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HomeMy WebLinkAbout96-00233 ,f"c> ~ '76 ~/'if' ,r .....' .....-. . " -_.......--,,-- .. . - .: " ::. f-4 'j .....1 j ~ Z ~ Ioo-ol ~ ~ '" ~ Q ::s ~ -. Z -< f-4 0 -< f-4 ~ I:"I.l ~ -< I:"I.l ~ ~ ,Xi .. .....1 " . &1.1 ~ l- e Q 1.1-' ....,.,.., . ,'l'un''\ \'0 v, '.'-; "-," U IHl'; , ;'IJID 911: OlV L- MdV L6. Sf"I'" ,- ',"u ;,!\~ ; >,' :~"'~ 10 .. ,'" -'-")'1.01:1 , -.-'-',:f" ;'- '~ ....- , "~.;.~ , .~.-._._,-,....,~---- _. "'- 'l ' . .. .,,; " ~. =Ij - . ~.. .: ..... l. ..' ! ..:I ~ .'. .. ATARIO j Jf1roha, Q U,S, POSrllGl "IIame, (lulU Plltllf CIIY,HQ ':- .."61Q7~. . .s; "L- """'DH""S r-Lt.. '''' Ul f row.;U~i f1MOlJUr UUUU $J2.25 J UUU1"tl1I1&-U& S1) i AFFIX POSTAGE OR , 1; CORPORATE ACCOUNT LABEL HERE. - j l! ADHIERA Aoul EL FRANOUEO 0 SU (; ~ i I . ETlOUETA DE CUENTA CORPORA77VA - .!l iii USO NACIONAL UN/CAMENTE '_I )" j , \ ~ ,J I .....----.. lii I . .. :Ii ~ = ~ " I I , . -- --_I..........~ ..'.............J4.~_ 4>:-."'1.,. ,:~:. .. .. ~5511(a). An affidavit of scrvicc containing spccific avcrmcnts as to thc abovc rcquircmcnts shall bc prcscntcd at thc bcginning of thc court hcaring. 3. At Icast twcnty (20) days prior uoticc of thc court hcaring. togcthcr with a copy of thc pctition, shall bc givcn pcrsonally or by ccrtificd mail to all pcrsons who arc sui juris and who would be entitlcd to share in the estate of D'nelle Parker if she died intestate, namely: MichaelParkcr 1'.0. Box 1411 Platte City, MO 64079 4. Petitioner and/or cOllnscl for petitioner shall notify the court. in writing. at least seven (7) days prior to the court hcaring if counscl has not becn rctained by or on behalf of the alleged incapacitated pcrson in accordance with the provision of 20 Pa.C.S.A. ~5511 (a). TIlis notice shall also contain all pertincnt information which would indicate to the court whether or not counsel should be appointcd to rcpresent the interests of D'nelle Parker. 5. D'nclle Parker shall be present at the court hearing unless it is established by clear and convincing evidence medical evidence that her physical and mental condition would be harmed by hcr presence in court, in accordance with the provision of 20 Pa.C.S.A. ~5511 (a). TIle court hearing shall be closed to the public unless D'nelle Parker or her counsel demands otherwise. By the Court: ;. I . ( (./ I ) fl' ) . 1. 3 -I S.'ll" f\ A t',(f.,~. ~ .J VU"'" ~ITI , f. ~ ---- i' _._..........~.-1:jI,. ..-&.T\... ...,,:. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA ORPIIANS' COURT DIVISION )/.- No.,BL -9( -~~) ESTATE OF D'NELLE PARKER. AN ALLEGED INCAPACITATED PERSON Social Security No.: 433-36-4964 ........................................................................ PETITION FOR AD.'UDlCATION OF ,NCAI>ACITY AND APPOINTMENT OF PLENARY GUARDIAN OFTHE ESTATE AND I>ERSON IN ACCORDANCE WITH 20 PA.C.S.A. ~5511 TO TilE COURT: Pelitioner. Ann Parker, respectfully submits this petition to the Court for the appointment of plenary guardian of the person and estate of D'Nelle Parker. an alleged incapacitated person. and in support thereof avers as follows: JURISDICTION AND VENUE I. '\lIe alleged incapacitated person, D'Nelle Parker. who was bom on November 28. 1913. is an eighty two (82) year old widow and is domiciled in Pennsylvania. residing at 1428 Bradley Drive. Unit J-214. in Carlisle, Pennsylvania. 2. Pursuant to 20 Pa. C.S.A. ~5512(b) and (2). this Court has jurisdiction over and is the proper venue for the appointment of a guardian of the person nnd estate of the alleged incapacitated person. 3. The only other court which has ever assumed jurisdiction in any proceeding to determine the capacity ofD'Nelle Parker is Buckingham County. Virginia FA( TH_A I ,11,~l'K!-.mW JNJ) II, D'Ncllc Parkcr has rcsidcd at hcr currcnt addrcss sincc Fchruary I. 19')~ with Petitioncr. Thc propcrty is rcnlcd liom Phcasant Run Propcrtics. I~. D'Ncllc Parkcr prcviously rcsidcd at II ~3 Phcasant Drivc North. Carlislc with hcr husband until his dcath in Fcbruary of 199.\ ami wilh hcr daughtcr, thc Pctitioncr. sincc approximately Dcccmhcr of 1993 whcn Pctitioncr movcd into thc rcsidcncc to assist in caring for hcr parcnts. 13. D'Nclle Parker is suflering from Alzheimcr's Discasc and rclatcd dcmcntia. Shc is unable to lakc carc of hcrsclf and rcquircs 24 hour carc. including assistancc lor fecding. drcssing. and pcrsonal hygicnc. IIcr ability to rcccive and cvaluatc information cflectively and communicate dccisions in any way is impaired to such a significant extent that she is totally lIImble to managc hcr financial rcsourccs or to mcct thc csscntial requiremcnts for hcr physical hcalth and safety, 14. Bccausc of hcr agc and mcntal hcalth. D'Nclle Parkcr's condition is not expectcd to improvc. 15. Thc tcstimony of hcr trcating physician. Dr. Earl Morton. will bc prcscntcd by dcposition. NO LESS RESTRICTIVE AI.TERNATIVE 16. The following support Pctitioncr's position thai thcrc is no less rcstrictive altcrnativc tothc appointmcnt ofa plcnary guardian ofthc pcrson amI thc cstatc ofD'Ncllc Parkcr: a) D'Nelle Parker has bccn cnrollcd in an adult day-carc program. Eldcrly Day Activities, Pctcrsburg Road. Carlislc. Pennsylvania sincc on or about Fcbruary of 1995. Pctitioncr was instructcd by Eldcrly Day Activitics not to bring D'Ncllc Parkcr back to thcir Iilcility on or aboutthc cnd of Novcmhcr. IlJlJS duc to bchavior and control problcms thcy wcrc cxpcricncing with D'Ncllc Parkcr. bl D'Nellc Parker has rcecivcd in-homc health earc assistanec through First Amcric.m Homc Carc who Ims provided nurses on a parl-limc basis sincc Dcccmbcr of 1995. Thc timding for this scrvice has bcen discontinued duc to thc fact that it is only supplied for "acute" conditions. Ahhough chronic, D'Nclle Parker's condition is no longcr "acute" as a result of changes in mcdicine. First Amcrican Homc Carc determincd that although [)'Ncllc Parker docs need constant carc, skillcd nursing carc. such as thcy providc. is not reqnired. c) The constant care and level of care requircd by [)'Nelle Parker mandates placcment in a nursing facility designed for the nceds of Alzheimer's paticnts as Petitioner is no longer able to provide the amount and level of care dcmanded by O'Nelle Parker for her own heahh and safety and docs not havc the rcsources available to hire private nursing assistants to care for O'Nelle Parker. ASSETS ANO INCOME 17. At prcscnt. O'ncllc Parkcr's assets. to thc extent known by Petitioncr. arc as follows: a) $21.85 in a bank account ill her mllne. 18. To the best of Petitioner's knowledge, information and belief, D'Nclle Parker's annual income is approximately $20.000, derived from her former husband's military mllluity and Social Sccurity. 19. I),Ndlc Parkcr docs nolown any rcal propcrty. nor docs shc hold any valuahlc liquid asscts nor pcrsonal propcl1y, PLENARY CilJi\JWIANSIIIP REOlJESTEJ> 18. Thc scvcrity of J>'Ncllc's mcnlal condition. thc lack of viahlc. Icss rcstrictive altcmatives and Ihc immincnt nccd for nursing homc placcmcnt. ncccssilatc thc appoinlmcnt of a plcnary guardian of f)'Ncllc Pmkcr's cstalc to managc and administcr allmallcrs conccming hcr financial allilirs. including but notlimitcd to: . hcr cash. chccks and any bank acconnts; . hcr othcr individually owncd propcrty: . paymcnt of mcdical, pharmaccutical. and othcr bills incurrcd to providc hcr with propcr mcdical carc and nmintcnancc ofhcr lifestylc; . prcparation and signing of tax rclurns and paymcnt of statc. local and fcdcl'lll taxes: . handling claims madc on bchalf of or against hcr: . cxccution of documcnts and cntcring into contracts; . Social Sccurity bcncfits and any othcr govcnullcntal or non-govcmmcntal bcncfits; . applying for insurancc and/or Mcdicarc or Mcdicaid bcncfits. 19. Thc scvcrity of D'Ncllc Parkcr's mcntal condition and thc lack of viablc. Icss rcstrictivc altcmativcs ncccssilatc thc appointmcnt of a plcnary guardian of hcr pcrson 10 handlc all issucs rclating to hcr pcrson. including hnt notlimitcd 10: . authorizing or withholding conscnt to mcdical trcatmcnt or mcdication and psychiatric carc; '. .. IN RF:: D'NELLE PARKER IN TilE COUR1' OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPIIANS" COUR'f DIVISION NO. 21-96-233 CITATION WE COMMAND, you that laying aside all business and excuses whatsoever, you be and appear in your proper person before the Honorable Judges of the common Pleas Court, Orphans' Court Division at a session of the said Court there to be held, for the County of Cumberland to show cause why she should not be adjudged an incapacitated person and why a plenary guardian of her person and estate should not be appointed; the hearing thereon to be held in Courtroom 1, Cumberland County Courthouse, Carlisle, pennsylvania on May 6, 1996 at 1:30 o'clock P.M. petitioner shall cause to be served by personal service the Citation with Notice and Petition pursuant to the provisions of 20 Pa. C.S.A. 511 (a), upon D'nelle Parker, at least twenty (20) prior to the court hearing. The contents and terms of the Citation with Notice and Petition shall be read and explained to the Maximum extent possible in language and terms the alleged incapacitated person is most likely to understand in accordance with the provisions of 20 Pa. C.S. A. 511 (a). An affidavit of service containing specific averments as to the above requirements shall be presented at the beginning of the court hearing. At least twenty (20) days prior notice of the court hearing, together with a copy of the petition, shall be given personally or by certified mail to all persons who are sui juris and who would be entitled to share in the estate of D'nelle Parker if she died intestate, namely: Michael Parker P.O.Box 1411 Platte City, Mo. 64079 Petitioner and/or counsel for petitioner shall notify the Court, in writing, at least seven (7) days prior to the court hearing if counsel has not been retained by or on behalf of the alleged incapacitated person in accordance with the provision of 20 Pa C.S.A. 5511 (a). This notice shall also contain all IN RE: D'NELLE PARKER IN Till:: COUIl'l' 01' COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPIIANS" COURT DIVISION CO~-'-l NO. 21-96-233 CITATION WE COMMAND, you that laying aside all business and excuses whatsoever, you be and appear in your proper person before the Honorable Judges of the Gommon Pleas Court, Orphans' Court Division at a session of the said Court there to be held, for the County of Cumberland to show Gause why she should not be adjudged an incapacitated person and why a plenary guardian of her person and estate should not be appointed; the hearing thereon to be held in Courtroom 1, Cumberland county Courthouse, Carlisle, Pennsylvania on May 6, 1996 at 1:30 o'clock P.M. petitioner shall cause to be served by personal service the Citation with Notice and Petition pursuant to the provisions of 20 Pa. C.S.A. 511 (al, upon D'nelle Parker, at least twenty (20) prior to the court hearing. The contents and terms of the Citation with Notice and petition shall be read and explained to the Maximum extent possible in language and terms the alleged incapacitated person is most likely to understand in accordance with the provisions of 20 Pa. C.S. A. 511 (al. An affidavit of service containing specific averments as to the above requirements shall be presented at the beginning of the court hearing. At least twenty (20) days prior notice of the court hearing, together with a copy of the petition, shall be given personally or by certified mail to all persons who are sui juris and who would be entitled to share in the estate of D'nelle Parker if she died intestate, namely: Michael Parker P.O.Box 1411 Platte City, Mo. 64079 Petitioner and/or counsel for petitioner shall notify the court, in writing, at least seven (7) days prior to the court hearing if counsel has not been retained by or on behalf of the alleged inGapaGitated person in aGGordance with the provision of 20 Pa C.S.A. 5511 (a). This notice shall also contain all "U'. ..'..,............'...... COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ,MAR 13 1996 -f:r>-' COpy NO. c:?/ crt -::I :l3 ESTATE OF D'NELLE PARKER, AN ALLEGED INCAPACITATED PERSON Social Security No.: 433-36-4964 ........................................................................ PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF PLENARY GUARDIAN OF THE ESTATE AND PERSON IN ACCORDANCE WITH 20 PA.C.S.A. ~551 I TO THE COURT: Petitioner, Ann Parker, respectfully submits this petition to the Court for the appointment of plenary guardian of the person and estate of D'Nelle Parker, an alleged incapacitated person, and in support thereof avers as follows: JURISDICTION AND VENUE I. TIle alleged incapacitated person, D'Nelle Parker, who was born on November 28, 1913, is an eighty two (82) year old widow and is domiciled in Pennsylvania, residing at 1428 Bradley Drive, Unit J-214, in Carlisle, Pennsylvania. 2. Pursuant to 20 Pa. C.S.A. ~5512(b) and (2), this Court has jurisdiction over and is the proper venue for the appointment of a guardian of the person and estate of the alleged incapacitated person. 3. The only other court which has ever assumed jurisdiction in any proceeding to detennine the capacity ofD'Nelle Parker is Buckingham County, Virginia FACTUAL BACKGROUND II. I)'Nelle Parker has resided at her current address sinee February I. 11)1)5 with Petitioner. l11e property is rented from Pheasant Run Properties. 12. D'Nelle Parker previously resided at 1153 Pheasant Drive North, Carlisle with her husband until his death in February of 1994 and with her daughter, the Petitioner, since approximately December of 1993 when Petitioner moved into the residence to assist in caring for her parents. 13. D'Nelle Parker is suffering from Alzheimer's Disease and related dementia. She is unable to take care of herself and requires 24 hour care, including assistance for feeding, dressing, and personal hygiene. Her ability to receive and evaluate infonnation effectively and communicate decisions in any way is impaired to such a significant extent that she is totally unable to manage her financial resources or to meet the essential requirements for her physical health and safety. 14. Because of her age and mental health, D'Nelle Parker's condition is not expected to improve. IS. The testimony of her treating physician, Dr. Earl Morton, will be presented by deposition. NO LESS RESTRICTIVE ALTERNATIVE 16. The following support Petitioner's position that there is no less restrietive alternative to the appointment ofa plenary guardian of the person and the estate ofD'Nelle Parker: a) D'Nelle Parker has been enrolled in an adult day-care program, Elderly Day Activities, Petersburg Road, Carlisle, Pennsylvania since on or about February of 1995. Petitioner was instructed by Elderly Day Activities not to bring I)'Nclle Parkcr hack to thcir facility on or aboutthc cnd of Novcmbcr, 1995 duc to bchavior and control problclIIs thcy wcrc cxpcricncing with I)'Ncllc Parker. b) D'Nclle Parker has rcceivcd in-hollle health care assistance through First Amcrican Homc Care who has provided nurses on a part-time basis since December of 1995. l11e funding for this service has bcen discontinued due to the fact that it is only supplied for "acute" conditions. Although chronic, D'Nelle Parker's condition is no longer "acute" as a result of changes in medicine. First American Home Care detennined that although D'Nelle Parker docs need constant care, skilled nursing care, such as they provide, is not required. e) TIle constant care and level of care required by D'Nelle Parker mandates placement in a nursing facility designed for the needs of Alzheimer's patients as Petitioner is no longer able to provide the amount and level of care demanded by O'Nelle Parker for her own health and safety and docs not have the resources available to hire private nursing assistants to care for O'Nelle Parker. ASSETS AND INCOME 17. At present, O'nelle Parker's assets, to the extent known by Petitioner, are as follows: a) $21.85 in a bank account in her name. 18. To the best of Petitioner's knowledge, infonnation and belief, D'Nelle Parker's annual income is approximately $20,000, derived from her fonner husband's military annuity and Social Security. 19. D'Ncllc Purkcr docs not ownuny rcal propcrty. nor dncs shc hold uny valuablc liquid usscts nor pcrsonal propcrty. PLENARY GUARDIANSIIIP REQUESTED 18. 11lc scvcrity of D'Ncllc's mcntul condition, thc lack of viablc, Icss rcstrictivc altcmatives and thc immincnt nccd for nursing homc placcmcnt, ncccssitatc thc appointmcnt of a plcnary guardian of I)'Ncllc Parkcr's estate to manage and administer all matters coneeming her financial atTairs, including but not limited to: . her cash, checks and any bank accounts; . her other individually owned property; . payment of lIledical, phannaceutical, and other bills incurred to provide her with proper medical care and maintenance of her lifestyle; . preparation and signing of tax retums and payment of state, local and federal taxes; . handling claims made on behalf of or against her; . execution of documents and entering into contracts; . Social Security benefits and any other govemmental or non-govemmental benefits; . applying for insurance and/or Medicare or Medicaid benefits. 19. TIle severity of D'Nelle Parker's mental condition and the lack of viable, less restrictive alternatives necessitate the appointment of a plenary guardian of her person to handle all issues relating to her person, including but not limited to: . authorizing or withholding consent to medical treatment or medication and psychiatric care; ~ IN RE: IN '1'IIE COUll'!' 01' COMMON PLEAS 01' CUMI3EHLAHD COUN'I'Y, PENNSYLVANIA D'NELLE PARKER ORPHANS' COUll'!' DIVISION NO. 21-96-233 DEPOSITION OF: Earle Edward Morton, M.D. TAKEN BY: Petitioner BEFORE: Cheryl Farner Donovan, RPR-Notary PLACE: Dunham U.S. Army Health Carlisle Barracks Carlisle, PA 17013 Clinic Thursday, April 11, 1996, 1:00 p.m. DATE: t' ) ,..: APPEARANCES: @J .. ;oo! CHERYL FARNER DONOVAN Registered Professional Court Reporter 305 Bullshead Road Newville, PA 17241 Phone (717) 776-3515 Courtroom & Free.lance Reporting . Experience Since 1975 (")(") c- =l!P C r f c ~ ..,,:IJ ...c:' :-1.1 \) :..::~ 0 ':1 Of; ::0 N 0'\ c, ,-- ~; ;..." -.;-;; - , l ~~ G?~ ORIGINAL % 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 (It is stipulated by deposing counsel for the respective party that this deposition is in lieu of the doctor appearing in person.) (Commenced at 1:05 p.m.) Whereupon, EARLE EDWARD MORTON, M.D. having been first duly sworn, according to law, testified as follows: DIRECT EXAMINATION BY MRS. DEITCHMAN: Q Doctor Morton, I'm Jennifer Deitchman and I represent Ann Parker, the Petitioner, in this guardianship proceeding concerning her mother, D'nelle. I understand that you were the treating physician of D'nelle Parker. Is that correct? A That's correct. Q Have you been a part of a deposition process before? A Never. Q This one is a little bit different from the norm in that there's not another attorney sitting here. As far as I know, an attorney has not been appointed to represent D'nelle Parker, at this point in the proceedings. I will just be asking you some questions, which 3 1 you will be answering under oath. It will be transcribed 2 into a written transcript. 3 You have the opportunity to review that 4 transcript or sign it, or you can waive that and just 5 allow it to be filed as the court reporter has typed it. 6 We can make that decision later. 7 Everything that you state needs to be oral. In 8 other words, nods of the head are not taken down on the 9 paper. 10 A Understood. 11 Q And that's really the only rule of thumb for the 12 transcript. 13 So to begin, would you just state your full name 14 and credentials for the record? 15 A Dr. Earle Edward Morton. I'm a medical doctor. 16 Q What type of practice do you have here? 17 A I am Board certified in family practice. I 18 practice a full scope family practice. 19 Q And your office address? 20 A Dunham U.S. Army Health Clinic, Carlisle 21 Barracks, 17013. 22 Q Do you have any specialties inside of that 23 family practice area? 24 A No. I have no subspecialties except the family 25 practice. 4 1 Q Are you licensed to practice in Pennsylvania? 2 A No. I'm licensed in New Jersey. My 3 Pennsylvania license is still pending. 4 Q How many years have you been in practice? 5 A For three years. 6 Q How long have you treated D'nelle parker? 7 A I assumed D'nelle's care when I arrived here in 8 September of '95. 9 Q How often do you see D'nelle? 10 A I see D'nelle approximately one to two times a 11 month; however, I'll talk with Ann, her daughter, on the 12 telephone probably three to four times a month. 13 Q What is the primary diagnosis of D'nelle Parker? 14 A D'nelle has end stage Alzheimer's disease. 15 Q End stage? 16 A Yes. 17 Q Can you describe a little bit about end stage 18 Alzheimer's? 19 A Alzheimer's disease is a large continuum from a 20 very mild disease, which would present with just mild 21 memory deficits and difficulty. 22 It will progress usually over the course of fiv~ 23 to ten years to more severe dementia, worsening memory 24 problems, worsening acathisia. By that I mean 25 restlessness and inability to sit still, increasing 5 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 agitation and vocal and physical outbursts. In D'nelle's case she ha~ the end stage disease in that she is severely demented. She is unable to sit still. She has severe acathisia. She's always getting up and moving about. She is having worsening problems with her vocal and physical outbursts. She's becoming very violent to her caretakers, striking out/ hitting them. As well as, she's having worsening of self care. She's not caring for herself, not performing the normal activities of daily living as far as her own personal hygiene. Q When you first saw her three years ago, was she in the end stage of Alzheimer's? A Well, I've only seen her since September of '95. Q Okay. A At that point she just had a more moderately severe Alzheimer's. She clearly has progressed in the six months that I've been caring for her. Q Have you treated other patients with Alzheimer's disease? A Yes. I've treated approximately twenty to thirty patients with Alzheimer's. Q Have you prescribed prescription medication for Mrs. Parker? A Yes. D'nelle has been on multiple prescription 6 1 medications. 2 Q How is she responding to that medication? 3 A We've used multiple benzodiazepines and 4 antipsychotic medicines. These are medications to control 5 her behaviors, her severe outbursts, her difficulty with 6 sleep, insomnia and her aggression. 7 Because she is also a geriatric patient she has 8 difficulty with metabolizing drugs. So, therefore, it has 9 been difficult to adjust her medicines appropriately. 10 Like most geriatric patients the kidneys and 11 liver don't function as ours do and the medications will 12 accumulate. Then you have worsening problems as far as 13 overdosage and severe sedation. 14 D'nelle also has problems with parkinsonian 15 symptoms with the antipsychotic medicines, which is not 16 untypical, in that they get what are known as 17 extrapyramidal symptoms. 18 Q What are extrapyramidal symptoms? 19 A Those are symptoms where they get severe 20 twitching of the head and body, torticollis which is a 21 wryneck kind of syndrome. 22 So we've had to work around that by changing 23 medicines and keep trying different ones. 24 Q You had mentioned her daughter, Ann? 25 A Yes. 7 ,-. 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 Q Does Ann supply you with information about how the medications are working or not working? A Ann is my soul source of information. Ann and her husband, because they're the sole caretakers for Mrs. Parker. Q Is Mrs. Parker able to communicate to you what she feels as a result of the medication? A Mrs. Parker has what we call sort of a nonsense talk. She clearly enunciates very well, but her speech just has no meaning. other than pain, she is not really able to vocalize her feelings and expressions. Q Would she be capable of taking the medications on schedule on her own? A No. Clearly she cannot handle her medications. Even as far as knowing which medications to take or the schedule, no, she's unable to do any of that. Q Is there someone who always accompanies her to the visits to your office? A Ann always accompanies her. Q Let me go a little bit further and ask whether YOU've seen a degeneration of D'nelle Parker's condition since you first began treating her? A Yes, I have. When I first started treating her she was going to a senior Day Care Center during the day. After several months that I was taking care of 8 1 her, she was basically thrown out of the Day Care because 2 of her violent behavior. She was striking out at other 3 patients there as well as the staff. 4 We were unable to control it well enough with 5 her medications. So they basically told her not to come 6 anymore and they kicked her out. 7 Q Have you ever seen her exhibit violent striking 8 out type of behavior in the clinic? 9 A Usually every visit. Yes. Nearly every visit. 10 Because of her inability to sit still and her 11 restlessness, her attention. within just several minutes, 12 she's wanting to leave and get up and move about. And if 13 you try and redirect her, she'll often kind of strike out 14 at you, swing at you. And that's fairly common. 15 Q Do you expect that with medication or otherwise 16 there might be an improvement of her symptoms? 17 A No. Alzheimer's disease is a chronic 18 progressive disease. It has one direction only and that's 19 to only get worse. 20 Q Are you able to determine whether she's oriented 21 as far as time and place? 22 A She's very disoriented to time and place. 23 Q Does she know current events? 24 A No. She has no idea what's going on. Usually 25 doesn't know what season or anything that's going on 9 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 around her. Q Are you able to m~ke an opinion whether she could manage personal finances, whatever assets or savings she might have? A No. She's totally unable to manage her own finances and affairs. Q What would you say she would be capable of doing? A That's a more interesting question. Q Are there any abilities or capacities that D'nelle Parker has that if left on her own she could do? A Let me say that with an Alzheimer's patient at this point your goals are to have them do some of their activities of daily living. Basically having them feed themselves. You really need to get to the very basic things. If they're able to feed themselves when you put the food in front of them. Clearly they can't prepare it themselves. Your goal is to have them feed themselves, if possible clothe themselves and do their personal toileting. D'nelle is kind of on the border with that, the very basic things. And so as far as anymore advanced or the higher things that we need to do, she's unable to do that. 10 -. ,-- 1 Q So, do I take it from your answer, that she's 2 not able to prepare her own meals? 3 A No, she's unable to prepare her meals. 4 Q What level of care does D'nelle Parker require 5 as far as nursing care? 6 A What she needs is, she needs someone there 7 constantly to watch over her to prevent her from injuring 8 herself. 9 Remarkably she's in very good health other than 10 her mental disease and her Alzheimer's. So she doesn't 11 require much assistance in getting about. Well, let me 12 reword that. Let me say that she needs direction and 13 assistance. She needs help in those normal activities 14 that require thinking and cognition. 15 Therefore, she needs someone else to be there, 16 to think for her as far as meal preparation and she needs 17 someone to direct her through the day, because clearly a 18 problem with Alzheimer's patients is the wandering. If 19 she didn't have someone to watch over her she would wander 20 off and clearly be lost. 21 These are the reasons why you have to lock the 22 doors in nursing homes because patients wander off. They 23 wander out in traffic. They're a danger to themselves. 24 She needs someone to protect her from herself. 25 Q Just one or two other questions, Doctor. Do you 11 1 know whether D'nelle Parker is oriented with regard to her 2 being able to recognize her relatives, or people such as 3 yourself or people in the clinic here, to recognize them? 4 A She never recognizes me. Every time I see her 5 it's like a new visit. 6 She will recognize the word doctor. "Oh, this 7 is your doctor, D'nelle." "Oh, how are you, doctor?". 8 But every visit is a new visit to her. She seems to be 9 unable to make new memories and to recall those. 10 As far as recognizing her family members, she 11 seems to know Ann and follow Ann's direction. 12 Q Does she recognize Ann as her daughter? 13 A I'm not sure. I really couldn't tell you that. 14 I've never really investigated that with her. 15 That really could go either way, because clearly 16 they do recall or retain some old memories. I'm not 17 really sure. I can't answer that. 18 Q Okay. You mentioned that she was in good 19 health. Are there any other physical conditions which 20 effect D'nelle Parker that we haven't spoken of thus far? 21 A Well, she has some sensory deprivation in that 22 she has some severe bilateral hearing loss. She also has 23 very poor vision and some mild cataracts. So her sensory 24 input is not what it should be. 25 That certainly will worsen her interaction with 12 1 2 3 4 5 6 7 8 9 10 11 12 t: , 13 14 15 16 17 18 19 20 21 22 23 24 25 the world, because she's junt not able to hear and see as well. We've maximized that to the best of our ability. She's just recently seen her optometrist and gotten new glasses, but it's just very limited in what we can correct. She has some other minor medical problems such as high blood pressure and a history of headaches, but overall she's in good health. Q We already covered a little bit of whether you would expect an Alzheimer's patient to improve or for their condition to degenerate. Are you able to state within a reasonable degree of medical certainty whether the prognosis for D'nelle Parker is better or worse? A Clearly with nearly one hundred percent certainty, she will get worse. This is a progressive disease and will only go from the mild forms to the more severe forms to the end stage where she is now. And her condition will only progress and worsen until her demise. Q And are all of the statements which you made in this deposition today within a reasonable degree of medical certainty? A Yes. MRS. DEITCHMAN: 1~ank you, Doctor. DR. MORTON: You're quite welcome. (Concluded at 1:23 p.m.) 13 .. \: ,-' FElHmAJ. HIIJ.ES OF CI VII. I'IWCED\J\m I. ~n. 11"\11..11I1111' 11'1111I O,.nl Exn",l"nllllll ,.) RIIII",I..IIIIIIII Willi",,: Ch.1I1:"': RI~lIhll:. "lIlh" "'olilllllll)' 10 fllll.I' IInll""1 ih",IIII" ,1"I"mi- I "hnll hi' liululIillrlllnllH' willll~~!,; rur (')UlIlIil1a. , ntlll ~hnll Ill' ".:,,1 Iu fir It.\' hilll, 1I11It'~~ mll'h min:lIinn ntlfl rr'mlhw nrr. w:Jivl'11 h.v Ihl~ wilnrm; ,IIY Ihr.ll:lllir~, ^".\' l.i1:Jl1nl~~ ill rill III or ~lIll!;I:l1lfl' dl till' \\'i'ItI'~!1llc'~hl'!\ In 1U:Jlw f.hallll(' rllle'Il,.1 "Ih" ,lrl'lIollllll1 II)' II". 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If':t~lIn, Ir rillY, ltkl'H 1IIf'IC'r"Il'; nlu( tlw ,It'/1l1r.ilinll mny 11"'11 he "r.I'11 u!; rully n~ 'hfllll~h !.iltllrl . 11111.~M IIw rUIIII. hlllil!\ Ihalllll'II';If.III1!ll'h'I!1I rnr Ihe lC.rllr.nl In r.inH "'I)lIl1e' Il'j,'c'lioll nr I Ill! Il"I'"r.ilinll in whnlr. fir ill 1':111. ~ J ...... J -",' I I . . . .--- ---..~.~ .--.-... -;.:. I" ~ '.>... I" \.) 0>- m " .... -..; ~ 11I fTl III lJ" B "' fTl .~ ~IJg I'- 1I1 I I J~ , ~ I 0- ~ " t] .. I ~ l ~ II ~~ . . 'G SENDER: "'D weompletll\erT'll 1 W'or 2 fot addluonalterV0c8l. I, "i .c.omPlete ttems 3. .1, and .b. .11 I wPNt your name and addrctllon \he nlvorl8olthlllom11O thai W8 can relumtNI . card to you. I wAl\lChtNI form lolhe from 01 thO mallploC8. 01 on thO back II space doOI not , ~I. II .WrlIo'Rotutn RocoIpt Requested' on \hO madpl"" _lhO a.;do numbe'. 5 .".. Rot"'" RocoIplwl' shOW '0 """'"' \hO artlda.... doliverod and \hO dala e delivered. o :1 ii. .E II 3'1h~~:;r~crkM It}. /JoX / ~I / IIJk C~{~ (/10 (p/fd1 ? I 8\ 1\ ~ Ul a:1 5. ReceIVed By: (Prlnl Name) !; 6.Slg o >- Domestic Return Receipt IN RI~: DO NELLE I'ARKI>H IN 'rill:: COUR'l' 01' COMMON PLI~AS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPIIANS" COURT DIVISION COFY NO. 21-96-233 CITA'fION WE COMMAND, you that laying aside all business and excuses whatsoever, you be and appear in your proper person before the Honorable Judges of the common Pleas Court, orphans' Court Division at a session of the said Court there to be held, for the County of Cumberland to show cause why she should not be adjudged an incapacitated person and why a plenary guardian of her person and estate should not be appointed; the hearing thereon to be held in Courtroom 1, Cumberland County Courthouse, Carlisle, pennsylvania on May 6, 1996 at 1:30 o'clock P.M. petitioner shall cause to be served by personal service the citation with Notice and Petition pursuant to the provisions of 20 Pa. C.S.A. 511 (a), upon DOne11e Parker, at least twenty (20) prior to the court hearing. The contents and terms of the Citation with Notice and petition shall be read and explained to the Maximum extent possible in language and terms the alleged incapacitated person is most likely to understand in accordance with the provisions of 20 Pa. C.S, A. 511 (a). An affidavit of service containing specific averments as to the above requirements shall be presented at the beginning of the court hearing. At least twenty (20) days prior notice of the court hearing, together with a copy of the petition, shall be given personally or by certified mail to all persons who are sui juris and who would be entitled to share in the estate of D'nelle Parker if she died intestate, namely: Michael Parker P.O.Box 1411 Platte city, Mo. 64079 Petitioner and/or counsel for petitioner shall notify the Court, in writing, at least seven (7) days prior to the court hearing if counsel has not been retained by or on behalf of the alleged incapacitated person in accordance with the provision of 20 Pa C.S.A. 5511 (a). This notice shall also contain all . .. ...... .~... ..-.':- . '. FACTUAL BACKGROUND I\. D'Nelle Parker has resided at her current nddress since February I, 1995 wilh Petitioner. 'nle property is rented from Pheasant Run Properties. 12. D'Nelle Parker previously resided at 1153 Pheasant Drive North, Carlisle with her husband until his death in February of 1994 and with her daughter, the Petitioner, since approximately December of 1993 when Petitioner moved into the residence to assist in caring for her parents. 13. D'Nelle Parker is suffering from Alzheimer's Disease and related dementia. She is unable to take care of herself and requires 24 hour care, including assistance for feeding, dressing, and personal hygiene. Her ability to receive and evaluate information effectively and communicate decisions in any way is impaired to such a significant extent that she is tolally unable to manage her financial resources or to meet the essential requirements for her physical health and safely. 14. Because of her age and menial health, D'Nelle Parker's condition is not expected to improve. 15. The testimony of her treating physician, Dr. Earl Morton, will be presented by deposition. NO LESS RESTRICTIVE ALTERNATIVE 16, The following support Petitioner's position tbat there is no less restrictive alternative to the appointment of a plenary guardian oflbe person and tbe eslate ofD'Nelle Parker: a) D'Nelle Parker bas been enrolled in an adult day-care program, Elderly Day Activities, Petersburg Road, Carlisle, Pennsylvania since on or about February of 1995. Petitioner was instructed by Elderly Day Activities not to bring 19. D'Nellc Parker docs not ownllny real property, nor does she hold nny valuahle liquid IIssels nor personal property. PLENARY GUARDIANS! III' REQJJESJJ~D 18. 111e severity of J)'Nelle's mental condition, the lack of viable, less rcstrictive altematives and the imminent need for nursing home placement, necessitate the appointment of a plenary guardian of J)'Nelle Parker's estate to manage and administer all mailers conceming her financial affairs, including but not limited to: . her cash, checks and any bank accounts; . her other individually owned property; . payment of medical, pharmaceutical, and othcr bills incurred to provide her with proper medical care and maintenance of her lifestyle; . preparation and signing of tax retums and payment of state, local and federal taxes; . handling claims made on behalf of or against her; . exccution of documents and entering into contracts; . Social Sccurity benefits and any other governmental or non-governmental bencfits; . applying for insurancc and/or Mcdieare or Medicaid benefits. 19. TIlc severity of D'Nelle Parker's mental condition and the lack of viable, less restrictive altcrnatives necessitate the appointment of a plenary guardian of her person to handle all issues relating to hcr person, including but not limited to: . authorizing or withholding consent to medical treatment or medication and psychiatric carc; 1,^:lT WII,I. fll' Ut''':I,t,l: II, 1'^"P:I:11 I, Utlll:I.I,': WII,I., r~vuktnl) m~I1.'Cf', frnlld, and nound mind. 1'^IUO:Jt, of VlrlJlnln, .1r'l~ln(t. (lff'vlour: wllln nlHI (~nllll~lln. II ,ul 1If' Influf'nl:f~ of nny pf'rllnn. 10 hf' my I.A.ST rt,." of flutenn, ntfl of logftl aqe 'h t n n (~t I II. nil or I. I 11m m.nrtf'd to .'llhUK H. l'hltKlm, .11t., I hnvf' two ('1 childrrn, n~mf'lYI A"" rARK~n n~Ar.~n nl1ll HICIIAE~ rARK~R. 2. 1 appoint rRArlK H. PARKER, HICIIAEL rAnK~R, oubntituto, ullwilling to act, or connen to JR., executor or my rnlnlr. I nppolnt in cane the executor 10 unnbl~ or do no. "altllor io to be bonded. , 3. I direct my executor to payout oC my estate my Cuneral eXpenrH!D ' nod enforceable debtn. Tn dlntrlhutc my entntc, I give my executor i full power to Dcl1, lenne, mortgnqc, reinvent, or otherwise dinpone of t tllc anocts oC my cntatc. 4. "ChildrenR or Rchildh aloo includen tho DC horn to mc or adopted hy me aCter execution or my will. The phrsDc RdieD berore meR includeD dieD at the name time ~r within 30 daya oC my death. Where appropriate, wordn oC the m~ncullnc gendor Ghall include the feminine nnd vice verna, nnd any reCerence to the oingular Ghall include the plural and vic~ versa. RInGucR means all peroonD who have dcocended (rom a common ancestor, or who have been adopted by a peroon who hao deRcended (rom n common anccntor. 5. I give, devine, llnd br.queath nil oC my renl and peroonnl property to FRMIK M. PARKER, JR. I r FRANK H. PARKER, JR., d i<l'o be fore me I give, devine, and beque.,th all thin property in equal sharen to my chil~ren. If a child o( mine dieD beCore me then hin/her share is to be divided equally among my surviving children. 6. Except 00 provided in this will, I have intentionnlly left out any other relative or any other peroon. IN TESTIMONY WIIEREOF, I have Bet my hand nnd Deal to this my LAST WILL MID TESTAMEUT conoistlng of 2.J typewritten pages, and on all poger. oC which I hnve placed my initial] or oignatures for securlty and identification thin ,V day oC .' ...... ~ i' ,19 ~.;.. . ~ ) .J t. \../ /, L~/J.__ JI (II '. ". IL.I ((t' t.A '- 0' NELLE R, PARKER _If If.! ~ .1t1'" ~l.. (.~\l' r "'. ,.. \.1- 1Li'v ~"\. y, Signed, !Jenled, published nnd doc lIr~d- lOr arid no her LAST WILL ArlO TESTAMENT by the Tentatrix in our preDence, we all being prCDent at the n.,me time: nnd wc, in her prenence and at her request and In the prenence of each other, have oubocribed our names ao witnesses whcrcoC, allan the date Innt ahove written. Page ONE of TWO pngen " t. I' I.. fi l~ ' :~. " ~ .I. : I ',t~ . ." , ~! :~i ,l- . "1' .. "'1 " f 't. .\ .' , h I, , , .,1 , (, " ",j, /. I , " 'j, ,. ,:~i' , I, I 'I: " I t, i I'. ", (: " ri " ",;,:' ...~ t:. ,'I' ~ .',' , ,'.... '..j :.). " ..\. , .J:. ~, ..;.f f~t'~I:H I I " , .~. \, . .' .! :. , .I ! , .'} . .; " , ;I PETITIONER'S lz :.i' H o[ (lt~'.\f., 1~....oJ j~1 I ./. \ .,1 ~ i:, n , I . ~ i~.~., .. . j" , .;' "II.~! . '.; 10' o[ e'-(j dJ )culf.(jlfl-"" Jl~,/\'v()~ . , \ ",j' . I~" .' (~~-,'-~ '. " \ :;"',, \ ') '. ., ..... o[ IN,!" _ 'I..~_ .. ...'\'J..n . \. ')" ~ ' " " ... , ,'1' : ~.: '{I' , " nTATp. OF VIRGIUIA COUNTY or PRINCE GEORGE ,', Defore me, the undcrnlgncd authority, on thin de perooj14 Iy npptHItI!ll D1flELLP. R. rAnKER, -;U:VI\\I.",. ",.. -T?JJc.'l~ " I,VJ L..t I. ___________, lInd ~~\.:...__\3 \\.. ....... , , known to me to be t 0 Tcntatrix and tho wltnooDCD, ronpactivbly, whoRe namon are nignod to the forcgoing lnntrumcnt and, all of thODO personn being by me (lrnt duly oworn, tho Tcotatrix declared to mo and to tho witnesscD In my prcscnce that said inotrument Is hot LAST WILL AND TESTAMENT and that she had willingly nIgned the Bamo and executed it In the presence of onid witnoooos no hor freo and voluntary act Cor tho purpooeo theroin expreoocd, that Gaid witncoDoO Dtoted beCore me that the foregoing "ill wao executed and ncknowledged by the Teotatrix as her LAST WILL AND TESTAMENT in the presence oC said witneooeo who, in her presence and at her requent, nnd in the presence oC each other, did oubscribe their names thereto DO atteoting witnesseD on the day of the date of Daid Will, and that the Testatrix, at the time of the execution or GDid lUll, wan over the Age oC 18 yearo and of Bound and diopooing mind and memory. J.J . . t, "I.." >. "/: / I .,..J , I., (l.' 1"1 _ . ~,-.~.{L.---- TESTATRIX ~U\1~Ln: l)IT~~ 1l))M' e (~( wf-MEss jI (/ (\0. 'I, ,~. :~ ,l" ,I,;.., 'I:'. .'.',',' i" ,~. '. ~' ',. ~" '. '~' ,1, .~: !~! . ., - ~ . " .. \~~ ~ I:~,.,l~: I~, . ").; I ,;;( ;-'~::~: .: .....t ,:1: ~~Ifl"'" IUTNBS "0' f r I .:.f . '. 1\ Subncr ibed, oworn to and PARKRR the Teotatrix, and Bald :~"\I.' 1\... r.r:s<'o1... ';..,J ~ ., - , ., \:\ "........ 19~. , . ,witnesses, me by D'NEttE R, beforo mo by tho and, ,." " ~I .,: D[ . . . . .~: " . ., f)/auc d! ~W~ o ARY PUDtle ' " '. Page TWO DC TWO PageD My CommlBDlon EXPlr.DI~qpt1~~ /7/05- . ' \" . . , ~ ;. " ": a: \;. ,. I No. 21-96-2)) Estate 01' Il' NEI.LE I!. PAHKEH , Deceased DECREE OF PROnATE AND GRANT OF LETTERS AND NOW APRIL 9 19~. in cOII,idcration of Ihc petilion 011 thc rcvcrsc sidc hcrcof, ,atisfaelOry proof havillg beell pre,elllcd before mc, IT IS DECREED Ihal thc inmumelll(s) datcd JANUARY 8, 1982 dcseribcd thcrcin be admilled 10 probale and filed of rccord n, Ihc last will of D'NELLE R. PARKER and Lellcrs TESTAMENJ'AB.Y arc hcrcby gralllcd III mCHAEL PARKER "tl): 'J(I .lit i l ~~ . ' Rc.~i\lc:r nf \\'iII~ FEES Probatc. LCllers. Etc. ..,....., S 18,00 Short Ccrtificates( 2) .,..'.,." S 6,00 9llli~n EX.TRA, PAGE, , ., S 3.00 JCP S 5.00 TOTAL _ S 32.00 Filcd . t\P.~u.. ,9.,. J ,9. 9. 7 . .. .. .. , . , , , ,. '. ,. ,\ TTORN[Y (Sur. Ct. 1.(>. No.) ADDRESS PHONE an ~ "" r- \0 .... _.~j ::tJ I -.J , " '. r 0' MAILED LETTERS AND ORDERS TO ATTORNEY APRIL 9, 1997 /I-I)(, .:"11 I II- i 1 II Ii, " " , I ~ 1 < ," IT" ", ., " 'i t, I :', -il " I .1. , ,'I; 'ill il.!I. ,f. ;;! !"I II.!, 01 ' ~ " , : I ,I of. \ \I" '.j .1, "J, WAJlNING II IS 11I"CJallo dllpllcal" IlIis copy bv pltolo',la! 0' pltolcHllaplt. I, .."""'{" '., /.<\o.\'~ If Prl" /..,~ IJ' i !i!~'II'~-('"' I~ Y' i~ -...- J'.~ i'-' ::. . hi \. " ..~,,~ ~ . ".: \1--.... ..,~,:"I ',~.;o", 'i-" /lfF~l u\~\ ' ~ . ,.," (;,::,<y...l '/ '1 ,. t c:~~ . '~~ ~~'.." .... .',,.,..~/...:.'" "".~i~.,~ !"II!,I ,'(.t' 11\1 _.-;v" ~.J' j:... .~{ ) " . : " ..) , , " ... , "/1 t.1S' 4183993 '- /' .:./' , , " ;, "IO\IU"'" 'II' COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (Coconec) c.oIlOltJUdH,-""-1 March 29. 1997 nHII"NMf .. __.T out<< ... ."'1,......-.. "J t(X;\Al.KtUl'll"---" Female , 433-36-4964 o II ~ . Parker :::"0 R ...."'(OJO(IolH<<.'..."'.."'..-_.......~..._..., -'" ~_O I~""O . '1oCll1Tl'''''''''t.~...............It.,........,--, Pike I Carlisle 1I./IC1.__.....-.- ,- White -....... 1I_~_""" UI'tOlIl I 0/01' - - l,IHOllIII.tlNl - "" T. 01". Middleaex Cumberland IolUOlllAl.WU......... --- eo-.ldlkalyl k ~.... 4ll'::rtl tlIlI ",10...__....- Middl~An. - -.. CumbeJtt't~.......' H'o:::.:=:;'':::::'' lolQ'rC".MAUllft.......ue~""- II Rubl lee T Ql l ""'{)AIol,AH"l.IolNl."OOl.QOlllu:..,...."-'$I-. ,,(;.- 1ft ... ~ ...to ~,:::::'~~iJ.;:: Homemalze-\ ' Dla.DlIfT'loIMJNOoItD(lIIll"'I>>"~""'.c.c.toI 1071 A HnA~i~buA9 Pi~e CaAlL6le, PA 11013 - OlClDlKtt "'..... "'''''''''' ...-- ~-- "...... 'k "" lJoWOIl .~"'t-. ~ .0-_ ClI.ema.Uon Soc.ie.tJj e PA C~emato. Il.uIt~AOOfIlUOf'AClUT'\' 4100 one lCUdoll'tUWlK" """'''", - .....0 c.-IJI ...........0 ...- -'-. "'TO'" n.H.-.l4l'IVCIlCol"SlI ......_"'..,.-......_........-....-IM<.- ."'.. ,.. no Nl5CA$lIll'11lflll TOWl . .. . FV ..0 ,. 1 11 DAl~ICl (WGt....O"'_1 , 4:17 P." Horch 29, 1997 11.....rIt. (-.__.......-.--_c...-...... OI.._..._"'",.............~._...,-_.-_. lMI""___.-II- ,- :-- \...."".... MIl't.: """'...----.......~ .....-............,.._..."~l Inanition OUl'lOICJII~.CUQ.~..ctCJl Advanced Alz eimer's Dise Be OUllOlCIl~.'CJ<nIQ.JlIiCICJI') out; IOIV'IAS.CCW'....OVlJoCt Of) OlK.f'lK_~"OCCUfWllD ITlMIOflOllUf'l' 1H"OI,jfI'~~' !DAlIOl'"""""' ,_OItt_l . ""MIolIfOl"t,'lHOIHOt -.u.al~1O COWU"tlON~C.t.USf 00'''''" ......."0101/011'1 __ 0 MoO o o . O rvcIOf"'^"'"..,--.....I.-....... -........ - ~ o o - -- c...ool........- ..- Coroner ..... -- ..ri ..~ .0 -- .. .... I- cun....o.:--- .CIIfT.,.IillI'"'tcAN~~o:..-~~_......~...I"-...-"'..,,_~....,ll ,...........,................---...........,...-........ 0, ut l).Cl'ltoGHlD~OI.~ o ' , A rll I 1997 ....Iol(.uoO .foOOIIIUOf "~'I'IfO<lcow,\~IDtAUSl Of tJlRM ,.._znt"".,...,.. Michael L. Norris. Coroner ~ 40S Fairway Drive . " ~ ! a 1 ."" __-"OCUl1..,IillI".'ICUJII~.,.IIUf'I_-'OIlol....-<--'-...(.....<J_1 ..._.....................---.......II...-.-............_"...~'I....-..""" '1IlDfCAL11'-'lt'ICO"'O"'VI OIlN.........."'*"'*"WIdI.~IIl..,~.dNtlltcQIO'OtlIlI""-....I,...~..........N_.....M(.I... -...........................................................................,.........,................ ". I'llQltTIW'IS 1'S1:J', ",-.I ......NCJ......... \.C .. ;;c .-" :~ u "" C:. .1 'ii: , r;- I' ~ ..' !~J , ! ~ c.:. " :T .. 1: :iJ ;1 I'. 'IIU: ~?'\ J~ :; a: uc.:, .. '. . . LAs'r WILL OF O'NELLE R, PARKER I, O'NEI.I.E R, WILL, revoking menace, fraud, and sound mind. all PARKER, of Virginia, declare previous wills and codicils. I or undue influence of any person, th is to be my LAST act free of duress, I am of legal age 1. I am married to FRANK M. PARKER, JR., I have two (2) children, namely: ANN PARKER BEALER and MICHAEL PARKER. 2. I appoint FRANK M. PARKER, MICHAEL PARKER, substitute, unwilling to act, or ceases to JR., executor of my estate. I appoint in case the executor is unable or do so. Neither is to be bonded. 3. I direct my executor to payout of my estate my funeral expenses and enforceable debts. To distribute my estate, I give my executor full power to sell, lease, mortgage, reinvest, or otherwise dispose of the assets of my estate. 4. "Children" or "child" also includes those born to me or adopted by me after execution of my will. The phrase "dies before me" includes dies at the same time or within 30 days of my death. Where appropriate, words of the masculine gender shall include the feminine and vice versa, and any reference to the singular shall include the plural and vice versa. "Issue" means all persons who have descended from a common ancestor, or who have been adopted by a person who has descended from a common ancestor. 5. I give, devise, and bequeath all of my real and personal property to FRANK M. PARKER, JR. If FRANK M. PARKER, JR., dies before me I give, devise, and bequeath all this property in equal shares to my children. If a child of mine dies before me then his/her share is to be divided equally among my surviving children. 6. Except as provided in this will, I have intentionally left out any other relative or any other person. IN TESTIMONY WHEREOF, I have set my hand and seal to this my LAST WILL AND TESTAMENT consisting of JI.i typewritten pages, and on all pages of which I have placed my TnIt"ialj or signatures for; security and identification this .f' day of . .... _ . ., ,19 6'/- I " 7.. J '/\ - /.. LL- ./,___ (, 1,,/ '. .1' . (( ("/\ D'NELLE R. PARKER '/'i~ '~~rJ ~L OJ\)' F -.'.~" \- ':.. It.... ".. -. , Signed, sealed, published and deci'a"'red' '!:'or'lrid as her LAST WILL AND TESTAMENT by the Testatrix in our presence, we all being present at the same time; and we, in her presence and at her request and in the presence of each other, have subscribed our names as witnesses whereof, all on the date last above written. Page ONE of TWO Pages PURPOSE OF NOTICE: PAVHun: REFUND I CR): To fulfill the requlr...nt. of S.ctlon 21~0 of the Inh.rltanc. and E.tat. Ta. Act, Act 21 of 1995. 111 P.S. S.ctlon 9140), D.tach the top portion of thl. Notlc. and .ub.lt with your pay..nt to the R.gl.t.r of Will. print.d on the r.v.r.. sid.. -- Hak. check or .oney order payable to: REGISTER OF WIllS, AGENT. A r.fund of a taM credit, which was not reque.ted on the ta. return, .ay be r.quest.d by coepletlng an ~Appllc.tlon for Refund of P.nnsylvania Inheritance and Estate Ta.~ CREY-IlI]). Applications are available at the Office of the Register of Wills, any of the 2l R.venue District Offices or by calling the special 24-hour answering s.rvlce nu.bers for for.s ordering: In P.nnsylvanla 1-800-162-l050, outside Pennsylvania and within local Harrisburg ar.. (117) 181-8094, TOOl (111) l1l'ZZ5l (H.arlng I.palred Onlyl. OBJECTIONS: Any party In Int.r.st not satlsfl.d with the apprals...nt, allowance or dlsallowancl of deduction. or as.ess.ent of ta. I Including dl.count or Intlrlstl as shown on this Hotice .ay obj.ct within sl.ty (60) day. of receipt of this Hotlce by: --written protIst to the PA D.parteent of R.v.nuo, Board of App.als, D.pt. 281021, Harrisburg, PA 1712a-IOll, OR --olecting to have the .att.r deterelned at the audit of tho account of the personal repre.entative, OR --app.al to the Orphan.' Court ADHIN- ISTRATIYE CORRECTIONS: DISCOUNT: PENAL TV: INTERES r I Factual .rror. dlscoverad on this assess.ent should b. addr..I.d In writing to: PA Depart.ent of Aevenu., Bur.w of Individual Taus, AnN: Po.t A.......nt Review Unit, DEPT. 280601, Ilarrhburg, PI 11128-0601 Phone (717) 181-6505. Sae pagl 5 of the bookl.t ~Inltructlon. for Inh.rltance Ta. R.turn for a Resid.nt Dlc.d.nt~ (REY-1501) for an e.planatlon of adelnl.tratlvely corr.ctabl. errors. If any taM due I. paid within thr.. (1) cal.ndar eonth. after the dec.d.nt'. d.ath, a flv. perc.nt (5~1 discount of the taM paid I. allow.d. Thl 15~ taw a.nl.ty non-participation p.nalty I. co.puted on the total of the taw and Int.re.t as'.'lad, and not paid b.foro January 18, 1996, the flt.t day aft.r the end of the tl. aan..ty p.rIOd. Thl. non-plrtlclpatlon penalty is appealabl. In the sae. .ann.r and In the the sa.. tl.. p.rlod I' you would app.al thl ta. and Intere.t that has b.en Iss'lsad a. Indicated o~ this notlc.. Inter..t I. chlrg.d beginning with flrlt dlY of dallnquency, or nln. (91 eonth. and on. (I) day fro. the date of death, to the data of pay.ent. T.... which b.ca.. delinquent before January I, 1981 bear Inter..t at th. rat. of .1. (6~) p.rcant p.t annu. calculat.d at a dally rat. of .000164. All ta..s which beeae. delinquent on or a't.r January I, 1982 will bear Int.r..t at a rat. which will vlry 'roe cal.ndar y.lr to calendar y.ar with that rat. announced by the PA O.part..nt of Rev.nu.. Tho applicable Inter..t r.te. for 1982 through 1998 ar.: Vear Int.r..t Rat. Dally Intarest Factor V..r Int.rut Rate Dally lnt.rut Factor 1982 20~ .OD05U 1987 .% .000147 1983 16X .0DO~l8 1988-1991 11:< .000301 1984 11",( .DDUDI 1992 .% .000247 1985 U~ .DOU56 1991-1994 7% .000192 1986 In .DOOl7" 1995-1998 .% .000247 ulnterest Is calculated as folio...: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Hotlc. 1.lued aft.r the ta. baeoeas dellnquant will r.flect an Intar..t calculation to flft,.n (15' day. bayond the data of the a'lllseant. If pay.ant I. .ade aft.r the Int.r.st coeputatlon data Ihown on the Hotlc., additional Inter..t lU.t b. calculated. ",. ,~, II ,., REV-1500 /6- f COl,n,lONWEAl1H or .~, PENNSYlVANI,\ , u.; ..." DEPAHTMENT or HEVEllUE ." DEP! 280[,01 _~ .. IIAHHISBUHG, PA 17128 OGOI W :M::~'" U'", w"u ",00 u"'... .... .. " ,/. I! INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER _I._V '.6. uu',.-cotl ,r~..j __~ .~ ..1-}_ 1- 'O',lHII DECEDENT S NIWE 'lAST fIJ~ST AID 1,I.DiJl[ INiTiM) SOCIAL SECURITY tJiJ!.IBER I- Z W C W l.J W C _~R-'~J.~.O',AI~uc_ ~l-.- - '.n________ .T!-~~URN~U~T;EF~~D~NO~:C::~THTHE D^;; ~EA~I~\'~'O~'~RI_., .~. ::~~~_~R~ I~':~D:'[A=___,__~__~_ ______~EGISTER OF WILLS (IF APPLICABLE) SURVNI~jG SPOUSE S ~~^I,l[ iLAST FIRST Al,jD p.1IODLE INITIAL I SOCIAL SECURITY NUI,lBER ~ Ongmal Return o 4 lllTlltcd Eslate D 6 Decedent Died Testate 1J,!b.-l1 ("'j:.l \','JI D 9 l.IIgallon Proceeds Rcwlt'ed D 3 RcmalnderReturnI111"J1oJltIVUIOI1'}e~l [:=J 5 Federal Estate Tal Return ReqUIred 6 Tolal ~~umbcr 01 Safe Dcposlt BOles [] 11 ElctMn IOIaI under See 9113(A){J,!\J~Sd\OI [J 2 Supplemental Return o ':a Future Inlerest COfTlptOmlse i J..'HJOoJ" ~~...'~ '2 '~l o 7 Dccedent Malnt.llncd a llt'lng Trusl iJ,!t..ll c." rJ IMt, o 10 Spousal PO'w'crty Crcdltl1.ll<! ,J.,..I."to"..~""~;)':i1....1 ~,' '/'1 ... ffi c z o .. <II W '" '" o u THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME '" , I COMPLETE MAILING ADDRESS ,.,/ "-,,fl. f~ R I< e/'L ~ n I tlf FIRM NAME" """"" ( 0 . !> ",/- ~ ... CJ ,/(..~'= C ," f, ,-1 (If '-'17 TELEPHONE NUMBER f/€,- ,f-{l - {"b~ r Real Estale (Schedule A) 2 Stocks and Bonds (Sd1edule Bl (1) .A<.1l..... ~ 121 ..iTry.H':,I' 131.u~t (4) .....J.1L 0,", e. 151 'i 'J 'fl -f z o 5 :) I- a: c:( l.J W a:: 3 Closely Held Corporation. Partnership or SoIe.Propneloo.hlp 4 Mor1gages & Notes Reccr'w'able (Sthedule D) 5 Cash. Bank OepoSllS & Miscellaneous Personal Property IScI1cdulc EI 6 JOlnUy Owned Properly (Sc.hedule F) D Scparale BlUing Requested 7. lnler,Vi~os Trans!ers & Miscellaneous Non.Probate Property IScI1cduieGorL) (7) JY.v", ( (6) -'Y. . t/,; IBI~/lf(t 8 Total Gross Assets tlOlalUnes '.7) 9, Funeral Expenses & Adminislralroe Costs (Schedule HI 10 Debts 01 Decedent. Mortgage liabtll!les. & Liens (Sd1edule I) 11, Total Deductions (tolalllnes 9 & 101 191...:J. 1.=11.- , (101 IV" "",It (11) 'i, '-1'" (121 :;. q 12_ Net Value of Eslate (Line 6 minUS line 11) 13. Chantable and Govemmenlal Bequests/See 9113 Trusts lor ",hlch an eleclloo 10 la. ~as nol been madeIScl1e<Ju~J) (13) ,bU/V" I") '1 L{ 14. Net Value Subject to Tax (line 12 minus lIne 1Jl SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;t I-' :) l1. :!E o l.J ~ o 15. Amounl olUne 14lalabJe al ttlc spousal tax rale. or transfers under See 9116 (a)(12) o x:o~ (151 10~ (161 , '2 (171 .15 IIBI (191 .,. If q o (j '1' I{I1 16 Amount olUne Mlalable al lineal ralc ~I.( o 17 Amounl olllnc 14 lalable at Sibling talc '8 Amount 01 lIne 141a_abk.! at (.Qnateral rate o 19 Tn Due 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE ANO RECHECK MATH < < Decedent's Complete Address: SlHl[l A~URlSS ' ________lo?'LJl _ I( t/:t;t.,f/J "rt (, ~:j': ~ -CiW-------.------'---------' - C AtLL ;/1.1;. stAll. p) Tax Payments and Credits: " Tax Due (Page ll,ne 19) 2, Cred,I~PaymenIS A, Spousal Peverty Cred,t 6, Pno' Payments C. Discount Cl --~..--- ----~---_. o ----~~ ____,.._f}__ Tolal Cred,ts (A' 6' C I (2) 3 InlerestiPenany ,I apphcable D, Interest E, Penally /.10 /, II 4, TotallnlcresUPenally ( D + E I II Une 2 is greale"han Lme 1 + Une 3, enler Ihe d,fferencc Th,s is the OVERPAYMENT. Check box on Pagel L1n. 20 10 ,equusl a ,elund 5, If line 1 + line 3 is greater than Line 2. enter the difference. ThIs is the TAX DUE. A. Enter the interest on the lax due 6, Ente, Ihe lolal 01 Une 5 + SA. This is Ihe 6ALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) (3) (4) (5) (SA) (56) !I'P 1.1. " J ___IJ.~'f~,-..- () ).71 C. i, .61 :I- . ') r.. PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"'N THE APPROPRIATE BLOCKS No ltl [i1 ~ o [;:] ~ 0'" ,. Did decedent make a transfer and a. retain the use or income of the property transferred;...... ..... . ......"........ .......... ....."........ ".. ..... b. retain the righlto designate who shall use the property transferred or liS Income; ..... ... c. retain a reversionary interest d. receive the promise for life of either payments. benefits or care? ..... .... 2. II death occurred after December 12, 19B2, dod decedent Iransfer p,opcrty wllhin one year 01 dealh without receiving adequate consideratIOn? 3. Did decedent own an -in lrust for- or payable upon death bank account or secunty at his or her death? ........... 4. Old decedent own an IndIvidual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation? Yes .0 ..0 o .0 o .0 o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penalbeSof perJU'Y.I declare NIl ha,e l!l~ned 1M ret~.If'\CIul:.ng aOCOfT'l;)an11l'lq sched0l1es and sta~emeflts al'd 10 !tie besl 01 my knooWdge and bel.el. II 11 Inie. conKl and complete DKlar3I(ll'l 01 ptpParer othef than the prf\Ol'lall!pI!stnta~\1! IS ba~ on a~ ltllormatlOfl 01 'llItuch pre~art1 has al'li knQ'foltodq! SIGNATU~N RESPONSIBLE FOR FILING RETURN 'J<I' ~ AODRESS (.0, ,90>)-- /'fl( {JL ~f! SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE c: T1' , ~() 6'1 " -=1") ADDRESS DATE r.:.> ~. 1.. u/ DATE For dates 01 death on 0' ahe, July 1, 1994 and before January " 1995,Ihe ta' ralelmposed on Ihe net value ollransfers 10 orlor Ihe use ollhe surviving spouse is 3% 172 PS, ~9116 (al (1.1) (,)). Fo, dates 01 death on 0' after January 1. 1995, the tax 'ale ,mposed on the nel value 01 bansfers to or lor Ihe use 01 Ihe surviVing spouse is 0% (71 PS ~9116 (al (1.11 (OIl). The slalute does not exemol a bansfe, 10 a survw,ng spouse from lax, and Ihe statulory requo,ements 10' d,scIosure 01 assets and f,hng a tax 'etum are sl,1I apphcab'e even ,I the surviving spouse is the only benefiCiary For dales of death on 0' afte' July 1,2000: The tax 'ale imposed on Ihe nel value 01 translers \,om a deceased ch,ld twenly.one jears of age or young" al dealh 10 or for Ihe use of a nalu,al pa'enl an adopbve parenl, 0' a slepparenl 01 the ch,ld is 0% 172 PS ~9116(a)(1 211 The tax 'ale Imposed on Ihe net value 01 bansfers 10 0' fo' the use 01 the decedenfs hneal benefioaries 's 4 5%, e,cep\ as noled In 72 PS ~91161121171 PS ~9116(al(l)) The la, rale imposed on the net value of lransfers to 0' fo' the use 01 the decedenfs s,bhngs IS 12% (72 PS ~91161a1l1311 A S,bhng is der,ned, under Sect,on 9102, as an individual who has at least one parent In common ,^,ttl the decedent. .....hettler by blood or adoptIon . (. '~; Mil. 'J III ,,~:A~:9to ....i-iwu.. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY (Ol,lMONWf Amt Of PlHN!loYlVAU1A INHUIlANcr fAI .nURN RU_lpr~,! DrC!p~~_f_. . ~lea.~Prinl_ar Ty~e _ FilE NUMBER I { of ,- ., 0 L 11 ESTATE OF O'~GI.I.'- 71.. PIJ(l./~,,-~__ ~_~~l_PloP.'I~_lolnlly.own.d with th. Right 01 Survlvoflh,lp mUlt b. dlulol.d on Sch.dul. FI ITEM NUMBER I. L. '). If. ,. (. l' ". ~. I u. , t. ( t. Il. ,y. HO. ,Co. fr-. If. to. DESCRIPTION _.~-_. ----------- /'/'0 l!.I cu"'''-r OL,.r C t..71..lfrt r,,"I\->!""l I t....;~ ~.,/ ( <.J...r~ 0+ J,.(;lc-...r ,,;,I.'t Jt,....P f'-./~ t;'i U.... ~ rlv~f. 1'....', cl'Lr ~ ....n It. 1'"{(,,v~'J (./ Ir ...,.,( 1 'L' t"- J' U~ (1'(.... ,U 1"r- tr"'.{.~,) I'J. o'd' tz.r~...J.l /...I'r l.{l..(.b~ rJ.".r(.rr.1-~~"O ") """t\t...... &.,,+1 (~r ,~vl,) 1. foil,'" &,,~(Jcto ~~.~) 'l- /c.,..-ft...< A...Ir (rr -a. ~/., ) II ,.,.' L..., J (rt!.J-- .d" 1,] ., fp:,,' T' (t. "'I"IJ~-f~:" (;-J {I'r <hU I~.... t.t<,r,. ..~ , 0 1 1'1'" /o"-;D~'" .r : /....... --I- t 0 ~ ( A rJ",k. J I'. {-{;....I: "1 J': I v.r .f'~ of ....1\1..... (,(,YolK f U ~.. "'.,/ If J',,(,.e.r. ............/"-H..t~ ":"5 ('t',..~~ /tl-..~() f ;--.. (lor f"~ r .-------.--.-------..---- VALUE AT DATE OF DEATH (l., {"D .. "&J ro.,",'; q(". "0 Zoo(. c> <l (u. tJ " t.t.r.uu I/O. u,; t.'. ,," '";fl. " 0 ('0. e> G) ~ 'Lf. c) cI /D (). tlu I D. c)u (r/' c) 0 6 o. c) 0 1("' D 0 riJ, v U '1':>v. J" 6 o. (J 0 I,G. c) j) TOTAL (1.1'0 onlor on line 5, Recapitulalion) S '1, 1 'f' . ::." ;Jl. ;;.. .~le"h .IIT'...... ~f.'u~tt jl needed.) \ ."....,....."" ~~:>~ ~tJ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COf.lUOfIWl.Al t1i OJ PH,'iSnVAMA '''It[RI1~E lAA Rl1\JHN RESIDENT DECEDENT FILE NUMBER 'l.tJ1b - 00'/...77 ESTATE OF P~n/(.. f\.. O'AI../(" 71. Debls of decedent mUll be repo~ed en Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1, FUNERAl EXPENSES: V,'r." t- Crf...........rliJ... /61'i: ,",u t'tf.(?U tt'" 0 I I~' " () --?i 1(0. 0 () Urn 1)14'-"\ ( ,4 rr""".......,1 t', Cof;'" .,f P4"{l" C.._l;.f;,...f.... (HI B, ADMINISTRATIVE COSTS: Personal Representabve 5 Commissions Name of Personal Representab'le (S) "'....l';\.f( ,a"rtfC'~ Soc~1 Securrty Number(.) I EIN Numbe' 01 Personal Rep'..enla"e(.) 0 Gb <{ () ~ '1 f 51'001 Add'''' 1'. ". iJ~ (<( (' Crly 1'1. n '7/"1: c .'n Slale /"I () Zrp (;>1(0 ~ 1 Year(s) Commission Paid: /l/ 0 A/ 'i. Allamey Fee. IV ~ tv ( Family ElemptlOn: (If decedent 5 address is oollhe same as claimant s. attach e1planabon) CI~manl iLv../ ?il ~IC.€;L , 5uoelAddr... I 0 ':/ (II 4-{ If""fl" r.l ~f'- I :,~~ Crly C 4ft /.. " r.~ ,14 Slale ,,:l/1l z,p l=l" 7 RelallonSlllpof Clamanl 10 Oecedenl fJAe-. &. H ,1;'" A}- 1. 2. 3. 1. ro', ,,() 4, P,ubalo Fee. r'3 'l- 3 t. .,,, 5, Accountant 5 Fees r 6, Tax Relum Preparers Fees e.- 7, TOTAL (Also enter on hne 9, Roeap,lulal"") S 'f. 1. ':\' "- (If more space is needed, insert add,tional shools of the same size) " COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE / I I BUREAU OF INOIVIOUAL TAXES HnlUU UHCL lAX 1I1VISIOH DU'I. 16DbDI ItARRISlltlNG, II" lIlla-oMI NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR OISALLOWANCE OF OEOUCTIONS ANO ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-16-2001 PARKER 03-27-1997 21 96-0233 CUMBERLAND 101 MICHAEL PARKER PO BOX 1411 PLATTE CITY MO 64079 A.aunt Remitted '-/- v. ;/ *' "'.1\"" ".111.111 DNELLE R MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiE'Y:i54"'i"E;[-AFP-ii'2:iiiii-NcifICE--oj:-YNHERIfANcE-TA'x-APPRAISEHENT-,--,H.i-owANcE-oR"--------------m DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PARKER DNELLE R FILE NO. 21 96-0233 ACN 101 DATE 04-16-2001 TAX RETURN WAS: I X I ACCEPrED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re.l Estate (Schedule AJ 2. stocks and Bonds (Schedule OJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Hortg.ges/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule G) 8. Total Assets CHANGED III 121 131 141 ISI (6) 171 .00 .00 .00 .00 4.346.00 .00 .00 IDI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hlsc. Expenses (Schedule HI 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Het Value of Tax Return 13. Charitable/Governmental Bequests; Hon.elected 9113 Trusts ISchedule J) 14. Het Value of Estate Subject to Tax If an assessment was issued previously, lines 14. IS and/or 16, 17, 18 and 19 will reflect figures that include the total of ahh returns assessed to date. ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate CIS) 1&. AMount of Line 14 taxable at Lineal/Class A rate lib) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due C ~ S' DATE 02-08-2001 NOTE: NUMBER AA477991 seD (+ INTEREST/PEN PAID 1-) 1.11- Iql 1101 4,272.00 HOTE: To insure proper credit to your account, SUbMit the upper portion of this for. with your tax pay.ant. 4.346.00 4.?7'J nn 74.00 .00 74.00 llq): .00 4.44 .00 .00 4.44 .00 Ill) 1121 1131 1I4) .00 X 00 : 74.00 X 06 : .OOXOO: .00 X 15 : AMOUNT PAID 7.36 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN, TOTAL DUE 6.25 1.81CR .00 1. 81CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I RESERVATION: PURPOSE Of HOTICE: PAYMENT: REFUHD C CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUHT: PENAL TV: INTEREST: E.t.t.. of deced.nt. dvlng on or b.for. Dec..b.r 12, 1982 -- If any future Int.r.st In the ..t.te Is tr.nsf.rred In po.....lon or enJoye.nt to Cl.ss B Ccoll.t.rall ben.flcl.rl.. of the d.c.dent eft.r the .xplratlon of anv est at. for llf. or for y..r., the Co..onw..lth h.r.by expr..slv reserves the right to appr.I.. and asse.s transf.r Inh.rltanc. Tax.s at the I.wful Class 8 (collat.ral) rate on any such future Inter..t. To fulfill the requlro..nts of Section 2140 of the Inh.rlt.nc. and Estat. Tax Act, Act 23 of 2000. (72 P.S. S.ctlon 9140). D.tach the top portion of thl. Notice and s~lt with your pav..nt to the R.glster of Wills printed on the r.vers. side. uHak. check or .onev :Jrd.r payabl. to: REGISTER OF HILLS, AGENT A r.fund of a t.x credit, which was not requested on the T.x Return, eay b. requ.sted bV co.pl.tlng an "Application for Refund of P.nnsylvanla Inheritance and Estate T.x" (REV-131]). Applications ar. available at the Office of the R.gl.ter of Wills, any of the 2] R.v.nu. DI.trlct Offlc.s, or by calling the spacial 24-hour BRsw.rlng ..rvlc. for fares ordering: 1-800-3b2-2050J s.rvlces for taxpay.rs with sp.clal hearing and I or speaking ~eds: 1-800-447-3020 Cll only). Any party In Interest not satlsfl.d with the appralse..nt, allowanc., or disallowance of d.ductlon., or ..s.....nt of t.x Clncludlng dl.count or Interest) as shown on thIs Natlc. QUst Object within sixty (60) days of rec.lpt of this Notice by: --written prat.st to the PA D.part..nt of Rev.nu., Board of App.al., D.pt. 281021, H.rrISburg, PA .-electlon to have the ..tt.r d.t.r.ln.d at audit of the account of the p.rsonal repr.s.nt.tlv., --appe.1 to the Orphans' Court. 17128-1021, OR OR F.ctual .rrors dlscov.r.d on this ess.s..ent should b. addre.sed In writing to: PA Depart..nt of Revenue, Bureau of Individual T.x.., A1TN: Po.t Ass.ss.ent R.vl.w Unit, D.pt. 280601, Harrl.burg. PA 17128-0601 Phon. (717) 787-6505. Se. p.ge 5 of the booklet "Instructions for Inh.rltanc. lax Return for a Re.ld.nt Decedent" CREV-IS01) for an .xplanatlon of ad.lnlstratlv.lY corr.ctable .rrors. If any tax due Is paid within thr.. (3) cal.ndar eonth. aft.r the d.cedent's death, a flv. p.rc.nt (5~) discount of tho tax paid Is .llowed. lh. 15~ tax aen.sty non-participation penalty Is co.put.d on th. total of the tax end Int.rest .s.....d, and not paid before January 18, 1996, the first dav aft.r the end of the t.x een..ty period. lhls non-p.rtlclpatlon penalty Is appealable In the .~. .anner .nd In the the sa.. tl.. period as you would appe.l the tax .nd Int.rest that has been .ssess.d as Indicated on this notice. Int.r.st Is charged b.ginnlng with first day of delinquency, or nine e91 eonths and on. CII dav froe the date of d.ath, to the date of pay.ent. laxes which beea.. d.llnquent bolore January I, 1982 bear Inter.st .t the rate of six C6~1 perc.nt p.r annue calculat.d at b dally rat. of .000164. All t.xes which b.ea.. dellnquont on and .ft.r January I, 1982 will bear Interest at a rnto which will vary fro. calondar year to calend.r year with that rat. announc.d by the PA Depart.ent of Rev.nuB. Th. applicable Interest rates for 198Z through 2001 ar.: Vear lntenst Rate Dalh Interest ractor Vear 1nt.r.st Rate Dnih Inhrnt Factor 1982 20Z .000548 199i' 9~ .000247 1983 l.~ .000438 1993-IIJ94 ,. .000192 19114 IIZ .000301 IIJ95-II)'JI'J OX .000247 19115 13l .00035& 1999 n .00019Z 198b lU~ .000214 1000 .~ .000219 1987 9~ ,000247 ZOO) 9~ .000147 1988-1991 Il~ .000301 --Int.nst I. calcul.ted a. follows: IHrEREST = BALAHCE OF TAX UHPAID X HUnBER OF DAYS DELIHQUEHT X DAILY IHTEREST FACTOR --Anv Notice I..ued after tho tax beco.es d.llnquent will refloct en interost calculation to flfte.n 11~1 days beyond tho date of tho a.,oss..nt. If pay.ont 15 .ade nfter Ihp Inlorosl coeputation date shown on tho Notice, additional lnlerost .ust bo enlculnted.