do dialysis?
9 A This is a real complicated question. It begins
10 to really get at the crux of the thing. As I said before,
11 we were talking about the chicken and the egg kind of
things here. You described oppositional or defiant
behavior. We need to look beyond that and try to
understand what it is that is causing that oppositional
and defiant behavior, and there are a multitude of
possibilities. It could be a personality disorder, and
this could be the individual's style on the way thoy react
to authority. And it may have been characteristic of an
individual throughout their entire life. That is one
20 possibility. In that case, of course, is much more
21 resistant to treatment. An oppositional, defiant, angry
22 attitude can be a consequence of depression. It can be an
23 expression of depression or even associated with other
24 psychiatric disorders, in which case the underlying
25 disorder would have to be identified and treated.
C.P.C.R.S. (717)258-3657
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1 I have also seen oppositional, defiant
2 responses to one's own subjective response to their memory
3 impairment and mental deterioration. It can be a stage of
4 denial, perhaps, that one goes through.
5 So, with Mrs. Baum, unfortunately, I don't know
6 enough about her to say what is the cause of that
7 interpersonal style. I don't even know enough about her
8 to say that it may have been situational. I may have hit
9 her on a bad day. She may not have liked my face or
10 haircut. There are so many factors in that short-term
11 kind of setting that I would be at a loss to say what kind
12 of treatment she might benefit from.
13 I'm also at somewhat of a loss to say what
14 percentage of her test results can be attributed to that
15 oppositional and defiant style. I think that some of it.
16 It is my opinion that the degree of contribution from her
17 style, her situational or personality or emotional
18 factors, is significantly less than the organic bases for
19 that memory impairment.
20 0 Okay. Very briefly, I think this is probably
21 my last question. Her judgment is affected by her severe
22 memory impairment. If somebody else could supply that
23 memory component for her, reminding her do things, could
24 she function without a guardianship? Could she, if we
25 could alleviate the oppositional or the defiant type
e::)
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behaviors or condition, could somebody else supply the
memory component and allow her to act on her own?
A Memory is a real complicated human function.
If it were simply overcome through reminders, we wouldn't
have things like Arcadia units, which are specialized
Alzheimer's facilities. Reminders are not enough for a
person to overcome their memory impairments. Memory, as I
was saying before, is a crucial component of intelligence
that we need to call up not only recent memory, but past
memory to understand things. Without memory, nothing
makes sense. So that, memory cannot simply be overcome
through reminders. Some compensations can be made.
Okay? But there is no way to compensate for the role that
memory plays in one's ability to understand the world,
organize information about the world, find meaning in it
and make decisions based on that. It is a matter of one's
memory impacted to the degree that all of those appended
functions are affected. So, I think the answer to that
question is a no.
o Okay. One last kind of administrative
question. You referred several times to Triple A.
A Area Agency on Aging.
MR. SODUS: Those are all the questions I
have. Thank you.
REDIRECT EXAMINATION
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BY MR. POWELL:
o I have three quick follow-up questions. The
first one deals with some of your cross-examination
testimony. There was a lot of discussion about her being
defiant. Is that right?
A Yes.
o And your knowledge of that was based apparently
upon her reaction to you and the nursing notes that she
had refused treatment with regard to some oral treatment,
medication?
A More I think solely on my interaction with her
that there was a sense of defiance there, yes. But, you
know, a person can, in my mind, refuse treatment without
being defiant. They can do it very politely and that then
is registered more of uncooperativeness. But defiance has
a certain bite or edge to it, I think, and I could kind of
feel that with her.
o In the review of the charts or the medical
history, did you find any evidence that would lend you to
believe that she actually refused dialysis treatment?
A That she actually -- I believe that she would
not show up for appointments.
o But you don't know what would cause her to not
show up?
A
14
15
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23
24
25
A lot of things could cause people to not show
C.P.C.R.S. (717)258-3657
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1 up for an appointment. They could forget it if there is a
2 memory impairment. They could not want the dialysis, in
3 which case it's kind of passive suicide or resignation.
4 It is not necessarily defiance or what could be defiance,
5 I suppose. I think a real strongly defiant person would
6 go and kind of chew out the doctor.
7
o
But you can't really tell whether it was an
8 overt refusal or simply she forgot to show up. Is that
9 correct?
10
A
Typically, yes. I do believe that there is an
11 instance in which she left against medical advice. So
12 that would be a little bit more active. You know, leaving
-'~)
~""""
13 a place kind of connotes something different than not
14 going to a place.
15
o
Attorney Sodus discussed with you some of the
16 time that you spent during the consultation. How much
17 time did you spend in the overall preparation and
18 consultation of Miss Baum?
19
A
It was over three hours.
20
o
And lastly, you discussed on cross-examination
21 that upon your -- I'm not sure if it was your third or
22 your second meeting with Nettie Baum, that she knew that
23 she had, quote, bad kidneys and that if she didn't get
24 dialysis that she would die. Is there anything suspicious
J
25 or inconsistent with that and some of the memory tests
C.P.C.R.S. (717)258-3657
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1 that you gave her?
2
A
perhaps your question is with a person whose
3 memory is impaired to the degree that hers is, how is it
4 that she was able to remember the dialysis and the
5 consequences of it.
6
o
Correct.
7
A
Right. I think that is something that kind of
8 stands out as perhaps unexpected. However, it is not
9 necessarily completely unusual. I am aware that she had
10 just spoken with her attorney and maybe that served as a
11 reminder at that time. Although, I asked her that
12 question at the beginning and then also at the end, and
')
...........
13 her response at the end was the same as it was in the
14 beginning. So, the time had passed with her contact with
15 her attorney. I think that at that moment, for whatever
16 reasons, she was able to hold on to the information about
17 the dialysis and her kidneys.
18
o
You also mentioned that there is the dialysis
19 machine right next to her bed?
20
A
I believe that is what it was. That's the way
21 it was described to me.
22
o
Did you ask her ~bout that machine?
23
A
I asked her what it was.
24
o
And her response was?
-,J
25
A
I don't know.
C.P.C.R.S. (717)258-3657
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n 1 MR. POWELLI That's all the questions I have.
2 MR. SODUS 1 I have no other questions.
3 (Whereupon, the deposition was concluded at
4 10145 a.m.)
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C.P.C.R.S. (717) 258-3657
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1
2 COMMONWEALTH OF PENNSYLVANIA )
) SS.
3 COUNTY OF CUMBERLAND )
4
5 I, SUSAN O'HARA, RPR, a Court Reporter-Notary
6 Public authorized to administer oaths and take depositions
7 in the trial of causes, and having an office in Carlisle,
8 Pennsylvania, do hereby certify that the foregoing is the
9 testimony of MICHAEL SCOTT GREEVY.
10 I further certify that before the taking of
11 said deposition the witness was duly sworn; that the
12 questions and answers were taken down in stenotype by the
13 said Reporter-Notary, approved and agreed to, and
14 afterwards reduced to computer printout under the
15 direction of said Reporter.
16 I further certify that the proceedings and
17 evidence are contained fully and accurately in the notes
18 taken by me on the within deposition, and that this copy
19 is a correct transcript of the same.
20 In testimony whereof, I have hereunto
21 subscribed my hand this 23rd day of August, 1995.
22
/(]€~.Jl O1L"-
'~otary Public
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My Commission Expires February 15, 1997.
C.P.C.R.S. (717)258-3657
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MIc:Hl\EL SCOTT GREEVY
.\03 VALLEY VIEW DRIVE
MECHANICSBURG, PA 17055
Home (717) 691-1616
Work (717) 231-6360
OBJECTIVE
Geriatr ics Educational Consul tan t
SIIIlKARY
Sixteen years' diverse geriatric experience in multiple settingn.
Energetic educator/facilitator. Communication skills encompass
abilities to translate concepts into practical applications.
Enjoys creating learning environments resulting in valuable and
useful understanding or geriatrics.
AREAS OF EFFECTIVENESS
.
Helped to develop, implement and conduct innovative "Focus
on the 50's" program for Harvard University employees as an
aid in planning for their later aged needs.
Taught popular aging and development courses at Harvard
University and Pennsylvania State University. Capital
Campus and Hershey Medical Center, for both undergraduate
and graduate students.
Strategized, developed and implemented a "Sensit:.vity to
the Eldedy" program for health care professionals
integrating a training and staff evaluative model; accepted
for presentation at The AHA. Aging and Long Term Care
Conference in fall, 1989.
Worked extensively in providing timely, useful and
motivating seminars for caretakers and family of tho elderly
on numerous topics in geriatrics.
Served as the geriatric psychologist consultant for the
Alzheimers Disease Assessment Program, Contract H158005,
Pennsylvania Department or Aging.
Invited and accepted to present at numerous local, state and
national conventions, workshops and conferences on a wide
range of topics in geriatrics.
Instrumental in the conceptualization, development and
implementation of an innovative. comprehensive,
multidisciplinary assessment team.
Developed and participated in pre-retirement programs,
including repeated presentations for Pennsylvania
Dapartment of Education. United Parcel Service, and the
Hershey Entertainment and Resorts Company.
Designed and conducted training workshops for health care
professionals accredited for continuing education credit by
the Pennsylvania Nurses Association.
o
o
~ DEPOSITION
J ~~:;y~ /
1[[-,;)'0 9. ~
'1
MICHAEL SCOTT GREEVY
103 VALLEY VIEW DRIVE
MECHANICSBURG, PA 17055
Home (717) 691-1616
Work (717) 540-5353
OBJECTIVE
Broad-based practice in psychology with an emphasis on clinical
gerontology.
CAPITAL PSYCHIATRIC AND PSYCHOLOGICAL ASSOCIATES
Harrisburg, PA
1987-1992
PROFESSIONAL EXPERIENCES
CLINICAL:
o
COMMONWEALTH AFFILIATES, P.C.
Harrisburg, PA
Clinical Gerontoloaist and Psvcholoaist
Provide a full range of evaluative and treatment
services to the adult and geriatric age groups.
Provide training seminars to professional and community
groups.
1992-PRESENT
Clinical Geronto1oaist and Psvcholoaist
Provided a full range of evaluative and treatment
services to the adult and geriatric age groups.
Supervised psychology staff.
Provided training seminars to professional and
community groups.
INDEPENDENT PRIVATE PRACTICE
Harrisburg, PA
Clinical Gerontoloaist and Psvcholoaist
1982-1987
HARRISBURG INSTITUTE OF PSYCHIATRY
Harrisburg, PA
1978-1988
Chie
st Sta f
o
Developed the Department of Psychology Services which
became responsible for the delivery and supervision of
Psychological evaluative and treatment services.
o
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HARVARD UNIVERSITY
Cambridge, MA
1977-1978
Pre-Doctoral Intern in Clinical Psvcholoov
Experienced diverse and intensely supervised internship
focusing on emergency, intake, evaluative, and
psychotherapeutic services to undergraduate, graduate,
and professional students and University employees.
OHIO UNIVERSITY
Athens, OH
Clinical practicum student
Completed didactic and clinical experience practicum
sequence in individual, group, family counseling,
Gestalt, cognitive, interpersonal and advanced
therapies including all age groups and a special focus
on geriatrics.
1973-1977
Assessment sequences completed in Individual
Intelligence Testing and Psychodiagnostic Objective and
Projective evaluation.
ATHENS MENTAL HEALTH CENTER
Athens, OH
1973-1977
Adiunct Psvcholooist and Psvcholoov Trainee
Completed mental status intake and re-evaluations and
short-term Psychotherapy with adult and geriatric acute
and chronic inpatients.
TEACHING:
PENNSYLVANIA STATE UNIVERSITY
Capital Campus at Harrisburg
The Milton S. Hershey Medical Center
1979-1987
Instructor
HARVARD UNIVERSITY
Department of Psychology and Social Relations
1977-1978
Teachino Fellow
OHIO UNIVERSITY
Department of Psychology
Teachino Assistant
1974-1977
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INRE:
NElTIE R. BAUM,
AN ALLEGED INCAPACITATED:
PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21.95.426
ORDER
AND NOW, this
.z S"~ dny of August, 1995, ufter heuring, the court nppolnts
Mnry Buekenhower ns gunrdlnn of the person of Nettie Bnum, nlleged incompetent, for the
purpose of mnking nil resldentlnl nnd heulth cnre decisions for the Incnpncltnted person nnd
providing consents necessnry therefor.
BY THE COURT,
W. Dnrren Powell, Esquire
For Petitioner
Ad..
Dnnlel Sodus, Esquire
For Nettle R. Bnum
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[l OI!iIrJCI Justu:U )(l Commun Plei1s n Appollnln o Qlhcr u_ --, m. _.._... ___. N~ 1669
J ron IOJ, C P, APPELLATEI ...- _.- 5 BUDGET CODE
4. AT ICITY/STATEr
C.P. Cnrlinle, onnnylvania ",1. ""-" - I.LlI,v'-;O
6 IN HiE CASE or 1. CHAnGEJOf'FEt-J5E lPURDON CITATlONI e 0 PETTY OFFENSE
In Re Nettie Il. !lawn Allegod Incapacitated Pernon o FELONV 0 MISDEMEANOR
fj P"OCEEOltmS IOOSCIlb, br.efl." II, PERSON REPRESENTED '6 Cljjk DOC~E~ Divil
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Guardian appointed for reoidentia1 and , II 0"."11,,,, ,J".,",I. 21-95-426
health cara deoinione. , " "Op.lI.nl 13 CRIMINAL DOCKET NO
. :] "tlp,f1...
, 'J tl.b.., Pelll''''"t/
. II M".",IW'lnn,
, " P"'ol.." C",'grll w"" V,ol.tl.on
10 Pln~jON REPRESENTED IFull Namal . G fl,Ob.honYfn'g''tiw'r V'OI,I,OI'I 1 t tE 14. APPEALS COCKET NO
. ~ 01"" a e e ncapao a d
perDon
AI,pl n.,... June ? 1995 16 NAME or- "rraRNEY/PAYEE AND
MAILING ADDAESS
Ihnie1 J. SOduB, Eeq.
Kevin A. Hose, J. Sodus &: Verney
NAME OF COMMON P~EAS JUDGE ASSIGNED TO CASE 7 Irvino Row
Cnrlia1e, Pa. 1701:3
17. TEl~HONi No. 1~.$~~~89947NO ORFI'IP.O
717-2 :3-9 90
CLAIM FOR SERVICES OR EXPENSES
19, SERVICE HOUPS OATES AMOUNTS CLAIMED
I. A"liGnmln' Indlor PI.. Mulllply 'Ir. JM' "ou, 'Inl" 10111
b Ptthmlnl,.,. H..rlng "our, 'a oblaln "In Court" com,
pen'lllon. erIe' ralll below
e. MoUon, Ind RIQUI'I'
... d. al,1 Hurlngl
0:
" iii. Sln'lnCI HI.,lngl
8
0; I. T,III
g. A.vOClllon HII,lng,
h. Juvlnlll HII,lngl
.1. DePOeition 1.6 8/21 19A. TOTA~IN COURTCOMP.
I 01"., ISPKlly an IddiUonl1 ,,,,.h.tGuarCUanahlp .0 tJ/ll,tJ/2Lj.
2.2 'Ie - $-H1h-OO- \/"'-,00
TOTAL HOURS. XJ58'PER/jm.a/ 1
20, I. Inlervl'WI Ind coni Irene.. :3., ~/,tJ,,~, 7/25,i!.O,i!.~ MUlllply 'II. par "our limn 10111
b. Oblllnlng Ind ""llwinO recO'dl 2.1 6/22.7/' "OUtl, Enllr 10111 "Oul ot Court4
...... eomp,nUlIon b.low.
00: Co LeOl1 r....rch Ind b,lar w'llIng 1,0 r'l7 ,7/ ~
..."
88 d. Invesogao"" and olne, wolk (S~ty Oi'l addlllonal &hltts) 20A. TOTAL OUT OF COURT
COMP,
TOTAL HOURS. 6,:3 X $40 PER HOUR -$252.00
21, ITEMIZATION OF REIMBURSABLE EXPENSES AMT PER ITeM
Miloao8 $.25 D9r mile J( jO.O l'traVe .0 a .L6.fo.u;;
0: Dopeal tlon Tranacrlpt )'l-.;JU
w
:z: 21A. TOTAL ITeMizeD EXP.
I-
0
-$69.15
22, CERTIFICATION OF ATTORNEV/PAVEE 23, ORAND TOTAL CLAIMEO
HII comp.nullon and/or relmbu,.lmlnl 'or wo~ In Ih'l ca.. pravloulty be'~I'd 'Dr? 0 YES IJ NO - ~:31.1/ 'lWI-IS
lIyes,wereyouPI'd? 0 yeS 0 NO U)...bV~homwereYOl,U)aId? How much? 24, oeou8T, PAIDI' PYMTS,
Hu ,n. .'"on ...'...nl.d .":~on'i you, or I. Y~~~~;:%ln COnn.cllon w,lh Ih. m.n.. 10.
w"ICh you were apDoln'ed 10 ptO de r.p,. IntllJRn' ~ NO If r1YI dllllll on Iddillonll Ih.ell _ -$
I Iwear Ot .lfItm I". truln or CO"ICt (u. 23. c,.."S 25 NET~CLAIMEO
or I"e 'bO". srltements 850nllur .y/PI,... Oil. - $ ,/(17,1(,
26~1'''"1 '~l ~'I "'-. -?" /.... , /l~d 21. AMT. APPROVED
,,," Soonlhll.ol 'l. 't. [)-
,'.."', ~I Jllag. .0111: I<J . -$ '10,./1-
Copy 1 Mallia Court Admlnlslralor 01 complellon 01 sarvlca /llo~ /tJ :-11-
on
"
Register of Wills of Cumberland ,County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estlt.ol Nettie R. Baum
also known as
No. 21-95-426
. D.clased
SaclolSocurityNo, 162.22-3649
Mary Buchenauer
P.tltIono~I). who Isle.. 18 y.... olege or older, epply(lu) lor:
(COMPLETE '1.' or '8' BELOW:)
o A. Probal' and Grant of leners Testllnwntary and IV" that p,tttloner(s) 1s/.,. the .x.cut
the Docod.nt, d.tod end codlclb) d.t.d None
""mod In tho loll Win 01
State "I,...anl circumstances, ..g.. r.nunclatlon, death of IIC.cutor, Itc.
Except as follows. Oecldent did not many. WIS not dlvorc.d, and did not hI"" . child bom or adopted aft.r execution of the docunwnts
offered for probate; WIS not the vlctJm of . killing and was nlv.r adjudicated Incompetent:
!Xl
~~""
(c.la.; d.b.n,c.la: pend.nt. Ih.: durante absentia: durante rrmoritlt.)
B, Grim of l.ne.. 01 Adninlstr.tlon
Pothlono~.) en.r e prop.. ....ch hoslhe.. ..c.rtoln.d thot Decod.nt I.n no Will and w.. .urvlved by tho following .pou.. (K eny) .nd
heirs: '. "
N.me
R.latlonshl
Hueband
Dau hter
Son
R,ski.nee
DECEASED 10 31 00
150 Pine Hill Road Carlisle PA. 1703
2 West Penn A t. No. 306 Carlisle
Arthur C. Baum
Mar Buchenauer
Arthur J. Baum
(COMPLETE IN All CASES:) Anach .ddhlonol.he.ts K noc....ry.
Docod.m w.. domiciled .t dooth In Cumbar land
County. P.nnsylYenlo with hlslhor loll I.nily
Dr princlp.1ruld.ncOlt 2 Weet Penn, Carlisle, PA 17013
(II,t llreot. numbor. .nd munlclpelity)
D.cod.nt,then~..rsofag.,dled 12/05/95 at Carlisle Hospital. PA
(lac.lIon)
Decedent at death owned property with estimated yalues as 'ollows:
(If domiciled In pAl All person.1 property
(If not donicllod In pAl P.rson.1 prop.rty In P.nnsylYanl.
(If not donicllod In PAl P.rsonal prop.rty In County
Value of real estate In Penmytvanla
t.],7SQ.88
s
s
s
s
42 ,000.00
situated as follows:
Whorelore. p.tItIono~.l respoctlully request(.) tho prob.t. 01 the lost Will.nd Codlcl~.) pros.mod with this Petition end tho grim of
letters In the a ro riate form to the unders ned:
S nature T ed or rimed nanw and resJd.~
I \'1 to. r I",.
Mary Buchanauer
,~ . \~'-'<"h.t.",-,....>-,,- 150 Pine Hill Road Carlisle Penns lvania 17013
Pt~ by the~fotanl' Sar AnodItlon
Copyrtght (c) 11M tonnlOftwl'. arIy CPSyI1..,....lnc.
/6'/,<;'/9'-5'
F.... RW-l (''''I
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130
21-95-426
Register of Wills of Cumberland
County, Pennsylvania
RENUNCIATION
Eml.ol
Nettle R. Dawn
No,
abo known at
I Dec..,ed
The und.,.lgnod,
Son
01
(R.lollon'hlp) (eopachy)
tho oboy. Doced.nt, ho..by r.nouncol.) tho right 10 odmlnlst.r tho ....,. ond ra.poClfully ..qu.S1(.) thol l.na,. bo Is.u.d 10
Mary Duchenauer
WITNESS
hond this
d.y 01
#~1 -,~~
(sig'notu..) ArthWY'J. aum
2 West Penn, Apt. No. 306
Car1is1s, Penney1vania, 1;013
'.
-
(Addr...)
(Slgn.tu..)
(Add,...)
(Slgn.'u,a)
(Add,...)
Sworn to or affirmed and subscribed
bolo.. ....lhls
doy
or
Notary Public
My Commission E.plro.:
(SIgNih.. aM Mal at Notary 01 other otflct.1
quanfled to Idmllitt... 0I1M. Show dlt. pf
aplfltlon of Notary.. comrnI"'on.)
NOTE: R.nunclollon. o.ocuted outsld. tho Ollie. of RogIs1., 01 WII1s
In .ome countlo. 0.. ..qulrod 10 bo nobIrlzed,
~byl...l'onnoytvar/.ell_Uon
_hI (e) ,... form IO/IwIII rrit Cl'Syot_.Inc.
F......RW-4 (''''1
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Commonwoo"h 01 Ponnlyl.lnlo
County 01 Cumborland
Oath of Personal RepresenJatlve
Tho POlhlonor<l) .bo.l-nomod .WOlr<.) or Imrmll) Ihlllhe st.l.monl.ln Ih. lotogolng p.lhlon .ro truo
.nd co"oct 10 the bost 01 tho knowlodge .nd bollal 01 p.lhlon.r<.) .nd Ih.l. II porson.1 ropro..ntallvo(.) 01
tho Docod.nl, Potltloner<.) win won .nd trul)l.dmlnlstor tho o.tat. .ccordlng 10 law,
,
Swomtoor.mrmod.nd .ub.crib.d \'l't<.~, )...("6...., Lk.L ,-,_~
Mary Buchonauor
boloro mo thl. 1 7 t II d.y 0'
1\-\"1-cO
NOVEMllER . 2000
l ^ \ " ,
7.-" ////V' (/'lrl',..",..., ' /.,....,,/ /lr/II.// .
/ , ./ For 1110 Roglstor
No.
Estataol Nottio R. Bawn Doc....,
21-95-426
Social Socurily No: 162-22-3649 0.10 0' D..th: 12/05/95
AND NOW.
NOVEMllER 21
. 2000 .In con.Id".IIon"
01 tho p.tltlon on tho rova..o .ldo hellOn. .0dst.Clory prool hevlng bo.n pro..ntod boloro mo.
IT IS DECREED thot Lott... 0 Tostamontary [ID 01 Admlnlstr.tlon XClllI1QIIltltlxu..nllH
(c:.ta.j d.b.n.c.t.I.i pendentllltli durante absentlli dUrlnte m1noritate)
.,. hereby granted 10
Mary Buchonauor
In tho .bo.. ostat. Ind thet lhe Instrumon~.) dlt.d
d..cribod In lhe p.tItIon bo .dnlitt.d to prob.t. .nd fll.d 01 rocord II tho I.st Will 0' D.c.d.nt
FEES
Letters. . . . . . . . .
Sho~ C.rtillcato(.), , . , , $
R.nuncladon. . ..... . $
Affid.vIls ( $
Exlr. P.go. ( ).,. . $
Codicil, , , . . ..... . $
JCPFoo. . , $
Inventory. . . $
Othor ... . $
$
BO.OO
/' ' YI"~(:'
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t/, /,'
iI/-,I'/.< _ ,..~(__
-",' Rtgfst.r of Wi 5
};",I",-/</
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6.00
5.00
Galon R. lIa1tz
Attorney:
I,D. No:
.
39789
IUro Law Officoo
28 South Pitt Stroot
Address:
5.00
Car1is1o, Ponnsy1var la. 17013
T.I.phone: 717/245-9688
TOTAL. , . , . . . ., $ 96.00
~ by the ~anI. Sat Al8ael&Uon Copyright (c) ,_ form .,ftw.,. only CPSyltlml,lnc..
,.... RW-' (,ft,)
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'.'\- ~'. JRD/June 30, 1992117858
JAN , '1 /".'J.{.'l
Estate No.:
21.1995.0426
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
In Re: Estate of NI::TTll:: Il. DAUM
Late of CARLISI.~~ DOROUGH
No. , Q95-0426
NonCE OF FAILURE TO FILE SlATUS REPORT AND REQUEST TO
CONDucr A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RULE
Personal Representative:
Counsel for Personal Representative:
GALI::N Il. WALTZ, 1::80.
Date of Decedent's Death:
12.5-1995
Date of Delinquency Notice:
11.16.2000
The undersigned. Mary C. Lewis. Register of Wills, in accordance with Rule 6.12, Supreme
Court Olphans' Court Rules, hereby notifies the Olphans' Court Division, Court of Common Pleas of
Cumberland County, that neither the above named personal representative nor the above named counsel
for the personal representative have filed with the Register of Wills or CierI: of the Olphans' Court his,
her or Its Status Report required by Rule 6.12, Supreme Court Olphans' Court Rule and that the requisite
notice, pursuant to Rule 6.12, Supreme Court Olphans' Court Rules, was given by the Register of Wills
on 11. 1 ~ ,21>..08 and that the ten (10) day notice to file the StalUs Report has Cltplred.
Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency .the
undersigned requests that a Court conduct a hearing to dctermijcther sanctions should be i po
upon the delinquent personal representative or counsel \k deli ucnt persona~ r-;p.reseotativ .
Date: JANUAIlY 16, 2001 Lf} - _ _ IUJ). l.:...\,}IJ.J f)VJUl
M s. egistcr 0 ills :/
Distribution: Personal Representative
Counsel for Personal Representalive
Estate File
A hearing is scheduled for )2, tllI,jf ,j
, j
courtroom no. 3. If the status report is
hearing will automatically be cancelle
~tJ)
filed prior
at / /J:.'1) /4. In,
to the hearing date, the
in
(J.J.
.. - ..,
4 .-\
~
. 'Completd Items 1. 2, nnd 3, Also complete
Item 4 " Rest~cled Delivery Is desired,
. Print your name and address on the reverse
80 thot we can return the card to you.
. AUech this cord 10 Ihe back of the mallplece,
or on the front II space permits.
1. Article Addrelsed 10:
q A1..tW R \\l Ai- TL ES Q.
31650 ~2R RD,
1-hrKR,~Bl.,LRLi 1 PA.
III II
. II delivery Dddrou I from Ilem 11
II VES, ontflf de cry addr"1 be4ow:
o Agenl
o Addt"see
OYe.
ON.
3. ~C8 Type
;zr Certified Mall 0 Expresl Mail
o Aegllt8f8d 0 Allium Receipt IOf MerchandIse
o InlUred Mall 0 C.O,O,
4, R..lrlctod OeIivOf)"l (E>tf8 F.., 0 Ve.
2. Article Number (Copr from lOIVice IIIbeI) " /
(J - 25- /!)Ch - g 2.D
PS Fonn 3811, July 1999 ()omeIllc Relurn Recelpl
JPI
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ru {EndOl't.f!ment HI'QU'ltlUl
C R.'lf1cledo-lr;OfY Ff!olI
C \E~tnemlllllllI!QU!!OOJ
C Tolal po.lag. a h" $
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: Nt:' Ihl'_ 1(, 13 0.. v ""
Date of Death: /~ - ,;,- - /'1 9:r~
Admin. No. If??.j~ - C90 I~'
Will No.
O.A. ~'J /'II) -..:/1 - 'IS - 0 1f:2-6
,n .1', 4 Pursuant to Rule 6, 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1.
State whether administration of the estate is complete:
Yes No ~
2. If the answer Is No, state when the personal
representative reasonably believes that the administration will be
complete: 10 ..... ." JA J
3. If the answer to No. I is Yes, state the following:
a. Did the personal r~sentative
account with the Court? Yes NO~.
file a final
b. The sepal'il te Orphans' Cuurt No. (i f any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the p,lrties in interpst? Yes No ~
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be att hed to this t.
Date:
I /.:1. Jj/o 1
,
r---"-~-'
~~
Name (Please type or print)
'Iu R. 0 Lo..-.J O.a':, Cc.-,{ II)
~"iI Sclluth '\",-t+ S-\', Co.... /,'J Ie) f"
Address 7 '10\~
(1C'71 ~tl5"- 'ItS'S>
Tel. No,
Capacity:
Personal Representative
~ Counsel for personal
representative
(HAH I rmf/ AM3)
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REV-1500 117 - /l?9~~';-
"*_"'01___ INHERITANCE TAX RETURN ;....._
......::W:.:r-- RESIDENT DECEDENT 21 95
hMRIIIl.MO.'" "....., COUNTY rrvv: YEAR
'---~DEciDEtff8NAME (lAST. FIRST, AND MIOOlE lNiTw..m. '" &OCIAt. SECURITY NUMBER
:1I.wlI. NClticR 162.22.3649
! DATE oi=-WTH ~YEAAi----Ti:iAtEOf-B1~TH-cMt4r>>YEA~-'- u__.__._ -- - ~---~ ._'"~ RnullN MUIT..'LaD III DUPUCAUwrTH THI
1210511995 ! 01/2911927 ! REGISTER OF WILLS
:(If APPlICABLE) BURVMHQ 6POUSE"1 NAME (lAST, FIRST AND MIOCllE INfTlALI - 8OCW. SECURnv NUMB[R
, 1I.um,ArthurC
--:181 1. Ot1glnalRetum 0 2. SupplementalRetum D 3. RMNInCSef RliCUm (d."rAdMilhpnotlo 12.1U2)
1l!1! D.c. Umtt.d~..te D....FIltute'nt.erMlComplUm...ld.l..G1ctNOI 0 S. P'ederaIE.....T..Rteum..lJqulfed
aftM 12.12.a2)
; 0 e, ~OiodT_"I_"'" 0 /, DocedentMolntoJ.....LMngT"'..I_ I, TDlII Numbol 01 Silo 00p00lI Box..
01 WIll) copyolTruIQ
,0 e,IJtigItlon_.RocoMd 0 lD,S_IPovonyClod.I..........._ 0 ",~Ioc:Ilon.....u_s.c,e113(A)(._....0)
. "-31081 and 1-1-851
--Jnu IlECTION MUaTUCllIIPU1m. ALL COR.~. NlO CONfIDENTIAL TAX INI'OIIMATION IIlOlJLD U DlRKTm TO:
UAME : COMPlETE MAIlING AOORE58
G.leu R. Waltz
. .
11I\'._11I.'"
13, Charlt.ble and Govemmental BequntllS.. 9113 Trusta 101 which In el..tlon 10 lax hs. not been
made (Schedule J)
14, Nil Vllus Subject 10 To (Uno 12 mlnul Uno 13)
SEE INSTRUCnONS ON REVERSE SIDE FOR APPUCABLE RATES
15, Amount 01 Una 141aX1b1e It the _I lax rata,
OItransl... unci<< Sec. 9116(1)(1.2)
,
*'
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FIRM NAMe: (I.pelIicatMl
: Turo LIW Offices
'tELEPHONE NUMBER
717/245-9688
1, Real Estate (Schedule A)
2, Stocks and Bonde (Sc/1edule B)
3, CIoIIIy Held CorporeIIon, PlItner1hlp at SoIe-ProprietorIhlp
4, Mortg_ & Noles Recalvsble (Schedule D)
5, Cosh, Bank Oepoeitl & Mlscaltaneoua PIIIOOIII Prope<1y
(Schedule E)
a, Jointly OWned Prope<1y (Schedule F)
o SIperalI BUIIng Requntad
7, InIar.VIYoa Transl... & M_leneoua Non.Pmbale Properly
(Schedule G at L)
B, Total Ora.. Auels (total Unes 1-7)
9, Funetal Expenaea & Admln_ Cootl (Schedule H)
10, Debts 01 0_1. Mortgage Llabllnles, & liens (Schedule I)
11, ToIAl Deduc1lons (total Unes 9 & 10)
..../Jd
r.>' (tv
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UU426
NU~DER
28 S. Pill SI.
Carlisle. PA 17013
(1)
(2)
(3)
(4)
(5)
(8)
(7)
_"' ,.~[~.
~
~
~
12, Net Vllua alEwl1 (Un.B mlnUl Llno 11)
~ 1 a, Amount 01 Una 14 taxable It 11neo1 rate
~
n 17, Amount 01 Uno 14 taxable IllIbIJng rata
~ : lB. Amount 01 Uno 14taxablllt CDIleterel rale
19, Tax Due
44.0011,OO
None
None
None
None
None
NODe
(B)
44.000.00
(9)
(10)
12.151.31
I
213,34
(11)
(12)
(13)
(14)
12.365.65
31.634.35
31.634.35
x .00
(15)
31.634.35 x .06
(18)
1.898.06
x .12
(17)
x .15
(lB)
(19)
1.898.06
20, 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAyr,1ENT.
.. BB8URII TOAHSW2RALLQUI!lITIONaaN RE\11!R.1118lDIIAND RECHECK MATH..
COl,yrlghl 2000 lonn softwara only The Lackner Oroup. Inc.
Fonn REV.1600 EX (Rev. 1.(0)
-:~.'
. .
Decedent'. Complete Address:
STRI~!T A1lDRESS
2 We'l Penn
CITY
. STAm I'A
~ZIP 17013
Carlisle
Tex Paymente and Credits:
I, TIX Duo (Pogo 1 Line 19)
2, CredftolP~
A, Spousal PlMfIy Credft
S, Prior Peymonto
C, DiIcounI
(1) __-.!.o~98,96
ToteI Credlte (A . B . C) (2)
0.00
3, Int....tlPenelty II eppIiceble
D, Intoroel
E. PoneIly
S30.00
(3) S30.00
(4)
(5) 2.0\28,96
(SA)
(58) 2,428.96
Tolellnt8f8OtiPenelty (0 . E)
4, II Une 21e grNler IhIn Uno 1 . Uno 3. enlor the dilforence, TIlle Ie the OVERPAVMENT.
Checlc box on Pego 1 Uno 20 to reqUOIt e refund
S, If Une 1 . Uno 31e greetor than Uno 2, enlOlthe difference, Thiele Ihl TAX DUE,
A, Entor the Intoreol on the lax duo,
B, Enlor the lolel 01 Uno 5. SA, Thiele the BALANCE DUE.
Make Chack PeyabIB 10: REGISTER OF WILLS, AGENT
. .,..: .~fn:.~~i.i' ~l!M1!II, ....---=r.ic'ti.\:j mr~:i;:"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PlACING AN .X.IN THE APPROPRIATE BLOCK8
1. Old _ make 0 tranafennd: Voo No
e. releIn the use '" Income 01 the ptOflOf1y tnonerorred;..................................................................................... ~ I
b, releIn the right to deoIgnelo who IhaJI use the pnperty lIan.forred '" Ite Income;..............,..........................
c, relIln e revorsIorlIIy In_; or,..""""..""'.....,......".."...,.,........."...."...,......'"""...........".....,...."""..,..'......
d. .......... the pn>rniIe '''' Ulo 01 elIher peymenle, bonerlll or CIflI?........................,.........................................
2, If _ occurred l!tor llecembor 12, 1562, did decedent 1Ian,'er ptOflOf1y within one YNt 01 death WIthout
receMng edeque\1 con_?......"..""",.."",.........,..".."".,.",.......,....",....,....,.."..'........,....'........,...........,..,.. 0 ~
3. Old _ own on'ln trusllot" '" peyoblo upon death bonk lICCOUnl '" aecurlty el hie", her d..lh?............... 0 ~
4, Old decedent own on IndMduel Rotlremenl Account, IMUIly, or other non.probalo proROrtY wl11ch
contains 0 benellclary doIIgnetlon?....,.."..""...."".........,......."....",..,...."..",..........",,...".......,....,........',......,..,..... 0 ~
IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS VES, VOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
UnMr penalbM oIl*}Ury, I cMdare IN' I ~ narNMd ifill J'IIb.Im, Indudlng ~ptn'l"na lCMdu'" Ind mlilmenCl, and 10 the bMt 01 my ~ and I>>/Ief, II ..we, corrwd and compltlel
Oeeta...bOnol ~,.,othefthantM petICNI~.. baud on an lnfomubondW\1Ch ~reftlal.n, ~
SlGNAT\JAE OF PERSON RESPONSlBLEfOR FUNO RETURN ADDRESS DATE
'Jr~ l?:,...,l--...."L.>.......
SIGNATURE ~R5ON RESPONSIBLE FOR FILING RE'TURN
1 SO "I 'DC Hill Road
Carh. c. PA 17013
~-\2.-91
CA.e
AOORESS
AOORESS
CAre
Anve
28 S'\'iIlSI.
Carlis c. PA 17013
3/'-'>/0 (
. ~~~. . .- ~~".$~~~E_ .~.~J::..:.=~~.iif.~!\';ti#i."':r;.;;;l,,~r..(..,I-~if'i
F'" deln 01 death on '" Inor July I, 11194 end berore Jenuery " 1005, the tIlC relllmpooad on the net veluo oltren.r... to '" '''' the use 01 the
surviving_ie 3'11. (72 P,S, 59116(0) (U) (l)),
F'" del.. 01 death on '" InOl Jenuery I, 1005, the tax relolmpoeed on the net velue or lranll...lo or lor the .... ollhe surviving spouNI.ll'l(,
(72 P.8. 59118(0) (1.1) (11)), The 1lItlQ--- not "",,",DIe tnonelOlto 0 survMng IpOUMlrcm lax, end the lllIIulory requlrornenta I",dildolur.
01 __ Ind nllng e tax return ere lWloppllcable even Ilthosurvtvlng _Is lhe only benef1cllry,
F'" <lain 01 deeIh on '" I"", July " 2IXXl:
The tax relllmpoeed on the net velue 01 tranal... lrom e d....18d child lwenty.onl yeare olegl '" youngOl 01 death 10 '" lor the UN 01 0 natureI
peronI, on edoptIYe parent, '" e eleppIrenl 01 the child Ie ll'l(, (72 P.S. S91 16 (e) (1,211,
The tax ratelmpoeed on the net velueoItranal...to or lor the use 01 the decedenl'. UneeI bena_le4,5%, .....pt.. noted In 72 P,S. 59118
1,2)(72 P,S, 59116 (e) (1)1,
The taxrelllmposed on the net velueoltranarereto or lor the UI8 0' thedecedenl'alibllnge lel2'!f. (12 P,S, 591 la (0) (1,3)1, Alibiing ledenned,
undot SectIon 9102. .. en IndlYldual who '- elleut one perent In c:cmmon WIIh lhe decedent, whether by blood "'_,
\.
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Eetete 01 IIlwn. Netti. R
No, 21-01-0'1426
Dete 01 Death 1215/1995
SoelalSacurity ,,~, 162-22-3649
also known ae
. Deceeeed
M8I)' lIucbenlucr
Tha Pe...nal RepreeentaUve(e) olthe ebove Eetate, decaeeed. verily thet the tteme eppearing In the lollowing Invantory
Include aD 01 the pe...nal8888le wherever eiluate end all 01 the raal 88tate located In the Comrr..,nwealth 01 Penneylvenla 01
said Deceden~ thet the valuation placed oppoeila aach ttam 01 aald Invantory rapreeents Its fair ',alua 88 01 the data 01 the
Decedenre daath, end that the Decedent owned no real eetate outside 01 the Commonwealth l f Penneylvanla except that
which appea..ln a memorandum at the end olthlslnvantory. !MIa verily thet the statemants ",,)de In this Inventory are true
end correct. lIWe undarstand thet lalea etatements hereln ere made subJect to the penalties 01 ; 8 Pa, C, 5, Section 4904
releting to unlWOrn Ialeitlcation to authorities,
Attorney: Gllen R. Waltz
Personal RapreeantaUve
Slgnetura: ~~b, ~"'l..\,."...,,^,.....L.-
M8I)' llucbltl\l1uer
Signature:
I,D, No.: 39789
Signature:
Address:
28 S. Pitt St.
Carlisle. PA 17013
Address: 150 Pine Hill ROld
Carli,le, PA 170lJ
Telephone: (717) 245-9688
TelePhone:( ., 1'1) ~~-;'-l.L"'';
-
Daled:
3-\2-DI
>Real Estate
161 E. MUlberry Avenuo. Carlisi. Pennsylvania
44,000,00
Total Real Estate
$44,000.00
(Attach additional sheets W necessety)
Tolal Personal Property and Real Eelale
$44.000.00
'*
SCHEDlILEH
FUNERAL. EXPENSES &
ADfrWSTRATlVECOSIS
1-
IFILE NUMBER
I 21.01-00426
COMMOMUiTHOfI f"IIrMY\\INM
HlIM'NCI TAl ~
.--
E:lTATE OF n N II' R
aum, C Ie
Debts or decedenl mU.I be I1Iported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Hoflinlllllld Roth Funeral Homa
5,828,20
B. ADMINISTRATIVE COSTS: 2,200.00
1, PoncnaI Rop._IlatMI'. CcmmIoaIona
MaIy BuchCl1lucr
SocIII Socur1Iy NumboI(l) I EIN Number ar PIl'ICROI RIpInIlltItJve(I):
SIrwIl__ 150 Pina Hill Rood
City Culislc SlItl PA ZIp 17013
Velr(l) Commlaalon paid
2. Attorney'l F_ Two Law Offices .. Galen R. Waltz 1,800.00
3. FII1IiIV Elc8mptlcn: (If _I _Is not 1hI..",... clIlrnanl'l, IlIIch expilnltIon)
,
CIaJmont
SIrwIl Add....
City SlItl ZIp
RllItlcnohIp or ClIIll\II1t Ie lloc:edent
4, Probotl F_ 100.00
S, AcccunIonI'1 F_
8, T.. RIlum PtIpoter'I F_
7,
I
2
3
0IhIt AdmInIolrot/ye Colla
The ScoliDc~ Eotate Notice advertising
Cumbctlllld Low Joumal, Estate NOlice
Lony E. Foota: Approisa1 report for 161 E, Mulbcny Avenue, Culisla. PI
84.11
75.00
250.00
Total of ConUnulUon Schedule(.)
TOTAL (AIao entar on line 8, R8CllpllulaUonl
1,800.00
12,137.31
*'
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COtIYClJMtAl TH OIII'INII't\VNM
HtIIUTNCI TAX RfNIIrt
fl.UlDIHT 0ICGlIN1'
ESTATEOF B N' R
Iwn. cllla
I FILE NUMBER
21.01.00426
Includo unrelmburaed medlcal..pen....
ITEM
NUMBER
I
DESCRIPTION
Real Estala Tax, 161 E. Mulbcny Avenue, Carlisle, PI.
AMOUNT
213.34
TOTAL (Also .nler on Une10, Recapltulallan)
213.34
. .
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTli OF Pl!NNSYLVA.NIA
INHEfU1' AHC& T M. RETURN
RE8lDENT OECEOENT
I FILE NUMBER
21-01.00426
RELATIONSHIP TO
DECEDENT
ESTATE OF
8lum. Nettio R
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXASLE DISTRISUTIONS (Include outrighllflllUul dlatrtbulJonl)
Mary L, Buchcnlucr
150 Pine Hili Road
CarlJalo, PI.17013
2 I Arthur J. Blum
I 2 Wcol Penn, Apt. N306
I CarIJaJo, PI. 17013
AMOUNT OR SHARE
OF ESTATE
NUMSER
...
Dlughler
ifty percent
Son
Fifty pcrccnl
I
i
i
I
I Enter doIIIr III1OUIltIIor dlalrlbullona _ above on 11_ 15 through \7, .. apjlIllpI1atl, on ROY \5lXl covet_
II. NON-TAXASLE DISTRIBUTIONS:
A. SPOUSAL DIBTRIBUTIONS UNDER SECTION 9\ 13 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
Is, CHARITABLE AND GOVERNMENTAL OISTRIBUTIONS
I
I
I
I
I
I
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.15lXl COVER SHEE~
,'-~
BUREAU OF INOIVIOUAL TAXES
UllERITAHCE TAW. DIVISION
DEPT..U0601 ..
HARRISIURa, PA 17128.0601
GALEN R WALTZ
TURD LAW OFFICES
28 S PITT ST
CARLISLE
PA 17013
CUT ALONG THIS LINE ~
r-:--------............ .:-. ~~.~.~.:-~.;"'..,,-"'...."""'.i.
:1t" --,--
/f/Lj, !JJ-,
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
RETAIN LOWER PORTION FOR YOUR RECORDS ...
I
_u"_ _."....._,_..,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INNERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF OEOUCTIONS ANO ASSESSMENT OF TAX
DATE
ESTATE DF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-23-2001
BAUM
12-05-1995
21 95-0426
CUMBERLAND
101
A.aunt R..1 tt.d
.
_.->.J,.~~"",,-,,~,"".'L'
"
'*'
.n.""II "'III'U'
NETTlE
R
,
~
,
\
~
',.t
.
I
h'
r ,"f.'
.,' I
1". '.'
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, ' ." ,{ .
>
".
,
<0 ~. ' " -'
.! '\1" ~ '. '
" ., of *\
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...
, ,-
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.~
,
.
c
I
",
.
. '
"
...._-~'"-
,
-- ....-.......~
t ~~~:---~.-----...~ J '"- -........
...-
-'.- ." .'_.... ._---.....
Il:IY.14fOlJIlUIl
..
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUReAU OF INOIVIDUAL TAXES
DEPT, 280801
RRI P 7 8-o1l01
DECEDENrS NAME
FILE NUMBER
2195-0426
101
NETTIE R BAUM
REVIEWED BY
ACN
John Kealy
SCHEDULE ITEM EXPLANATION OF CHANGES
NO.
H Total on Schedule H was not correctly carried forward to recapitulation page.
tiC;
~ ;.:.. cJ
i;,":
f,j
\.~..!
1''')
ORIGINAL
Page 1
MAKE CMECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV=is4nix--iii:i,--ri'lf:ooriioYiciniF-INHEifii'AiicirTAiDiP"pii^-miiiiiT~--iimiwAiicE-ifJi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAUM NETTIE R FILE NO. 21 95-0426 ACN 101 DATE 04-23-2001
TAX RETURN WAS. ) ACCEPTED AS FILED I X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..I est.t. (Schedule AI
2. stocks and Bonds (Schedule OJ
3. Clos.ly Held stock/Partnership Inter..t (Schedule CJ
4. Hartg.ge./Not.. Receivabl. (Schedule DJ
5. C..h/Bank Deposita/Hisc. Parsonal Property (Schedule EJ
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedule GJ
8. Total A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS I
t 12,137.31
9. Funeral Expense./Ad"_ Cas a/Hlsc. Expense. (Schedule HI (9)
10. Debts/Hortgage L1abUiU../LJens (Schedule 1) nO) 213.34
11. Total DeducUons (11)
12. Net Value of Tax Return (12)
13. CharJtable/Gov8rnnental Beque.t., Non-elected 9113 Trusts (Schedule ~) (13)
14. Het Velue of Eatate Subjeot to TaH (14)
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ B1h returns assessed to date.
ASSESSMENT OF TAXI
IS. Anount of Line 14 at Spousal rate lIS}
16. Anount of Line 14 taHable at Lineal/Class A rate 116}
17. Anount of Line 14 at Sibling rat. 117}
18. Anount of Line 14 taHable at Collaterel/Class Drat. (lS)
19. PrJncipal T8H Due
\. /.6-/~?-..s-
DURE~U OF INDIVIDUAL TAKES
nnllR-1ANCE "',' DIVISION
D[PI. ta060t
IlARRISBURO, PA t71Za-06ot
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
-J
(, .
./
HOTICE OF INUERITANCE TAX
APPRAISEHENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
GALEN R WALTZ
TURD LAW OFFICES
28 S PITT ST
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-23-2001
BAUM
12-05-1995
21 95-0426
CUMBERLAND
101
Anount R.nl Hed
PA 17013
II)
121
(3)
141
(5)
(61
171
44.000.00
.00
.00
.00
,00
,00
.00
(D)
,00 X
31,649.35 X
.00 X
.00 X
00 =
06 =
00 =
15 =
119)=
DATE
03-12-2001
+
INTEREST/PEN PAID I-I
530.90-
AHDUNT PAID
2,428.96
NUHDER
AA478136
BALANCE OF UNPAID INTEREST/PENALTY AS OF 03-13-2001 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE IHDICATED, SEE REVERSE
FOR CALCULATION DF ADDITIONAL INTEREST.
*'
U..I"'" "'111.'"
NETTIE
R
NOTE I To insure proper
credit to your account,
subnit the upper portJon
of this forn with your
taH pay.ent.
44.000.00
1:>.3~n ~~
31,649.35
.00
31,649.35
.00
1,898.06
.00
.00
1,898.06
1,898.06
.00
184.63
184.63
IF TOTAL DUE IS LESS TUAN tI, NO PAYHENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY DE DUE
A REFUND. SEE REVERSE SIDE OF TIllS FORH FOR INSTRUCTIONS. I
RESERVATION I E.t.t.. of deced.ot. d~lna on o~ b.fore Dec.abe~ 12, 1982 -- If an~ future Intere.t In the ..tat. I. t~an.f.rred
In po.....lon or enJoy.ent to CI... I (coll.t.ral) beneflcl.rl.. of the d.cedent .ft.r the a~plratlon of any e.t.t. for
Ilf. or fo~ ~..r., the C~.lth hereby .~pr."IY ~.'.rv.. t~ right to eppral.. and ...... tran.f.r Inheritance T.~..
at the lawful C1... I (coU.tar.U r.t. on any .uch future Int.r..t.
PURPOSE Of
HOTlCEI To fulfill the requlrea.nt. of Section 2140 of the 1nh8~ltDnC. and E.t.te T.. Act, Act 21 of 2000. (72 P.S.
S.ctlon 9140).
PAYHENTI Detech the top portion of thl. Hotlc. and .ub.lt with your p.y.ent to the R.gl.t.r of Will. printed on the rev.r.. .Ide.
--HIIk. cheek or aon.y order p.yable tal REOISTER OF MILLS, AOENT
REfUND (tA)1 A ~efund of e t.x credit, Which NO' not requalted on the Tax R.turn, .ay b. r.qu..t.d by coapl.tlna en "Application
for R.fund of Penn.~lvanle Inheritance and E.tate Tax" IREY-1113). Application. .ra evallabl. at the Offlc.
of the R.gl.t.r of Will., any of the 23 Revenu. DI.trlct Offlc.., or by calling the .paclal 24-hour
Mlwerlng ..rvlc. for for.. ordering I 1-800-362-2050, Itrvlc.. 'or ta~p8Yerl with .p.elal h.arlng and I or
speeklng need'l 1-800-447-3020 ITT onl~).
OJJEtTIONSI AnV p.rty In Int.r..t not .atl.fied with the .ppr.I....nt, allowanc., or dl..llowance 0' deduction., or ........nt
of tex (InclUding dl.eount or Inter..t) .. .hown on thl. Notlc. au.t Object within .I.tv (60) d.~. of ~.celpt of
this MoUc. bYI
"-wrltt.n prot..t to tho PA o.p.rt..nt of R.venutl, Board of App...., D.pt. 281021, Itarrhburg, PA 17128-1021, OR
--.I.otlon to have the .att.r dat.r.ln.d .t .Udlt of the account 0' the p.r.onal repr..entatlv., OR
--app.al to the Orphan.' Court.
AONIN-
ISTRAlIVE
CORRECTIONS I
factual error. dl.cov.red on thl. ........nt .hould b. .ddr....d In writing tal PA Oepart..nt of Rev.nu.,
Jur.au of Individual hu., ATTNI Po.t A.......nt Review lkllt, O.pt. za0601, t1arrhburg, PA 11128-0601
Phon_ (717) 787-6505. S.. page 5 of the bookl.t "Inatructlona 'or Inherlt_nc. Ta. Return for _ Re.ldent
Oecad.nt" (REY-1S01) for an .~plan.tlon of adalnl.tratlvelY corr.ctable errora.
DIStDUHJI
If anv talC: dua I. paid within three (3) cal.ndar aonth. after the decedent'. death, a flve percent 15,U dhcount of
the tax paid la .llowed.
PENAL TV I
Th. 15X ta. aan..ty non-participation penal tv I. co.put.d on tho total of the tax and Int.r..t a......d, and not
p.ld b.'or. Januarv 18, 1996, the flr.t dav .ft.r the .nd of the ta. aane.ty p.rlod. Thl. non.partlelpatlon
penaltv .. appealabl. In the .... .anner and In the tho .a.. ti.. period a. YOU would appeal tha tax and Int.rnt
that ha. b..n .......d a. Indlcat.d on thl. notice.
INTEREST I
Int.re.t i. charged boglnnlng with fir.t dav of dollnquency, or nln. (9) .onth. and on. el) day fro. the data 0'
deeth, to the data of pav.ent. T.... which beca.. dal1nquont b.fore January I, 1982 bear Intere.t at the rate of
.1. (6%) percant per annu. calculat.d at . dallv rat_ 0' .00016~. All ta.e. which beca.e delinquent on and aft.r
Januarv 1, 198Z will boer int.r..t at a rat. which will v.ry fro. cal.nder ve.r to calendar y.ar wIth that rat.
announced by the PA Depart.ant 0' Revenu.. The appllcabl. Int.r..t rat.e for 198Z through 2001 .r.,
Vear Intar..t R.te Dally Inter.at Factor V..r Internt Rate Dallv Int.n.t factor
1982 :OX .000548 1991 'X .000247
1983 lOX .00043& 1993-1994 7lt .000192
I'" m .OODSOI 1995-1998 'X .000247
1985 I>X .000156 1999 7X .000192
1986 lOX .000274 2000 OX .000219
1987 'X .000247 2001 OX .000147
1988-1991 m .000101
ulntarnt I. c.leulat.d .. 'ollow"
INTEREST = BALANCE DF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Anv Hotlc. 1.lu.d aft.r the tax beeo... d'llnqu.nt will refleat an Inteta.t calculation to flf'.on (IS) day.
beyond the dat. of the ........nt. If paya,nt h ..d, "ftllt the Inhr..t cHPUtatlon dft'e .hown on U..
Hotlc., additional Int.r..t au.t b. c.lculatad.
,
\ /?- /j'1~ 5
COHMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'K~
') (~ 'RQ'
BUREAU Of INDIVIDUAL TAMES
U.tERIIAHC[ TAM DIVISION
[l(Pl. za..Ol
HARRISBURG, PA 171Ia~O.OI
In-I"'''''' IU-II'
GALEN R WALTZ
TURO LAW OFFICES
28 S PITT ST
CARLISLE
DATE
ESTATE OF
DATE OF OEATH
FILE NUHBER
COUNTY
ACN
05-21-2001
BAUM
12-05-1995
21 95-0426
CUMBERLAND
101
A.ount R..ltt.d
NETTIE
PA 17013
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I To In.u~. proper cradit to your account, aub.lt the upper portian of thl. for. with your t.K pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOllER PORTION FOR YOUR RECORDS ....
hirv:i6iWExu"iip--Cl2=cioT"-----...--iflHiiiiTANci--fAx--si'iifEHi-tif-iiF-ACcciiiiif--.-i.----------------- ----
ESTATE OF BAUH NETTlE R FILE NO.21 95-0426 ACN 101 DATE 05-21-2001
THIS STATENENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW
IS A SUNNARY OF THE PRINCIPAL TAM DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT, 04-16-2001
PRINCIPAL TAX DUE ,~___.._...~_ 1,89S. 06
PAYMENTS (TAX CREDITS),
PAYHENT
DATE
03-12-2001
04-23-2001
DISCOUNT (+)
INTEREST/PEN PAID (-)
530.90-
184.63-
2,428.96
184.63
RECEIPT
NUMBER
AA478136
AA478297
AMOUNT PAID
TOTAL TAX CREDIT
1,898.06
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FDR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN 'I,
HO PAYNENT IS REQUIRED.
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIOHS. I
R
If RESiOEHT DEaDEHT .... chllck or IIOMY ord.r p.~abl. tal REGISTER OF WILLS, AGENT.
If NOH*RESlDEHT DECEDENT .... check or IIOMY order paywbl. tal COHHONWEALTH OF PENNSYLVANIA.
PA\'tENT I
OwtltCh thw top portion of this Hotle. and .ubIIlt wUh your pay..nt .1Id. paywbla to the n... and eddr...
printwd on the ravar.. .id..
REFUND (CAlI A r.fund of . ta. credIt, which wa. not raqua.tad on the ,.. R.turn, .ay b. r.qu..t.d by coaplatlng en
"AppllcatJon for Rafund of Pwnn.ylv~la Inheritance end E.tate Ta." IREY.1313). application. .re avaIlable at
the Office of the R.gl.t.r of Willa, wny of thll 23 R.venue DI.trlct Offlca. or froe the Owpartaent'. Z4*hDUr
en....rlng ..rvlc. for for.. orderlnGl 1*100*562.2050, .arvlc.. for t..p.y.r. wIth .p.clal hIIaring and I or
.paaklng ~" 1.100*447*3020 ITT only).
REPLY TDI
QuestIon. ragardlng .rror. contaIned on thl. notlc. should b. eddr....d tal PA Owpart.ent of R.venua, Dur..u
of IndIvIdual Ta..., AT'HI po.t A......ent R.vl.w unit, Dept. Z10601, Harrl.bUrg, PA 17128.0601, phone
(717) 717.6505.
DISCDUHTI
If any ta. due I' paid within thr.. (3. calandar eonth. eft.r the dacadant'. d.eth, a flv. percant C5X, dl.count
of the ta. paid I. allowad,
PENAl TV I
The 15X ta. eane.ty non*particlpatlon penalty I' co~t.d on the total of tha ta. end lnt.r..t .......d, and not
paId b.for. ~~ry 11, 1996, the first day eft.r the .nd of the ta. .-na.ty p.rlod.
IHTEREST,
Intara.t 1. chargad b.glnnlng Mlth flr.t day of dallnqu.ncy, or nine I~) eonth. and ana 11) day fro. the data of
daath, to the data of pay.ant. Ta.a. which bac..e dallnquent b.fora January I, 1912 bear Intara.t at tha rata of
.IM 16XJ p.rcent par annua calculatad at . dally ratu of .OOOI6Q, All ta.a. Mhlch b.ea.a dallnquent on end aftar
January 1, 1912 Mill b.ar Int.ra.t at a rata which Mill vary fro. calendar ya.r to cal.ndar y.ar Mlth that rata
lIf\IlOUhCad by tha PA napart.ant of Ravanua, Tha eppllcable lnt.re.t rala. far 1982 Ihrough 2001 IIr.1
Y.ar lntar..t Ral. DaUy Inlarut file lor Vaar Inlarast Ral. Dally Intara.1 fllotar
1982 20X ,000541 199Z .. .000247
1983 16X ,OOD431 1993.1994 ]X .000192
1914 11;( ,OOD301 1995*1991 9X .000247
1915 13X ,OD0356 1999 7X .000192
1916 lOX .DDoZ7.. 2000 OX .000219
1987 9X .000247 2001 9X ,OOOlft1
1981*1991 IlX .000301
..Int.r..t I. calcul.tad a. follow"
INTEREST a BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTF~EST FACTOR
uAny Halle. ".ued afhr the t.. b.coa.. d.llnqu.nt wUl nfl.ct an Inl.r." calculation to flU..,. US, d.y.
b.yond the d.l. of the ..........t. If pay..nt Is aada .ft.r the Inl.r..t coaput.tlon data .hown on the
Hatlc., ~Itlon.l lnl.r..t au.t be celcul.lad.
.--.....__.~.~..-...-----._-
--:;-
-.~~_JJ ___
""""-......",..."
- -. .- ..... _. -~ .
~. -- ~-. -. -.~ .--.-- - --.-.. --..- .-. .~.._- -....... - - -'- -~ ..--.--...,--. -.. - --..- - - - _.- -- -...-... --- -- -- - -. ~....-.- _.~
DATE OF DEATH 61<
12105/199~
REMARKS L H
: .-____"" g~~C~:L;~~ _ WAC T~~U"OA:=::TEA OFWllLs__________~l~~~J
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DURI!AU D~ INDIVIDUAL TAXED
DEPU8oeo1
HARRISBURG, PA 17128.QG01
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
.
No.AA 478136 REV,""UXC"""
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
GALEN R WALTZ
C/O TURO LAW OFFICES
ee S ,PITT STREET
CARLISLE, PA 17013
101
se.4ee.96
ESTATE INFORMATION:
FILE NUMBER
21-1995-0426
NAME OF DECEDENT (LAST)
9AUM NETTlE R
OATE OF PAYMENT
3/1e/eOOI
POSTMARK OATE
0/00/0000
_HEIlE
SSN 16e-ee-3649
(FIRST)
(MI)
COUNTY
CUMBERLAND
TOTAL AMOUNT PAID
s2,42e.96
. "
...
.')
,
.
I
.,
.
1
. '
"
.---. r""4.............
~.~._....-.----'...~~A I t.. _"-.& """,,:0.
.
,,~. .~
... ~. ~.... -... -. .,. .
--.-- -----~-_.- --- -~._--_...------------------------
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OP INDMDUAL TAXES
DEPT .280601
HARRISBURG, PA 17t28.Q801
'*
No.AA 478297REV'"02EX'It...)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
1'1
RECEIVED FROM:
r
~ I
.
"
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
WALTZ GALEN R ESG
101
_184.63
38:57 ELDER RD
HARRISBURG, PA
17111
FOUlllERE
--
ESTATE INFORMATION:
FILE NUMBER
21-1993-0420
SSN 102-22-3649
(FIRST)
(Mil
NAME OF DECEDENT LLAS!)
BAUM NETTIE R
DATE OF PAYMEt>/T
4/23/2001
POSTMARK OATE
0/0010000
COUNTY
CUMBERLAND
DATE OF DEATH
12/0:5/199:5
REMARKS
_184,03
TOTAL AMOUNT PAlO
C/O GALEN R WALTZ
CHECK" 1939
SEAL
,DO
f,/ \.,./
,","".-
. r J' '/" i' ". '. . ..'
RECEIVED BY ", ,r,.../'./ '._ /,...,."..",1,/,.<;..
MARV C, LE;Wjl> ; ./' .,' .-
REGISTER gF WILLS/:-:JIJ,.(i,,1/r,-'i'!/'
REGISTER OF WILLS
.~--------------------------~--------~--'--
....'
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_."_'_'~'_"'~....1Jl __ . "'<1':--'
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J~~
FAMILY SETTLEMENT AND FINAL RELEASE
ESTATE OF NETTIE R. BAUM
KNOW All MEN BY THESE PRESENTS, that Nettie R. Baum, late of Carlisle
Borough, Cumberland County, Pennsylvania, deceased, died Intestate on Decamber 5,
1995.
WHEREAS, the said Nettie R. Baum, had been separated and abandoned by her
husband for approximately the last three (3) years of her life, and was survived by her
two (2) natural children, Mary l. Buchenauer and Arthur J. Baum;
WHEREAS, letters of Administration on the Estate of the said decedent were
duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said
Administratrix, hereinafter called personal representative;
WHEREAS, the personal representative has gathered the assets of the Estate of
the said decadent and the assets consist of real property with the total value as set forth
In Exhibit "A", which is a copy of the Pennsylvania Inheritance Tax Return filed and
approved by said personal representative.
WHEREAS, the debts and deductions, including the payment of inheritance tax
in the said Estate, which have now been paid, leave the real property known as 161
East Mulberry Avenue, Carlisle, Cumberland County, Pennsylvania for distribution;
WHEREAS, the distribution as shown in the said Deed marked Exhibit "B" has
been distributed as herein indicated In accordanca with the statutory laws pertaining to
the said Decedent;
NOW, THEREFORE, Mary l. Buchenauer and Arthur J, Baum being the only
children and heirs under the Pennsylvania Intestate law of the said decedent, and
being those persons entitled to inherit under said Intestate Statutes, do hereby each of
us acknowledge that we have this day had and received from the aforesaid personal
representative, in full satisfaction and payment of all sums of money, or property as are
given, directed and provided to each of us respectively by the said Intestate law, the
amounts due us under said Intestate law, which amounts we have recaived this day or
prior to this day; and, each of us do hereby stipulate that In order to avoid the expense
and time involved In the filing of a formal account and schedule of distribution, we each
agree that no account is necessary and we do hereby agree that we do consent to
distribution being made without the filing of an account and schedule of distribution, the
same to be with the same force and effect as if they had been filed and confirmed by
the Orphan's Court Division of the Court of Common Pleas of Cumberland County,
Pennsylvania,
THEREFORE, we and each of us, do hereby remise, release, quitclaim and
forever discharge the said personal representative, Mary L. Buchenauer, her heirs,
executors, administrators and assigns, of and from the said estate and from all actions,
suits, payments, accounts, reckonings, claims, and demands whatsoever for or by
reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon
the Estate of the said decedent, and each of us do further hereby covenant and agree
that should any liability come due to the estate of the said decedent after the signing of
this Agreement, we and each of us do hereby covenant and agree with each other and
the aforesaid personal representative, that we will contribute pro-rata our share of the
Estate to satisfy any and all claims, demands, suits or causes of action which may be
successfully prosecuted against the said Estate or the aforesaid personal representative
after the signing, sealing and delivery of this Family Settiement Agreement and Final
Release.
IN WITNESS WHEREOF, we have hereunto set our hands and seals the day
and year noted below.
3 -.) 8'.,) ,)uc.-'"
Date . Witness
d/~A.~ .~..,
Arthur J, Ba
IN WITNESS WHEREOF, we have hereunto set our hands and seals the day
and year noted below,
.~~~, B~~e~a~ef.:> , " \-.... ,", ....J-L-
3. ~%-C\
Date
.;.~~....;:.,,: <', "'~'-. :<,:"",~,:"\, ..-."' "
......_D.~
.
,I'. M
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
,...NUMaU
2\
CiOlIlIIIIOIMCAl1HOfI'tMC'l'\YIHA
Dl'MTWDIT Of lIYDUI
Dl",__
tWltlIllJllO.'" "'~
9~
00426
8OCW. SECURITY NUMBER
,.
.,
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:1
...
, DECEDENTS NAME (lAST. FIRST, ANDMlOOLE INmAl)
; Blum, Nettie R
\ DATE OF DEATH (Mf.a.oo.YEARI
I
112/0~/\99~ 0\/29/1927
(IF APPUCA8lE) SURYMNO SPOUSE'S NAME C LAST, FIRST AND MICOl.E 1Nl'TlAL)
: alum, Arthur C
~ 181 1. Origlnalft.m 0 2. Suppl.tment8lftMum
, 0 4. UmttMl!ltI" 0 .. F\Itufe~Comprom"'(41"oIcMI"
I . .,. '2.12-82)
I 0 I. o.c.denIDledT"",AbctU:09Y 0 7. DecedentMillntalrMMhLMngTrult(AtlKh 1.1otaINumbetdS.,.DtpodBoxn
II 0 "'WIll 0 _"'TNOll
I. Utlgrion ProoNd...~ 10. Spoutal Powttyer.ctIl(dl"oI""~ 0 11.rlection tel tax undelSeo.111J(A)(AaaehSdlO)
na AC11llN llUaTUCOUI'UmD.'.w.COItJU!IPONDl!NClI NlOCONI'IDQl'IW. TAX IHI'OIIMATlON IHOULD U DlftB:Tl!D 10;..' " ~
~E COMPLEtE MAUNQ ADORESS
i Galen R. Wallz
162.22.3649
DATE Of DlRTH(MM.{)().YEAR)
TIt. RnuR" _IT II PLID II DUPUCATI WfTH Tltl
REGISTER OF WILLS
8OCW. SECURrTY tf\JIMBER
~~!
u~
wll
!i~
,
'l
o 3. R~lndtlfRIItum(d"'ddedlpncwlD'2-tU2)
o
5. rederal!!." Tu ftetum ftequlf*t
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FIRM NAME (l1pPlc8.tM)
i Two Law Offices
~NUMBER
; 717124~.9688
1, ROIl Eatato (Schoclule A)
2. Sloclco ond Bonds (Schedule B)
3. CIooeIy Hold COrpcn\Ion, Portnerahlp or SoIe-Proptletorahlp
4. Mortgogoo & Not.. RocelvIbIe (Schedule D)
S. Cooh, Bank DopooIIo & MllCIIlanoouo Ponsonol Properly
(Schoclule E)
B, JolnUy OWned Pn>petIy (Schedule F)
o Sopomo Billing Roquoslod
7. InI....VIYoo Tronel... & MloceIlanoouo Non-Probolo Pn>petIy
(Schoclule G or l)
B, ToIol Groll AIIeIo (totol Unoo 1.7)
9, Funerol Elcpenoeo & Admlnlstroll'le CooIa (Schedule H)
10, Debb 01 Decedent, Mortgage llabllftlos, & Ueno (Schedule I)
1 1, ToIol Deduc1lono (lotol Uncs 0 & 10)
28 S. Pitt S1.
Culis1e. PA 170\3
(1) 44.000.00
(2) NODe~
(3) NODe
(4) NODe
(5) NODe
(6) NODD
(7) NODe
:.f'F,":.'.. ...:iE:"..
a
I
44.000.00
(9)
(10)
12,152.3\
,
213.34
(11)
(12)
(13)
(14)
12,36~,6~
31.634.3~
12, Net V.luo 01 Emlo (UneB minus Une It)
13, Chorttoble ond GoYemmonlol BequoalalSoc 91 13 Trusto lor which on olectlon to lax hoe not boon
modo (Schedule J)
14, Net Vol"" Subject 10 Tax (Une 12 minus Une (3)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
lS,Amount DIUne 14taxablo ot tho spoosallaxralo.
or hnsr... undor Soc. 9118(0)(1,2)
31,634.3~
(15)
x ,00
A
i
~
31,634,35 x .06 (16)
1,898.06
I B, Amount 01 Une 14 taxable ot II....., rato
17.AmounlDI Une 14 taxable ot oIb11ng rato
x .12 (17)
lB, Amount DIUne 14 taxable ot coIlatoral ralo
x .15 (IB)
I 19, Tax Due
120.0
(19)
1.898,06
CHECK HERE IF VOU ARE REOUESTING A REF UNO OF AN OVERPAV/.IENT.
- '-'-. '~:.-..j-.,.::Joji.aaauRa.TDAHSWERAIJ;-
ecK MATH C4
EXHIBIT
Form REV.1&OO EX IRoV,loGO)
COI.yrlgh12000 lonn softw... only The lJlckner Group, Inc.
J
A
Decedent'. Complete Addre..:
RTRl'Jn' AllllRIUlH
2 W..,I'.nn
CITY
STATE PA
ZIP 17013
C.rll.l.
Tn Plymlntl and Crldltl:
" To Duo (Pogo lllno Ill) (I)
2, CrodftllPoymonll
II S_I pcrmty Clodft
0, Prlot Plymentl
C, DlIcount
1.898.96
0,00
TolII Credlta (A + 0 + C) (2)
3 Int....tlPonolty IIlppllClble
0, Int.....
E, Ponolty
530.00
(3) 530.00
(4)
(5) 2.428.96
(SA)
(58) 2,428.96
Tot.llntoraatlPenalty (0 + E)
4, IIllna 218 gr.....lhan Una 1 + Uno 3, ont..tha dlrtoranc:e, ThIa 18 tha OVERPAYMENT.
Check boa on Page 1 Uno 20 10 ~u.at . relund
5, IIlIna \ + Una 311 groatorlhln Uno 2. onl..lho dlrtll8nee, Thla I.tha TAX DUE,
II, Entorlho Int..... on tha la>c duo,
0, Ent..tho total 01 Uno 5 + SA, Thl. I. tha BALANCE DUE.
Make Chack Payebla 10: REGISTER OF WILLS, AGENT
,'.('~.'~~~~Ji- .L, &1'
PU!AlI! ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X"IN THE APPROPRIATE BLOCKS
\, Old _ makl.llanllor Ind: YI. No
., rataln tho UM or Income 01 tho ptopar1y tran.lerrad;................................................,.................................... ~ g
b, rataln tha right to dealgnat. who ahall uae tho ptopar1y llanalerrad or Ita Income;..............,..........................
o. rataln. ravoraIonary Int.....: or"................".............................,......",......,............",..,............,....................
d, racaM tho ptOmlM 10< III. of.1Ihat paymenta. banal1ta or ..ra7.........,.........,..............................................
2, II deo'" oocurrad In.. Docembar 12. 1ll62, did decedent llanal.. ~r\y wtlhln one year 01 daath without
rac.Mng odoquat. conaIdaratIon7.....".......,......""""...,..............,..................................................,....................... 0 181
3, Old _, own.n 'In truat 10f" or payable upon death bonk account or aecul1ty.t hla or hat dea"'7............... 0 181
4, Old _ant own.n IndMdual Retlrament IIcc<>unt. .nnulty. or other non.probat. prollOr\y whlch
oont.lna. banallclary d..lgnalIon7",........"..",.......""...............,.........."......"..,.............,...................,.................. 0 181
IP TH! ANSWER TO ANY OP THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
UMet pene.... d E*1UIY, I ~ It\It I hew...mIMd thIt r.un, lncludlnO ~PM}Vlg 1CtlecIv* Ind IW!lMMnta, WId D ~ bMt 01 my ~ Ind bIIW, II: It bW, c:cnwct Ind c:om~
~~ 01 ~ cIhw lhM eN peI'IClNl,.pIWMl ~ M buedCll'lI"Womoltlon rA\IIIItIld'I ~"'h.. Iny knlJW\edot.
ISlOHATVAII Of PEAION RIJSPONSf9lE FOR FllINO RETURN AoonESS DATE
~ \ ~ I~rl~~~
1"r{,^,~~~ 5....Lh...A.-.~'_ Carlise,PA 17013 '2>-\'2.-.0\
OOw.TUiiE~H&ON RE6PONSlDLE FOR FllINO RE1\JRN AOORESS DATe
.me
ADDRESS
llATE
28 S, Pitt St.
Carlisle. PA 17013
/U/QI
"
Fo< dat.. 01 death on or .n.. July I, 19l14.nd bofor1l J.nU8ljlI, loos. tho la>c ratllmpoaed on tho not valuo 01 llanalera to or for tha uae 01 tho
auMvlng 8pOUM 1.3'11I [72 p,s, 59115(.) (1.1) (1)),
Fordlt.. of death on or .n..January I, lU9S.tha la>c ral.lmpoMd ontha not value 01 IlaMlera 10 or lortha UMoftha aurvMng 8pOUM 1a0'l6
(72 P.B, SllI1S(.) (1,1) (11)). The__ not oxemot. tranal..to.auMv\ng._ lromla>c, and thoalllluto<yrequlromenta lordlacloaura
ol._.nd nllng .la>c ratum.ra alIlI.ppUcablo even If tho aurvMng _Ia tho only benellclary.
Fo<dal.. ol_on or .norJuly 1, 2lXXl:
The to ratllmpoMd on tha not valuo of tranalll8 /rom . -.ad child Iwonty-ono yeara 01 age or younger at death to or lot tha uae 01 . naturat
parant. an odofllIva parant. 0<. alepparanl oltha child Ia 0'lII [72 P,5. S91IB (.) (1,2)),
Tho... ratllmpoMd on tha not valuooftranalera 10 or 10< tho UMoltha docedont'.lIne.1 banallclarles 1a4.5'llo. oxceplunotod In 72 P.S. S9\IS
\,2) 172 P ,S, SgllB (I) (I )1,
Tho... ratllmpoaedontha net valuo 01 tranalera to or forth. uae oltha_ont'. sibling. Is 12'llo [72 P,S. 59IIB (.) (\.3)), A sibling ladenned,
undor lIectlon 9102... an IndMduel who haa at IeasI one parent In c:onuroo wtlh tho decedent. _ bY blood or~,
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
eatate 01 Dlum. Nettie R
elao known es
No. 21-01-00426
Date 01 Death 1215/1995
Social Securtly No, 162.22.3649
, OecellSed
Mary Buchcnlucr
The Personal Represenlallve(a) 01 the above eatate, deceased, verily that the itema appearing in the 10Dov.ing Inventory
include all 01 the personal assets wharevar Illuate and all of the real eatate located in the Commonwealth 01 Pennsylvania 01
eald Deceden~ that the valuation placed oppoaite each item 01 eald Inventory represents Ita lair value.. 01 the dele 01 the
Oecedenfe death, and that the Decedant owned no raal eatate outslda 01 the Commonwealth 01 Pennsylvania except that
which appears In a memorandum at the end 01 thla Inventory. lIWe vertly that the atatementa made In thla Inventory are true
and correct lIWe underatand that lalae atatements herein are madeeubJect to the penalUee 0118 Pa, C. S, Section 4904
releting to unsworn laIalftcatIon to authorities,
Attorney: Galen R. Waltz
1.0, No,: 39789
Personal Representative
Signature: '--'rn~.. L. f-u, l-...~,. _~ -
Mary BuchOucr
Signature:
Slgneture:
Addr...: 28 S. Pill SI.
Carlislc,l'A 17013
Addr...: 1 SO Pine Hill Road
Carlisle.PA 17013
Telephone: (717) 245.9688
T e1ePhon(:l\.,) rl ~ '\ - (. (, 2.. ~
Dated: 3'\"2.-0 \
~eal Estate
161 E, MUlbeny Avenue, Carlisle Pennsylvania
44,000,00
Total Real Estate
S44,o00.00
Total Personal Property and Real Estate
(Attach additlonel.heets II neeeseery)
S44,o00.00
'*
SCHEDULE A
REAL ESTATE
ClOM~~ftlClff'llMY\WIM
tHM'NClrAlAI1\.IIlIIl
--
ESTATI! OF B N I R I FILE NUMBER
. awn, en 0 :U .01.00426
All_I praper!y _n~ solely or aa alenanlln common mual be re~ al fair markel value. Fair markel value II defined.. the price
at W111ch PfllpertY would be exclianged between a W1Wng b~r and a vAWng lIelIor, nolthor being compe!Jed to buy or ll8Il, both hevtng
rell80nalile KnoWledge or tho relevent racta, Real prapertyWhlch la JolnU-y-owned with rlghfolaurvlvorshlp mual be dlacloaad on
IChedule F.
ITEM
NUMBER
I
DESCRIPTION
161 E. MUlbcny Avenue, Carlislo Pennsylvania
VALUE AT DATE
OF DEATH
44.000.00
TOTAL (Also en~ on LIne 1, Recllpltulallon)
44,000.00
,
.
SCHEDULEH
FUNERAL EXPENSES &
ADWtSTRAllVEl..U) l::i
I
I FILE NUMBER
21.01.00426
~1MOI~VNM
NtlM'NCI TAlltl'1\M
--
ESTATE OF Blum, Nettie R
Debts of decedent mUlt be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
AMOUNT
A.
FUNERAL EXPENSES:
HolJ'man md Roth Funeral Home
5,828,20
B. ADMINISTRATIVE COSTS:
" PolaonaI Repl_datJye'. CommIuIona
MIIy Buchcnaucr
SocIII SecurlIy Numbot(.) , EIN Number 01 P.......I RoprwMntalIve(.):
_~ 150 Pine Hill Rold
Clly Carlisle StaI. PA ZIp 17013
Year(l) Commlsalon peld
2. AIlllmey'. F... Two Law Offices - Galen R. Waltz
3, F.mlly Exwnpllon: (11 decodent'._....1a noIlhe lima II claimant'., al1ach oxpIana,lIon)
Claimant
SIrHI Add....
2,200,00
1,800,00
4,
CIIy
Relationship 01 Claimant 10 Decedent
Probata F...
100,00
StaI.
ZIp
5, Accountant'. Fees
8. T.. Ralum PrapIl1Il'. F...
7.
1
2
3
Othar_ CollI
Thc Scn1ine~ Eslate Notice advertisin8
Cumbcrllllld Law Journal, Estatc Notice
Lany E. Foole: Appraisal rq>ort for 161 E. Mulbcny Avenue, Carlisle, PI
84.11
75.00
250,00
Tolal of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
1,800.00
12,137.31
*'
CCIoIMClIMWALTH ClI' PENNIYI. VANIA
_AHCaTAllRIlUIIN
Raum DEaDINT
ESTATEOF Blum,NcttloR
4
SchecUe H
Fu1eraI ~ as &
Ad.. ilIlc6la CostsCCll"6uld
Carllalo Memorial: marker
FIll! NUMBER
21.01.00426
1,800.00
P1SC 2 of Schedulo R
~r:Q"J't~t~:;;;';';'~;;;'~:~~~;""~'~~'~:("""~~t'.ik'f,~D\IijJti:~11iU-'m.~i;:o:.t';~U"i.'~...~l-
'*
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
OOIfMCIMALTHOI.......,,\WM
"""'NI:I TAll II1WIC
--
ESTATEOF B N' R
awn, c1t..
I FILE NUMBER
21 .0\ .00426
Includ. unralmburaed medlcal..pen....
ITEM
NUMBER
\
DESCRIPTION
Real EstaIcTax, \6\ E. Mulbcny AVClIUC, Carllsl., Pa.
AMOUNT
2\3.34
TOTAL (Also enter on Une 10, Recapitulation)
213.34
_......,.'~:<.,~~....-.;.....-'.\h_..';...'n':,':;'<-,,~-.;....._;..',:,'"I.;';-.i(;:,-,,;,:-,.
\,0 ,,'
.
SCHEDULE J
BENEFICIARIES
c:ot.WOtNt'EAL 114 CIf' PENNSY\. VNM
IHtlERlTANCI TAX AEt\JRH
RESIllCHT DECEDENT
=
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
FILE NUMBER
21.01.00426
RELATlONBHIP TO
DECEDENT
AMOUNT OR SHARE
OF ESTATE
EflTATE OF
DIWD, Nenie R
I. TAXABLE DIBTRIBUTIONS (1ncIudt cutrtght apouaal dlotrtbutlonl)
Mil}' L. Bucbcolucr
150 Pine Hill Road
i Carlisle. PI.17013
2 Arthur J. Blwn
2 West Penn, ApI. 11306
Carlisle, PI. 17013
Dlughter
illy pcrc:cnl
Son
illy pcrc:cnl
i
lEntil' dollar amounta lor dIalr1butlona ahown lbow on 11neI15 thrcugh 17, II IpprllIXlaIl, on Rev l!ilXl CtNet_
II. NON.TAXABLE DISTRIBUTlONB:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IB NOT
BEING MADE
!
I
I
I
I
I
1
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
EXHIBIT
TOTAL OF PART II. ENTER TOTAL NON-
I
1)
E 13 OF REV-l!ilXl COVER SHE
cumberland County - Register of wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/05/2002
WALTZ GALEN R ESO
28 SOUTH PITT STREET
CARLISLE, PA 17013
RE: Estate of BAUM NETTIE R
File Number: 1995-00426
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 12/05/2002
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
,a""",tL. J1I. ()~/pt/J,jU;d.-JfJl:V
J-~/)l :6-
MARY C. LEWIS ~ tf
REGISTER OF WILLS
cc: File
VPersonal Representative(s)
Judge
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