HomeMy WebLinkAbout96-00787
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Court Administrator
CUMBERLAND COUNTY COURTHOUSE
One Courthouse Square
Carlisle, PA 17013
File No. 5093.96
In re: Mae A. Mayberry
Dear Sir or Madam:
I enclose herewith the following:
1. Original petition and copy (to be certified) of petition for incapacity with Order of Court
attached.
2. Register of Wills filing fee check in the sum of $32.
3. Sherifrs service instructions.
4. Sherifrs service costs check in the sum of $ 100.
I ask you to do the following:
1. Upon the entry of a hearing date on the Order of Court, please complete the "IMPORTANT
NOTICE" page attached immcdiately under the Order of Court. Please fill in the courtroom
number and the date of the hearing on the first page of the notice and sign and date the third page
of the notice. This should be done on the original copy and the extra copy (to be ccrtified) and
served on Mrs. Mayberry.
2. Deliver the citation, certified copy of petition with order attached, Sherifrs instructions and
Sheriff's check to the Shcriff for service.
3. Complete and return the third copy of the Order of Court to me inthc cnclosed self-addressed
stamped envelope.
Thank you for your assistance in this matter. If you have any questions, please contact me.
Very truly yours,
P {, .lVt wel.; 'd(V,Il-f1e( f .:>to"Lo<XUC(
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS COURT
III rc: Mae A. Mayberry
No.
IMPORTANT NOTICE
TO: MAE A. MAYBERRY
CHURCH OF GOD, INC.
801 North Hanover Street
Carlisle, PA 17013
A PETITION HAS BEEN FILED WITH THIS COURT TO HAVE YOU
DECLARED AN INCAPACITATED PERSON. IF THE COURT FINDS YOU TO BE AN
INCAPACITATED PERSON. YOUR RIGHTS WILL BE AFFECTED. INCLUDING
YOUR RIGHT TO MANAGE MONEY AND PROPERTY AND TO MAKE DECISIONS.
A COpy OF THE PETITION WHICH HAS BEEN FILED BY KATHY J. ADAMS IS
ATIACHED.
YOU ARE HEREBY ORDERED TO APPEAR AT A HEARING TO BE HELD IN
COURTROOM NO. ~ OF THE CUMBERLAND COUNTY COURTHOUSE. ONE
COURTHOUSE SQUARE. CARLISLE. PENNSYLVANIA ON fJdi\P.,,-, 17 .1996
AT / /: 00f)M. TO TELL THE COURT WHY IT SHOULD NOT FIND YOU TO BE AN
INCAPACITATED PERSON AND APPOINT A GUARDIAN TO ACT ON YOUR
BEHALF.
TO BE AN INCAPACITATED PERSON MEANS THAT YOU AHE NOT AI\LI~
TO RECEIVE AND EFI'ECTIVELY EVALUATE INI'ORMATION AND
COMMUNICATE DECISIONS AND THAT YOU ARE UNAI\LE TO MANAGE YOUR
MONEY AND/OR OTHER PROPERTY, OR TO MAKE NECESSARY DECISIONS
ABOUT WHERE YOU WILL LIVE, WHAT MEDICAL CARE YOU WILL GET, OR HOW
YOUR MONEY WILL BE SPENT.
AT THE HEARING. YOU HAVE THE RIGHT TO APPEAR, TO BE
REPRESENTED BY AN A TIORNEY, AND TO REQUEST A JURY TRIAL. II' YOU DO
NOT HAVE AN A TIORNEY, YOU HAVE THE RIGHT TO REQUEST THE COURT
TO APPOINT AN A TIORNEY TO REPRESENT YOU AND TO HAVE THE
ATIORNEY'S FEES PAID FOR YOU IF YOU CANNOT AFFORD TO PAY THEM
YOURSELF. YOU ALSO HAVE THE RIGHT TO REQUEST THAT THE COURT
ORDER THAT AN INDEPENDENT EV ALUA TION BE CONDUCTED AS TO YOUR
ALLEGED INCAPACITY.
IF THE COURT DECIDES THAT YOU ARE AN INCAPACITATED PERSON,
THE COURT MAY APPOINT A GUARDIAN FOR YOU BASED ON THE NATURE OF
ANY CONDITION OR DISABILITY AND YOUR CAPACITY TO MAKE AND
COMMUNICATE DECISIONS. THE GUARDIAN WILL BE or YOUR PERSON
AND/OR YOUR MONEY AND OTHER PROPERTY AND WILL HAVE EITHER
LIMITED OR FULL POWERS TO ACT FOR YOU.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS COURT
III Re: Mae A. Mayberry
No.
PETITION FOR ADJUDICATION OF INCAPACITY AND
APPOINTMENT OF PLENARY GUARDIAN OF THE ESTATE
AND PERSON AND ESTABLISHMENT OF BURIAL FUND
To tbe HOllorable Jlldges of Sajd COllrt:
1. The Petitioner is Kathy J. Adams of 311 Oak Lane, Gettysburg, Pennsylvania
17325, daughter-in-law of Mae A. Mayberry and natural guardian of Mrs. Mayberry's twO minor
grandchildren who are tWO of Mrs. Mayberry's heirs-at-law.
2. The alleged incapacitated person is Mae A. Mayberry, who was born on September
29, 1910, is 85 years of age and resides at Church of God Home, Inc., 801 North Hanover Street,
Carlisle, Cumberland County, Pennsylvania 17013.
3. Late in life Mrs. Mayberry married David Mayberry, her second husband, who is
presently 89 years of age.
4. The following persons are the only heirs-at-Iaw of Mrs. Mayberry:
a. David Mayberry, her husband, who resides at III Ridge Drive,
Carlisle, Pennsylvania 17013.
b. Jessica K. Adams, a 17-year-old granddaughter, who resides with the
Petitioner.
c. Cameron R. Ad.lms, .1 14-ycar-old gr.\ndson, who resides with thc
pctitioncr.
5. The following arc the known "ssets of Mrs. M.lyberry:
a. Cash accounts at Mellon Bank of $53,288.69.
b. Church of God Home, Inc. personal cash account of $28.84
6. Mrs. Mayberry's monthly income is comprised of interest on the "bove accounts
and social security of $866 per month.
7. Mrs. M"yberry was not" member of the Armed Services of the United States and
is not receiving benefits from the United States Veterans' Administration.
8. Mrs. Mayberry suffers from Alzheimer's Disease and the physical frailties of old
age, symptoms of which are described as follows:
a. She is unable to recognize her family and their relationship to her.
b. She is unable to comprehend her financial affairs.
c. She lacks the ability to comprehend her surroundings and her
physical needs and is dependent upon others to provide these needs.
d. She is wheelchair bound.
e. She is incoherent and irrational in her talk.
9. Because of her mental and physical condition, Mrs. Mayberry is totally unable to
manage her financial affairs, property and business and to make and communicate responsible
2
decisions relating thereto, including the 'lbility to communic"te her need for 'lssistance in these
areas. She has little or no comprehension of the f'lctthat bills ,1fe owing, could not prepare checks
or instruct others to prepare checks for payment, nor can she remember the need to pay the bills
or comprehend the amount of money which is necessary to pay them.
10. Because of her impaired mental and physic,,1 condition, Mrs. Mayberry lacks the
capacity to make or communicate responsible decisions concerning her person. She has no ability
to keep herself properly nourished and hydrated and must rely completely upon the services
provided at the nursing home to make sure that her physical needs are met. Mrs. Mayberry lacks
the ability to understand her physical needs.
11. Mrs. Mayberry's mental and physical "bilities are such that there are no alternatives
to the appointment of a guardian of her estate. Her son, Galen R. Adams, handled her financial
affairs from February of 1994 to his death in August of 1996.
12. The severity of Mrs. Mayberry's mental and physical conditions and the lack of
viable, less restrictive alternatives necessitate that a plenary guardian of her estate be appointed
to manage and handle all respects of Mrs. Mayberry's estate, specifically including, but not limited
to, all issues relating to her cash, checks and "ny bank or savings accounts held in her name, her
personal property, her estate, her insurance, her entitlement to "ny governmental or non-
governmental benefit plans, federal, state and local taxes, claims made or to be nude on her behalf
or against her, execution of documents, entering into contracts affecting her .\Od p.lyment of
reasonable compensation or costs to provide services for her.
3
13. Thc scverity of Mrs. Mayberry's mem,ll ,lIld physid condition and thc tIck of
viable, less rcstrictivc ,llternatives neccssitatc th,lt ,I plcn.lry guardi.lIl of her person bc 'Ippointcd
to handlc all issues relating to hcr pcrson, specifically including, but not limited to, hcr living
,Irrangcments, mcdical C,lrc, the administr.lIion of mcdication to hcr, ,lnd the cmploymcnt and
dischargc of carctakers, physicians .lnd other health c.lre profcssionals for her physical and mental
trcatment and carc.
14. Pctitioner is not aware that Mrs. Mayberry has cxecutcd any currcnt powcr of
attorney, advanced carc dircctivc or has in any other way dcsignated anyonc to serve as her agent
over her pcrsonal or financial affairs or as her surrogatc over her mcdical carc, or that shc
designatcd in writing her wishes with rcgard to hcalth care, including the use or refusal of life-
sustaining treatment.
15. The proposcd plcnary guardian of Mrs. Maybcrry's estatc is Adams County
National Bank with its trust office located at Lincoln Square, Gettysburg, Pcnnsylvania 17325.
Adams County National Bank providcs guardianship services as part of its trust services.
16. Thc proposcd plcnary guardian of Mrs. Mayberry's pcrson is the Petitioner, Kathy
J. Adams, hcr daughtcr-in-bw. Mrs. Mayberry's husb,lIld is inc.lpacitatcd from the cffects of a
stroke and hcr grandchildrcn, the other heirs-at-Iaw, ,lrC minors. Mrs. Mayberry's siblings havc
dcclincd to servc as guardian of hcr person. The proposcd guardian is not cmployed out of hcr
home and will have rcgular contact with Mrs. Mayberry to arrange for hcr physical necds.
4
,
17. Thc proposed plenary guardians havc no intercst .\dverse to Mrs. Mayberry.
18. The consents of the proposed plcn,\ry guardi.ms arc attOlched hcrcto.
19. No othcr court has evcr assumed jurisdiction in any proceeding to determine thc
capacity of Mrs. Mayberry and no other guardian hOls been appointcd for her cstate or pcrson.
20. Petitioncr, at the request of thc proposed guardian of the estatc, Adams County
National Bank, requcsts the Court to authorize thc guardian of thc estatc, if appointed, to set
aside the sum of $5,000 in a burial reserve for Mrs. Mayberry.
WHEREFORE, Petitioner respectfully requcsts that this Court award a citation to Mac
A. Mayberry to show cause why she should not be adjudged a fully incapacitated person and
Adams County National Bank appointed plcnary guardian of her estate and Kathy J. Adams
appointed plenary guardian of her person. Further, Petitioner requests the Court to authorize
the guardian of the cstate, if appointed, to set aside the sum of $5,000 as a burial reserve for Mrs.
Mayberry.
TEETER, TEETER & TEETER
/ ] 6' j/j /" L
By: j{(l... '/d,1/'J ,~6!. <
Robert G. Teeter,
COllnsel for Petitioner
108 Wcst Middle Street
Gcttysburg, P A 17325
(717) 334-2195
Supreme Court ID #19622
5
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS COURT
In Reo' Mae A. Mayberry
No.
CONSENT OF GUARDIAN OF THE ESTATE
AND REQUEST FOR BURIAL RESERVE
I, Ronald D. Baker, Trust Officer of Adams County National Bank, hereby consent on
behalf of the bank to serve as guardian of the estate of Mae A. Mayberry.
Adams County National Bank has no interest adverse to Mae A. Mayberry.
If Adams County National Bank is appointed guardian of the estate, it requests the
authorization to set aside $5,000 as a burial reserve for Mrs. Mayberry.
ADAMS COUNTY NATIONAL BANK
Dated: .s~pr /cpJ.
,1996
By:
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CUMBERLAND COUNTY COURTI10USE
Qlle COllrthOUlC Sqllan'
c;!!ii.I~, PA 17013--
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File No. 50'13.96
lure: M:le A. M;\yhcrry. :III in~Jp:ldl:llcd persoll
No. 21.96.787 -
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Dc.lr uUge 11JY\~
I received J tdel'hone l\IlI from )'ollr s,'crel.II)'. ShJron, \Vllo imlic.\I,'.lth.\1 )'ou wo"I.\ ;Ill,,\\' 1.,,11',
M"ybcrry's physil'ian to tl'~tify I>y tel,'phOIl!..\1 Ihe illl'.II';\l'ilY I,,'arilll\ sd1l'dlll"l\ for 11:00 a.l\I.
on O.loher 17. I ;\SSIlII'" fl'lll\l Ih.lt ,ollv.>rs.lliOIl 1I1.\1lyoull,\\'c.I sl'l\\ker p\wlle .IV.li\.ll>\e ill your
ch.\lnbl'r; ;\I\J th,It I do not hJVl' \0 11",1,,' .Irr,\IIf,"l1lents fnr ,I srl,.lker I'hor\1'. I will .1I'\'alll~c 10
h,IVe Ihe I'hysiei.IIl ;\V.til.tble to be questioned ,II IIII' "l'l'oillll'.I hour.
1.1111 wrilillf, 10 ,,,h'ise Ih.lt to thc I'etilioner's kllowlt.,I\','" MIS, tvl.1ybrr 11 h,Is 110\ o"t,lInc,1 counscl
10 rep,,""1I1 h,'r ill II", in,';lI'.lCilY (lI'ol'''l.,lillbs. g,I".,lul"'1l rllY (Ollv,'rsJtinl1s wilh \\\'r physici,II1,
Ihe p"titioncr ,\llJ the 1\\Il',Sill!; hon\\', il dOl'S Il(ll ,ll'pcar Ih.1I lvlrl. tvl.lylR'rry h.\s Ihc ",cnt;l\
CilI',\Cit}' to ,mist eoullI,.1 ill tilt' il1C;lp.ICilY Pllll""",lill!;', I h.I\''' \""'l1lold lh,ll Mrs. Ivl.lybcn'y is
slIffer;lI!; from A"I.ltclIIlI'r's nis,',lst' or.1 form 01 dl'III1'nti.1 silllil.1r to it. I h,Il'e ,11-0 ""l'n told h)'
the IIl1rsil1g hllllle t1ut Mrs, M.\yhenfs ph)"i.:i,1I1 I>eli,'''''s il will Ill' ll.lrl II fill lor her to JIl""'! the
pwccl,dillgs, I will oht,lin the r"q\lirC,1 affid.lVit fl','IIII",r I'hpil'i,\n if. ill f,lI'l, il .\ppe,1I5 thaI s\\l~
is not ;Ihle to ,\\lclld I'l'C,\uW of the h,1f<1I which it will C.III''',
III oHler 10 efficienlly IISl.the Cll\lll's tillll', il Illl> COUr! .11'1'"illts ;I\\I1.\[ll;.1I1 of Mrs, M.lyb,'rry's
cst at'> 011 OC\llhcr \7. tI\\' \',u,lIdian .\llIi,'il'''\<'5 ill\ll\l.,h,l\dy requeSlill(\ the ((1\lIt III all(lw it 10
cst.I\,lish .1 burial reSl'l've ,llId \0 p"y Mrs. M.lybe11 )"s llln,'1I1 ,\1111 f\llllr<' bills from il1eollle .\lI,1
pril1cip,'1. The leqlll'sl to r\I;lblish ,1 hur;,11 ft',,'rve is il1dll,I,.,1 ill the orillill,,1 .llljmlic.llion
I'I'tilioll. A 51'p.\I';\IC 1"'lilioll rel.llill\~ 10 tit(' e:<p,,",lilllr<: of prim'ip.I' ;\11,1 income I'll lviI'S.
M;\yb"l'Ifs beh,,\[ willlll'pl'(~ell\<.d to Ihe COllr! ,II Ihe cOlld\lsi,,,' of Ihl' illr.,p.Il';I)' 1'1')l','ellill!;.
It is hoped th.lI till' CI'\lrt will allow time oil (1<1011<'1 Ii fM till' COllsi,I"I"'liol1 of IheS\' 1II.lllerS ;15
wdl. Copil'~ of tlIl'SI. I'elitioll~ .Il'e twill\,. ,,'Ill ill ,ll\\'.III\''' oll\\\' I\\'.\rill!; I,) d", .It'st of kill.
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rcn.j",',l >:""1' ()r.ielof c:..",1 c1.II",( (),'I"b,'(' I Sftl in~ Ihe ~O,I\ ,ll.OlIshil' he,,, ill~, f"r ()''''\l('1 17. S,'(li"l\
5511(..) oj Ihe l'rohJlt', br,II" .lIld Pidllcl.Ili('\ CoH" S.l)" Iholt 110 less Ih,II1 .~() ,\.':.., .1.lv.H'<'" 1I0,in' sh,lll be
giwlI ", :':", M,lyberry 01 Ihl' 1"'.lrillg. 1'.lr"gLlph 3 of till' 0,,\.:1' of C,'IIIl J1.", l.r)" Iholl the <,il.lli,," .",,1
p,'lilinn <:\\1',: hI' \e('\.,.,1 011 Mrs. M,'yllL'ny ,\llc.I" 10 d.I>:' prior It Ih,. <'Olllt 1"',l\illl:'
Mrs, :>1.I)'h "";1 is sllrf"IIIII~ frolll 1\17.1I<'III\I"S Di,,'o\Sl' .111\1 h." b,'en ;I n""lont of J nursing h.,mc lor "'
excc" "f 11"1) )',',U'5. A,tuu' COIIIII)' Nalinn,,1 B.u,k is Ihe I'I<'p,,\('d I'lcn,n)' ~II.l!.Ii,ln III p"y h"1 nur'"'~
home hilb, 1'1."lk..1 bills '"1,1 h",.lIh in'''fo,n,'l' 1'1'...11 i r.'" As.I I'r.KlI,,,,1 r",,",'r. lilt. ~O .by n.,r"e
reqlli""" Ii' i, nol iml'ol\..nl hilI Ih,' \1,'"'''' .!,'e' ,'.111 fIr ,t.
I b.,,1 m.:\",llhe 1ll'1;li"n I') lhc ((Juri .lrhuinim.lIM (lI' S"l'llmba 2,1 .'u,\ .."IIult:il Ih,'1 it h,1l1 b,,'n
rl".,.",,,.!,.n,\ Ihal selvic.. h,\(IIll'cn m"tI,. on Mrs,II'Liylo",'ry in a limely I.I,hi"n. 10111)' leCl'i"ctl )',,,n
0"1,,, "I Cnnt )'I"l,'r.i.ly ,n1\llIolie.'.1 tilt. lime discrerJIII')', While 1 b..li. ",' Ihal 1...11, M.lybal-y's
ph)";,:i,III" 1,'"I110IlY .."I tll.1I of I hI' pdill"ner will c"'l\'in~e lhe COUll th,ll ~lrs, ~l.Iybcrry is cOlllpl,'I..!)'
ir1t',II"",il"wl,I.lnI wlilin!: \0 inquirc whclh,'r )'0\1 rrcl)"llI will b,' .lble '" <ult'r.1II ord,'r ~ivclI Ihc 1.lCk
of ~c .I"\,, .",,",lOCl' 1"'liCClln M", ~lo\)'\.,'rry, I ."'li,ip,II" Ih,1! Ihc CIIIIl!""tlllll CnunlY $\l<'lirf',
Depannlcnl h,15 ~rv,'d 1\lrs. tvl.1yb"IT)' so lI...t shc will h.,'<: '\l'l'fllxirll,ucI)' 15.\..)" adv,lnc,' noli,,' or Ih..
htarinl:' Frum wh.1I I h",," \'>"('" ",t.! 10" rhr p,.,itioner ;n"I1\lrs, tliloiY!"'l'r"" physiri,lIl, I beli,'"" n ;,
eXlr'I'mcly unlikdy Iha, Mrs, M,l)'hrr)' 11',11 cO"lt"1 tilt. .11'1'"nlll1lel1l "f .1 \'.11,11'.11.11' (,( hcr ,"t.lle .nd
PCI'",'1. Ii Ihe court l> willlll(; II) llVl',I'lOk tI,e 20'tI,l)' lint in' 1I"l'nll'nWI1l 01",110 .Ipl'oi"t .\ \;u,\IOli.", 1-.1\, ,t
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17. If yo" heli,','e Ih,'III". 20 d,,)' nOli,'c j" 11I,lI1d,lltlry ,11,,11'1'1"','11" )'ou 11")(11 ,,11,'1 in~ .111 ""Ier, Ih,'nl"~
11I'.ll'in\: dollc should I... 'ncl....III\,.'\1O allu\\' (""lnl~h til1lC to s('rve M", ~1.\\.I"'r"',
Would you pl...ls(' "'I II'" kiln I\' \\'helh,'1' )'uu f,',,\ \\'e nl,'}' 1'1'00",,(',1 with till' l.lrt,)h,'r I/Ih !II'.lril1~.
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IN RE:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 96-787 ORPHANS' COURT
MI\I, 1\. MI\YBF.RRY
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with this Court to have you declared an Incapacitated Person. If the Court
finds you to be an Incapacitated Parson, your rights will be affected, including our right to manage money
and property and to make decisions. A copy of the petition which has been filed by
KATHY .1. AI11\M5 is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No.2, Cumberland
County Courthouse, Carlisle, Pennsylvania. on Or.TOBER 17 , 1 $~, at 11:00 ~.M. to
tell the Court why it should not find you to be an Incapacitated Person end appoint a Guardian to act on
your behalf.
To be an Incapacitated Person means that you are not able to receive and effectively
evaluate information and communicate decisions and that you are unable to manage your
money and/or other property, or to make necessary decisions about where you will live.
what medicel care you will get, or how your money will be spent.
At the hearing, you have the right to appear, to be represented by an attorney, and
to request a jury trial. If you do not have an attorney. you have the right to request the
Court to appoint an ettorney to represent you and to have the attorney's fees paid for you
if you cannot afford to pay them yourself. You also have the right to request that the Court
order that en independent evaluation be conducted as to your alleged incapacity.
If the Court decides that you arc an Incapacitated Person, the Court may appoint a
Guardian for you, based on the nature of any condition or disability and your capacity to
--
make and communicate decisions. The Guardian will ba of your parson and/or your monoy
and other property and will have either limited or full powers to act for you.
If the court finds you are totelly incapacltatad, your lagal rights will be affected and
you will not be abla to make a contract or gift of your money or other property. If the court
finds that you are partially incapacitated, your legal rights will also be limited as directed
by the Court.
If you do not appear at the hearing (either in person or by an attorney representing you) the court
will still hold the hearing in your absence and may appoint the Guardian requested.
-I'
By: ___<,' u( ,
Clerk, rphans' Court'Division
Cumberland County, Carlisle, PA
My Commission Expires 1 st Monday,
January, 199.:8:.
DATED: October 2,1996 ,199__
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS COURT
Itl Rc: Mac A. Mayberry
No. 21-96.787
CERTIFICA TE OF SERVICE
I hcreby certify that on October 8, 1996, copies of thc (A) pctition for Adjudication of
Incapacity and Appointment of Plenary Guardian of thc Estatc and Pcrson and Establishment of
Burial Fund and Order of Court datcd October 1, 1996, (B) Citation datcd October 2, 1996, (C)
Petition for Pcrmission to Distribute and Apply Income and Principal Under Probate, Estatcs and
Fiduciarics Code $5536, and (0) lettcr attached hereto as Exhibit" 1 " wcre mailed by ccrtified mail
and rcgular mail to thc following pcrsons constituting the next-of.kin of Mae A. Mayberry:
1.
David Maybcrry
111 Ridgc Drive
Carlisle, PA 17013
2.
Kathy J. Adams, natural guardian for
Jessica K. Adams and Cameron R. Adams
311 Oak Lanc
Gettysburg, P A 17325
I certify that thc itcms sct forth as A, B, and C above and Exhibit "2" attached hercto wcrc
mailcd on Octobcr 8, 1996 to the institution in which Mrs. Mayberry currently resides: Church
of God, Inc., 801 North Hanovcr Strcet, Carlislc, Pennsylvania 17013.
The rcceipts for ccrtified mail arc attached hercto, none of the letters wcrc rcturncd by the
U.S. Postal Service as undeliverable.
I vcrify that the statements made in the forcgoing are truc and correct. I understand that
false statemcnts herein arc madc subject to thc penaltics of 18 Pa.C.S. $4904, relating to unsworn
falsification to authorities.
Dated: Oc.+.:>~)''- 11 ,1996
/2IuJj~,~L
V" Robcrt G. Tcetcr
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TEETER, TEETER & TEETElt
Inn \\'1'1 MlIlIlII SINIII
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DANIII E. 1111110: 11'" I I"'ILlI
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TO THE NEXT.Of.KIN Of MAE A. MA YBEUUY:
IIIII'IIONI
17\71 1\01.) 1 'J~
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Kathy J. Adams has filed a petition to h.IVe a gu.mlian of the est.lIe and guardian of the pcrson
appointed for Mac A. Mayberry. A he.uing on thc petition h.ls becn set for October 17, 1996 at
11:00 a.m. in Courtroom No.2 of thc Cumbcrbnd COllnty Courthouse, 1 Courthouse Squarc,
Carlislc, Pennsylvania. All of you .lrc required to be notificd as Mrs. Mayberry's next-of-kin and
arc permitted to attend thc procecdings if you so dcsire but do not havc to attcnd.
I rcprescnt Kathy Adams in the petition and will also be rcprescnting Adams County National
Bank as guardian if thc bank is appointed guardian of Mrs. Maybcrry's financial affairs. While
thc law allows the appointment of an attorney to rcpresent Mrs. Mayberry in these proccedings,
it is unknown whethcr shc will secure thc scrviccs of an attorney. Bascd upon the information
which I have received from hcr physician, the nursing home and Kathy, it does not appcar that
she would be able to assist an attorney in prcsenting a defcnse to the appointmcnt of a guardian
of her estate and person bccause of her mcntal condition. She has thc right, howcvcr, to retain
an attorney if she so desircs. I do not believe the court intends to appoint a lawyer for her.
If Adams County National Bank is appointed guardian of Mrs. Maybcrry's cstatc at the hcaring,
the bank intends to rcqucst the court to allow it to establish a $5,000 burial reserve for Mrs.
Mayberry and to pay her outstanding and futurc bills from her incomc and hcr assets. A copy
of the Petition for Permission to Distribute and Apply Incomc and Principal Undcr Probate,
Estates and Fiduciarics Codc $5536 is cncloscd and ,,'" I. - - ' .. .1.. --..- fM
consideration at the October 17 hcaring.
In addition to the petition rccitcd in the previous paragr;
Petition for Adjudication of Incapacity and Appointment 0
Person and Establishment of Burial Fund, a copy of the COli
October 2, 1996 and a copy of thc court's order dated Octo\
Mrs. Mayberry's condition, Kathy Adams will bc .lppointel
and Adams County National Bank will bc appointcd guar
If you have any questions, pI case do not hesitatc to contac
Vcry truly yours,
TEETER, TEETER & TEETER
Robcrt G. Tcctcr
RGT:law
encls.
EXHIBIT "1"
P 486 260 082
us PO~I.1' SpfVlce
Receipt for Certified Mail
No Insurance CO'.'f'rago P,ovlded.
00 ncl tJ5tJ IOf InlofnJllonal Mall St'o re~'ersfJ'
tirr.ll'l
David Ma berr
Silt/of t, ~fi.Jmtl'!
111 Ridge Drive
P,,~l ()It<~ SI,lle!\ liP C()Oo
Carlisle, PlI 17013
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P 486 260 083
p 486 260 082
us poslal Sur.ice
Receipt for Certified Mail
Uo 1f\'.iUlanct.' COO'(>IJ90 Pro\'lded.
00 ncl tlSO lor Inlel".11ional Mall S~e re~'erse)
5l'.~llD
David Mayberr
Snc<-'l ft tiu(tltJf!1
III Ridge Drive
PG~\OIHC, S!all!," lIP Code 13
carlisle, PA 170
us PcslJl Sef'<'ICl\
Receipt for Certified Mail
No InsUfancl' Co~elalJo PIOI/ided
Do not U1!IIQf Inloll!.l1hOrhll ~."lil~St'()/t\'(lrs(l1
'n'lO "a1:~"7"'/ldam, atura'
for Jessica 1<. /IdmG am
SIre;!! &. r~umbef WI.....\.A1
311 Oak Lane
Pcsl Qt1,ce, Slale. ^' lIP CMIl
Gettysburg, PA 17325
Posla']e
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TEETEII, TEETEIl & TEETEII
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Octobrr 7, 19')(,
11111'111I~1
17171 1.IoI.lI'lS
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TO THE NEXT.OF.KIN OF MAE A. MA YBERR Y:
Kathy J. Adams has filed a petition to have a gu.trdian of the est.tte .1I1d guardian of the person
appointed for Mae A. Mayberry. A hraring on the petition has been set for October 17, 1996 at
11:00 a.m. in Counroom No.2 of the Cumberland County Courthouse, 1 Courthouse Square,
Carlisle, Pennsylvania. All of you are required to be notified as Mrs. Mayberry's next-of.kin and
are permitted to attend the proceedings if you so desire but do not have to attend.
I represent Kathy Adams in the petition and will also be representing Adams County National
Bank as guardian if the bank is appointed guardian of Mrs. Mayberry's financial affairs. While
the law allows the appointment of an attorney to represent Mrs. Mayberry in these proceedings,
it is unknown whether she will secure the services of an attorney. Based upon the information
which I have received from her physician, the nursing home and Kathy, it does not appear that
she would be able to assist an attorney in presenting a defense to the appointment of a guardian
of her estate and person because of her mental condition. She has the right, however, to retain
an attorney if she so desires. I do not believe the court intends to appoint a lawyer for her.
If Adams County National Bank is appointed guardian of Mrs. Mayberry's estate at the hearing,
the bank intends to request the court to allow it to establish a $5,000 burial reserve for Mrs.
Mayberry and to pay her outstanding and future bills from her income and her assets. A copy
of the Petition for Permission to Distribute and Apply Income and Principal Under Probate,
Estates and Fiduciaries Code $5536 is enclosed and will be presented to the court for
consideration at the October 17 hearing.
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In addition to the petition recited in the previous paragr.tph, I enclose a copy of the original
Petition for Adjudication of Incapacity and Appointment of Plenary Guardian of the Estate and
Person and Establishment of Burial Fund, a copy of the court's Citation to Mrs. Mayberry dated
October 2, 1996 and a copy of the court's order dated October 1, 1996. It is anticipated that given
Mrs. Mayberry's condition, Kathy Adams will be appointed guardian of Mrs. M.tyberry's person
and Adams County National Bank will be appointed guardian of her estate.
If you have any questions, please do not hesitate to contact me.
Very truly yours,
TEETER, TEETER & TEETER
Robert G. Teeter
RGT:law
encls.
EXHIBIT "I"
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TEUTI;R, THHTER & THETHR
108 \Y1~l MIDllll S'R'"'
GII t'VsnURG, I'l NNS'Vl VANIA 11) 2 S.2194
DAHill E. TllllR t19t'.'9901
ROIIOI G. lU11R
sAMUIl E. lllllR
October 7, 1996
TlltrlloNt
(7171334.2195
fAl
(717) 334.2913
CHURCH OF GOD HOME, INC.
801 North Hanover Street
Carlisle, PA 17013
File No. 5093.96
Re: Mae A. Mayberry
Ladies and Gentlemen:
I represent Kathy J. Adams who has filed a petition for appointment of a guardian of the estate
and guardian of the person of Mae A. Mayberry, a resident at your home. I enclose a copy of the
Petition for Adjudication, Citation, and Order of Court setting a hearing on the petition for
October 17. 1996 at 11:00 a.m. in Courtroom No.2 ofthe Cumberland County Courthouse, 1
Courthouse Square, Carlisle, Pennsylvania. It is proposed that Adams County National Bank
be appointed guardian of Mrs. Mayberry's estate and Kathy J. Adams be appointed guardian of
her person.
This notice is given to you as required by law in the event you wish to attend the hearing. Your
attendance at the hearing is not required, however.
Please contact me if you have questions.
Very truly yours,
T:ETE', TEE, TER &Z~;!~~-' 1_---
.~/ 4.(c~t/j iu, tc-.-
Robert G. Teeter
RGT:law
encls.
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EXHIBIT "2"
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IN THE COURT or COMMON PLEAS OF CUMlmRLAND COUNTY, PA
ORPHANS COURT
III Re: Mae A. Mayberry
No. 21-96.787
PETITION FOR PERMISSION TO DISTRIBUTE AND
APPLY INCOME AND PRINCIPAL UNDER PROBATE,
ESTATES AND FIDUCIARIES CODE ~5536
To the Honorable Jlldges of Said COllrt:
Your Petitioner, Adams County National Bank, guardian of the Estate of Mae A.
Mayberry, an incapacitated person, respectful1y represents that:
1. Mae A. Mayberry was declared an incapacitated person and your Petitioner was
appointed guardian of her estate.
2. Mrs. Mayberry has resided at Church of God Home, Inc., a nursing home located
in Carlisle, Pennsylvania, since 1994.
3. While the Petitioner has not had an opportunity to file the Inventory as of this
date, it is known that Mrs. Mayberry has cash assets of approximately $62,611.37 and social
security income of $866 per month.
4. Mrs. Mayberry's expenses, including those of her nursing home care and medical
expenses, have not been paid since early August of 1996 when the death of her attorney-in-fact
necessitated the appointment of a guardian of her estate.
. .
I verify that the statements made in the foregoing are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa. C.S. $4904, relating to unsworn
falsification to authorities.
ADAMS COUNTY NATIONAL BANK
Dated: Oc..to LQ..I'" /7 ,1996
By:
.
IN TilE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY.PA
ORPIIANS COURT
III Ill!: Mnc A. Mnybcrry.
un incupncitutcd pcrson
No. 21 -96 -787
STATEMENT OF PROPOSED DlSTRIHUTION OF ADAMS COUNTY
NATIONAL BANK, PLENARY GUARDIAN OF THE ESTATE OF
MAE A. MAYBERRY, AN INCAPACITATED PERSON
Adums County Nutional Bank. plcnnry gunrdian of the cstutc of Muc A. Mnybcrry, an
incapacitatcd pcrson and now dcccascd on May 8. 1998, scts forth thc following statcmcnt of
proposcd distribution in conncction with its first und final account:
Total Rcccipts ...................................................... $ 133,535.48
Total Disbursemcnts ................................................. - 94.308.42
Balancc for Distribution ..........................................,.. ~ 39.227.06
SCHEDULE OF DISTRIBUTION
Cash to bc distributcd to thc Estatc of Mac R. Maybcrry, also known us
Mae A. Maybcrry, dcccuscd ............................................ ~ 31).227.09.
Nancy L. Reichart, Trust Olliccr of Adums County Nationnl Bank. thc abovc namcd
Accountant, being duly sworn. says thntthc forcgoing is ajust statcmcnt ofthc proposcd distribution
of the guardianship cstatc and thatthc lollowing is n just and truc account and sclllcmcnt of thc
goods, challcls, und crcdits which camc into its hands or posscssion us plcnury guardian aforcsaid.
Sworn to and subscribcd beforc mc
c. . /" , . . "
J'J.,./' ,1,' ';!" 'j',,' .j
_ .... '/ " _" ,e
Nancy L. Rcich~rt
,
this J'Tlh.. day 01':1, )/.,,,
. 11)1.'S
?:x{ L. fA i.
Notary Public
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Notarial 50al
Lorl ,.,. WhininglOn. Notary Public
Genysbur9 Bora, Adams County
My CommisSIon e'pues "'pllI22. 2000
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS COURT
III Rc: Mac A. Mayberry,
,m incapacitated person
No.21-96-787
A...C-.CJlllli.
The First and Final Account of Adams County National Bank, Plenary Guardian of thc
Esta1c of Mae A. Mayberry, an incapacitated person, of North Middleton Township, Cumberland
County, Pcnnsylvania, upon thc dcath of 1hc incapacitatcd pcrson on May 8, 1998.
Received and filed in my officc thc
day of
,1998, and advcrtised
according to law.
Clcrk of the Orphans' Court
Pcrsonally camc Nancy L. Rcichart. Trus1 Officcr of Adams County National Bank, thc
abovc named Accountant, who being duly sworn, says: Thatthc abovc is a just and true account
and settlement of thc goods, chattels and credits which came into thc Plcnary Guardian's hands
or possession as Plcnary Guardian aforcsaid, or into thc hands or posscssion of any othcr person
or persons for thc Plcnary Guardian.
Sworn to and subscribcd beforc mc
this 1"Jih day of ':S l,nt' . 1998
'- -; ~, 1 ~,'
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Nancy p: Rcichart, rust Ort1ccr
'~ll P, (, I Lt 'III '~81li"ll
Notary Public
My commission expires:
Notarial Soal
Lorl A. Whilllnglon. NOlary PubliC
Gollysbulg Boro, Adams County
My CommisSIon E,piros April 22, 2000
.... __. ._ _.., 0"
]>JUNCIPAL RECEIPTS
456.42
170.00
85.00
5,439.04
16,040.21
30,321.68
17.56
Pcnn Trc'IlY Lifc Ins. Co.; mcdic.11 bcncfits from Policy N1102')\2
Pcnn Tre'lty Life Ins. Co.; mcdic.11 bcnefits from Policy NP20(,622
Penn Trcaty Lifc Ins. Co.; mcdid bcncfits from Policy NH78132
Mcllon B,,"k Certific.ltc of Dcposit NA03968C
Mellon Bank NOW account NI42-108-2403
Mellon Bank Money Market "ccount NI40-070-7624
Mellon Bank Certificate of Deposit NA03968C intercst 9/1-9/30/96
Adjustmcnts to blVcntory
Pcnn Trcaty Lifc Ins. Co.; mcdical benctits from Policy 111102912
Pcnn Trcaty Lifc Ins. Co.; mcdical bcnctits from Policy 111178132
Pcnn Trcaty Lifc Ins. Co.; mcdical bcnctits from Policy 111'203085
Additional procccds Mcllon Bank NOW account 11142-108-2403
Additional procccds Mcllon Bank Moncy Markct acctIl140-070-7624
Pcnn Trcaty Lifc Ins. Co.; long-tcrm carc paymcnt
TOTAL PRINCIPAL RECEIPTS
1,400.00
19.200.00
20.120.00
3.503.04
5.085.48
600.00
102,438.43
PRINCIPAL DISBURSEMENTS
11/29/96 Penn Treaty Life Insurance Company; premiums 178.16
12/03/96 Capital Blue Cross; premium 294.15
12/03/96 Clerk of Orphans' Court; certified copies of guardian appointment 6.00
12/19/96 Church of God Home, Inc.; nursing home expense 6/96-12/96 20,323.12
01/22/97 Colonial Penn Health; premiums 325.14
01/27/97 Teeter, Teeter & Tceter; counsel fees 3,207.87
01/27/97 Carlisle Hospital; medical services 474.66
02/14/97 Church of God Home, Inc.; nursing home expense 6,807.96
02/18/97 Emerald Drug; prescriptions 895.49
02/28/97 Capital Blue Cross; premium 300.45
03/05/97 Kathy J. Adams; reimbursement for expenses incurred 931.52
P .1gc 3 of Account
03/11/97 Church of God I-Iomc, Inc.; nursinl\ homc cxpcnsc 3,584.82
03/21/97 Emcmld Drug; prcscriptions 170.54
04/16/97 Church of God Homc, Inc.; nursinl\ homc cxpcnsc 3,475.70
04/21/97 Emerald Drugj prescriptions 58.80
05/16/97 Coloni.tl Penn Franklin Ins. Co.; prcmium 54.19
05/16/97 Church of God Home, Inc.; nursing home expcnse 3,586.32
OS/21/97 Emerald Drug; prescriptions 91.56
05/30/97 Cotpital Blue Cross; premium 300.45
06/10/97 Peotse Ph.trmacy; prescriptions 2,895.94
06/16/97 Colonial Penn Franklin Ins. Co.; premium 156.05
06/16/97 Church of God Home, Inc.; nursing home expense 3,487.50
06/23/97 Emerotld Drugj prescriptions 131.25
06/30/97 Mellon Bank, N.A.; safe deposit box rentotl 15.00
07/16/97 Church of God Home, Inc.; nursing home expense 3,613.92
07/21/97 Emerald Drug; prescriptions 126.87
08/15/97 Church of God Home, Inc.; nursing home expense 3,590.02
08/21/97 Emerald Drug; prescriptions 134.18
09/02/97 CotpitaI Blue Cross; premium 300.45
09/16/97 Church of God Home, Inc.; nursing home expense 3,506.70
09/22/97 Emerald Drug; prescriptions 139.02
09/30/97 Register of Wills; filing fee 10.00
10/17/97 Church of God Home, Inc.; nursing home expense 3,654.35
10/20/97 Register of Wills; filing fee 10.00
10/21/97 Emerotld Drug; prescriptions 171.05
11/14/97 Church of God Home, Inc.; nursing home expense 3,473.90
11/19/97 Register of Wills; filing fee 10.00
11/19/97 Teeter, Teeter & Teeter; counsel fees 221.00
11/24/97 Emerald Drug; prescriptions 123.15
12/01/97 Capital Blue Cross; premium 300.45
P.lgc of 01 Account
\2/\6/97 Church of God I-lome, Inc.; nursing home expense 3,593.94
\2/22/97 Emerilld Drug; prcscriptions 131.40
0\/\6/98 Church of God Homc, Inc.; nursing homc expense 3,764.06
01/22/98 Emcrilld Drug; prcscriptions 68.85
02/\6/98 Church of God Home, Inc.; nursing home cxpcnse 3,436.06
02/24/98 Philrmcricil/Emcmld; prcscriptions \65.23
03/02/98 Cilpitill Bluc Cross; premium 3\0.65
03/\6/98 Church of God Home, Inc.; nursing homc expcnse 3,729.90
03/24/98 Philrmcricil; prcscriptions \13.42
04/17/98 Church of God Homc, Inc.; miscclbneous cxpcnses 152.22
04/24/98 Philrmcrica; prescriptions 934.11
06/12/98 Burial rcservc; liquidiltcd for buriill cxpcnses 5,000.00
11/30/96. Adams County National Bilnk; fiduciary fecs 1,207.88
06/12/98
06/22/98 Tcctcr, Teetcr & Tccter; counsel fees 450.00
06/22/98 Cumberland County Orphans' Court; filing fees 113.00
TOTAL PRINCIPAL DISBURSEMENTS 94,308.42
INCOME RECEIPTS
Mcllon CD # A03968C
10/31/96 Intercst 2.92
11/29/96 Intcrest 15.59
12/\6/96 Intcrcst 5.39
01/14/97 Intcrcst .lZ..22 41.89
U.S. Treasury Obligiltions
12/03/96 Dividend 2.96
01/03/97 Dividend 116.02
02/04/97 Dividcnd 235.88
03/04/97 Dividend 256.86
04/02/97 Dividcnd 267.70
05/02/97 Dividcnd 291.53
P.,~(' 5 of Account
V.S, Tmtsl/lJ' Ob!ig,lliO/lS colllil/lll'll
06/03/97 Dividcnd 292.92
07/02/97 Dividend 268.6\
08/04/97 Dividend 251.64
08/\1/97 Dividcnd 24.67
09/03/97 Dividcnd 226.94
10/02/97 Dividcnd 231.66
11/04/97 Dividend 229.77
12/02197 Dividend 2\4.73
01/05/98 Dividend 212.06
02103/98 Dividend 200.55
03/03/98 Dividend 172.13
04/02/98 Dividcnd 179.03
05/04/98 Dividend 169.67
06/02/98 Dividend \77.92 4,023.25
U.S. Trcasury
12/03/96 Social Sccurity 823.00
01/06/97 Social Sccurity 846.00
02104/97 Social Sccurity 846.00
03/04/97 Social Security 846.00
04/03/97 Social Security 846.00
05/02/97 Social Sccurity 846.00
06/03/97 Social Sccurity 846.00
07/03/97 Social Sccurity 846.00
08/04/97 Social Security 846.00
09/03/97 Social Sccurity 846.00
10/03/97 Social Security 846.00
11/03/97 Social Security 846.00
12/03/97 Social Security 846.00
01/02/98 Social Security 865.00
02103/98 Social Sccurity 865.00
P.'~e (. or Account
U.S. Tn'amry CllIlli/llll'll
03/05/98 Sociil\ Security 865.00
04/06/98 Sociil\ Security 865.00
05/01/98 Sodil\ Security 865.00 15,300.00
Penn Treilty Life Ins. Co.
01/28/97 Long-term cilre benefits 600.00
02/06/97 Return of renewiI\ premiums IIP203085 2,065.41
02/26/97 Long-term cilre benefits 600.00
04/30/97 Long-term cilre benefits 600.00
OS/29/97 Long-term cilre benefits 600.00
06/27/97 Long-term cilre benefits 600.00
07/30/97 Long-term cilre benefits 600.00
08/28/97 Long-term cilre benefits 600.00
09/29/97 Long-term cilre bcnefits 600.00
1 1/04/97 Long-term cilre bencfits 600.00
12/01/97 Long-term care benefits 600.00
12/31/97 Long-term care bencfits 600.00
02/02/98 Long-term care bcncfits 600.00
02/27/98 Long-term carc bcnefits 600.00
03/30/98 Long-term carc bcncfits 600.00
04/27/98 Long-term care benefits 600.00 11,065.41
PA Bluc Shield
07/30/97 Benefits 666.50
TOTAL INCOME RECEIPTS 31,097.05
P.,se 7 of Account
'1
IN THE COURT OF COMMON PLEAS or ADAMS COUNTY, PENNSYLVANIA
ORPHANS COURT
III Re: Mae A. Mayberry
No. 1996.00787
ANNUAL REPORT OF GUARDIAN OF THE PERSON
PURSUANT TO ~5521(c)(l)(ii) OF THE PENNSYL VANIA
PROBA TE, ESTATES AND FIDUCIARIES CODE
NOW, this 2-0 t.:. day of November, 1997, Kathy J. Adams, guardian of the person of
Mae A. Mayberry, an incapacitated person, files the following report:
1. Mrs. Mayberry currently resides at Church of God Home, 801 North Hanover
Street, Carlisle, Cumberland County, Pennsylvania 17013. She has resided there since Apri11994.
2. Mrs. Mayberry suffers from Alzheimer's disease and experiences loss of memory
and confusion. She is very feeble and unable to sit for long periods. She is seen by Dr. Brophy
once each month and also by her podiatrist, Dr. Pinker, on a regular basis. Mrs. Mayberry has
been treated in the past year for high blood pressure, water retention, edema in her legs, weakness
in her wrists, agitation, and excitability. She has had no overnight hospitalizations during this
period.
3. Mrs. Mayberry occupies a hospital-type room in a full-care wing of the nursing
home. The nursing home provides social and recreational activities in which Mrs. Mayberry
participates as she is able. She also attends church services regularly at the home's chapel. An aide
feeds Mrs. Mayberry her meals in a small room with other residents who suffer similar
infirmities.
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