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Home My WebLink About96-01041 'I'hi, i, 1" ,<lIiil' tl1.I1 tll.' 11110'"1...."'" II"" V''''III'' "."",1< "'1.,..111"1" ,III "";'lIl.d .""li.,II' "I .I.' lilt .1,,1< tik.l "lilt I"., ,1\ I ",.,11("1:1\".11,' II", ""I:il1.l1 o<'llIli.,II.' ",II h. 1"1,,,11,1,,11" Ii" \1.11. \.I.d 1:.,,,,,.1,, ,'II,,,' 1", 1"'11"."1,"1 lillll!, WARNING: \I is Illegal 10 duplicate this copy by photostat or photograph. S :; 4 .1 0 r3 ,,<~i.\lilifP[J'" " ,\,/.1' /i~' .~.~'\ i:.; '... ~: .5 .~.. i2j: \ . ,_ II ~ .,.}I ,~ .::w- ~.'I \~ ~,/ , "I r" '}'I'EN1 ~\~\./ IL- ~, ~t:u-~-t"~~ 1,...11 H'1',I'II.11 I ~.~. I,'l till' l~'lll1i..lh', ....' 110 "LP ~ \~~\j8 11,1\(' ~'I t\ .J COMMONWEALTH Of PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF OEATH ...C'\,.,-,,''lP ~I \'.oll'~f__. :-;i~~;:':;";"7e';;e;-'--'~ --'=--'--'----- ;" Fe;;..1:t196~:-i4 -=--;;~~t~~~~':~_~'____.' 'n ~ j ..0(".._ 1,10IO(",.....,. UI'O~ g_...,,!"'_IH _,..-vau,_ PVI:.~~_o(!:!!..+~~~~'~~~:~,":.~ I _ 0.,. _ i _ --' _,.._l....... ~W1,,", -.' ---.-. 85 .. ,~unel1,191,DeSLaCS,ND ;:--0 .-'" -;J._..__::~~.___..i c.ouoo OfOlJll'M Ofl',IIOl'IO"",,"OIDf:-.JH 'AC.'"...IoI(~__....".IJ'4......--. ""'. ._..._.~_.N"'.'" I ,!._... I !.' ~~;~~7"-4._. ____J __ ...~.._ I I --,-~\ P 17112 ----1 f'l.OCI(lI~fOol'__C-"',~"" ~0CJ.I00I ...--"... .c- __4\ .CIMo"'" Emanuel Lutheran t~.:;~~98 "" rn'j;:.;"=" "u'" Hoff";~-Rot S~~-~-----J _Q127AELL 19 allO.'le !UJA.j701)_______._ .......-................,.----,-...- ~1C1..".lNUlIIlI 0&71-'",,0 .'_ ._0...., ,;f.t:l 3S'.D\.1o L. !l!Sc~~",l._-'lJ'M- ....'u.I(N.u.A10m..U)lt14 ......,..u...;.QIIC.....". ...0 ...D( eunoer1and .. .. . OlCIOl"t'USU....OC(;...Hl'OOI --......-.....ooq- --...... ---....-. "."'tAlSl"l/S"_ -.......- ~..'""""'" .. ,~ ... -- -.. CUrttx!rland.- -' .,,0::':='=.. "C"...II'...........I..-..._'""- .. Rebecca Frey ..,~I'_..-JIoIlOflfU~_~_J.~ "oX] _ ___..--5autlLMiddleton ,. ., CIIaCIIIl1'''u..HJ un.o_ ~ s-t..c...- Manor Care Health services 940 Walnut Bottom Rd, ~ IDI"'S octUAl M""O<< - ~-- ". ,,-_JP- ,. .QM .. , O. Ross Le er NOI'II&MI'S.........(T~ ..- """ ......~c._O --- "-_.....0 ''''' IOO(AO,_l'..,_1 . P . ".~f: 1___'_ .........___...-_..... 0.____........ _......_.._MPl...- -................ ,......_t_.........- .......- l:='':: -----~- \ .-ciil:JOiiiAiTItH'.r~"i~------ ----------- .---:-~ t -------- --- ------- ---- ~--- r-Il1O'''A5&{OJ<.Iu.AHC'UI : . __ __ _ ~__ ~ ___~1.--u_-- WI"'.U~"~' _"0lI0l1.... 0AI1~_^'".' -n""l)lI~" .........,.."fIIOIltlt DI!lC""'_~A.o'''(ICC\IfNOf:'l .........I.....:llllO ,_0....., ~1'1(JOt('6~ '""-Cl [J (llIIDUl'Il' _II "" -.. [J [] ao-_ LJ ..........-- [] - . .. _ I_I .. 0 _... n r_........._ rJ ~'O<:f~H"IUfl. .._-..::...........-;"- *- 'OC.lO;-r.oo~~~-.,&;;;'"-' -....- .._...\ * ""l. ~......_.-.._..:It.... ,;;--- ...-.......................--..,...', .~?" \l OlIlIOUU.s.CCH'AOIllot::".I(" _. ,... calft....fI<C...._- .Ufl''In'WilO''"SlCJ..''........_'-.....'r_____...__.......'''..................._,,''''_-lJ .._.........,--.,....""-......._......-.1--".- .. \I{'...., .MlOfCAlll.........."-<()IIOfI(fI oc.............--.........,......''S..-......,--.....,. "'..........,...-.."....... "'H'..'"''.''''' u..MI .1.... -...."...... ............ ........ . ... ..."'~I".II~$IG.."'\IfOI.~ U t:\. ~~~t"",~ ~I'd.\I()1 o I ~\_ h..... \1C1~oy.tM'\ ~c7'O;;;:-[~.:.-....-.~.. -.. 0' .""" O\\,'L'iI'_l"._~P'1__\.~.\~\ll "."1 IUtO.o.OOIIfUClt",....\OOt'(ftll(ft()U""IIICtAUY OJDII.'" "'-"'lfl'rPllIII....... ....f""I. c.'O<Y'f- P. Q,l"~.....""~ ......., II II ~ v.>t.""""" ~.,... n.:\) ~'t~ OAII"IO...._U.._. ( __ ~__ H' \\, ~------ ~P.._ '. --q.NOClln.'_~"IC'U1'"""'"_I..'~..........ooq,_..,.~.<-~- ..__...,'..-.........-..e_..._..... .............._......_.1_.._.._.. ..:LI-q/.p' (01-) / :)Q s ~'~ ...~ _lJi "1 c, '~ I: I' " p.: .t~ l.iJ ";;1 -:' " ., .. .' .. .~.. ", ",. .. . ..... . ~' '.m;tt~;ld,ni;~l~ nn;b,:ttr~'s;htut~,wf; ~,A~ '~....IP4Vt)q. rt<H--"'" d..~i. .~<-;....~t1v""~v'~ I, MILDRED B. LEYDER, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and testament and revoke all wills which I have previously made. I I give and bequeath certain items of household furniture and furnishings to the individuals named in a letter of instruction to my executor and accompanying this will and made a part hereof. , I I to \ I a.r"r'" III 8l II I give and bequeath all of my d1shes and jewelry " my niece, Elizabeth Anne Leyder Grace, and should she disclaim said articles, I give and bequeath the same to my nephews to be divided Under no circumstances shall I among them as nearly equally as possible. said articles be sold or leave the family. III I give and bequeath my collection of Hummel figurines to my niece and nephews, to be divided among them as nearly equally as possible. IV I give and bequeath my coin collection to my four nephews to be divided among them as nearly equally as possible based upon the appraised value of the coins for inheritance tax purposes. V All the rest, residue and remainder of my estate, I give and bequeath to my niece and nephews living at the time of my death. VI I appoint Farmers Trust Company of Carlisle, Pennsyl- vania, as executor of this will. this ~ ,)" IN WITNESS WHEREOF, day of :1/-11 " I have hereunto set my hand and seal 1980. 'n] ~ (ij,kuJ If Signed, sealed, published and declared by Mildred B. Leyder, testatrix above named, as and for her last will and testament, written on one sheet of paper, in our presence, who, in her presence, at her request, and in the presence of each other have hereunto subscribed our names as attesting witnesses: ":(<1' ~ /l~1T J I - (SEA ) dr'.. . .' , . r ' // "l_.~/~';,I_'>//' /,('".._/-'./t. / 1".L/? }J....~, I Rue!-::.I {)f FIt ' ,'5 '98 SEP 3D P 1 :1111 CI;r, .It GUIl1._ .. . I~A " ... 1 ".. RCl~O'(''''.' .. (11 \.. ,:",.,1 . .....' RC~):L1. .' '.'Jill::; '98 SEP 30 P 1 :44 CI..rl" Cumb Si r'" ...j" '. ;VJrl :,..1, PA t , t ~ ,,- Itl . !:l L,~_ ~ II: ~ t g ~ >-l .~ r.:. III j ii" l! . X :! ~ - .Q - ".... /%l ::l ... dllll < - ':. 1:: !:l :z: '< ~ = ~ ~t ~ ~t,,~&l ,;;I. !:l III ~ 15 ~ Ii >-l III 0 VI ~ .. ~;;(#. .... X II: VI .~.~ ::<: ~" - l.. . < <( = " ~ ., ~~~ ... . 10___ -~. . .. O-I-ctLo - Lbl-tl I. t "~"< ,; ~+"- I ,;t.C. ~ 1- qLo 101-1/ REGISTER OF WILLS OF Cumberland COUNTY OATH OF SUBSCRIBING WITNESS Shirley W. Ahlers lClIldioil< (each) a subscribing witness 10 Ihe will presenled herewith. (each) being duly qualified according to law. depose(sj and say(s) that she was present and saw Mildred B. Leyder the testat rix . sign the same and Ihal she signed as a witness at the request of testal r ix in " er presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). , 1 () ) Sworn to or affirmed and subscribed before _ ~/J Lh'fJ..eff '1 A/. /.bU'iPA<J) me this 30th 'day of ame) .J2~~MBEH ;;.,!~ Carlisle, A 11 ~l.~ I J (' 'N 111 1 ,ui/J1",~ ~[P~r (Address) MAHY C. LI'l'lIS Register (Name) (Address) REGISTER OF WILLS OF Cumberland COUNTY OATH OF NON-SUBSCRIBING WITNESS David C. Gority (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that he familiar with the signature of Mildred B. Leyder ltlS4ltlP< testal r ix of (one of the subscribing witnesses to) the will that he presented herewith and codicil believes the signature on the will is in the handwriting of Mildred B. Leyder to the best of his knowledge and belief. iLd~~ ( Mam~) Carlisle, PA Sworn to or affirmed aud ,ubscribed before me this 30th day of ~r I~ ----n _ . (', lllJ. W i1!iD11:J 111 ( I- MAHY C. LFl'/IS ' Regis er (Address) (Name) (Address) IN THE MATTER OF THE PERSON AND ESTATE OF: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION MII.DRED B. LEYDER AN ALLEGED INCAPACITATED PERSON NO. PETITION FOR APPOINTMENT OF PERMANENT PLENARY GUARDIAN OF THE PERSON AND ESTATE AND NOW COMES THE PETITIONER, The Area Agency On Aging, county of Cumberland, 16 West High street, carlisle, Pennsylvania and represents and avers as follows: 1. The Petitioner is the Area Agency on Aging (AAA) in and for Cumberland county with offices located at 16 West High street, Carlisle, pennsylvania. 2. The alleged incapacitated person is Mildred B. Leyder, 83 years of age, who has an apartment at 201 N. Hanover street, carlisle, Cumberland county, pennsylvania and has resided there for a period exceeding one (1) year prior to the filing of this Petition but, since October 30, 1996 she has resided at Manor Care, a nursing home facility, in carlisle, cumberland County, Pennsylvania. 3. Mildred B. Leyder is unmarried and has the following known living heirs: A. Joe R. Leyder - Brother 46 E. Main st. New Bloomfield, PA 17068 B. Donald W. Leyder, sr. - Brother 502 park Hill Dr. Mechanicsburg, PA 17055 c. Gary L. Leyder - Nephew 2225 Dover Rd. Harrisburg, PA 17112 D. Ronald J. Leyder - Nephew 46 E. Main street New Bloomfield, PA 1706B E. Donald W. Leyder, Jr. - Nephew P.O. Box 137 Lithia Springs, Georgia 30057 F. David Leyder - Nephew 1225 Bridge street, Apt. A New cumberland, PA 17070 G. Elizabeth Grace - Niece P.O. BoX 301 New cumberland, PA 17070 4. Mildred B. Leyder has, for at least four (4) months, been incapable of managing and caring for herself. 5. Mildred B. Leyder exhibits symptoms of mental incapacity, including but not limited to senile dementia of the alzheimer's type, impairment of memory for immediate as well as remote recall, absent-mindedness, and eccentricity. 6. Mildred B. Leyder's mental incapacity prevents her from managing and caring for the affairs of her person and estate. 7. Mildred B. Leyder's condition has deteriorated in that: A. Her appearance and hygiene are extremely poor; B. She is unkempt and disheveled; c. She appears disoriented and confused; and D. She is unable to manage her financial affairs. B. On or about July 30, 1996, the Petitioner was advised that all the burners of the stove belonging to Mildred B. Leyder were found to be turned on high with pots of boiling water on each. Allegedly, she was afraid that the stove was going to blow up and did not know how to turn it off. 9. On or about July 30, 1996, two Protective Service case workers for AAA visited the residence of Mildred B. Leyder and made the following observations: A. She was unable to finish sentences and often lost her train of thought; B. She asked three (3) times who the Protective Service case workers were and what they were doing there; and C. She unsuccessfully attempted to light a cigarette and then "dragged" on the unlit cigarette and made ash flicking motions into an ash tray. 10. On or about September 5, 1996, Protective service case workers for AAA visited the residence of Mildred B. Leyder and observed a stack of money, totaling $950.00 on the dining room table while five (5) $100.00 bills were found in her wallet with an additional $lB5.00 in an envelope on the table together with her social security check. 11. On or about october 20, 1996, the petitioner was notified that Mildred B. Leyder had been found by the Carlisle police wandering one to two blocks from her apartment at approximately 4:30 to 5:00 A.M. and appeared confused, disoriented and incoherent. 12. On or about october 20, 1996, Mildred B. Leyder was examined by RoccO L. Manfredi, M.C. at Carlisle Hospital who made the following diagnoses: A. senile dementia of the Alzheimer's type; B. peripheral vascular disease; c. Irritable bowel syndrome; D. status-post left breast cancer in 1991; and E. status-post deep venous thrombosis of the left leg. 13. On or about october 20, 1996, Mildred B. Leyder was examined by RocCO L. Manfredi, M.D. at carlisle Hospital who, in his recommendation, stated that: A. she was not aware of her condition; B. She was not aware of the severity of her memory impairment; and c. She is no longer competent to make decisions regarding nursing home placement. 14. On or about October 24, 1996, the Petitioner was notified by Philip A. Neiderer, D.O. that Mildred B. Leyder is cachectic, currently weights 7B pounds and lost B pounds over the last year from malnutrition. 15. Both Dr. Neiderer and Dr. Manfredi conclude that she would require 24 hour supervision to prevent potential harm and would need permanent nursing home placement with custodial care. 16. Less restrictive alternatives are not available because there is no one able to care for her. 17. On or about October 30, 1996, Mildred B. Leyder was placed at Manor Care, a nursing home facility, in Carlisle, Pennsylvania. lB. The approximate gross value of the estate of Mildred B. Leyder is $65,000.00 and her monthly income consisting of pension and social security totals approximately $1,500.00. 19. Since Mildred B. Leyder has been a resident of Manor Care, her household bills have remained unpaid. 20. The Petitioner has no interest adverse to the alleged incapacitated person. 21. The Petitioner is a human service agency that is qualified to be the Permanent Plenary Guardian of the Person of Mildred B. Leyder and is agreeable to assuming that responsibility. 22. Financial Trust company of carlisle, Cumberland county, pennsylvania, is qualified to be the Permanent Plenary Guardian of the Estate of Mildred B. Leyder and is agreeable to assuming the responsibility of being appointed Permanent Plenary Guardian of the Estate of Mildred B. Leyder. 23. Financial Trust company has no interest adverse to the alleged incapacitated person. 24. No application, to the knowledge of Petitioner, has been made for the Order herein asked for. 25. No other Court has ever assumed jurisdiction in any proceeding to determine the incapacity of Mildred B. Leyder. 26. The failure to appoint Petitioner as Permanent Plenary Guardian of the Person of Mildred B. Leyder and Financial Trust company as Permanent Plenary Guardian of the Estate will result in irreparable harm to the person and estate of Mildred B. Leyder. 1'1: H UlI'I: Z c..z 1'1:> ~~ 0 A o 1'1: III Ul III E-<HE-< <t: Il<Ul I>: E-< ZAI'I: ZZ III 1'1: 1Il1>:E-:1'1: Z CIA W ==t;; - o ,> E-< IIlIl< H >OZ 0 :5w it. U>OH A 1'1: 0l>:1'I: ~ J: ~ . E-<A c.. >OU Il<I'I: . c..z 0 IIlZ Il<ZZ ...J >-~)(~ OPE-< .. ...:IH 1'1: III 0 W lilz 01>: I>:c.. I>: ...:I Ul >- Z ~ . a: E-<UP III 0 . A a: 00.. o Il<gj Z o n:U) I>: 0 E-< III III 1='" Cl PAU E-<1Il CI c..E-<1l< 0 - z OZ ;J~ A III Z J: <- :J U 1'1:- III ...:IZ ZIIlIll fa ...:IUl E-: ...:10 o z:c I- IIlI>:Z IIlUl A 1'1: Ul HI'I:E-< Z :C1ll1'I: :Clll ...:I I>: E-<~ <t: E-<1Il:C E-< H ZIIl HI>:c.. Sll<' A ~ I'I:Il< E-<1Il0 Z 1>:0 ZZ IIlIl< H U OZ HI'I: Il< ., ~. ( j 3 199601-- IN THE MATTER OF THE PERSON AND ESTATE OF: MILDRED B. LEYDER, AN ALLEGED INCAPACITATED PERSON IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-96-1041 ORDER OF COURT AND NOW, this 6th day of February, 1997, upon consideration of the Petition for Appointment of Permanent Plenary Guardian of the Person and Estate, and following a hearing, Mildred B. Leyder is adjudicated an incapacitated person and the Area Agency on Aging, County of cumberland, is appointed plenary guardian of her person and Financial Trust company of Carlisle, Cumberland county, Pennsylvania, is appointed plenary guardian of her estate. The guardians are directed to file reports in accordance with the provisions of 20 Pa. C.S. section 5521(C). Notice is hereby provided to Mildred B. Leyder and her court-appointed counsel, Peter J. Russo, Esquire, of her right to appeal from this adjudication of incapacity and to petition to modify or terminate the guardianships created herein. By the court, , . Wesley Anthony DeLuca, Esquire Solicitor for Area Agency on Aging Peter J. Russo, Esquire court-appointed counsel for M.B. Leyder :lkt c IN THE MATTER OF THE PERSON AND ESTATE OF: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION MILDRED B. LEYDER, AN ALLEGED INCAPACITATED PERSON NO. 21-96-1041 IN RE: PETITION FOR GUARDIANSHIP BEFORE OLER. J. OPINION AND ORDER OF COURT OLER, J., February 6, 1997. At issue in the present case is whether Mildred B. Leyder should be adjudicated an incapacitated person, and if so whether Petitioner, the Area Agency on Aging, County of Cumberland, should be appointed plenary guardian of her person and Financial Trust Company of Carlisle, Cumberland County, Pennsylvania, should be appointed plenary guardian of her estate. A hearing was held on the matter on Thursday, February 6, 1997, before the undersigned judge. Based upon the evidence presented at the hearing, the following Findings of Fact, Adjudication and Order of Court are made and entered: FINDINGS OF FACT 1. The allegedly incapacitated person is Mildred B. Leyder, a domiciliary of Cumberland County, Pennsylvania, presently residing at Manor Care, Carlisle, Cumberland County, Pennsylvania, and formerly residing at 201 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. 2. Ms. Leyder was born on June 11, 1913. 3. Petitioner is the Area Agency on Aging, County of Cumberland, 16 West High street, Carlisle, Pennsylvania. 4. The allegedly incapacitated person, Mildred B. Leyder, suffers from a condition known as senile dementia of the Alzheimer type. She has suffered from this illness for at least a year and has been in deteriorating mental health as a result of that condition, which is a progressive illness. 5. As a result of the aforesaid condition, the allegedly incapacitated person is an adult whose ability to receive and evaluate information effectively and communicate decisions is impared to such a significant extent that she is totally unable to manage her financial resources and totally unable to meet essential requirements for her physical health and safety. 6. The aforesaid condition is apparently of a permanent nature. 7. Based upon the aforesaid condition, the Court finds that it is necessary to establish a plenary guardianship with respect to the estate and person of Mildred B. Leyder. B. In the absence of a contrary prognosis at this time, the nature of the guardianship required must be said to be indefinite, pending further Order of Court, and apparently permanent. 9. The guardianship to be established herein is necessary notwithstanding outside assistance which Ms. Leyder has received. 10. Petitioner is an entity qualified under 20 Pa. C.s. section 5511(f) to serve as plenary guardians of Ms. Leyder's person and Financial Trust company is an entity qualified under 20 Pa. C.S. section 5511(f) to serve as plenary guardian of her estate. 11. The foregoing Findings of Fact are made on the basis of clear and convincing evidence. ADJUDICATION The provisions respecting an adjudication of incompetency have recently been amended and are contained in 20 Pa. C.S. sections 5501 et sea. Petitioner has complied with these provisions in terms of notice of the hearing herein. At the hearing the Court received testimony from a number of persons, including the allegedly incapacitated person's nephew, Gary Leyder, Esquire, and her brother, Donald Leyder. The Court notes for the record its appreciation of the willingness of Gary Leyder, Esquire, to serve as guardian of Ms. Leyder's person and estate. Based upon the foregoing Findings of Fact, the following Order of Court will be entered: ORDER OF COURT AND NOW, this 6th day of February, 1997, upon consideration of the Petition for Appointment of Permanent Plenary Guardian of the Person and Estate, and following a hearing, Mildred B. Leyder is adjudicated an incapacitated person and the Area Agency on Aging, County of Cumberland, is appointed plenary guardian of her person and Financial Trust 30.(' 3~Y fS JI. /' Gtll y L,. '/1'1'.'1 ( J\H.r...,". \ L n LG. ,,(, ~ m:N~:RAI, POW~:R 0... ATTORN.:Y m' MILDRED 8. LEYDER A KNOW ALL MEN BY TII~:SE PRESENTS. that I. the undersigned MILDRED B. LEYDER, of 201 North Hanover Street. Carlisle, County of Cumberland, and Commonwealth of Pennsylvania, having been born on June II, 1913, and having Social Security Number 196-14-2321, have constituted, made and appointed and by these presents do constitute, true and lawful attorney-in-fact for me and in my 2225 Dover ROfld, to .- I . \,7) ,": r. Pennsy vanlab m~ ..; ,. rt"1 :-:: n (1 I ~:.~, 0 Tn name, P ace ~an"r"' :~, rl ,,~ :.~:..?::1 c..: ,.. -I t~. ::J :U -0 ('") C) r.. ::3 0 -,- c: a r'l ...c ~ rn ~ -, I'" -.:af'l'1 o I tn:;O r\J -. .. make and appoint GARY L. LEYDER, my nephew, of lIarrisburg, County of Dauphin, and Commonwealth of stead and on my behalf and for my use and benefit: 1. Accounts Receivable To ask. demand, sue for, recover, collect and receive all sums of money, debts, dues, accounts, legacies, bequests, interest, dividends, annuities and demands whatsoever; all goods, merchandise, chattels, effects and things of whatsoever nature or description; and all property, whether real, personal, or mixed And wheresoever situated, as are now or hereafter shall be or become due, owing, payable or belonging to me in or by any right whatsoever; to claim an elective, statutory, or intestate share of or distribution from the estate of my deceased spouse, to elect to take against the last will and testament of my deceAsed spouse or of any codicil or codicils thereto; and have. use and take all lawful ways and means in my name or otherwise for the recovery thereof, by attachments, arrests, - \1 J - bOOK 53'7 l'hG( 561 distress or otherwise and to compromise and aKree to the some and give acqittances or other sufficient discharKes for the same, and, upon receipt thereof, to make, sign, executl! and del iver such receipts, releases or other discharges for the some as he shAll deem to be fit and proper; 2. Deposits, Withdrawals and Loans To deposit, either in my name or in his name in trust for my use and benefit, with any bank, trust company, savings association, credit union or other financial institution any money, bill of exchange, check, draft, note, trade acceptance or negotiable or commercial instrument which may come into his hands as such attorney-in-fact; to create a trust or trusts for my use and benefit and to make additions to an existing trust or trusts established for my use and benefit; and to withdraw and receive any of such money or valuable instruments or any other money or valuable instrument or principal amount or corpus or income to which I am or shall be entitled which now is or shall be so deposited as he shall deem to be fit and proper and, for that purpose, to sign and endorse checks or other withdrawal orders and to draw, accept, make, endorse, discount or otherwise deal with any checks, bills of exchange, promissory notes, orders for the payment of money, or other negotiable or commercial instruments, to deposit in any account in my name, in his name in trust as aforesaid or in the name of any other person in trust as aforesaid any such check, order or valuable instrument; and to borrow or to loan any sum or sums of money on such terms and with - \2 J - BOOK 537 P^GE 565 such security as he shall deem to be fit and proper and, tor that purpose, to sign and execute or to demand and receive all notes or other instruments which may be necessary or proper; and to hove access to any and all safe deposit boxes registered in my name, either alone or with any other person; 3. Accounts Payablc To pay all sums of money at any time or times that now arc or hereafter may be owing by me by reason of any account, bill of exchange, check, note, trade acceptance, negotiable or commcrcial instrumcnt made, exccuted, endorsed, accepted or delivered by me or on my beha If; 4. Investments To invest in my name or in his name in trust as aforesaid in any stock, sharcs, bonds, securities or other property, real or personal, and to vary such investments as he shall deem to be fit and proper; and to vote at meetings of shareholders or other meetings of any corporation or company and to sign and execute any proxies or other instruments in connection therewith; to sell, assign, transfer or disposc of or mortgage, hypothecate or surrender for redemption any and all shares of stock, bonds, other evidences of deposit or of indebtedness or other securities, mortgages or loans now or hereafter belonging to me; to collect and receipt for all interest and dividends due and payable to me; and to purchase any shares of stock, - \3 J - BOOK 537 PAGE 566 bonds or other securities for any sum or sums of money or other exchange; 5. Real Estate To make, seal and deliver, bargain, contract, agree to, purchase receive and take lands, tenements, hereditaments and accept the possession of all lands and all deeds and other assurances in the law therefor, and to lease, let, demise, bargain, sell, remise, release, convey, mortgage and hypothecate lands, tenements and hereditaments upon such terms and conditions and under such covenants as he shall deem to be fit and proper; and to sign, execute and deliver such instruments as may be required in connection therewith; 6. Management of Property To enter into and upon all and singular my real estate and to take possession of any and all of my personal property, and to let, manage, maintain, and improve the same or any part thereof; to conduct, engage in, operate, and transact any and all lawful business of whatever kind or nature; and to repair or otherwise improve or alter the same and to insure all or or any part thereof; to sell either at public or private sale, or exchange all or any part or parts of my real estate or personal property for such consideration and upon such terms as he shall deem fit and proper and to execute and deliver good and sufficient deeds or other instruments for the conveyance or transfer of the same with such covenants of warranty or - 14 J - BOOK 537 PACE 567 otherwise as he shall deem to be fit and proper and to give good and effective receipts for all or any part of the purchase price or other consideration and to sign and execute bonds and warrants and all other Instruments and documents in connection therewith and related thcreto; 7. Borrowing To borrow money from such sources and upon such terms and conditions and giving such collateral or other security as he shall deem to be fit and proper and to sign and execute in conjunction therewith any security agreement covering any of my real or personal property and to execute, sign, acknowledge and deliver in such form as may bc required any promissory note or any othcr instrument that may bc rcquired in conjunction with such transaction; 8. Leasing To contract with any person for leasing for such periods, at such rents and subjcct to such conditions as he shall dcem to be fit and propcr all or any of my said real estate or personal property, to lct any person into possession thereof; to sign and execute all such lcases and contracts as shall be necessary or proper with respect thereto; to give notice to quit to any tenant or other person in possession and to receive and recover from nIl tenants or persons in possession all rents, arrears of rent and sums of money which now arc or hercafter shall become due and payable by reason of such leasing - 15) - 800K 537 PAcr 568 and also on nonpayment thereof or of any part thereof to take all necessary or proper means and proceedings for determining the tenancy or possession of such tenants or persons in possession and for ejecting such tenants from or recovering from such persons all or any of my said real estate or personal property; 9. Encumbrance and Alienation of Property To bargain and agree to, buy, sell, mortgage, encumber, pledge, hypothecate and in any and every way and manner deal in and with goods, wares, merchandise, ehoses in action and other property in possession or in action and to make, do and transact all and every kind of business of whatever nature and kind; 10. Gifts, Devises, and Bequests To give, devise, and bequeath; to transfer and assign; and to grant and convey, either for full and sufficient consideration, or for inadequate consideration, or without any consideration or exchange of value whatsoever, either outright or in trust and either by inter vivos gift or by testamentary devise or bequest, any property, whether real, personal, or mixed and wheresoever situated, which I may own, or in which 1 may have any right, title, or interest, either in law or In equity, or over which I may have any control or power of appointment upon such terms and conditions and under such covenants as he may deem to be fit and proper; and to sign, seal, deliver, and execute such instruments, including, but not - \6\ - -~~~ limited to, any trust agreement or agreements and my last will and testament and any codicil or codicils thereto and any revisions thereof, as may be required in connection therewith; 11. Disclaimers To disclaim, decline, renounce, or refuse to receive or accept or claim or acknowledge or to abandon, remise, release, quitclaim and forever discharge: \1\ any property, whether real, personal, or mixed and wheresoever situated, and any right, title, or interest in any such property in law or in equity, and any control or power of appointment over any such property; \2] any gift, devise, or bequest; and \3\ any fiduciary position, appointment, or function; 12. Li ligation To commence, prosecute, discontinue, defend, settle, adjust, compound, submit to arbitration and compromise all actions, suits, accounts, reckonings, claims, demands and other legal proceedings regarding me, my estate or any matter in which I or my estate may be In any manner interested or concerned that now arc or hereafter shall be pending between me and any person, firm, association or corporation in such manner and in all respects as he shall deem to be fit and proper and for such purposes to sign, execute and deliver such releases, discharges or other instruments as he shall deem to be fit and proper; - \7 \ - !lDDY. 537 1'ACE 570 13. Sign, Seal, Deliver and Execute Agreements To sign, seal, execute, deliver and aeknowledKe such deeds, leases, mortgages, hypothecations, bills of lading, bills of exchange, bills, bonds, notes, receipts, evidences of debt, contracts, agreements, assignments, instrument, indentures, releases, satisfactions of debt and such other documents and instruments in writing of whatsoever kind and nature as he shall deem to be fit and proper; 14. Tax Returns To execute, acknowledge and file all federal, state, municipal and local tax returns and to request, receive, and inspect confidential tax information from or in any office of the Internal Revenue Service or any office of any state, municipal or local tax authority for any and all matters and for any and all tax years; 15. Contract for Services To engage, employ and dismiss any agents, clerks, employees, servants or other persons as he shall deem to be fit and proper; and 16. Medical Procedures and Admission to Facilities To authorize the administration of drugs and medicines to me; the performance of medical, surgical, chiropractic, therapeutic or other health care procedures on me, either on an Inpatient or an - \8] - nOOK 537 PACE 571. outpatient basis; and authorize my admission into any hospital, any medical or rehabilitation or diagnostic or mental health or nursing or health care or similar facility, or any residential facility; and to enter into such agreements for my care as he shall deem to be fit and proper or as may be required in connection therewith; 17. Advance Health Care Directive \A] It is also my intention that this General Power of Attorney shall constitute a durable health care directive in that, firstly, 1 hereby do state, as an advance directive for health care, that my dying shall not be artificially prolonged under the circumstances set forth hereinafter and I hereby do declare that, if at any time I should become comatose, incompetent, or otherwise mentally or physically incapable of communication and/or should have, incur, or suffer an incurable injury, disease, or illness certified to be a terminal condition by two physicians who have examined me personally, one of whom shall be my attending physician, and the said physicians have determined that there is no hope of my recovery beyond a reasonable degree of medical certainty and that my death will occur whether or not life-sustaining procedures are used and that the application of such life-sustaining procedures would serve only to artificially prolong the dying process or that the application of such life-sustaining procedures would serve only to result in my existing in a persistent vegetative state, then I hereby direct that such life-sustaining procedures, including, but not limited to, a continuous regimen of nutrition and hydration, surgery, - \9 I - BOOK 537 PhCE 57:.? resuscitation, respiration, kidney dialysis, blood and hlood products, and antibiotics, be withheld or withdrawn and that be permitted to die naturally with only the administration of medication or the performance of any medical or surgical procedure deemed necessary to provide me with comfort care and/or pain management. \BI In the absence of my ability to give such directions regarding the use, withholding, or withdrawal of such life-sustaining procedures as aforesaid in such circumstances as aforesaid, I hereby give and grant unto my attorney-in-fact full power and authority and legal right to refuse to allow, permit, or direct the application of such life-sustaining procedures and to direct that such life-sustaining procedures be withheld or withdrawn as fully, completely, and effectively and as to all intents and purposes as I could do personally. GIVING AND GRANTING, without in any manner limiting the foregoing, and in addition to the powers and discretion herein specially given and conferred upon him, and notwithstanding any usage or custom to the contrary, unto my said attorney-in-fact full power and authority to do, perform and cause to be done all acts necessary or proper to be done in all matters and things; transact all business; make, sign, execute, acknowledge and deliver all contracts. deeds, writings, assurances and instruments which may be requisite or proper to effectuate all or any things or matters whatsoever - (10) - m~.m .. . relating, appertaining or belonging to me or my estAte, property and affairs and things and matters herein, either particularlY or generally or generally described, as fully and effectively to all intents and purposes as I could do if personally present, hereby ratifying and confirming all that my said attorney-in-fact or substitute or substitutes or successor or successors lawfully shall do or cause to be done by virtue of these Presents. In the event that the aforesaid GARY L. LEYDER, my nephew, the original attorney-in-fact named hereinabove, once qualified, becomes unable or unwilling to continue to serve in this capacity as my attorney-in-fact, whether due to death, resignation, renunciation, or any other reason, then I hereby constitute, make, and appoint RONALD J. LEYDER, my nephew, of 46 East Main Street, New Bloomfield, County of Perry, Pennsylvania, 17068, to be my first successor attorney-in-fact for me and in my name, place, and stead and for my use and benefit with full power and authority to do, perform, and cause to be done all acts necessary or proper to be done in all matters and things relating to me or my estate and affairs as fully and effectively to all intents and purposes as I could do if personally present as aforesaid. In the event that the aforesaid RONALD J. LEYDER, my nephew, the first successor attorney-in-fact named hereinabove, once qualified, becomes unable or unwilling to commence to serve or to continue to serve in this capacity as my attorney-in-fact, whether due to death, resignation, renunciation, or any other reason, then hereby - [111 - BOOK 537 PAGE 574- . . .t"!.'. . . \\C."'".', ....... "'t'". '..i....:.t:,..lol;~. ....\. .. .......\...... ..t ',;' : ","','~ t\r' ~'. 0 '.:. ~ ,:')otJ .. ,:".".....,~i',,", ." ':.:, 2~: .....:,.~Ji.:~.:.' .~, \ ".~.-';~ ::.... ':"\'~.' . Jo-I.."loo . ...:....:. , -\" ..~ .... '01 ........ ,~. :}.).~. w :'~ :.c.. : l./)'~' 'h' ~ . ~.. ::'. . "..: .'-':'~':: t "S' ''l'.,.~'" ':i~,.I~ ....r-:-. g.!" -':~1'1"" 'j' :.':',.< Exp " ~~'~';.1' 'i('~~:"';' ~'\}:'i'''' ,~t\, . .... ,I' \~t,......'''' COMMONWEAI,TII OF PENNSYLVANIA COUNTY OF CUMBERLAND BEFORE ME, the undersigned officer, a Notary Public in and for the aforesaid Commonwealth, personally appeared Gary L. Leyder, known to me or satisfactorily proven to be a member of the bar of the highest court of said Commonwealth and a subscribing witness to the within instrument, and certified that he was personally present when Mildred B. Leyder, whose name Is subscribed to the within instrument, executed the samc and that said person acknowledged that she executed the same for the purposes therein contained. IN J3e1, WITNESS WHEREOF, 1 day of "I)gf/~ have hereunto set my hand and seal this , A.D. 1996. Ji NOTARY PUBI,IC My Commission ..:,..:r...... .,,-; ~.," '!I-....... ..I~...... \ ..... ..;~..4t' "; . "I '.' .1... ..~. r"r" ~.. "....', ~. ~'f:"~' . t.... "'I ~.... ...........':. :{ ..J' ""'". l.;. :l~, ~', ,. ::nnsvlvania } ~':~\:".;.if"r.. . .....l{,;~'i',r:1.;.1 .' I sr, .; '~'\ :~t~._:i :.rrI111!~" , -': l,)8i1and r~..\t}.~~. '':: 'l"'~e.!~'~" ~,,. ..." . ,.._ .1':1" "'i\l\~:ll:."." . ",'flt-I:: tor tne recording of 0 "H t ~.t ., .~.I.-~'.:~'t :'~.., ,~" 0"/' .~~ 'p.....,. . _'11' -'''""0 county~ FI,.....~ 'j.' .....'11)"\1'<... 11.;~, . L'l'1 . ~ :~af\e".' ~...., r"'~'\ . . .;;>V (,.,: - fra~~ ~ '. ~I'~'" ,',"f 1......'. -_.- . :-" .;.~. ~..s;., -. ~~...~\.~'. 1... l. .JnJ'~ 'il of office a' ',"(i "I ~tN't.1' ~:~~~.: . ~ 1\00' .<'.r".r.:~'"''':'~''' ., ".IIlS ~dt~ 19 ;;. . *'ffi. ~i~/" . A~ . "R~'," "I ~ -' ...-.(.'. I '. e der ...~t""'~ Nol,,,,.'li SoaI JoonA Sommons, Notvy I'tIlic lDMJm\ T"I'.. O:Qlh. '0':-oool\I MvC.ot11!l'isSlOnE,pms.u.. 16. 1997 ,Pil.....ylll.ria 01_ ~ BOOK 537 f'AGE 576 Q!umher1an~ Q!ountl1 (@ffice of Aging COMMISSIONERS NANCY A. BESCH CttAIRMAN Human Sorvlcos Building 16 Wost High Stroot Carllslo, PA 17013.2922 (717) 240.6110 Fax (717) 240.6116 TERRY L. BARLEY UiR[CTOR EARL R. KELLER VICE.CHAlnMAN MARCIA L. MYERS SECRETARY I, Priscilla Whitman, Protective Services Worker with the Cumberland County Office of Aging, served the Petition for Appointment of Guardian, to Mildred B. Leyder at Manor Care Health Services on Friday, December 20, 1996 at 10:30 am, fiA;o/JrtQO" )JI,~ ~ PETITIONER'S I E2.IB1T \ I U!-T 2.l&fQ7 [' OlUtllbCl .111~ Oll1ul1tu OOffic{ If A~lil1~l COMMISSIONERS NANCY A. OESCll CIIAIUMAU Hlll1101l Services l311ildlllll 16 West High Slreut Carlisle, PA 17013.2922 (717) 240.61111 Fox (717) 240.6110 lEllllY L IIAIU.EY IJllIICfllU EAIlL n. KELLEll VICI:.cIIAIRUA" MARCIA L. MYEIlS seCReTARY October 4. 1996 Mr, Gary Leyder 105 N, Front St. Harrisburg PA 17101 Dear Mr, Leyder: On August 21. 1996 our office contacted you regarding multiple concerns about the safety and well being of Mildred Leyder, your aunt. The main cause of these concerns is Ms. Leyder's mental confusion. Her confusion has resulted in such incidents as unsafe operation of her stove, inability to find her way back to her apartment, withdrawal of large sums of cash which she keeps on her person and in open view in her apartment. In addition, her lack of appetite has resulted in significant weight loss to the point that her current weight is 781bs. Protective Service workers from this office have expressed their concerns to you and your wife on numerous occasions, The vulnerability of your aunt's situation and the urgency of placing her in a long term care facility was stressed from the time of our first contact. During your most recent telephone conversation on September 24,1996, with a Protective Service worker you agreed that the situation was urgent and that you would be making application to the Church of God Home. As of this date no such application has been received there nor at any of the other facilities given to you as possibilities. I would like to again impress upon you the gravity of Ms. Leyder's situation. Because we feel the safety and well being of your aunt could easily be threatened. I want to inform you that unless you contact Priscilla Whitman or Janet Paull of this office by October 18. 1996 with evidence that a serious attempt has been made to place Mildred Leyder in a long term care facility, this office will be forced to intervene through court procedings. Sincerely, .11':::;( t~ /~'Ift; I Ter~ L. Barley \J Director ~ PETITIONER'S ,. EXHIBIT .~ 2. .~ ': H"~ .. j ! " .' " I I I r I , \ I I ! G1,NElIAL POIiER 01' ATTORNEY KNOli ALl. HHN BY TIWSH PIIHSHNTS, tha t I, ~1I1.1l111'1l II. 1,I'YIll'Il. of the Borough of Carlisle, Cumberland County. Pennsylvania, do herehy appoint FAIlMHRS TRUST COHPANY of Carlisle, Pennsylvania. as l'Iy true and lawful attorney-In-fact, to do and perform 011 acts and transact all business, without limitation, for me. and in my name. which I could do if personally present, hereby ratifying and confirming all that my said attorney-in-fact may and shall do pursuant t~ these presents. This power of attorney shall not be affected by disability of the pr inc ipa 1, this I have hereunto set my hand allll seal IN \HTNESS 1. s It;' day of , 1980, 'm.ddJo, J ~ ;/(hldt~1 (SH"I,) I STATE OF PENNSYLVANIA ) COUNTY OF CUHBERLAND ) On this It; ~ay of , 1980, before me, the undersigned officer personally a e above named Hildred B. Leyder, who declared the foreg i g letter of attorney to be her true act and deed, and desired hat the same might be recorded as such. SS IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ........:;.'"..:., ..... ~C'>i.,1l...~..... .~..~ ''';.''(Io:~'('J'':'. : ~':"..,~I, "'0.",,...,<.,..,,"_ ...":,,'.)~' ......0;".-0:. ~. i~ ....-. ~\-:o~' : to.> Ul'. .': ':: '.""" . '..'= o'.-::,o'r' ~.' : . O'+A' -..' .t" \. ..,. "'~\'\:I"Y ,." .~. ........ '. .. ., "" .'. "'1''''..... ...,....... ~ L...<" otary U Ie Jimel R. HUllIer. NohlY Publ"lC Mt (~II" In;'" WI, 11. 1'" CIlli"-," (~(-" C-1r'/IL -htC-f., aJ {'C-.1-U<'/ C?J7 ' C:::'jC:'-'~Jo_/Q?7~ /- 31-77 ",I I '1 IN THE MATTER OF THE PERSON AND ESTATE OF: MILDRED B. LEYDER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY , PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21.96.1041 VERIFICATION I. David C. Gority, an authorized representative of the Financial Trust Company, verify that the statements made in the foregoing document are true and correct to the best of my knowledge. I understand that false statements herein are made subject to the penalties of 1 B Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: April 7 , 1997 IN THE MATTER OF THE PERSON: IN THE COURT OF COMMON PLEAS OF AND ESTATE OF: CUMBERLAND COUNTY, PENNSYLVANIA MILDRED B. LEYDER, AN ALLEGED INCAPACITATED PERSON : ORPHANS' COURT DIVISION . . : NO. 21-96-1041 ORDER OF COURT AND NOW, this 6th day of February, 1997, upon consideration of the petition for Appointment of permanent Plenary Guardian of the Person and Estate, and following a hearing, Mildred B. Leyder is adjudicated an incapacitated person and the Area Agency on Aging, county of Cumberland, is appointed plenary guardian of her person and Financial Trust Company of Carlisle, Cumberland county, Pennsylvania, is appointed plenary guardian of her estate. The guardians are directed to file reports in accordance with the provisions of 20 Pa. C.S. Section 5521(C). Notice is hereby provided to Mildred B. Leyder and her court-appointed counsel, Peter J. RusSO, Esquire, of her right to appeal from this adjudication of incapacity and to petition to modify or ter~inute the guardianships created herein. By the court, Anthony DeLuca, Esquire Solicitor for Area Agency on Aging P~J. Russo, Esquire ~;~t-appointed counsel for M.B. Leyder :lkt IN THE MATTER OF TilE PERSON AND ESTATE OF: IN TilE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MILDRED B. LEYDER, AN ALLEGED INCAPACITATED PERSON ORPHANS' COURT DIVISION NO. 21-96-1041 III REI PETITION FOR GUARDIANSHIP DEFORE OLER. J. OPINION AND ORDER OF COURT OLER, J., Februnry G, 1997. At iDDue in the preDent case is whether Mildred B. Leyder should be ndjudicated an incapacitated person, and if so whether Petitioner, the Area Agency on Aging, County of Cumberland, Dhould be appointed plenary guardian of her person and Financial Trust Company of Carlisle, Cumberland County, Pennsylvania, should be appointed plenary guardian of her estate. A hearing was held on the matter on ThurSday, February 6, 1997, before the undersigned judge. Based upon the evidence pre Dented at the hearing, the following Findings of Fact, Adjudication and Order of Court are made and entered: FINDINGS OF FACT 1. The allegedly incapacitated person is Mildred B. Leyder, n domicilinry of Cumberland County, Pennsylvania, preDently reDiding at Manor Care, Carlisle, Cumberland County, PennDylvnnin, nnd formerly residing at 201 North Hanover Street, c.1rllsle, Cumberlnnd County, Pennsylvania. 2. MD. Leyder was born on June 11, 1913. 3. Petitioner is the Area Agency on Aging, County of Cumberland, 16 West High street, carlisle, Pennsylvania, 4. The allegedly incapacitated person, Mildred B. Leyder, suffers from a condition known as senile dementia of the Alzheimer type. She has suffered from this illness for at least a year and has been in deteriorating mental health as a result of that condition, which is a progressive illness. 5. As a result of the aforesaid condition, the allegedly incapacitated person is an adult whose ability to receive and evaluate information effectively and communicate decisions is impared to such a significant extent that she is totally unable to manage her financial resources and totally unable to meet essential requirements for her physical health and safety. 6. The aforesaid condition is apparently of a permanent nature. 7. Based upon the aforesaid condition, the Court finds that it is necessary to establish a plenary guardianship with respect to the estate and person of Mildred B. Leyder. B. In the absence of a contrary prognosis at this time, the nature of the guardianship required must be said to be indefinite, pending further Order of Court, and apparently permanent. 9. The guardianship to be established herein is necessary notwithstanding outside assistance which Ms. Leyder has received. 10. putitloour iu an ontity qualified under 20 Pa. C.S. soction ~~ll(r) to ourvo aD plonary guardians of MD. Loydor'O purDon and Financial Trust company is an entity qualiriod undor 20 Pa. c.s. section 5511(f) to serve as plenary guardian or her ootato. 11. Tho rorogoing Findings of Fact are made on the basio or clear and convincing evidence. bDJUDICATIOti The provisions respecting an adjudication of incompetency hove recently been amended and are contained in 20 pa. c.s. sections 5501 at seq. petitioner has complied with these provisions in terms of notice of the hearing herein. At the hearing the court received testimony from a numbor of persons, including the allegedlY incapacitated person's nephew, Gary Leyder, Esquire, and her brother, Donald Leyder. The court notes for the record its appreciation of the willingneSs of Gary Leyder, Esquire, to serve as guardian of Ms. Leyder'S person and estate. Based upon the foregoing Findings of Fact, the following order of court will be entered: ORDER OF COURT AND NOW, this 6th day of February, 1997, upon consideration of the petition for APpointment of permanent Plenary Guardian of the Person and Estate, and following a hearing, Mildred B. Leyder is adjudicated an incapacitated person and the Area AgencY on Aging, county of cumberland, is appointed plenary guardian of her person and Financial Trust EXHIBIT B FliF~11EP':.~'1H 111 . 1[' : ;" I ;" .:: 41)" :. l? l'IH'p7Jl"'~, 1 '4-" "-p " .;,.j ,a ,U.:"... ,!j.::_ BI~~ TO . STATEMENT MANORCl\U Hf;ALTH SERVICE 960 walnut Bottom Road Carlinlo, PA 17013 (717) 249-0085 RETURN WITH PAVMENT FOR PROPER CRIlOIT (AtCCl,d Amoun\ 01 paymeml Dr Davlc1 Gority Finanaial Trust Sorvic.. Co. P.O. Box 220 carlisle, PA 17013 L -, _J C1~ARGf6 Oil PAYMENTS INCURREP AFTER OlLUNlJ CAlK WILL APPeAR ON NF.lCT 8'ATCMI!NT RENllERED, ~. .. 11t~~-;;;;;; ~!. "';"[8.1 ~1~~ION~a;IOCHM(;~ ......."'" . U~lf M1C Le~d.~, Mi~dred .~,-=:~. 96'1~8' iO/30/96" .-. T~~;0T;7 : '. .. ., . ... --....:;, ,. .. _. -- = 00Ilf' ~t"ViCi RCHOCIIIiU alAllGU .. ., OIlel)IT~ 03/01/97 Previous Balance ..- -- ' 20,liio.Zl.... ....-... . 03/25/97 Payment - Thank YOU 5,000.00 04/01..04 /30/97 Room Charge 30 days at 120.00 3,600.00 03/31/97 Pealth Shakas (qty 18) 22.14 03/20/97 Liquid Dial Soap (qty 1) 3.31 03/31/97 Health Shake8 (qty 53) 65.19 03/31/97 Laundry (qty 31) 15.50 03/31/97 T.V. Cable (qty 1) 5.00 ... '. payment Due Upon Receiptl - __.: '18,891.35 1 ., . '. nn c - \!5 '0:0 ::1CT- -I - '" ,~. (") . ,.., "" .; ;}l (-., .. - - . . -0 . -. . : j ~ "<J i.i 1'1: Z hJ UlI'I: Z ~ ~~ 0 Ul l1< <t: l>: H A l1<Ul fLI U ZfLI U Z Z l1< Zc..I'I:Ul :J ... ZZ 0 l>: H ~ OfLI H fLI fLI l>:Ol>:P ...J ~l1< Ul :c A l1<lIlfLItj W ==t;; - H E-4 >0 E-<A 0 :5 w it. 0 , > fLI fLIl'1:>O~ ~ J: ~ . U>< H c.. ...:I AE-<fLI0 . c..~ A 0 I'I:Ul...:l:c ...J U))(~ .. . > ~~lil;!; OP E-< l>:c.. III Z fLI . Ul >- Z ~ . n: 0 g; fLI0 HfLllIlO a: 00.. E-: E-<E-<1Il J: <- :J A II:fL1 fa UI'I: - E-< ...:I Zc..A...:I I- ...:I Ul fLIUl H OO...:lP Z fLIl>: Z :CfLI ~ H HII: <t: :CfLI 1'1: E-< E-< ~ E-<gj :c A H l1< ZZ E-< ZP ~ HI'I: III HU l1< ~_._-- APR 0 8 1997. b'f- MILDRED B. LEYDER IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-96-1041 IN THE MATTER OF THE PERSON AND ESTATE OF: ORDER AND NOW, to wit, this ;l. ~ tl, day of May, 1997, upon consideration of the within Petition, and on Motion of Anthony L. DeLuca, Esquire, attorney for the Petitioner, the Rule to Show Cause executed on April 9, 1997 wherein Financial Trust company, the Plenary Guardian of the Estate of Mildred B. Leyder, requests the authority to compensate Manor Care in the amount of $18,B91.35 for the services provided to date and to authorize the expenditure of principal for the health, welfare and maintenance of Mildred B. Leyder as it may deem necessary in the future is hereby made Absolute and Financial Trust company is authorized to proceed in the payment of said bills. BY THE COURT, J MILDRED B. LEYDER IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-96-1041 IN THE MATTER OF THE PERSON AND ESTATE OF: MOTION TO MAKE RULE ABSOLUTE AND NOW, this;l7(~day of May, 1997, the Petitioner, Financial Trust company of 1 West High street, Carlisle, Cumberland county, Pennsylvania moves this Honorable Court to make the Rule to Show Cause signed by the Judge J. Wesley Oler, Jr. on April 9, 1997 Absolute for the following reasons: 1. No objections have been filed by counsel representing Mildred B. Leyder or the Area Agency on Aging to the Petition to Invade Principal of the Estate of Mildred B. Leyder; 2. Counsel for Mildred B. Leyder in his response to Petition to Invade Principal of the Estate of Mildred B. Leyder requests that this Honorable Court grant Financial Trust Company, the Plenary Guardian of the Estate of Mildred B. Leyder, the authority to compensate Manor Care for the services provided in the amount of $lB,B91.35, as well as all reasonable services provided by Manor Care in the future; and 3. said response of counsel for Mildred B. Leyder is in substantial conformity with the prayer as setforth in the Petition to Invade )/' AD /J (, ; 4v :x.. .{!P iZ<.(L Anthony L. Luca, Esquire 113 Front Street P.O. Box 35B Boiling springs, PA l7007 Attorney for Petitioner no -0 _ :n r: ;,-:- ,., -.J ~J '!~ " 2< 0- N 00 ~ w (~.) - ~ .:' r'..j U1 Z Z tzl III 1'1: E-< 1'1:> 0 P tzl...:l Ul ...:I <t: ...:1>< It: l>: 0 U l1<Ul tzl III :J ... ZZ l1< tzl ~ ~ ZZO !a ...J OrilH tzl W == t;; - ~p.:!l :c tzl tzl 0 :5ll!~it. E-< ...:I ...:lit: o ,> Pril ...... . c.. . <U))(~ U><H . It: A ...J E-<C 0 III l>: >-"'lilz w z - c..Z ... .. tzlO >- Z ~ . II: OPE-< .,. l>:c.. A :'::'6 a: 00.. E-<8gl 0 tzlO III ;J~ Z o n:U) ... E-< l>: 0 I:: '" Cl 8!E8 I E-<tzl A - z <- ~ \D ~~ ...:I 0 J: fa 0\ H E-< I- UI'I:- I E-< ~ Z ...:I III ... tzlUl Z tzll>:Z N :ctzl 0 <t: :ctzll'l: E-<A H E-<~re E-< . ZZ 0 ZPl>: 0 HI'I: ~ HU Q -' ....... F. . \T->'IISI(.. . 'InancJa l... '. ,OIn\)any .~~ (\'Ices rin,ult'i;11 rIll" C.Hp 111) .\11('11 R.',III. 1'.11. nOj\ '.:l.!O' Lull,llI'. 1',\ 1;.)13 t i11' '.! I~ djlH)j For the Account 01: I'U:N"'~Y GIIJIIWI..t.v, ,Ill W/lm /I. 1.I11lW Account Number: .12 OIJ 52.10 07 b Date: JUNE .10, 1997 Review of Assets hi. Sh..... or Unll Invlllment Tot.1 Annuli Curr.nt Plr V.lue M.rk.. CoU Bul. M.rktl V.lu. Incom. Vleld CASH INCOME CASH 0.00 0.00 PRINCIPAL CASH -2,581.29 -2.581.29 TOTAL CASH _2,581.29 .2.581.29 CASH EQUIVALENTS U,S, SAVINGS BONDS 7,000 SERIES E AND EE U S SAVINGS 3,500.00 3,500.00 0 0.00 BONDS BANK CERTIF OF DEP 14.000 FARMERS TRUST CD 63179 14,000.00 14,000.00 742 5.30 5.30'10 DUE 7/2/97 20,000 FARMERS TRUST CD 88471 20.000.00 20,000.00 1. 020 5.10 5.10% DUE 7123197 10,000 FARMERS TRUST CD 75790 10,000.00 10,000.00 510 5.10 5.10'10 DUE 8/6197 TOTAL BANK CERTlF OF DEP 44,000.00 44,000.00 2.272 5.18 TOTAL CASH EQUIVALENTS 47.500.00 47.500.00 2,272 4,78 GRAND TOTAL 44,918.71 44,918,71 2,272 5.08 PaOI , ........ Financial r"'lI~1 (;ollll)Clny . '''Lf\'ICCS HII.lfIfi;Ill"rU\1 CUIJl .11'..\11("11 H..I.lII. 1'1) n'J\~~').L.ullll.., 1'.\ 11,11~ 1 il; I :.! IJ . "'"'U ~Ol Ihl Account 01: IJ/JNAUI'WItlIUII..tN:.If/WU/'IJI/.//1I1W Account Numbll: .1Z 00 ,';2.10 07 ,i Dllo: "'"mtl/'/UI.I. N~71"',,".~IrIIl.vt:.lO. 1"~17 Receipts & Disbursements Incom. PrincipII Inv..tmenl D.II C.." C..h Co. I Bul. BEGINNING BALANCES .20.01 0.00 21,713.91 04/02/97 DIVIDEND 90.13 PROVIDENT FED FUND-PRINCIPAL 04/02/97 DIVIDENO 14.54 PROVIDENT TEMP FUND-INCOME 04/03/97 PURCHASE -84.66 84.66 PROVIDENT TEMP FUND. INCOME 04/04/97 3.500.00 SERIES E AND EE U S SAVINGS BONOS 04/07197 INTEREST/FTC C/O # 1-63179 182.96 04/07/97 RECD FROM MILDRED LEYDER 14,000.00 FARMERS TRUST CO 63179 5.30% DUE 7/2/97 04/07/97 RECD FROM MILDRED LEYDER 20.000.00 FARMERS TRUST CO 88471 5.10% DUE 7/23/97 04/07/97 RECD FROM MILDRED LEYDER 10,000.00 FARMERS TRUST CO 75790 5. 10% DUE 8/6/97 04/07/97 FARMERS TRUST -110.00 FEE TO DRILL SAFE DEPOSIT BOX 04/08/97 CSA ANNUITY 1.277.14 04/08/97 CARLISLE COMM. AMBULANCE -250.00 BALANCE DUE SERVICES 04/08/97 PURCHASE -72.96 72.96 PROVIDENT TEMP FUND-INCOME 04/09/97 DARLENE L MOYER. C/O CTCB -9.90 1997 PERSONAL TAXES 04/09/97 REDEEM 259. 90 -259.90 PROVIDENT FED FUND-PRINCIPAL 04/09/97 PURCHASE -1.277.14 1.277.14 PROVIDENT TEMP FUND-INCOME 04/10/97 PP&L -12.36 SERVICE 2/26-3/26197 04/10/97 UNITED OF PA -7.80 SERVICE 04/11/97 REDEEM 20.16 -20.18 PROVIDENT TEMP FUND-INCOME PI;' 2 ~or thl Account of: I'I.l:NMlY GIIA/WI"N: ,Ill I /JIlW /I. I.nll,.,l Account Number: .1Z Oil 52,10 117,; Dill: f",," ..u'/lI I. I, Igg7 t10nlllxh JIINI: .lll, 1:1:17 f. . \T"l\SI(., . '1l1al1Cla l.. '. .O\ll\)anV ,'L \"\'1 CCS . (-'1II.lUri,,1 TllI'l' (".llp .\10 \I\..nl{o,\,l. It,n Ih\ '.!::,) 01 .11 l..lt' , ",\ Ij'QI3 lilil ~u. ,;'}IJ~ Pig. 3 1"0' tho Account of: /'I./:NMlymMIl/ll..l,v:,II/W/m> /I. 1.I1'1Jr/1 Account Numb.,: .1200 52.10 117 Ij D.t.: r""nM'1l11. I. /99711r"mglr 'UN/: .10, /!I'17 Financial r"IS.' COl1llJany . ,'l:I'\'lCCS Fin.1IIri.11 Tnhl Cllrp :"') .\llt-II RUol.I. 1'.0. 1\'1\ '..!~n. C.lIlnlC'.I'.\ 11'111 1;11, ~n. N'ill' Receipts & Disbursements Income Prlnclp.1 Inv..lm.nt 0.1. Cash Cuh COil Sui. 05/02/97 REDEEM 250.00 -250.00 PROVIDENT TEMP FUND-INCOME 05/05/97 MONTHLY CSA ANNUITY 1,279.06 05105/97 TRUST DEPARTMENT FEE FOR QUARTER ENOED 04/30/97 -167.50 05/05/97 PURCHASE -99.17 99.17 PROVIDENT TEMP FUND-INCOME 05/06/97 INTEREST 124.36 FARMERS TRUST CD 75790 5.10% DUE 8/6/97 05/06/97 REDEEM 165.56 -185.58 PROVIDENT TEMP FUND-INCOME 05/07/97 BELVEDERE MEDICAL CORP -20.00 BALANCE OUE SERVICES 05/07/97 PURCHASE -124.36 124.36 PROVIDENT TEMP FUNO-INCOME 05/08/97 VITALlNK PHARMACY SERVICES -5.61 NON PRESCRIPTION ORUGS 05/08/97 REDEEM 20.00 -20.00 PROVIDENT TEMP FUND. INCOME 05/09/97 MANORCARE HEALTH SERVICES 372 -6.00 TV CABLE CHARGE 05/09/97 REDEEM 5.61 -5.61 PROVIDENT TEMP FUND-INCOME 05/12/97 CONESTOGA AUCTION CO - PROCEEDS SALE OF HUMMELS 2,357.10 05/12/97 REDEEM 6.00 .6.00 PROVIDENT TEMP FUND-INCOME 05/13/97 PURCHASE -2.357.10 2.357.10 PROVIDENT FED FUND-PRINCIPAL OS/27/97 CARLISLE HOSPITAL -196.00 BALANCE DUE SERVICES 1/1/97 OS/28/97 REDEEM 196.00 -196.00 PROVIDENT TEMP FUND.INCOME OS/29/97 MANORCARE HELATI-l SERVICES -18.891.35 CARE PER COURl ORDER OS/29/97 REDEEM 18.891.35 -18.891.35 PROVIDENT FED FUND-PRINCIPAL Pig. 4 "'. . . T"ust ' II Fl11ancm\ L . (.OI1l\JanV ,-,d'\'ICCS ' "'11.1111'1..1 TIU\I ellll' :iI" :\\I..n R'l.W. l'.n. ('"~ :!~.). (:,1111\1... 11.\ 1;1'>11 filii :!11. hl)tn ~or the' Account ot: /JI.fN,tnYGllAlWI..tN: ,IIIUJ/l[/) /I. I.nll/'ll Account Numblr: .1200 5!JII 07 6 Oltl: r"'mM'Im. I, 1997,'",mgh IIINt:.lll, I!197 Page 5 ~ . >. l: :';l Q., ,.. c: ~ O :..] :n __ U~8;J _ u _' s ;a'?=.~!:~ - - - tilt" $. ~ =;;~ i'; E-< :Jj 'g 0 ~ ~ ~o,;~ .:... ~i U :i! l: .. .. l: .... ~ n ; !:: ~ Cl:.... 0< <UJ ...J OlQ z< ::l...J 10.... < ....> z< UJ :ll:W ....Cl: CII<UJ UJ U >CII'" Z....u. "'Zu. UJO UJ:II: >UJ> .......Z ....<< U....o.. UJCII:II: ...J 0 ...J...JU 0< U....... UCII ZZ::l "'<Cl: Z.... CII'" ....10.>- ... Z Z....< ::lZ UJ.... CIICl:U OCl:< ...J::l.... OUZ :: 0 'U 00 "'ZW ...J::lCII 010.< 10. W ......:...J Cl:Uo.. 00 0...... CII. CII .... "'ZUl ::00 ....:II:U :II: 10.00 "'UZ . " 'i! '" n is '" ~ .., ~ :::l R ~ 9 ~ :;; 2: l:> ~ ~ ~ :l:: ~. S '<) ~ .... ~ :J >- ~ ~ :l:: ~ ~ !!l ,... !:l :l, ~ 'J> - I: Ii 0 .. 7; ~ ... c E Q " ::I 0 Z ~ <( c .. ::I .c 0 ~ .. <( If .. UJ U ... .... o Z CUI:, . (,1. :'j. . \ Ocr III I 05 I'll '91 ... ~ 8 Cl Z a 01; LL o W u ~... ottl~ .a::~ o....~ uUl c:I:< ...JzQo.. :::l<:I: a:a!....~ WUlUl l-aJW:J ~::E==o: <::lte< ...,U,...U For thl Account 01: /,/'/;\,'\IlY (;/lA/WI,l,\': .\11 /./JIm I 1/. IIT/lIR Account Numblr: JZIJIJ52.111117,i Dill: SIl' 11;\11/1.'/1 .111, '!1~7 F. . 1 TI~,.lSl C m 'InancJa S . ompany .. (; I vices FilliHtdal I'rll\l Corp :1I').\IIf"n 14,1/,1.1. .',n, U"n :!~'J.t'.lIl1,IC'.IJ,\ litll:i 17111 :! 1:1. !il)." Review of Assets hL Shun or Unll Invttlmul Total AnnUli Cur...n' Pu Valu. Mark,1 Co.t Bul. Marhl VII". Incom. Ylold CASH INCOME CASH 0.00 0.00 PRINCIPAL CASH 0.00 0.00 TOTAL CASH 0.00 0.00 CASH EQUIVALENTS U.S, SAVINGS BONDS 7,000 SERIES E AND EE U S SAVINGS 3,500.00 3.500.00 0 0.00 BONDS MISC CASH EQUIV.TXBL 4,366.30 PROVIDENT TEMP FUND-INCOME 4.366.30 4.366.30 240 5.50 23,496.18 PROVIDENT FED FUND.PRINCIPAL 23,496.16 23,496.18 1,257 5.35 TOTAL MISC CASH EQUIV. TXBL 27,862.48 27.662.48 1,497 5.37 TOTAL CASH EQUIVALENTS 31,362.48 31.362.46 1,497 4,77 GRAND TOTAL 31,362.48 31.362.46 1,497 4.71 Pig. t ,--., F. . 1 Tp.l.sl (' ., . manClil S.' . ,ompany . l:l VIces Fiu,tIId,\t rill'" COI p 110 .\II,on It.wi, ('0. 1\0\ '.!'.!Ij. ClIlull", 1',\ INI1 17111 '.!.,. .';tlllI For th. Account 01: I'I1:NM/Y(;(I:II/ll/.tN:.IIlW//W /I. u:\'/lm Account Numb.r: .1200 52.1/1/17li D.t.: /'",,""ll.Y I. 1!'~7 tllI.",.~h ~/l'I1;ll/Im .111, /'1"7 Receipts & Disbursements Income Principal lnv.llmtnl 0.11 C..h C..h COil Bul, BEGINNING BALANCES 0.00 -2,581.29 47,500.00 07/01/97 PURCHASE .1,279.06 1,279.08 PROVIDENT TEMP FUND-INCOME 07/02/97 DIVIDEND 23.87 PROVIDENT FED FUND. PRINCIPAL 07/02/97 DIVIDEND 14.57 PROVIOENT TEMP FUND-INCOME 07/02/97 INTEREST 184.99 FARMERS TRUST CD 63179 5.30% DUE 7/2/97 07/02/97 MONTHLY CSA ANNUITY 1,279.06 07/07/97 MATURED 14,000.00 -14,000.00 FARMERS TRUST CD 63179 5.30% DUE 7/2/97 07/08/97 PURCHASE -11.418.71 11,418.71 PROVIDENT FED FUND-PRINCIPAL 07/08/97 PURCHASE -223.43 223.43 PROVIDENT TEMP FUND-INCOME 07/10/97 MANORCARE HEALTH SERVICES 372 -4.712.15 ROOM AND BOARD 07/11/97 REDEEM 4.712.15 -4,712.15 PROVIDENT FED FUND-PRINCIPAL 07/17/97 VITALlNK PHARMACY SERVICES -5.61 NON PRESCRIPTION DRUGS 07/17/97 REDEEM 5.61 -5.61 PROVIOENT TEMP FUND-INCOME 07/18/97 RURAL METRO MEDICAL SERVICES -40.00 TRANSPORT 6/30/97 07/21/97 REDEEM 40.00 -40.00 PROVIDENT TEMP FUND-INCOME 07/23/97 INTEREST 254.30 FARMERS TRUST CD 88471 5.10% DUE 7/23/97 07123/97 RDMD 20000 20.000.00 -20.000.00 FARMERS TRUST CD 88471 5.10% DUE 7/23/97 07/24/97 PURCHASE -20,000.00 20.000.00 PROVIOENT FED FUND-PRINCIPAL 07/24/97 PURCHASE -254.30 254.30 PROVIDENT TEMP FUND-INCOME Plgt 2 ""'"" Financial Ts l:.L\:'i.1 C0ll11Jany II . t;. l'lces FIIl.III1"i.lllll1'll ('olP .\1'1\11<'11 I{",ld. I' o. n.., '~~'I'<< _HIL,I.. 1',\ I i.d' 1711 I ':! I' . ""HI' For th. Account 01: l'U:NMlYWlMl/J/,lN: .1111 OHm /I. /.rWrtl Account Numb.r: .1200 .;2.11/ 1/7'; 0.10: rmm Jill. Y I. I!I'/7 IhnJl/g/. SI1'1I:II/IlR .10. 1!~17 Receipts & Disbursements Incom. Principal In......lm.nt 0.11 Cuh Cash Coli Bul, 08/01/97 PURCHASE '1.279.06 1.279.06 PROVIDENT TEMP FUND.INCOME 08/04/97 DIVIDEND 49.46 PROVIDENT FED FUND-PRINCIPAL 08/04/97 DIVIDEND RECEIVED 7.05 PROVIDENT TEMP FUND-INCOME 08/04/97 MONTHLY CSA ANNUITY 1.279.06 08/06/97 RDMD 10000 10.000.00 ,10.000.00 FARMERS TRUST CD 75790 5.10% DUE 816/97 08/06/97 TRUST DEPARTMENT FEE FOR QUARTER ENDED 07/31/97 -187.50 08/07/97 INTEREST ON 10000 PAR VALUE 128.54 FARMERS TRUST CD 75790 5.10% DUE 8i6197 08/07/97 PURCHASE .10.000.00 10.000.00 PROVIDENT FED FUND-PRINCIPAL 08107/97 REDEEM 130.99 -130.99 PROVIDENT TEMP FUND-INCOME 08/08/97 PURCHASE -128.54 128.54 PROVIDENT TEMP FUND-INCOME 08113/97 VITALINK PHARMACY SERVICES -28.99 PRESCRIPTION DRUGS 08/14197 REDEEM 28.99 -28.99 PROVIDENT TEMP FUND-INCOME 08/26/97 BELVEDERE MEDICAL CORP -10.00 BAlANCE DUE SERVICES 816/97 08/27/97 REDEEM 10.00 -10.00 PROVIDENT TEMP FUND-INCOME 08/29/97 PURCHASE .1.279.06 1. 279.06 PROVIDENT TEMP FUND-INCOME 09/02/97 MANORCARE HEALTH SERVICES 372 .4.555 92 ROOM AND BOARD 09/02197 MONTHLY CSA ANNUITY 1 .279.06 09/03/97 DIVIDEND 159 74 PROVIDENT FED FUND. PRINCIPAL 09/03/97 DIVIDEND 14 48 PROVIDENT TEMP FUND-INCOME '.g. J ~- F. . tTr'1SI(.. ill '1 nanC)(l S "ompany . L. l'ICeS Fiu.llldill r,mt Corp \ltl.\II.'11 1(",1.1. 1',fJ.lhJ' :':'.:"1(".111111<.- 1',\ INI, I1lij ~I.t' '<;1,4)1 Fa; thl .Accaunt af: I'U:N..tUY (; II:l1WI, t.\': .111 W/lf/) II. /.I.1'/lm Accaunt Numb..: .1200 52.10 1/7 ti Dill: f'mm 'III.Y I. 1997 th,,'ugh ~Il''':\l/fm .10, /!N7 Receipts & Disbursements Incem. PrincipiI lnvlUmlnl DI'I c'ln Cash COI' B..I, 09/0J/97 REDEEM 4,555.92 .4,555.92 PROVIDENT FED FUND. PRINCIPAL 09/04/97 PURCHASE .174.22 174.22 PROVIDENT TEMP FUND.INCOME 09/08/97 MANORCARE HEALTH SERVICES J72 .8,654.46 ROOM AND BOARD 09/09/97 REDEEM 8.654.46 .8,654.46 PROVIDENT FED FUND.PRINCIPAL 09/11/97 DARLENE L MOYER. C/O CTCB .9.90 1997.98 PERSONAL TAXES 09/11/97 REDEEM 9.90 .9.90 PROVIDENT TEMP FUND. INCOME 09/12/97 VITALlNK PHARMACY SERVICES .25.88 PRESCRIPTION DRUGS 09/15/97 REDEEM 25.88 .25.88 PROVIDENT TEMP FUND.INCOME ENDING BALANCES 0.00 0.00 J1,382.48 'lgI . .-." Financial '"f''''~t COIllI)any II Sc..:IVICCS Fill.lIld;al rnl\1 Curp jln .\lIrn It",lt!, I'.fl, [l,)'e :.!~IJ' f.ulnlc. I'A 17013 1111, :.! 13. Slit;' Far th. Accounl a': I'U:NAI(YC;!MIWltlN:.lflWIU'/J/I.I.l.1'nm Account Numb.r: J2 00 52..1007 ri O.t.: fnrm IlI/.Y I. 1997 t/rnl/lS" ~11J 11;ll/IflLlO, 19!17 Capital Gain Statement C.pll.IO.ln D.le of o.t. or SecurUy Hlml Shar.. Pun:h.,alCol. S'laJProe..d, Short long FARMERS TRUST CO 63179 14000 07/02/85 07/02/97 0.00 5.30% DUE 7/2/97 14.000.00 14.000.00 FARMERS TRUST CD 88471 20000 01/23/90 07/23/97 0.00 5.10% DUE 7/23/97 20,000.00 20,000.00 FARMERS TRUST CD 75790 10000 08/06/88 08/06/97 0.00 5.10% DUE 8/6/97 10.000.00 10.000.00 TOTAL 44,000.00 44,000.00 0,00 0.00 Pag. S iii ... ~ 8 :r >.. " 0 l: <; - ('II !: I 0.. ~ .:J 5 .!i OCll e-.a <:;- U:.J 8J" Cl z I ...\j_.~ <:5 :n'- Sfl < ,... C:.k , . ... -~" u. '(j '"' :.J:" - f-4 3" 0 \Jj' '- !:o ,.. ll:1- w --- -.- 0 -JzQQ. Z< :J~J: W ~O::I-~ z:w I-ll: tuWUlUl mw:; Ul<W Z::!;==a: w U >UlM <:J",< Zl-lI. ..,U~U "'ZlI. WO wz: >W>- MI-Z 1-<< UI-Q. WUlZ: -J 0 -J-JU 0< U"'I- UUl ZZ:2 "'Cll: ~ ZI- Ul'" I-lI.> ... Z ZI-< :2Z o:! WI- S Ulll:U Cll:< ~ -J:21- OUZ :l: 0 ~ 'U :i!: OA "'ZW ~ -J:211l ~ Oll.< lI. W . ~ .. I-:':-J :) .' '.a ..' ll:UQ. \.:l ~ M 00 ), ~ ~ Q.I- a: Ul. ~ g Ul l- S MZIIl :l:OO C, ~ I-Z:U ~ I: ~ z: lI.OO 0 11 "'UZ l! E Q " " J Z .. - W c .. " U 0 ... of; I- .. < 0 If Z ~:~_.\~.":Cft>b"<:';.,."....";.<...-....,,,.*... For thl Account 01: PLENtI/{Y<;(L.llW/,\"': ,lfl/.1l/U'/J II. /./."Yll/l{ Account Numblr: JZ 00 52.JO 07 Ii Dlto: o<.-rollm J/. 1997 Fi nandal ~J'US.l Company II SCJ'\'lCCS FilliUlrii\1 '1'111\1 CIlI II J11) ,\II~n Ito."1. 1',0. Uo\ ~:!o. (',ulhl~. 1'.\ 170L1 lil71 ~U. Hlll)J Statement Of Account Contlntl Review of Assets /1 Receipts & Disbursements / 2 Summary Statement of Transactions / 3 Statement of Transactions / 5 Summary of Dividends & Interest / 16 EFFECTIVE NOVEMBER 1. 1997. A NEW STATEMENT FORMAT WILL BE PUT IN PLACF.. THE ATTACHED TRUST STATEMENT COVERS TRANSACTIONS FROM YOUR LAST STATEMENT THROUGH OCTOBER 31. 1997 AS WELL AS A SUMMARY OF TRANSACTIONS FROM JANUARY 1. 1997 THROUGH OCTOBER 31, 1997. THE NEW STATEMENT FORMAT WILL BE PROVIDED ON YOUR NORMAL CYCLE AND WILL INCLUDE TRANSACTIONS FROM NOVEMBER 1 1997 THROUGH THE END OF YOUR NEXT NORMAL STATEMENT PERIOD, INCLUDED WITH THE NEW STATEMENT WILL BE A BROCHURE DETAILING SOME OF THE SIGNIFICANT FORMAT CHANGES TO THE STATEMENTS. THE NEW STATEMENT WILL ALSO REFLECT YOUR NEW ACCOUNT NUMBER. PLEASE CONTACT YOUR ACCOUNT ADMINISTRATOR IF YOU HAVE ANY COMMENTS OR QUESTIONS REGARDING YOUR STATEMENT, THANK YOU FOR YOUR CONTINUED CONFIDENCE IN OUR ABILITY TO MEET YOUR FINANCIAL OBJECTIVES. For the Account 01: /'/.fNMIYt;(HIWI,tN, ,IIIUmm II. /.nll/'ll Account Numb.r: .12 (HJ Sl.10 07 ri D.t.: ocro/lrR.11. W97 Financial 'frus.tCompan)' II ServIces Fin;llll"j,11 rlll'\l e'lll' :ill) ,\11"11 1(",1.1. II,el. n.." 'J'.!f) -Clflnl,.. 1'.\ 171)):\ 1711,'.!U.I\i!tij Review of Assets ht. Sh.,... or Unll InV'ltm.nl Toll' Annuli Curr.nl P., Value M.rkel Colt Bul, Marhl V.lu. Income Yield CASH INCOME CASH 0.00 000 PRINCIPAL CASH 0.00 0.00 TOTAL CASH 0.00 0.00 CASH EQUIVALENTS U.S, SAVINGS BONDS 2,000 US SAVINS BOND SER E 359.520 1,000.00 7.190.40 0 0.00 ISSUED 12(75 1,000 US SAVINGS BOND SER E 359.560 500.00 3,595.60 0 0.00 ISSUED 03/76 1. 000 US SAVINGS BOND SER E 347.160 500.00 3,471.60 0 0.00 ISSUED 12/76 3.000 UNITED STATES SVGS BDS SER E 304.480 1,500.00 9,134.40 0 0.00 DT012/01/77 12/01/82 TOTAL U.S. SAVINGS BONDS 3,500.00 23.392.00 0 0,00 MISC CASH EQUIV.TXBL 5,756.27 PROVIDENT TEMP FUND. INCOME 5,756.27 5,756.27 318 5.52 23,496.18 PROVIDENT FED FUND. PRINCIPAL 23,496.18 23,496.18 1,270 5.41 TOTAL MISC CASH EQUIV.TXBL 29,252.45 29,252.45 1,588 5.43 TOTAL CASH EQUIVALENTS 32,752.45 52.644.45 1,588 3.02 GRAND TOTAL 32.752.45 52,644.45 1.588 3.02 Pig. I For th. Account 01: I'LLNMl YlaM/l/ll..t N: .\flUmm 1/. UTIl/'Il Account Numb.r: 3200 52.10 07 ri Olt.: f,"m OC/'O/lf/l I. 1!l!17Ih..,,,S/' OtTOI/f/l.11. I!~17 F. . lTrt1sl(~ . 'Inancla S . .ompany . cr\'lccs 1:i!Mllt"i,tl TllI~' ('olP JII) ,\l1l"n It",.,I. ",n, n,), '~'.:q. Luli\ll". 1'.\ IN!:' 111]1 '.! I.t. HI;IU Receipts & Disbursements Incoma Principal Iny.,lmanl Da'. Cnh Cllh COI' Bnla BEGINNING BALANCES 0.00 0.00 31,362.48 10/01/97 PURCHASE -1,279.06 1.279.06 PROVIDENT TEMP FUND-INCOME 10/02/97 DIVIDEND 115.37 PROVIDENT FED FUND-PRINCIPAL 10/02/97 DIVIDEND 19.75 PROVIDENT TEMP FUND-INCOME 10/02/97 MONTHLY CSA ANNUITY 1.279.06 10/03/97 PURCHASE -135.12 135.12 PROVIDENT TEMP FUND-INCOME 10/10/97 VITALINK PHARMACY SERVICES -24.21 PRESCRIPTION DRUGS 10/10/97 REDEEM 24.21 -24.21 PROVIDENT TEMP FUND-INCOME 10/23/97 CHARGE OFF -3.500.00 SERIES E AND EE U S SAVINGS BONDS 10/23/97 SET UP 500 . 00 US SAVINGS BOND SER E ISSUED 12/76 10/23/97 SET UP 500.00 US SAVINGS BOND SER E ISSUED 03/76 10/23/97 SET UP 1,500.00 UNITED STATES SVGS BDS SER E DTD12/01l77 12/01182 10/23/97 SET UP 500.00 US SAVINS BOND SER E ISSUED 12/75 10/23/97 SET UP 500.00 US SAVINS BOND SER E ISSUED 12/75 ENDING BALANCES 0.00 0.00 32,752.45 P.ge 2 For th. Account 01: 1'/.L"Vtl/{YGtL-l/WlAN: ,Ill WHflJ II. 1.l.'Yl1/:U Account Numbor: 32 00 52.10 07 ri Dot.: rrom f'F./IlWA/{Y I. /99711",,,,.~h ocrollm .11, /!I!17 F. . ITruSl(" II 'mancJa S . ,ompany . cr\'lccs Hlland;.1 Trml CIlI II ~lll.\lIl"n Ro.!'1, II,n. n,), ~:!O. Lltl"I.., 1'.\ 1';")1,' 17111 '.!u. Ml}l)J Summary Statement of Transactions Incom. Principal Invellment elsh Calh COil B..I, BEGINNING BALANCES 0.00 0,00 0,00 RECEIPTS CONTRIBUTIONS 25,433.03 ORDINARY DIVIDENDS 722.53 CSA ANNUITY 15,257.36 NON. TAXABLE CONTRIBUTION TO INCOME CASH 2.082.66 PROCEEDS FROM MATURITIES 44.000.00 -44,000.00 PROCEEDS FROM THE SALE OF ASSETS 12,095.34 43.355.56 -55,450.90 TOTAL RECEIPTS 30,157.89 112,766.59 .99,450,90 DISBURSEMENTS FIDUCIARY FEES -375.00 OTHER EXPENSES -269.42 -45,926.95 NURSING HOME BILLS -8.695.89 PRESCRIPTION BILLS -82.89 ELECTRIC BILLS -126.73 TELEPHONE BILLS -89.62 REAL ESTATEiPERSONAL TAXES -21.10 LOCK BOX RENT -16.20 MEOICAL -703.97 REPAIRS AND MAINTENANCE -213.00 RENT, ROOM AND BOARD -1,650.00 TELEVISION CABLE .42.46 REAL ESTATEiPERSONAL TAXES .9.90 PURCHASES OF ASSETS -17.851.61 -66,851. 74 84,703.35 TOTAL DISBURSEMENTS .30.157.89 ,112,786.59 64,703.35 Page 3 For th. Account 01: Pf.EN..tRYGliJlIWltlN: M/I.lJIlflJ /I. 1.1.1TJ/1l Account Numb.r: 3200 5210 07 Ii D...: From fTlI/lll..tllY I. 1997Ihr"/I.~h OCrOllm .II. 1997 Financial ~ru~tCompany . Services ~'inal1t'i;11 '1'111\1 ("01 P ~Il) .\111'11 1(.1.1I1. 1'.0. Illl\ ~~l). C."h,I~. 1''\ 17QI:t 17171 ~ r'. S(h)j Summary Statement of Transactions Income Principal Inv..tm.nt CIsh Cllh Cost Bul, NON CASH TRANSACTIONS SECURITIES DEPOSITED TO THE ACCOUNT 51.000.00 SECURITIES DISTRIBUTED FROM THE ACCOUNT .3,500.00 TOTAL NON CASH TRANSACTIONS 0.00 0.00 47.500.00 ENDING BALANCES 0.00 0,00 32,752,45 Pia- .. FDr th. ACCDunt DI: 1'1,/,NMIYI;I/.WIlIAN:.II/UlIlrtJII.tnllf/l ACCDunt Numb.r: .12 IHJ:i1.10 07/; D.lo: /,,,,,,,ITIIIWMIl'I, /~!/71"r""g" nCl()IIIJI.11, /!/'17 F. . I Trllsl (' . 'I mll1CI<l S . ,()l11pany . cr\'lCCS nll.Uln.11 1'111" Cnrp \I.).\II,.n It., 1'1. 1'11. 1\", :!'."I -Lull.t.., P.\ 1;')1:1 ,il1, ~ll. ~')'d Statement of Transactions Incom. PrincipII Inv.'lm.nt Oal. Cuh Cuh Co,, aull CONTRIBUTIONS 02128/97 PROCEEDS FTC SAVINGS ACCT 1.310139 18,086.47 02128/97 PROCEEDS FTC CHECKING ACCT 4.24722 3.618.36 03/21/97 CASH FOUND AT APARTMENT 9,08 04/24/97 KENNY'S AUTION PROCEEDS FROM SALE OF PERSONAL 1.340.62 PROPERTY 05/12/97 CONESTOGA AUCTION CO . PROCEEDS SALE OF HUMMELS 2.357.10 06/13/97 PROCEEDS SALE OF COINS 21.40 TOTAL CONTRIBUTIONS 0.00 25,433.03 0.00 ORDINARY DIVIDENDS 04/02/97 DIVIDEND 90.13 PROVIDENT FED FUND. PRINCIPAL 04/02/97 DIVIDEND 14.54 PROVIDENT TEMP FUND.INCOME 05/02/97 DIVIDEND RECEIVED 95.05 PROVIDENT FED FUND. PRINCIPAL 05/02/97 DIVIDEND RECEIVED 4.72 PROVIDENT TEMP FUND.INCOME 06/03/97 DIVIDEND 101.72 PROVIDENT FED FUND. PRINCIPAL 08/03/97 DIVIDEND 12.08 PROVIDENT TEMP FUND.INCOME 07/02/97 DIVIDEND 23,87 PROVIDENT FED FUND. PRINCIPAL 07102/97 DIVIDEND 14.57 PROVIDENT TEMP FUND.INCOME 08/04/97 DIVIDEND 49 .46 PROVIDENT FED FUND. PRINCIPAL 08/04/97 OIVIDEND RECEIVED 7,05 PROVIDENT TEMP FUND.INCOME 09/03/97 DIVIDEND 159.74 PROVIDENT FED FUND. PRINCIPAL Page 5 For tho Account 01: I'L/:N..u~y c;IMlW/tlN: .\11 Wl/I.'/) II. l.n1J/Jl Account Numb.r: .120052.10071; D.t.: I'M" ITlI/WAl~Y I. 199711l'<I"gh OClOllrtl .11, /!197 F. . ITrustC II 'InanCla S' .,()1l1pany , crvlccs Finanl"ial Till'll eOI p :"0,\111"11 I({'-'II. 1'.0. Ih, ~~I)' C.ull,I,..I',\ 171)13 1117, '.!13. 1'III0j Statement of Transactions Incom' PrincipII Inve.tmlnt D.t, Cuh C..h CClllBul1 08/07/97 INTEREST ON 10000 PAR VALUE 128.54 FARMERS TRUST CO 75790 5.10% DUE 8/6/97 TOTAL NON.TAXABLE CONTRIBUTION TO INCOME CASH 2,082.68 0.00 0.00 PROCEEDS FROM MATURITIES 07/07/97 MATURED 14,000.00 -14,000.00 FARMERS TRUST CD 63179 5.30% DUE 7/2/97 07/23/97 RDMD 20000 20,000.00 -20,000.00 FARMERS TRUST CD 88471 5.10% DUE 7/23/97 08/08/97 RDMD 10000 10,000.00 -10,000.00 FARMERS TRUST CD 75790 5.10% DUE 8/6/97 TOTAL PROCEEDS FROM MATURITIES 0,00 44,000.00 -44.000.00 PROCEEDS FROM THE SALE OF ASSETS 03/07/97 REDEEM 1,893.28 -1,893.28 PROVIDENT TEMP FUND. INCOME 03110/97 REDEEM 152.97 -152.97 PROVIDENT TEMP FUND-INCOME 03/13/97 REDEEM 107.62 .107.62 PROVIDENT TEMP FUND-INCOME 03/24/97 REDEEM 128.00 -128.00 PROVIDENT TEMP FUND-INCOME 03/25/97 REDEEM 4,979.99 .4,979.99 PROVIOENT TEMP FUND.INCOME 04/09/97 REDEEM 259.90 -259.90 PROVIDENT FED FUND.PRINCIPAL 04/11197 REDEEM 20.16 .20.18 PROVIDENT TEMP FUND.INCOME 04/21197 REDEEM 50.86 -50.88 PROVIDENT TEMP FUND.INCOME 04/22/97 REDEEM 85.00 -85.00 PROVIDENT TEMP FUND-INCOME 04/24/97 REDEEM 10.00 -10.00 PROVIDENT TEMP FUND-INCOME 05/02/97 REDEEM 250.00 -250.00 PROVIDENT TEMP FUND-INCOME Pagl 7 Fa. th. Account 01: PI.I:.\'..tIU'I;II..t1WI:1,v: ,III WIU'" II. 11T11I'1l Account Numb..: JZOO.'i2.1007ri Oltl: ,."'''' f'/l/1W"'lY I. I!N711"''''g/r ClCIOII/Jl .11, 1!/'/7 F. . ITrllSL(, . 'mill1CliI S . .0111!)ilny , en'lces Fillalldal I'Ill"d Clllp Jlil,\Il.... It'M,I.II,I' n'l\ '.!'~!J.LlIh'I~.I),\ 1;01:1 lil71 ~u . SIll):' Statement of Transactions Incom. PrincipII Inv..lmlnt 0"1 Cuh Cnh CO'I eul. 09/15/97 REDEEM 25,88 .25.88 PROVIDENT TEMP FUND. INCOME 10/10/97 REDEEM 24,21 .24.21 PROVIDENT TEMP FUND. INCOME TOTAL PROCEEDS FROM THE SALE OF ASSETS 12.095.34 43,355.56 .55,450.90 FIDUCIARY FEES 05/05/97 TRUST DEPARTMENT FEE FOR QUARTER ENDED 04/30197 .187.50 08/06197 TRUST DEPARTMENT FEE FOR QUARTER ENDED 07131/97 .187,50 TOTAL FIDUCIARY FEES .375.00 0.00 0,00 OTHER EXPENSES 03/12197 VITALlNK PHARMACY SERVICES .82,62 NON PRESCRIPTION DRUGS 04107/97 FARMERS TRUST .110,00 FEE TO DRILL SAFE DEPOSIT BOX 04/08/97 CARLISLE COMM, AMBULANCE .250,00 BALANCE DUE SERVICES 04/18/97 VITALINK PHARMACY SERVICES .28.09 NON PRESCRIPTION DRUGS 04/24/97 REGISTER OF WILLS AND CLERK OF THE .22,50 ORPHANS' COURT PETITION TO INVADE PRINCIPAL OF ESTATE 05/08/97 VITALINK PHARMACY SERVICES .5,61 NON PRESCRIPTION DRUGS 05/09/97 MANORCARE HEALTH SERVICES 372 .6,00 TV CABLE CHARGE OS/29/97 MANORCARE HELATH SERVICES .18.891.35 CARE PER COURT ORDER 06/26/97 MANORCARE HEALTH SERVICES 372 .8,863,07 ROOM AND BOARD 07110197 MANORCARE HEALTH SERVICES 372 .4,712.15 ROOM AND BOARD 07/17197 VITALINK PHARMACY SERVICES .5.61 NON PRESCRIPTION DRUGS Plgl g For th. Account 01: l'/.r..vMlY (;(fA IWIAN: ,llIl./l/l/'IJ II. 1.I.1'IJ"'1 Account Numb.r: .12 00 52.10 07 6 Dill: r",m ITllIlllAIlY /, /997Ih""'g/r ()C/Ullt:Il.11. /!1!17 . . Trust:, . Fl11ancJaI S' . Company . crvu;cs Fillitlll'i,,1 Tlmt Corp 111) .\111"11 RU.ld. 1'.0, Un' ~:.!U' C.ulnlf'. 1'.\ 1701:\ 17171:.!U .lidllj Statement of Transactions Income PrincipII InvI.lm.nt D.., Cuh Cuh COlt B..I, 08/13/97 VITALINK PHARMACY SERVICES .28.99 PRESCRIPTION DRUGS 09/02/97 MANORCARE HEALTH SERVICES 372 .4,555.92 ROOM AND BOARD 09/08/97 MANORCARE HEALTH SERVICES 372 .8,654.46 ROOM AND BOARD TOTAL OTHER EXPENSES .289,42 ,45,926.95 0,00 NURSING HOME BILLS 03/24/97 MANORCARE HEALTH SERVICES 372 .5.000.00 ROOM AND BOARD 06/26/97 MANORCARE HEALTH SERVICES 372 .3,695.89 ROOM AND BOARD TOTAL NURSING HOME BILLS .8,695.69 0.00 0,00 PRESCRIPTION BILLS 06/16/97 VITALINK PHARMACY SERVICES .32.80 PRESCRIPTION DRUGS 09/12/97 VITALINK PHARMACY SERVICES .25.88 PRESCRIPTION DRUGS 10/10/97 VITALlNK PHARMACY SERVICES .24.21 PRESCRIPTION DRUGS TOTAL PRESCRIPTION BILLS .82,69 0,00 0,00 ELECTRIC BILLS 03/06/97 PP&L .107.80 SERVICE 1128.2/26197 04/10/97 PP&L .12.36 SERVICE 2/26.3/26/97 04/18/97 PP&L .6.57 SERVICE 3/26.4/7/97 TOTAL ELECTRIC BILLS .126.73 0.00 0.00 Pig I 10 For th. Account 01: l'l1NMlY (;[L.llW1AN: .1111.11llf]J II. 1.1.1'IJm Accounl Numb.r: 32 00.;1..10 07 ri D...: From rCll/WAllY I. 1997 th"J1/.~h oemllrtl .11, 1997 FinancialSTrus,L Company ill crvlccs Finandal rr 11\1 CUI P jltJ ,\IIt" II ItO.lll, I'.n. Ih, :!~O. c.ulult". 1'.\ 11013 1717, :!I:\. !iOIl:' Statement of Transactions Incom. PrincipII Invltlm.nl 0.,. Ca.h Cuh COil Bul. TELEPHONE BILLS 03/06/97 UNITED OF PA .81.82 SERVICE 04/10/97 UNITED OF PA .7.80 SERVICE TOTAL TELEPHONE BILLS .89.62 0.00 0.00 REAL ESTATE/PERSONAL TAXES 03/06/97 DARLENE L MOVER. CIO CTCB .11.20 1996.97 PERSONAL TAXES 09/11/97 DARLENE L MOVER. CIO CTCB .9.90 1997.98 PERSONAL TAXES TOTAL REAL ESTATE/PERSONAL TAXES .21.10 0.00 0.00 LOCK BOX RENT 04/18/97 FINANCIAL TRUST COMPANV .16.20 ANNUAL LOCK BOX RENT TOTAL LOCK BOX RENT ,16.20 0.00 0.00 MEDICAL 03/07/97 BONSALL AND MANFREDI ASSOC .33.85 BALANCE DUE SERVICES 03/07/97 MASLAND ASSOCIATES INC .75.12 BALANCE DUE SERVICES 03/07/97 RWC EMERGENCV PHVSICIANS .10.00 BALANCE DUE 03/07/97 CARLISLE IMAGING ASSOC .34.00 BALANCE DUE SERVICES 10/20/96 03/12/97 CARLISLE COMM. AMBULANCE .25.00 WHEELCHAIR VAN TRANSPORT 10130196 04/23/97 BELVEDERE MEDICAL CORP .10.00 BALANCE DUE SERVICES 05/01/97 CARLISLE COMM. AMBULANCE .250.00 BALANCE DUE SERVICES APPLIED TO OEDUCTIBLE PLUS NON COVERED SERVICES Pig. 11 For thl Account 01: PILNAf~YGLL-llWItlN:.\I1 WIIIJJ 1/. u:mlll Account Numblr: 32 00 52.10 07 b DIlo: from FF.81WM~Y '. 1997 rhn"'.~/I ()c:ro///."l~ .1/. /'1~17 Financial Trtls,t Company . Scn'lc.:cs Fill.llldill fill'll CUI P 1ln .-\II"n RrJ.,.I. 1',1 J. nt)' :!::rl. C.ulnlf', 1'.\ IfOI3 171~) :.! U. ."I0H1 Statement of Transactions Income PrtnelpII In.....lm.nl Dale Cuh Cllh Cou lilli, 05/07/97 BELVEDERE MEDICAL CORP .20.00 BALANCE DUE SERVICES OS/27/97 CARLISLE HOSPITAL .196.00 BALANCE DUE SERVICES 1/1/97 07118/97 RURAL METRO MEDICAL SERVICES .40.00 TRANSPORT 6/30/97 08/26/97 BELVEDERE MEDICAL CORP .10.00 BALANCE DUE SERVICES 8/6197 TOTAL MEDICAL .703.97 0.00 0.00 REPAIRS AND MAINTENANCE 03/21/97 JANET A. LLOYD .128.00 CLEANING APARTMENT 04/21/97 DAVE SHEIBLEY .85.00 REMOVAL OF DEBRIS FROM APARTMENT TOTAL REPAIRS AND MAINTENANCE .213.00 0.00 0.00 RENT, ROOM AND BOARD 03/06/97 WILLIAM E. HOFFMAN .1.650.00 RENT FOR NOV. & DEC. 1996 AND JAN.. FEB. & MAR. 1997 TOTAL RENT. ROOM AND BOARD ,1.650.00 0.00 0.00 TELEVISION CABLE 03/08/97 tv CABLE OF CARLISLE -42.46 BALANCE DUE CABLE DISCONNECTED 12/16196 TOTAL TELEVISION CABLE .42.46 0.00 0.00 REAL ESTATE/PERSONAL TAXES 04/09/97 DARLENE L MOYER, C/O CTCB .9.90 1997 PERSONAL TAXES TOTAL REAL ESTATE/PERSONAL TAXES 0.00 .9.90 0.00 Pig. 12 Far th. Accaunt al: 1'l./:NMU'I;ILHWI..t,v: .\rll./ll~n) II. l/.'l'/lm Accaunt Numb.r: .12 ()(/ 51..10 117 ri 0.1.: r"'m n'lllW,H~Y I, '~"'7 rh,,'/lg'/ OCfO/l/:U .1/, '~1o/7 F' , I Trust C' . '1llanCla S ' .olll!)an}' . cr\'lccs Hlland;!1 rllnl CUI p 11'1 ,\lIrn K"_ld. 1'0. n'l\ ~:!!). c'lJh,It>, 1'.\ 111)1:1 lil1, '.!l:t. Hllllj 'Ig. t3 Far th. Account 01: l'l1:.v"'~Y(aM'WMN: .\flWllflJ II. l./.'Y/JW Account Numb.r: J2 00 5l.JO 07 ri O.t.: l'mm IT/IlWtll~Y I, 1997 t/lm",~h OCm/lrJl JI, /997 Financial Trus.tcompany . Services Finall4..'ii,1 Tnnl CUr(J 310^I1~n KU.1d,il,O.lIuw. ~:!f)'C.ulitle.l'^ 1701' (717) 21'.801)3 Statement of Transactions Income Prlnclpll I"vellm,nl Ol'e Cash Cuh COl' a..l, 07/08/97 PURCHASE .223.43 223,43 PROVIDENT TEMP FUND. INCOME 07/24/97 PURCHASE -20,000.00 20,000.00 PROVIDENT FED FUND-PRINCIPAL 07/24/97 PURCHASE -254.30 254.30 PROVIDEIIT TEMP FUND-INCOME 08/01197 PURCHASE -1,279.06 1,279.06 PROVIDENT TEMP FUND. INCOME 08/07/97 PURCHASE -10,000.00 10,000.00 PROVIDENT FED FUND.PRINCIPAL 08/08/97 PURCHASE -128.54 128.54 PROVIDENT TEMP FUND.INCOME 08/29/97 PURCHASE -1.279.06 1,279.08 PROVIDENT TEMP FUND, INCOME 09/04/97 PURCHASE .174.22 174.22 { PROVIDENT TEMP FUND. INCOME 10/01/97 PURCHASE -1.279.06 1.279.06 PROVIDENT TEMP FUND-INCOME 10/03/97 PURCHASE -135.12 135.12 PROVIDENT TEMP FUND, INCOME TOTAL PURCHASES OF ASSETS -17,851.81 .88,851.74 84.703,35 NON CASH ENTRIES SECURITIES DEPOSITED TO THE ACCOUNT 04/04/97 3,500.00 SERIES E AND EE U S SAVINGS BONDS 04/07/97 RECD FROM MILDRED LEYDER 14,000.00 FARMERS TRUST CD 63179 5.30% DUE 7/2/97 04/07/97 RECD FROM MILDRED LEYDER 20,000.00 FARMERS TRUST CD 88471 5.10% DUE 7/23/97 04/07/97 RECD FROM MILDRED LEYDER 10,000.00 FARMERS TRUST CD 75790 5.10% DUE 8/8/97 10/23/97 SET UP 500 . 00 US SAVINGS BOND SER E ISSUED 12/76 'age t4 Far tho Account 01: PI.l:NMU'laL-\IWMN: ,\11 /Jl/I/:/J 1/. l./:mw Account Numbor: .12 00 52.10 07 ri Doto: from fl:lI/mU~Y I, 1~!17/llro",.~h ()e/OI/"'~ J/, 1!N7 F. . lTrustC' m 'mancJa S' ,,01l1!)any . Cr\'ICCS Fill:tndal TIlI\1 Corp 31f) ,\Ill"n!tfJ.lll. 1',0. 1\1" ~'.!l}. C.ulnl(', fl.\ 171)11 (1171~1j.,\O<l1 Statement of Transactions Incom. PrincipII Invlltm.nl Oate Cllh C..h COl. 8111. 10/23/97 SET UP 500.00 US SAVINGS BOND SER E ISSUED 03/76 10/23/97 SET UP 1.500.00 UNITED STATES SVGS BDS SER E DTDI2/01/77 12/01182 10123197 SET UP 500.00 US SAVINS BOND SER E ISSUED 12/75 10123197 SET UP SOO.OO US SAVINS BOND SER E ISSUED 1217S TOTAL SECURITIES DEPOSITED TO THE ACCOUNT 0.00 0.00 51,000.00 SECURITIES DISTRIBUTED FROM THE ACCOUNT 10123/97 CHARGE OFF -3,500.00 SERIES E AND EE U S SAVINGS BONDS TOTAL SECURITIES DISTRIBUTED FROM THE ACCOUNT 0.00 0.00 ,3,500.00 Page 15 , IN RE: MILDRED B.LEYDER IIN IILLEGF.D INC'IIPIICITIITED PERSON IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO.96.1041 ORPHANS' COURT IMPORTANT NOTICE CITA TION 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 Person, 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 county. n€ 1'\I1I1herland ThE! A rE!a A'ilE!ncy on A'ill n'il' IS'attacnea. You are hereby ordered to appear at a hearing to be held in Court Room No, 5 ,Cumberland County Courthouse. Carlisle. Pennsylvania. on February 6, 19 97, at 10: 00 II .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 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 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 attorney, and to request a jury trial. 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UI "I'l ...I'l ~o.l ...UI NUl ... ...u. ...u. < ...... "'... '" cost ...Z UlZ UI ...UI "'UI U I'l ClOl Z .-8 ~ "'... :Z:'" C U ~ UI> u> ... ..... "'.. C c i c'" ='" .. "'... ...... ~~~ .... .... .... .-u '" '" '" u..:~ UI " " " ~ ... ... ... '" '" '" I'l " " " QJ N N N ... ... ... V) IN TIlE COURT m" COMMON Pl.EAS OF CU~lIn:RI.ANJ) COUNTY. P~:NNSVI.vANIA ORI'JlANS' COURT IlIVISION NO. 1196-1041 ESTATE OF MILURED II. LEVDER, AN INCAI'ACITATEJ) I'.:RSON FlRll,. ANJ) I'ARTIAL ACCOUNT OF FINANCIAL TRUST SERVICES COMI'ANV, SUCCESSOR TO FARMERS TRUll,. COMPANY. GUARDIAN Dale of Appoinlment: Account Staled 10: FobnulIY 6, 1997 JRflIlRry 21. 1998 SUMMARY AND INDEX flwa Principel 2 $92,143,03 .00 $92,143.03 ISO.OS6.66\ Receipe. Net Oain or (Lo..) on Conversions Adjlllted BaI_e ..... Di.burserneol. 2 2 Principal BaI_e Remaioing $42,086.37 ~ Rec:eiplJ ..... Disbursernenl. 2 3 $22.318.36 120.311.62\ locorne Bal_e Remaining 2.006.74 Combined Balance Remaining $44.093.11 3-6.97 3.7.97 3.12-97 3.21.97 4.7.97 4.10-97 4.18.97 4.21.97 4.23.97 4.24-97 5.1.97 5.7.97 5.27-97 7-18-97 8.26-97 9.lt.97 '.. InCnltt6 DiBlmflt!lI1t!nla TV C.hle of C.rli.lo, U.I.n"e d". ...I,li'''OIllI'..:I f,'<l pp8<L. Service Sprinl.Servi"e D.rlone Moy.r. T.. Colleclor delin1r,.nIP'1'01lA1 T.... WiIIi.mHoffm.n. R.nl, Nov.mh.r 10 M.r"h 8on..1I 8< Manfredi Auo".. 0.1."". ,Ine M..land Auod.I... U.I"""e d"e RWC Emerg.ncy phy.ici.na. ",,11Ul". dn. C.rliale Im.ging Auoc.. O.I"""e dn. Carli.le Amhulance, Wh..lch.ir Van TIIII",o,I1 Janet A, Lloyd. ....I1m.nl cleaning F.nnen Trual ComJ'l'l1Y. drilling a.fe d.\o,.il I.IX pp&L. Service. rIMI Sprinl. Service. 1i",,1 F.m..n Tnlsl ComJ'l'l1Y' delinqu.nl s.f. deposil I.,. renl D.vid Sheihley. Irtllih r.mov.1 01 .pol1m.nl Belvedere Medic.1 Corp., Oolonce due Register of Wills, pelilion 10 InvoWe Prinei(1lll C.rlisle Conllllunily AmhnllUlce. OollUle. dne Belvedere Medical Corp.. Oolance d"e C.rlisle Hospilol. BallUlce due Rural MellO Medical S.rvic.s. Irmspol1otion Belvedere Medicol Corp.. Oahll1ce dne D.rl.ne Moyer. T.. Collector. P.rsoUllI To"s Vililink ph.nt1JIcy. Dalanc. dn. 3.12.97 to 1.13.98 Manon:.re Hca\lh S.rvice. Room and 8oonl. 3.24.97101-14-98 Financial TnLsl S.rvic.s ComJ1RllY' F.. 5.5.97 to 11.14.97 S 42.46 107.80 81,82 11,20 1.650.00 33.85 75.12 10.00 34.00 25.00 128.00 110.00 18.93 7,80 16.20 85.00 10.00 22.50 250.00 20.00 196.00 40.00 10.00 9.90 292.60 16.460.94 562.50 Total Income Disbunemenls S?0.311.62 COMMONWEALTH OF pENNSYLVANtA: COUNTY OF CUMBERLAND: David C. Gority. Vice President and Tmsl Offie.r. heing dnly sworn occonling 10 low, d.po'" and soyalhal he is Vice ......idm and Tmst Officer of FiURl1ciol TnlSl Service. COInpony. Ih. A"counlonl in Ih. E.slole obove l\IIIued, and lhallh. Accounl .. sloted i. In'. and "orrect. D It- .-/ (<.:tre. N.;.ry l'I;t.c NolBrtal 5..1 Joan l. Crowl. Nolary Publ,c Carllslo Boro. Cumberland Counly My commission E.pir.s ApJl123. 2001 Swom and subscribed tn before Ille Ihis~dayofJanuRry. 1998. 3 , . Ul E-< .s: l>: :z: ~ Eo< ~ P ...:I l>: A 0 ll<Ul U 0 III III U :z: U ...:IU .s: 0 ... ~><- .~ ...:I E-<Ul III I>: .s: O:z::z: III ... UP.S: AUl:Z: ~ O:C III .s: c..Ull:E-<'" 0 I>: AUlA ll< AO ~...:IPI>: E-<:Z: ......I>:.s: A l>:.s:1'I: o~E-::Z: I c.....:I U~.s::Z:\DO.s: . Eo< 1Il~00'1 ...>< Ul ~~><...~~U:Z: I>: :C::>UlUlNE-<:Z:.s: H E-<U:Z:'" .s:.s:ll< c.. :Z:~ 'E-<Z~ :z:c..IIl"'OUl"'O "'Oll<A:Z:~c..U ~ '-~11'3 ~"7?' IS'! PUUUIlUO~ luno"... :""0::> oUI ~1'/11.'",r':rJ . .Jlbof'-e;ilDw ,... I . . . r-- 0'1 to ~ 0'1 0'1 . ~ \D . >< 0 I>: ,... 1'1: ::> >< l>: I>: III .s: III ::> c.. :z: .s: l"J .. 0 ~ .. E-< A .s: III A ...:I ... III c.. III I>: III U ~ III A A .=1': C\.:- a . " . .,~ ~.. -, =-::: _n:J o~.t:frc:'u . "Ill ~"",= 1>:0 >- "Q) 0 Q) ~ U s:: ~ li~ ~ l:l; U ~ .-cu->CQ.o Htn """ -5~2lU~": tLI~ ...... o~>o-g ~u E ;II CO -'- ClJO H g' Q) 'C C g i U ~ OCll :: E ~ ~ C l3 ... E-: UQ) '= lX ~ .0 ~ III t ~ Ul ~ ~ U CD Q) 0 ca 0 tn .~ .c4l.r.CCCI) ...0:: e'c: '::-lU~i >4E-4E-4 i o C - OJ C - E-< Ul '. -.,- Q)"O.Q~~ HCO}~A""'''' .!! '; -g III ~ Ql .. \ I>: :z: I>: ~Cf.l -~","Ql.c '..J 0.s:E-<- Dc>> J:a._ ~ CI ~ ~ ~ ,5 .; ~.5 .. E-t ~ ..-4 Qlc.;05.c~ .:z:.s: U .;:'CtUEoo~ UCzJH c:: . C ",.. Ql~ A U ~ ~"'.l::ll;;E C"':Z: s:: _ llJ c: > .- H (J) ~ ....-4 ~.~8'2Qll6c ~1Il:Z: ~ -~ lXo:it .s:l>:'" ~ ai .2 - .~ _ A ll< c.. Q:~'C"'~U)( U 11' g ~ _ ... Q) >..cuoc:OC J:! - _.. 'V .... ~ C .J..i ~: ... =- 0 ~"t)f..I~~= .r '. ~'f~~~ r I 0150 wish 10 ,ocolvo Iho following sorvlcos (lor on 0,110 100): 1. 0 Addrossoo'. Addross 2. ~'Roslrlclod Dollvory consull postmas'o, 10' 100. 4D/IIlCIO ,~~'Zi.r cf' ~~- C:C? 4b. Sorvlco Typo o Rogls'orod o e,p'oss Moll o Rolum Rocolpllor Merchandise 7. Dolo 01 Dollvory ,. . LJ:" I, : ~ lCornplllllll;mt' .,wio'OI' :z lor adoJlllf)tlAl tef~" I 'I -Compl'" 111ma 3. 41. arlll4b :' I .Pnnt.,our namlllld add"" on ItwIIIW'''' ollhltln,m to thai "". can "lUt" II., c.tlt.llo'f'OU IMKh ,hl,lorm 10 lhe lIonl at the mAI'PI'I, Of on the .,.0.11 IP'~ do.. not ..,mo' . I I aWnt,"R.,um RtIC1IIpt n,qUfll.-JoOO Ihe mAllpi.c1 beIo'#l' lhe ar11C.1e rwtOOef. 'Ii . Th4I R"um nee..pC WIll ~ 10 .tlOrn the artldt w.. dohvlrltd and lhe dati I S CMtlYI,td : II 3. Miclo Add,ossod 10: ,11 )" .( ).../ . : i . N.,. "_' '"\ <J<{('~' , \ .~ pL-.a.Lj)/a. "" Jt. \...II. O.,.,,/Y- i.f LV- J /a..'" Ii {""~-IIlI,d~/I.t., , I ,., ./ ~~,' ," i a 'B a: E ~ a: III c ~ l5 - II '" ... c ~ G:Yliortlfied o Insurod o COD ,..~..~. ',\',1 8. AddlOssoo'S Addross (Only " roquostod and 100 Is paid) " , . .!l o '''' ,,!! , (( .vv~ Domestic Return Receipt '. ........ .....~.~ :. <, '. . ," ,'.-...~.i,. ",c,.;.",.~,~..,~.."""", .:> ... ENDER: .08 'Complel. itlms 1 and/or 2 tor addltionl!I8Me... I al50 wish to rocolve 1I1a ,;; eComplel.llems 3. 4.. and 4b. loIlowlng sorvlcos (for an I~ .Pnrd VOUf name and addr." on the rtvel'18 01 this form so thai we can return lhi, e><lra fool: Ii card 10 you. :~ _Anad1lhillorm 10 lhelronl of lhe mailpieC8. at on lhe back if space doeS not ,. ~drossoe'o Addross 1 permll. II aWrit,.Rerum Receipl Reque.rtd" on the ma~pi.ee below the .rhdt number. 2. Roslricted Dollvary 5 _The Rllum Receipt wll1hoW10whomlhe anldew..dtlivertd and the da" Consull postmasla' for foo. a c delivered. l 0 4a. f-rtlcto Num:i' II 3. Artlclo Addressod 10: 0,/0 JU.L"-'CtC /L( Yiybk.l, ~1 . p .fF 1/.1 ,?r:l!;- a: II E Ii. 4b. Sorvlco Typo a . g tr6rtlfiod \. , II ~ o Ragislo,ad a: , u 0(1.1 -At/!- yt-Ef! Ji2'u. . III o expross Mail o Insured c "-/Jiu /UZ1i~ Mot:! /> ;; /1l.. o Relum Rocolpllor Merchandise 0 COD ~ .. ~ /7t!5-;- 7. DolO 01 Dollvory $! ~ ' ~-z. 0 '" 8. Addrosseo's Addross (Only il roquosled ... .. and 100 Is paid) ! ~ 6. I" 0 '" ,,!! Domestic Return Receipt ( ; .-_1 -..,..,..- . -.--,.--.... .-' ~*-:,,--N. t.. - ., .. . .,:. A ~. ... ... UNITED STATES POSTAl SERVICE .I .I.. ..~ I" Flrsl.Cloll Moll POII4QO & Fool Paid USPS Pormlt No. G.l0 rt;"t,'l \ I ~ L.... :(J \ ../..,:.:/ -.' . Print your name, address, and ZIP Code In this box · Anthony L. DeLuca, Esquire P.O. Dox 358 Boiling Springs, PA 17007 ",./1/".11/.,,1/11,""""'" 111...1...111.11..11..1.1.1..1..1.1.1..1..1..11 ~.- u_s"~-~~G \ 111~~~~a:::: . Print your name. ad~resS, and ZIP.9ode In this box ._h '" '.' Anthony L. DeLuca, Esquire P.O. Box 358 3011ing springs, PA 17007 .": I:. , , , .' l ;. , " . . .~, , .. 1",111",111",11".1,.,111,",.11..1.1,1,,\"1,1.1"1"11"1 .' - . -_I ---~ _.-_---+.--~~ ~ _ 1":' -<.0 . .,. . . 1 , . I ,. ., ' ~ ... ~. .~1jfX: v~jt~'U" :>J.2~ J~ dN'<- ):;( ,..II~iUlj~ " f.:" 1711~ . I I 0160 wi.h \0 roeolvo tho loIlowing .orvleo. (lor on ..tro 100): I. 0 ~dro..oo'. Addr... 2. a'Ro.trtc1od Oonvory Con.ult po.tmo.tor 10' 100. 40. Artlel. NU"1~./ t ,4'7 Ic ') 07/ 4b. Sorvleo Typo o Rogl'1OI0d o expro.. Mall 0 In.urad o R.lum Recelpllor Mercl1an<i" 0 COO 7. Dol. 01 Oanv.ry I' ~rtlfl.d i 1l. I E ~ a: '" .5 ~ 15 - & ,.. ... c ~. I.- i~ \ i ~~ , 1& :1 ,,,, 'fi , lComplelllt;"" , ~or 2 'or .ddltJOnll'IrV'CtI, Icompellltemt 3, .a, and .b. .Pnnl: your name and addl'" on th."....". 01 thltlOlm 10 Ih.t WI can lelUlft Ihlt elld 10 you IAttach lhia to'"' 10 lhe "on! of lhe rn&llpltce, 01 on lhe back II apa" dota not po,m\. .Wnla'R.tum Rtc>>ipf RlQuetred"on lhe mI~pllce below the .ltd. number. IThe Relum Receipt WI! thaw 10 Yfhom the artlCl' w.. d.llv.,td and the dlla dltivlfad. 3. Artlela Addra..od to: / ,-J I; 8. Addro..ao'. Addr.s. (Only" ,oqu.sted 8nd 188 Is paid) 5. R.ealv.d By: (Print Name) , ,~ " ,0 ,.. '.!! Domestic Return Receipt .:;- ,;..i .-.,. .... ~--., . ,., >~*.",. '.."e";"'.,,' .. ... ; ~ SENDER: . " . Compte1e Itema 1 .nd/o' 2 tor additlon,l .ervle.. I .. . Complete item. 3, and 4. 8. b. . e . Print your n.me .nd .dd,... on the rtverll olthi. 10,", .0 tNl we eln ~ Itlurn thi. elrd to you. CD . Anleh lhl. form to the hont ollha mlilplece, 01 on the back if .p.ce I ; do.. not permit. I -5 . Wllte "Return A.celpt Requetted" on the m.i1p1eee below thl.rtiele number i C . The R.luln Receipt wlll.how to whom thl .rtlele wa. deliv.red .nd the dlle I 0 d.llvered. ,"'CI 3. Article Addressed to: '11 : I 't4-ndd'9' ~Hk ,8 1/6 ct~ 7. : ~ '-jaw- . 7/1P6''' r;~ '8 ~/~ ,< / ~~? i ~ 5. Signature X I also wish to receive the following services Ifor an extra feol: 1. 0 Addre...... Addra.. 2. ~stricted Delivery Consult ostmaster for fee. 4.pr~ :;;;.' ~O~ O?~ 4b. S.rvlee Typo o Ijpglsl.red 0 In.ured UYt.rtlll.d 0 COD o Expr..s M.II 0 R.lurn Ree.lpt for Mer I 7. Oat. 01 O.llvo,'O G U I ~ ~ ell ~ .e- II II a: E " . ~ II ; a: '" j; ~ ~ .2 :l o . 8. Addressee's Address (Only If requested':- . and fee Is paid) C II j!:' " DOMESTIC RETURN RECEIPT - . ---..,..,..- ...~ .. ------='~ -- T -1~. . ----. 1 I , I I , I 1 I I , I I I , I 1 , , I -, I 1 I II II \ Flr.I.Cla.. Mall postoga & Faa. Pold USPS Pormit No, Q.\O UNIT EO STATES POSTAl. SERVICE . Print your name, address, and ZIP Code In this box · Anthony L. DeLuca, Esquire P.O. Dox 358 Boiling springs, PA 17007 l ~SC~ t ~G,"i,-?/;:?'\ s:~rl. L t l L t t)r."\H ,-,,>.,."."'.'~' .,~. . UNITED STATES POSTAL SERVICE JJIIII ~- - u.s. MAIL - 1'u.P, ll;' J...:'..# \ ./..:"/.;" Ollie'" Ou.ln... PENAllY FOR PRIVATE use TO AVOIO PAYMENT OF POSTAGE, S300 . , I I I , I I I , I , I I , I I , I I ~. .; (. Print your name, address and ZIP Code here . Anthony L. DeLuca, Esq. P.O. Box 358 Boiling Springs, PA 17007 . · t. " :., . ~ " . .i, t '. 1, '",1/""1"",1""1","'"",1""""",,,',',1,,",",,' ,. . - - I --.,.,.,..- -;~:-._._.~--~~. ~ _ t.:.. <> . 1 . ;. f ~ ..., . . I -. ... ,~ E DER: \ oJ . Compl'te Ittm. , .ndlor 2 101 addltlone' tervle... . Compl.1I IlImt 3, .nd 4. . b. S . p,lnl your ",mt .nd .ddlll' on the flve,.1 01 uu. lo,m '0 lh.t we tin :i flturn thl. elfd to you. ! . AttlCh thlt fo,m to 1M Iront of the mlilpiece, Of on 1M blck il .plea dCM' not pllmlt. .J . W,lta "Return Receipt Requtl"d" on the m.ilpi'CI below thl.ttlcle number . The R,tu,n Rec,ipl wiU .how 10 whom IhI ertlel. w.' dellv.lld.Ad 1111 d.le a d.livertd, \ 'i 3, Artielo Addro..od 10: \! d/nzdr;( I/J. ~,} :! IO,tj,,( ~1 Iffi~' II 1 a: .u p.c. ,g '/ "I ct IZ I a: 5. it ,a: , ~ : :; P5 Form I 0110 wish to focolvo tho following lorvlcol lIor on oxtr8 .a fool: ~ 1. .x :e. ~ a: E a .l! d"tY.j-1 ~ o - 013 o Insurod coo Return Rocolpt lor e h i '"' 1 :l o ,.. 8. Addrossoo'S.l'1dr IS (Only II roquested ~ ~Jo~~ c <JepS_'!f')(;) ~ .U.S.GPO:ltt2~ DOMESTIC RETURN RECEIPT .",,^.,..'."v',",",""~.O-' ^ ~"....~.4~~_.'.'. 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MyeRS SECRETARV FINAL GUARDIANSHIP REPORT FOR MILDRED B, LEYDER SEPTEMBER 15, 1998 :-)\j r- ... ~ , " ~., , ' ,,' (,: Report from Guardian of Person Cumberland County Office of Aging Priscilla Whitman, Aging Care Manager II l I.) '.c On February 6, 1997, Guardianship of Person for Mildred B. Leyder was granted to the Cumberland County Office of Aging by Judge J. Wesley Oler Jr. At the time of the hearing, Ms, Leyder was a resident at Manor Care of Carlisle in the Arcadia Unit. Ms. Leyder's medical conditions included Dementia - Alzheimer's type, irritable bowel, history of deep vein thrombosis and breast cancer. She also suffered from (ASCVD) atherosclerotic coronary vascular disease and (PVD) pulmonary vascular disease. Ms, Leyder also had old compression fractures of her spine lumbar 2 and 3 due to her history of falling, The only medication she took was an aspirin daily, Upon admission to Manor Care, Ms. Leyder was able to assist with some of her activities of daily living. Ms, Leyder's mental capabilities deteriorated due to her progressive dementia to the point she required total care, Client was incontinent of bowel and bladder and she became non-ambulatory, Ms. Leyder recognized her name only and everntually was unable to express her simplest needs, She was always pleasant and cooperative with all her care. Client was transferred to a skilled unit on July 27, 1998 due to her declining condition, Office of Aging had been consulted, It wa~ decided Ms, Leyder's needs could be better met off the Alzheimer's unit. On September 9, 1998 Ms, Leyder died in her sleep, Her Advanced Directives had been honored, Her cause of death was listed as ASHD arteriosclerotic heart disease. October 21, 1998 Register of Wills Cumberland County Courthouse Carlisle. l' ^ 17013 CERTIFICATION OF NOTICE UNI>ER RULE 5.6(u) Name of Decedent: MILDRED B. LEYDER Date of Death: September 9, 1998 Will Number: 21-96-1041 To the Register: 1 certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above captioned estate on October 21, 1998. I i I Gary Leyder 2225 Dovcr Rd. Harrisburg,PA 17112 Donald W. Leyder, Jr. P.O. Box 137 Lithia Spring. GA 30057 Elizabeth Anne Leyder Grace P.O. Box 301 New Cumberland, l' A 17070 Ronald J. Leyder 46 E. Main St. New Bloomfield. pA 17068 David C. Leyder P.O. Box 1310 Harrisburg.PA 17105 Notice hus now been given to all persons entitled thereto under Rule 5.6(a). Date:," u; i:~ Signature: :... ;"'.J ., ::1 &.':.:: '," ) ~.~ ;:.n ......: :i ,~t: Capacity: ec: William S, Daniels avid C. Gority Sr, Vice President & l' st Officer Financial Trust Services Company 1',0. Box 220 Carlisle, l' A 17013 (717) 240-4505 I'ersonal Representative IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION No. 2196.1041 Estate of MILDRED B. LEYDER, AN INCAPACITATED PERSON Late of South Middleton Township FIRST AND FINAL ACCOUNT OF FINANCIAL TRUST SERVICES COMPANY SUCCESSOR TO FARMERS TRUST COMPANY GUARDIAN Date of Appointment: Account Stated From: February 6, 1997 January 21, 1998to September 9,1998 SUMMARY & INDEX PRINCIPAL ~ INCOME Receipts Less DI5bursements Income Balance Remaining 2 3 $ 42,086,37 (17 ,460.00) $ 24,626,37 (9,099,60) $ 15,526,77 $ 39,879,32 (24,915,89) 14,963.43 $ 30,490,20 Receipts Adjustments to Principal Adjusted Balance Less Disbursements Principal Balance Remaining 2 2 2 COMBINED BALANCE REMAINING PRINCIPAL RECEIPTS 01/21/98 Balance flOm Flr5t and Partial Account Adjustments to Principal: 03/28/98 Redemption of US Savings Bond5 dated 12n5 03/26/98 Redemption of US Savings Bonds dated 03n6 03/26/98 Redemption of US Savings Bonds dated 12n6 03/26/98 Redemption of US Savings Bonds dated 12/77 Total Adjustments to Principal TOTAL PRINCIPAL RECEIPTS PRINCIPAL DISBURSEMENTS 01/26/98 Regl5ter of Wills, Filing Fee 02127/98 Transfer to Income 04/15/98 Manor Care Health Services, care TOTAL PRINCIPAL DISBURSEMENTS INCOME RECEIPTS 01/21/98 Balance from First and Partial Account 02127/98 Transfer from Principal for Expenses 03/24/98 Interest, US Series E Savings Bonds 05/06/98 Refund - Cartl51e H05pltal 05/06/98 Refund -Intemal Revenue Service 1997 Taxes Provident Fund Interest 2-02-98 to 4-01-98 KeyPremler Money Market Fund Interest 4-01-98 to 9-09-98 KeyPremler Intermediate Income Fund Interest 7-01-98 to 9-09-98 CSA Annuity Payment 2-05-98 to 9-09-98 TOTAL INCOME RECEIPTS 2 $ 42,086,37 $ (4,988.56) (2.494,29) (2.494,29) (7,482,86) (17 ,460,00) $ 24,626,37 $ 101,00 5,000.00 3,998,60 $ 9,099,60 $ 2,006.74 5,000,00 18,844,00 196,00 2,160,00 242,79 701.44 322,83 10,405,52 $ 39,879,32 INCOME DISBURSEMENTS 03/12198 County and School PelSonal Taxes 04/20/98 Register of Wills. Filing Fee Manor Care Health Services, Care 2-17-9810 9.09-98 VilaLlnk Pharmacy Services, Pre5crlptlons 2-12-98 to 9-09.98 Financial Trust Services Company, Guardian Fee 2-13-98 to 9.09-98 Reserved: Filing Miscellaneous Closing Costs $ 19,80 10,00 23,501,32 622,27 562,50 200,00 $ 24,915,89 TOTAL INCOME DISBURSEMENTS Financial Trust Services Company Guardian Mildred B. Leyder David C, Gorlty, Sr, VJce Presl nt & Trust Officer COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND David C, Garity, Senior Vice President and Trust Officer, being duly sworn according to law, deposes and says that he Is Senior Vice Pre51dent and Trust Officer of Financial Trust Services Company, the Accountant In the Estate above named. and that the Account as stated Is true and correct. DaVid C, Gority, Sr, Vic Swom and subscribed to before me this ,;)-j day of October, 1998, (),~ /. t'~ Notary Pyliilc Notarial Seal Joan L Crowl, NOlary Public I Carllslu Bora. Cumberland County My CommISSion EllplrOS Aptl123. 200 I J 3 .,1 lit: I' " '9l1 '''12'} IJ\.J ,. \'1 "-8 I ' ,I. GI,: Ct;\I: Ul ~ ..: ;>, fiI to. u " Eo< ..:l 0 ..: " ~.1 s::: ~ Z ::.. ..: Ul ~ :~ I~) " g C\S 0 "'Z Eo<fi1 a) (~, ~,. .... 0.. 0 Z 0 ZU '" :, (J " E U 0 _H OH >0 '" .. '. " U :E>oUl O>OZ J c: ':; OCll ..: :EEo<H UO:Eo<": ...... .- .) OZ> UfiI '" '" , UQ) ..:l UOH ":UlP::E ...... : " ~.S:! ..: OC 00 '" 'J it Z to.U ..:lE-<UlU " IClJ1c: H 0 Eo< ":UlUl , :e~Q.)~'- to. CP:- ZOfilEo< == .. Eo<ZO.,.HO:UUl E-< -. ~lZl C p:,,:ooto.E-<UO ..: Z :::II-1U- 00: fiI - - ..: 00: I C..:lUlE-< Q C\S U fiI- \OZ": Z .- Eo< t%JtIlO\<H)04(J)~ t<. ;; U Ul fiI :EZ- UZO:H 0 , 2 .~ ~ s::: 0: :1:l O":NEo<Z..:fiIC .( ]~~ C\S H Eo< U:1:l Ul":Po:EP: fiI , t. s::: to. Po 'P:Z:EO:": E-< '.' .- Zt<.P:OHHO":O ..: C.L, HOOZto.t<.U""l-' Q ~ J - ~ V'T'7I'tf ~ 8~1 ~e '~IJ"eJO . ?I/lf'O .peijot peoodo'd 4 UOIIOQ/J,9,p '0 GIn P99Joep UOllnQ/JI~,I!" ooucP,o,ou u, P8WJ"UCl:l,uno'OV-j p pug ~lo,nlo'QV 66('17?: ' (lVu... . . . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN THE ESTATE OF MILDRED B. LEYDER AN INCAPACITATED PERSON SCHEDULE OF PROPOSED DISTRIBUTION Balance for di5trlbutlon as per First and Final Account filed October 23,1998 S 30",90,20 Distribution Market Value SeDtember 9, 1998 Cost Basis Financial Trust Services Company, Executor of the E5tate of Mildred B, Leyder Principal Cash Income Cash s 15,526,77 14,963.43 30,490,20 $ 15,526.77 14,963,43 $ 30,490,20 s STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION The above distribution is prop05ed because of the death of Mildred B, Leyder on September 9, 1998 In the Borough of Carlisle, COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND David C, Gority, being duly 5Worn according to law, deposes and says that he Is Senior Vice President and Tru5t Officer of Financial Tru5t Services company, the Accountant In the Estate above named, and that the facts set forth In the Statement of the Rea50ns for the Proposed DI5tributlon are true and correct. Sworn to and Subscribed before me this -2:t. day of October, 1998, ;j ro-.. ;( tu.....-( )Qotary Public Nota,lal Seal Joan L, Crowl, Nolary Public Carlisle 60'0, Cumberland County , My Commission expires April 23, 200 I 1_.___.. . nC(, " tH. 'Yo u~T 22 1'1 :2U Cl;"l r.l:n" " , " Ul - ."- 0<( ::; " ~ >> r rj) '" " '"5 0 0 ~ 0 H e>: a> .s 'C a S co c 0.. H Z H U >< Eo< '" c: c: '" co " E Eo< 0 -Ul Z Z '" '0 " c ~ :5 D II> " .s::; ::> ::E >< H Cl 0<( 0<( Ul J;' '" > u - o. E 'n ~ " (; OCl.l l%l ::E Eo< > r: " .S <; 8 " '" .c. r.. H 0 Z H Ul H ::E r: u ::> Cl 0 r.. 0 ::E " i ,. " " i~.~ ~ ~ Eo< 0 ~ U e>: z '" '" c: ;~ ~ r: t>: 0 Ul r.. H " .. " ~2:b:", ::> Cl Q ::> - ~ r: Eo< .. , ~Y) r: 0<( U 0 r.. 0 H Eo< 0<( 0<( - c .. ;:: :I: r ..:l - 0 H > ::> r: Ul , Eo< t>: e>: t.:l Cl Co " . ", t';l Ul 0 U r r< r.. " .' 0 r H Ul Z 0 :; ~ - s:: . i: t>: :I: ::> 0<( N Cl e>: Eo< r U ::E Eo< ro J.''; 0.- c .- Z r.. t>: 0 U H t>: ::> 0 0<( .s~ c.' 8 ~ c .. ~ '" ~{ I H 0 0 Z Ul Q Eo< Ul U Q ~o >- " E' <. ;,J .. :>- c ,~' c '0 , ... .--~ -,..-....--- COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-1996-01041 Estate of MILDRED B. LEYDER Deceased Late of South Middleton Township FIRST AND FINAL ACCOUNT OF FINANCIAL TRUST SERVICES COMPANY, EXECUTOR Date of Death: Lellers Granted: First complete Advertisement of Grant of Lellers: Account Stated to: September 9.1998 October 5, 1998 October 17. 1998 July 16, 1999 SUMMARY & INDEX Paoes PRiNCIPAL Receipts 2 $ 34,457,32 Less DI5bursements 2 9,465,54 24,991,78 Less DI5trlbullons to Beneflclarle5 3 115,00 Principal Balance Remaining $ 24.876,78 INCOME Recelpt5 3 $ 1,226,06 Less Disbursements 3 61.80 1.164,26 Le5S Di5trlbulions to Beneficiaries 3 $ Income Balance Remaining 1.164,26 COMBINED BALANCE REMAINING $ 26,041.04 COMPOSITION OF NET BALANCES Principal Market Value 7/21/99 $ 14,859,79 $ 1551,1265hs. Governor Intermediate Term Income fund Cash Ca5h 9,350,01 $ 24,209,80 $ Income $ 1,164,26 $ PRINCIPAL RECEIPTS Inventorv Flied Per copy Penn5ylvania Inheritance Tax Cost Basis 15.526.77 9,350,01 24,876.78 1,164,26 $ 31,283,07 3,000,00 108,25 66,00 3,174,25 $ 34.457.32 Sub5eauent Receipts 11/24/98 Federal Employees Group Insurance, Claim #986302 12122198 Governor Intermediate Term Income Fund Long Term Capital Gain Dividend 12122198 Govemor Intermediate Term Income Fund Short Term Capital Gain Dividend Total Principal Receipts 10/2198 10/2198 10/9/98 10/14/98 10/19/98 10/21/98 10/23/98 11/9/98 11/12198 1218/98 3/24/99 3/29/99 3/29/99 4/21/99 PRINCIPAL DISBURSEMENTS Regl5ter of Wills, Letters Testamentary Preparation 1997 Federal and State Tax Returns Vltalink Pharmacy Services, Prescription Drugs Cumberland Law Journal, adverti5ing Manorcare Health Services, Room & Board Carlisle Imaging Assoc, Hoffman-Roth Funeral Home, balance due for services Belvedere Medical Corp., balance due The Sentinel. advertising Register of WiII5, E5tlmated PA Inheritance Tax M. Rutland, Jewelry Appraisal Register of Wills, Balance PA Inheritance Tax Regi5ter of Wills, filing fee PA Department of Revenue, PA State Income Tax $ Reserved: Financial Tru5t Services company Executor Fee WIlliam S, Daniels, Esq, - Attorney Fee Closing and filing fee Total Principal Disbursements Page 2 71,00 175,00 76,67 60,00 1.112,35 10,98 95,00 20,00 68,04 3,375,00 26,50 290.00 15,00 70.00 2,500.00 1,250.00 250,00 $ 9,465.54 PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES 5/14/99 Elizabelh Leyder Groce - pel50nal property as appraised $ $ 115,00 Total Principal Distributions to Beneficiaries 115.00 INCOME RECEIPTS 11/24/98 3/15/99 Inlere51-Governor Intermediate Term Income Fund 11-2-98107-1-99 Interest-Governor Money Market Fund 11-2-98 to 7-1-99 Interesl-Federal Employees Group Insurance Addilionallncome earned In Guardian5hlp account $ 678,67 481,94 19.72 45,73 Total Income Receipts $ 1,226,06 INCOME DISBURSEMENTS Financial Trust Service5 Co" Income commission s 61,80 Total Income Disbursements $ 61,80 INCOME DISTRIBUTIONS TO BENEFICIARIES None $ Total Income Distributions to Beneficiaries s FINANC~A, TRUST SERV,ICES COMPANY, EXECUTOR / j /.//11/1'1 c':;'),"" David C. Garity, Sr. Vice Pre dent & Trust Officer / COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND David C, Gority, Sr. Vice Pre51dent & Trust Officer, Financial Tru5t Servlce5 Company, being duly sworn deposes and says thatlhe foregoing Account, both as to the items of charge and discharge, are just and true to the best of hl5 knowledge and belief. FINA~~L :~S2~:~l:~OMPANY' EXECUTOR David C. Garity, Sr. Vice Pr ident & Tru5t Olficer Sworn 10 and Subscribed be(ore me this....&. day of July, 1999, ;frr-.. ~ 0 / Nota Public Notarial Seal Joan L Crowl, NOlary Public Carlisle Bora. Cumberlilnd County My Commission Elpires April2J. 2001 Page 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN THE ESTATE OF MILDRED B. LEYDER, LATE OF SOUTH MIDDLETON TOWNSHIP SCHEDULE OF PROPOSED DISTRIBUTION Balance lor distribution as per Flr5t and Final Account liIed July 23, 1999 Distribution Gary Leyder 310.226 shs, Governor Intermediate Term Income Fund Principal Ca5h Income Ca5h Ronald J. Leyder 310.226 5h5, Governor Intermediate Term Income Fund Principal Cash Income Ca5h Donald W, Leyder Jr. 310,225 shs. Governor Intermediate Term Income Fund Principal Cash Income Ca5h David Leyder 310.225 5hs, Governor Intermediate Term Income Fund Principal Ca5h Income Cash Elizabeth Leyder Grace 310,225 Sh5. Governor Intermediate Term Income Fund Principal Ca5h Income Ca5h $ 26,041.04 Market Value July 21, 1999 Cost Basis $2,971,97 $3,105,36 1,870,00 1,870,00 232.85 232.85 $5,074.82 $5,208.21 $2,971,97 $3,105.36 1,870,00 1,870,00 232,85 232.85 $5,074.82 $5,208,21 $ 2,971.95 $ 3,105.35 1,870,01 1,870,01 232.85 232,85 $ 5.074.81 $ 5,208,21 $ 2,971,95 $ 3,105,35 1,870,00 1,870,00 232,86 232.86 $ 5,074,81 $ 5,208.21 $ 2,971,95 $ 3,105.35 1,870,00 1,870,00 232.85 232,85 $ 5,074,80 $ 5,208,20 $25,374,06 $26,041,04 STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION The above dl5tribulion i5 proposed In accordance with the terms 01 the Last Will and Testament 01 Mildred B, Leyder, Late of South Middleton Township, Cumberland County. Pennsylvania, / / ,'1.1 I" .;" j!./l/ .' L_'- ~'o-' ,- David C, Gority, Sr, )lice Pisident & Tru5t Ollicer Page 4 ."...... COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND David C, Gorlly, Sr. Vice President & Trust Ofllcer Financial Trust Services Company, Executor being duly swom according to law, deposes and says that the facts sel forth In the Statement of the Reasons for the Proposed Distribution are true and correct, Sworn to and Subscribed before me this ~ day of July, 1999, rJ,-.... ~ ~ /Notary Public NOlo/lal Seal Joan L. Crowl. Notary Public Carlisle Bora, Cumberland Counly My Commission explles April 23, 2001 ,. Page 5 t" t' ~...... ,,- .-.,.,. ""'.-- I I Financial Trust ~ I Services company~ \ M"'.....'..ln"'ftl--.IIl..... I II I .ll 11 \ i Estimated Pa Inheritance Tax Estate 121-1996-01041 ft No. 7001724 111086609 Exe: Mildred Leyder Dec. li~~~ 1998 'I:' (J .. L" :1" (':" $3375.00 ''I '.. 'i~".~-' .- ,". "l~"';;/' ; " , C', "' _' ,,". ,r - , . . T ~.. )0 '. ~ "". .. '; '0. t r. Of .. ,I l"'. ' .... ; (\ " . l . , . . , , , " , 1~ . I J :-., \. ~~~ , , 0, ., . _ _ .._ 1 ~- '. Y' "",~..- --._--- r--* . -~ - - J". .,.:-.... ' , , " IG, .~,. 1 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IIIV'103P'llt1} ~l COU...oNVo~SYLV'N" OEPARIUENI OF REVENUE OEPI11lO6O' ,.uRRI R p~ 171 1 OECEOENTSN.Wf lIAST. FiRST. /HJ....OO\.E lPmAll \1M. tlI.-'l DUlIlY9..WO'OI .. .. ",:5::1 ufu "00 "'0:-' U.." ~ Ii .. o '" o .. .. .. 0: 0: o U I- Z W C W U W C u. MIL D H E D DAn.Cf'OEATH LEY D E R SOCIAL SfCURlT"I' PUA6E.R CATlOfBlMTlI o 6 1 196-14-2321 09/09/98 (IF APPUCABlfl SUR'1t-MGSPOUSES kNJEl1..AST. FiRST. AHJUlOOlElflT1Al.) ~0ClAI. SECURITY NI)r.I6f.R L. ._,~--_._--_.. .- -. j.I~'( \.0' t (',tit, 'FUIIlIlOOt' .. ........-..----..........'.,......... -.... I 21 9 6 0 , 4 .. .... 1 1 3 IHIS RETURN MUST Bf FLED 1H DUPlICATE WlTH THE REGISTER OF WILLS Qg 1. Dng,naIRel1Jm 02. SupplemenlalRel1Jm 03 Rema"derRel1Jm,..._"""ol/.u<n o 4. LimrtedE.la1e 04a.Ful1JralnteresICompmmlSe,..._...I/.".a1\ 0 5. Federal E.ta1eT..Rel1JmRequirad o 6, Decedenl Died Tesla1e ,_,.., .w~ 0 7. Decedenl Ma"ta,ned a Living TMI,,,,,,,..,. 'MIl _ 8. Total Number 01 Sale Oeposd Bo... o 9. Li!Jgallon Proceeds ReceNed 010, Spou5aIPovertyCradd,...".._I/.l'," ...,.',9\1 011. Election 10 \all underSec. 9113(AI1"""'""0' THIS SeCTION MUST Be COMPLETeD. ALL CORRESPONDeNce AND CONFIDeNTIAL TAX INFORMATION SHOULD Be DIRECTED TO: f\.WE Cc:>>.RETE ..wuNG AOORESS David Gori t Sr. V. P. & Trust Officer FIA....NMlC ("~L. . FlnanCla~ 'tLUst Services company TElEPl10NENlNBER / Financial Trust Services company One West High Street, P.O. Box 220 carlisle, PA 17013 (8) 4 ,2 4 4 o 4 1 , 4 2 1 5 0 (11) (12) (13) 1. Real ESlale (ScI1edule A) (I) (2) 13) (4) (5) (6) (7) 5 , 7 5 6 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < umer~ofpet1l.lfy.ldeclnltlall havefLWTW'l<<lthtltelum.ltld\ldInl;l~yll"lQ$thedultS a'ldSlaelT8'lts.~IOl1lttleStolmy ~nbelJef.lt"tnJe. COfT'ICt.-.dc:ornolttl Oedar*,"oI~other 1tI IIWfl 1'1 k ~W~pC~~~NExecut8gRESS ,~ Senior Vice President & THE AN REPRESENTATIVE ADDRESS 2. SIOd<s and BondS ISclledule B) 5, 5 2 6 3. Close~ Held Corporallon,Partne"hip or S01e-l'roprietorship z o ~ :J l- ii: ~ u W 0: 4. Mortgages & Notes Receivab~ (Schedule D) 5, Casn, Bank Deposrts & MlSCellanecus Pe""nal Property (SoheduIeE) 6, Jo,nlly o..ned Property ISchedule F) 7, Inter-VlVOs Tran.fe" & MlSCellanecus Non-Probale Property ISche<lu~ G or L) 8, To\.ll Gross AslOts II0tal Lines 1.7) 9, Funeral E,penses & Adm,nistrallve Costs IScI1e<1u~ H) (9) (10) 10 Debts of DecedenL Mongage Liabillbes, & Liens (Sohe<lu~ 1) 11. Totsl Deductions (lOlal Lines 9 & 10) 12, Hst V.lue of Estate (Line 8 m,nus Line 11) 13, Chantable and Govemmental Bequests/See 9113 Trusts lor whICh an eleclion 10 \all h.. not been madelSchedule J) 14, Hst V.lue Subjecllo Tax ILUle12 m,nus Line 13) (14) 15, Amount ol'"e 14 \allab~ Z at dle spousal \all rale , I X .0 (15) 0 . See instructions on reverse side for applicable percentage i::: 16. Amounl ofhne 14 taxable ~~ at 6~~ rale x ,06 (16) ...:1 17 Amount oU;ne 14 \allable II- :E all 5% rale X 15 (17) 0 lJ 18 Tax Due (18) 19. Carllsle, 'PA Trust Officer . I . ~ -. .~ .. o 0 7"7 o 0 o 0 3 0 o 0 o 0 3 1 , 2 8 3 . 0 7 5 I 6 6 5 2 5 I 6 1 7 5 4 5 3 o 0 25,61753 o 0 o 0 25,617 53 3,84263 i7013 OATe i1X1 2~' 1SSJ DATe Decedent's Com leto Addross: Sl~lllA[)(,"I'" ~\lnOr ('are NUl"" 1 nq ,1I1l1 Hl'Il,ll> Center 940 \oI..l1nut Pollan Hmcl oe:.rlinic ~TAn: P^ I'P 17013 Tax Payments and Credits: 1. Tax DuelPage lLIOe (8) 2, Cred,lSiPaymenlS A, Spousal Po,eny Credll 8 Pnor Paymenls C DlsCQunl (11 3,842.63 3, 375.011 177.(,] TOlaICre<1IlsIA.8.C) (ll 3.552.63 3. InleresVPenally " applicable D.lnteresl E, Penalty TOlallnleresuPenally (0' E I (31 4, If line 2 IS grealer Ihan line 1 . "ne 3, enter the difference, ThiS IS Ihe OVERPA YMF.t>lT, Choek box on Pagel Line 19to request a refund (4) 5, I' line I . line 3 is greaterthan IIOe 2. enlerthe difference ThiS is Ihe TAX DUE, (5) 290 - 00 A, Enterthe inleresl on Ihe lax due, (SA) 8, Enlerthe lolal of Line 5. SA. This Is Ihe BALANCE DUE. (58) ?qn nn Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING OUESTIONS BY PLACING AN "X" IN THE APPROPRIATF. RI.OCKS 1. Did decedent make a transfer and, Yes No a. retain Ihe use or income of the p,operty transferred; ............................................................. 0 ~ b, ,elain the right to designale who shall use Ihe property transferred or its income; ................ 0 ~ c. retain a ,eversionary inlerest; or............................................................................................. 0 !Xl d. ,eceive the promise for life of either payments, benefits or care? ......................................... 0 !Xl 2. If death occurred on or before December 12, 1982, did decedent within two yea,s p'eceding death transfer p,operty without receiving adequate consideration? If dealh occurred afte, Deeembe, 12,1982, did decedent transfer p'operty within one year of death wilhout ,eeeiving adequate consideration? ..........""..........,.............."........,.,...,.......,.,',....,"....,..,....."..', 0 ~ 3. Did deeedenl own an "in trust for" or payable upon death bank account or security at his or her dealh? ................................................................................................................,..,.. 0 !Xl 4, Did decedent own an individual reli,ement account, annuity, 0' olher non-probale property?.... 0 !Xl IF THE ANSWER TO ANY OF THe ABOVE QUeSTIONS IS YES, YOU MUST COMPLETE SCHeDULE G AND FILE IT AS PART OF THE ReTURN __ _ __.-.--_ _.....:1 __ __~~,----~ ~-- ..~ 72 P,S. !j9116 (a) (1.1) (i) provided fa, the reduclion of the tax rate imposed on the net value of transfers to 0' for Ihe use ollhe surviving spouse from 6% to 3% fa, dates of dealh on or after July 1, 1994 and before January 1, 1995. 72 P,S, !j9116 (a) (1.1) (ii) provided lor the reduction of the rate imposed on the nel value of Iransfers to or fa, Ihe use of the surviving spouse from 3% to 0% for dates of dealh on 0' afte, January 1, 1995, The statule does nol exempt a transfer 10 a surviving spouse from tax, and Ihe statutory requirements fo, disclosu,e of assels and filing a tax ,eturn a,e still applicable even if the surviving spouse is Ihe only beneficiary, FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please answer Ihe lollowing question by placing an 'x' in the appropriale space, Old the decedent create a trust or similar arrangement which Is solely for the survIving spouse's beneflt for his or her entire lifetime? Yes 0 No [] If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the dealh 01 the second spouse, a\ which time it Will be fully taxable allhe rale(s) applicable to the ,emainde, beneficiary(ics). Enter the value of Ihe trust on Schedule J, Part II, in order to remove Itlrom Ihe calculation 01 the lax due in Ihis estate. You may wish to file Schedule 0 in order 10 make the election available under Seelion 9113. If the election is made, the trust or similar arrangement is taxed in the estate 01 the first decedenl spouse, the portion of the trust or similar arrangement which benefits Ihe surviving spouse is taxed at the zero tax rate, and the ,emainder Is laxed atlhe rate(s) applicable 10 the remainder benefieiary(ies), If you choose to make the election, you must attach Schedule 0 to a limely.fiIed lax return, along wllh Sehedule(s) K and/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficlary(ies). ....""U.,"~. C()I,tIl()N\\1WlH Of PEHHSYLVANlA INHERllANU lAX RETURN I HT SCHEDULE B STOCKS & BONDS FILE HUMBER 21-96-1041 ESTATE OF LE'iDER, MILDRED B. All praparty )olnUy~ wtth rlghl01 survlYo"hlp must ba dlaclosad on Schadult F. ITEM NUMBER DESCRIPTION 1, Keypremi.er Interrrediate Term Incorre F\lnd (;551.126 shares @$10.17/share) VALUE AT DATE OF DEATH $15,526.77 TOTAL (Also enleloo line 2, Recapitulation) $15,526.77 (If more space Is needed, insort addillonal sheets of !he same size ".,...,.. ~t11 .. COMMONWlALtH O' P!NNSYlVANIA INHllnAHCI TAX lnul" IIIInlNt DKIDINT ESTATE OF LEYDER, MIIDRED B. SCHEDULE C CLOSELY HELD STOCK, PARTNERSHIP AND PROPRIETORSHIP Ploa,o P,lnt or r 0 FILE NUMBER 21-96-1041 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH -0- 1. OONE TOTAL Also onlo' on line 3, Roea ilulation) S -0- (II more spoct ;s n"d,d, ins.rl addifional shlth or saml sjzl.) ,I ....,....P.,..'. C(lIoIU(lIffltALT" Of Pt:NNSYL VANtA 'NIlERllANCt TA' RETURN RESlOCNT OCC(OCNT SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21-96-1041 ESTATE OF LE'iDER, MIIDRED B. AU property JoInllY..wnod wtth \h. right 01 lurvi'lo"hlp must be dlttlolod on Sthodula F, ITEM NUMBER DESCRIPTION 1. OONE VALUE AT DATE OF DEATH -0- TOTAL (AlSO enler on line 4, Recapitulation) S (If more Space Is needed, Insen addilional sheelS 01 the same size) -0- 1IV.lsot f.. I1U', . COMMONWfAUH 0' 'lNNlnVANIA INHUllfANC! fAX .UU.N .fllOINf OfCIOfNf ESTATE OF LEYDER MILDRED B. Jolnllononlls). A. NAME OONE B. C. Jolnlly-ownod p,oporty. SCHEDULE F JOINTLY-OWNED PROPERTY ADDRESS FILE NUMBER 21-96-1041 RELATIONSHIP TO DECEDENT ITEM LmER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBEI JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. i TOTAL (AI.o onler on line 6, Rocopltulolion) S -0- (If more space is nt.d.d ins.rt additional sh..ts of sam. size) .....,...,''''. ~IH~P[HHSYlVNM Hl[R1lo1HCt lAX RlIURH SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF LEYnEH. MIlDRED B. DoblI 01 dtctdlfll mull be fIIlOr\Id on ScIIedulol ITEM NUMBER DESCRIPTION A, FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Hare FILE NUMBER 21-%-1041 AMOUNT $ 95.00 B. ADMINISTRATIVE COSTS: PetSOI\II RepresenIllDvo'S CommlsSIOl1S Name ofPenonalRepcesentaDvo(s) Financial Trust Servicf''; rn Social Secunly Numberts) I EIN Number of Personal R_IlIbve{S) SInlOIAddlOSs One West Hiqh Street 2,500.00 t, r .' .. City ;trt '~IP State 01\ Zip '"7(' , ) 2. 3, Y..~S) CommiSSion Paid 1999 AbOmOyF~ William 5. Daniels, Esq. FamIy~: (n _rs add.... is not Ille same as dalmanrs, allad1 explanation) Clainanl 5WelAddIOSs 1,250.00 Cty RaIationShl> 01 Clalmanlll Oecedenl Slam Zip 4, ~I8F~ CUmberland county Register of Wills - Letters Testamen 65.00 5, Aa:aI118n\'. F~ 6. T..RnmPnlparer'sF~ Miscellaneous Expenses: a. CUmberland County Register of wills-2 Short Certificates b. CUmberland Law Journal-Estate Legal Advertising c. The Sentinal-Executor Notice Letters Advertising d. Closing Costs (estimated) 6.00 60.00 68.04 200.00 7. TOTAL (Also enter on fine 9, Recapitulation) $ 4,244.04 (n mom space is needed, insell addiTional sheets cllhB same size) ....,.,,,..,,". COIAI,lO/rMJ,lIHOf PENNSVlVAtlIA INHERIIANCE lA' RETURN R I p.r PIT SCHEDULE J BENEFICIARIES FILE NUMBER 21-96-1041 REI.A TIONSHIP TO DECEDENT AMOUNT OR SHARE 00 Not List Trntee(s) OF EST ATE ESTATE OF LE'fDER, MILDRED B. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I, TAXABLE DISTRIBUTIONS (Inetude oolnghl spousal dlslnbutlons) 1. Gary Leyder 2225 Dover Road Harrisburg, PA 17112 2. Ronald J. Leyder 46 East Main Street New Bloomfield, PA 17068 Nephew 20% Residue Nephew 20% Residue 3. Donald W. Leyder, Jr. P.O. Box 137 Lithia Springs, GA 30057 4. David Leyder P.O. Box 1310 Harrisburg, PA 17105 Nephew 20% Residue Nephew 20% Residue 5. Elizabeth Leyder Grace 1705 Edgar Lane Camp Hill, PA 17011 Niece Jewelry (, 20% Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II, NON.TAXABLEOISTRIBUTlONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION g113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1, B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space Is needed, insert additional sheets ollhe same size) -, " ". COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128.0001 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT '*' No.AA 324358 REV.I102 EXI"'''I ReceiveD FROM: r ACN AsseSSMeNT CONTROL NUMBeR AMOUNT FINANCIAL TRUST SVC COMPANY PD SDX 220 DNE WEST HIGH STREET CARLISLE. PA 17013 1':' 1 .:3. 2:EL ge Fa..D HERE FOlD HERE ESTATE INFORMATION: FILE NUMBER I NAME OF DECEDENT (LAST) C _ t ~ ::J (FIRST) (MI) DATE OF PAYMENT POSTMARK OA TE COUNTY TOTAL AMOUNT PAID l&3.3'J5.00 DATE OF DEATH DO seALCHECKII 7001724 ReceiveD BY '))t~A:/ (i .;>:!:., ~lARY C. ;EW1!j REGISTER or- WILLS ~, ,,1.1. 1- I / " , ,~I'I(h.v ,I: ~ Z~ 1,~7'r' If . ./ ReMARKS FI NANC I AL TAUS T SERV 1 CES CO REGIS1Ui OF ';.JILL,,, .,.... J . . --' -~ . -:.:.~~.~_._._-~.J:OM __ .," 110 .. :;((,1' (/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE L--- * BUREAU OF IHOIVIOUAL TAXES U.I:AI1ANC[ laX DIVISION DCPT. 2'8D.Ol tlARRlSIURO, PA 171n-obOl HOTICE OF IHIIERITAHCE TAX APPRAISEHEHT. ALLOWAHCE OR OISALLOWAHCE OF DEDUCTIONS AHO ASSESSHEHT OF TAX .n.n.rII ,,, I....,' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-Z1-1999 LEVDER 09-09-1998 Zl 96-1041 CUMBERLAND 101 MILDRED B DAVID GORITV SR VP TR OFF ONE W HIGH ST PO BOX ZZO CARLISLE PA 17013 AMount R..itted 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 .... il-iv:iSW-EX-AFP-COij:97riiiiiicE--Oj:-YtiHEii'ii'Atfcn'-"in.-pjiiitiisEH€iif,--.m.-OWANcniR'----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LEVDER MILDRED B FILE NO. Zl 96-1041 ACN 101 DATE 06-Z1-1999 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aoount of Line 14 at Spousal rata (151 16. ~ount of Line 14 te.able at Lineal/CIa.. A rate 1161 17. Aeount of Line 14 te.abla at Collateral/Cle.. B rata 1171 18. Principal Tax Due TAX RETURN WASI I X I ACCEPTED AS FILED RESeRVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedula AI 2. stocks and Bonds (Schedule BI 3. ClosalY Held stock/Partnership Interast (Schedule CI 4. KortgagaslNota. Receivable (Schedule D) S. tashlBank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedula F I 7. Transfers (Schedula G) 8. Total Asset. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Hisc. Expenses (Schedule H) 10. DobtslHortoeoe Liabilities/Liens (Schedula II 11. Total Deductions 12. Hat Value of Tax R.tum 13. Charitabla/Govarneantal Bequests} Non-alectad 9113 Trusts 14. Hat Velua of E.tata Subject to Te. NOTE: TAX CREDITS: PAYHENT DATE lZ-07-1998 03-Z9-1999 RECEIPT HUHBER AA3Z4358 AA354651 DISCOUNT (+1 INTEREST/PEH PAID (-I 177 .63 .00 I CHAHGED (11 (21 (31 141 151 (61 (71 .00 15.526.77 .00 .00 15.756.30 .00 .00 (81 HOTE: To in.u~ proper credit to your acCOU"It.. subtlit the up""r portion of this fo", with your ta)( p.)'IIent. 31. Z83. 07 (91 (101 4,Z44.04 1.4Z1.50 (111 (121 (131 (141 ~.66~ ~4 Z5 ,617 .53 .00 25.617.53 (Schedule J) .00 X .00: .00 x' 06. Z5.617 .53 X .15: (1BI .00 ,00 3,84Z.63 3.842.63 AHDUNT PAID 3.375.00 Z90.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 3.842.63 .00 .00 .00 . IF PAID AFTER DATE IHDICATED. SEE REVERSE FDR CALCULATION OF ADDITIOHAL IHTEREST. I IF TOTAL DUE IS LESS THAH $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I RESERYATIDNr E.t.... of dectldlnt. dying an or befor. o.c-ber 12, 1912 -. if WlY future Int.r.at In the lltat. Ia trWld.rr..t In po.....lon or enJo~t to Cl... I (coll.t.r.l) beneflcl.rl.. of the decedent .ft.r the explr.tlon of any ..t.t. far Ilf. or for year., the C~lth her~y expr...ly r...rv.. the right to appr.l.. and ...... tran.f.r Inherltanc. T.... .t the l..tul Cl... I (coll.t.raU rat. on WlY such futura Int.rllt. PI.6lPOSE Of N'JTICE: To fulfill the rttqUlr.....ta of Section 2140 of the Inherlt8nC8 and E.tat. Tax Act, Act 21 of 1995. (7Z P.S. Section 9140). PA'nIEJIT1 DetKh the top portion of thla Notice and IUbaIt .,Ith your paYMf1t to the RlGht.r of Willi prlnt..t on the r.v.r.. side. -.Kak. dwc:k or .oney order p.pbl. to: REGISTER OF MILLS, AGENT REF1ICD (CAh A r.fund of II tax credit, Wllch .... not r~.ted on the TlIlC R.tum, AY be r~.ted by COIIPlatlng ~ "application for R.fund of Penn.ylvanl. Inherltanc. and E.t.t. T.lC" (REV.l!I!). applicatIon. .r. .vallabl. .t the Offlea of the Reglat.r of WIU., any of the Z3 R.v..... Dlatrlct Offlca., or by clllllng the specl.l 24.hour answerIng ..rvlca nuabar. far fora. ordering: In p~.ylvanl. 1.100.36Z.2050, out. Ide Penn'Ylvanla and .dthln local Harrhburg ar.. (717) 717.a094, TODI (717) nz.zzsz (....rlng lap.lred Only). OIJECTIONS: Any party In Int.rllt not ..tidIed .,Ith the appr.I....,t, .11~. or dla.ll0W8nC8 of deduction., or .....~t of till( <Including dllCCUlt or In"rllt) .. shown on thla Notice .....t obJact within sixty (60) day. of re<:8lpt of thh Notice by: -...rlttan prota.t to the PI. Depar....t of Ravenue, aoard of ApptI.lI, Dept. Z8lGZl, Harrisburg, PI. 17121.10Zl, OR -.alactlon to have the Att.r detaralned .t eudlt of the IICcooot of the J*taonal r~r'Hnt.t1V11, OR -.appul to the O~" Court. AIlIIIN ISTRATIVE CORRECTIONS: Factual Irrota discovered on thla .........,t should be addr...ed In writing to: PI. Iktparu..nt of R.v....., Bureau of Individual lUll, '11H: Po.t .......ent R.vl... Unit, Dept. 280601, Harrhbura, PI. 17121"0601 Phone (717) 717.6505. s.a pag. S of the bookl.t "In.tructlon. for Inherltanc. lalC R.tum for a R..ldent Decedent" (REY.1501) for an .xplanatlon of ~lnl.tr.tlv.lY correctable .rror.. DlSCCUIT: If any tu ck.- .. paid within thr.. (!) calendar .onth. attar the decadent'. de.th, II flVtl J*rcent (5%) discount of the tax p.ld I. .llowed. The 15% talC .....ty non.p.rtlclp.tlon penalty h caputad on the total of the tax and Int.raat ......ed, and not p.ld before January II, 1996, the flrat day .ft.r the end of the talC .....ty period. Thla non"partlc1p.tlon penaltY h appe.lable In the ... .......r and In the the .... tI.. perIod a. you would appe.l the t.lC and intar..t that has been ......ad .. Indicatact on this notlcI. PENALTY: tllTtREST. Int.rllt I. chargad beglmlna with first day of dllInquflnCy, or nine (9) aonth. and one (I) day frOll the date of de.th, to the date of PllYI*1t. TalC" which bee... dellnquM\t bafor. .Janu.ry 1, 198Z be.r Int.r.st .t the ute of allC (6%) ~rcent J*r annua calcul.ted at . dally rate of .000164. AU t.lC.. which bacaH delinquent on and .ft.r January 1, 198Z ,dll blar Int.rllt at II rat. which .,111 very frOll c.lendar ynr to calendar year with that ret. ~ed by the PA o-partaent of R.v.... The appllcebl. Int.r..t rat.. for 1982 through 1999 .r.: '!!!!: Int.r..t R.t. Oally Int.r..t Factor ~ Interest Rate O.lly lnt.r..t Factor 19ax xax .000Sltl 19M.I991 IIX .oonn 1983 162 .00008 I99X 9X .000247 19M IIX .GOnOl 199!-1994 n .00019Z 1915 13% .000!56 1995.1991 9X .000Z41 1986 lOX .000274 1999 n .000192 1987 9X .000247 ..)nt.r..t I. calculated e. follow'l llITEREST = BALANCE OF TAX UNPAID X IlUIIBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Any Notlca Issued .ft.r the tax bee~. delinquent will reflect an Intarllt calcul.tlon to flfteen US) days beyond the date of the ........,t. If paYHnt Is eada aft.r the Int.rllt CQIIPUt.tlon date shown on the Notice, additional Intara.t au.t be calculated. , .1 , " ..... AUTHORITY TO PAY COURT APPOINTED COUNSEL MAY 2 1 199t/~,-"""'itl 1 counT 2 VOUCHER o Qlstrlct JusllCO oC Common Pleas o Appoll.lo o Othor -,-.-----..--- ..- -... ....- NO 2427 3 FOR 10 J. C P, APPELLATEI 4. AT ICITY/STATE) 5 /JUDGET COOE 1- -~:iJ~, ., ull- flt"y) 6 III H.E CA5E OF 7. CH"RGElOFFEf45E !PURDON CITATlO~11 B o PETTY OFFEN5E y, o FELONY 0 MISDEMEANOR 9 PROCEEOIHGS (Oescflbe bflell'tl t1 PER50~4 REPRESENTED 12, glVIL OOCKET NO A\\c.~",~ 7c....~...... 1 " 0.'.1'11'11'" ....dull wq"'..",a c::.A T...c.~ po.c.\.\"'\~~ , il OI!'f!"d~"1 .JII.III'1,III ';;t\- C\Co-\O"l\ ?c:.~.\-.t..... .\,,, "'X....... '" J.... C:.,\-~ I " AtHl"t111'l1 13, CRIMINAL DOCKET NO . , "(lll..'I.... , ",ItI.." Pel".o",,' . " ~.'llr,..IW,I".U -- r " Pa'r,I.... Ch"Q.11 W,lh ...'01..'-011 10 PlnSOf4 n~PRESENTEO (Full Namel . :.. P'obcl,O""' Ch.,g.,,, "",Ih V,ol..toon 14 APPEALS OOCKET NO l) 1J<.0,"", {l'\\\chc..O ~. L <:'""'j d-a...... "PP'O,tll!~ 16 NAME OF "naRNEY/PAYEE AND MAILlN~ADORESS """Pe c:...... "";J". R......s.!o~ '=>\ We::..... L.o.... ~"'c.... ~l.r1'c.c..~ ~. We1>\c."1 (')\.. r -::r yo , Cc:.....\I:lo\C.. ?~ nc\:, NAMe OF COMMON PLeAS JUDGe ASSIGNeD TO CAse " TEL~HONE No, 18. SOCIAlSECURl1TNQ OR ElfHlO (,n ~"Iq-';;l,~\ c:l"lS- 'Io-~?;~ CLAIM FOR SERVICES OR EXPENSES 19. SERVICE HQUPS DATES AMOUNTS CLAIMEO a "'''I,gnm.nllnd/or PIli MultlplV t.te pel haUl lime. t01l1 b Pr.hm,nlry H..rlng houri 10 obl.in "In Cou"'" com. penuhon. Enler 10111 below c. Mollonl and ReQulSls ... d. alii Huting' 0: ::> " Senlence Hurlngs 0 U I. T'III :!: o Re~ocalion Hearing. h. Juverlll. Helling. I "DDUls Court 19A. TOTAL IN COURTCOMP, I 01"" ISClClfy on add,tlon.ls""lsl TOTAL HOURS - X $SO PER HOUR -Sa 20, iI. Inle~le>Ns and conl".nclU n\. Mulhply rll. per hour 11m,. t0111 b Oblalnlng and "........."g 'eco'd' ~c..~ hou". Enl., lolal "Oul 01 Court- ...... compenuUon below. 00: C- loegal re,e.,ch and brlel wrlhng ., , ...::> ::>0 ::i. In...esnQatl'o1t and Ol!"er wD,Ir.ISpeory on addlDOnal sheelS) 20A. TOTAL OUT OF COURT au COMP, \.0. II ..S -S ~~.';;}S TOTAL HOURS- X $<<l PER HOUR 2' ITeMIZATION OF REIMBURSABLe eXPENses AMT PER ITEM MlloaQo $25 Mr mila . 0: w :l: 2 I A. TOTALITEMIZEO EXP. ... 0 -s 0 22, CERrtFICATION OF ATTORNEY/PAYEE 23, GRAND TOTAL CLAIMED Has COmptlnSilllOn and/or reimbursement lor wortc. In Ihls ca.. pl....lou.ty been applied 'ot? ~YES o NO -s gl;,.';;lS II yes, were you PiJld? 'riYES o NO Ifyes.bywhomweleyoupald7 Ca"",,"-1 Howmuch7,,-,!;:.g-O 24. DEDUCT. PRIOR PYMTS, Has lhe person rep,usenlfld paid any money to you, 01 to youI knowledQe anyone else. '" connection wilh the m.ne, 101 whlC" you wer" aPDOlMled la provIde repres~~ ~~t!S NO II yes, Qlve detllls on Iddl!1onalsheel' -s I swear or allum the truth or canectn.,. . ~":slq, 25 NET AMOUNT CLAIMED 01 the abOY8 ,talemonts SiQnalure 01 Altom.y/P.y", Olle .S !S1o.'dS 26."'rlllh':'I "" . J f ! / ' 1/ 27, AMT. APPROVED J I ,.. SoI)natule 01 ,/ - / ~11, ) 2~ ,119, ".....1'.. JuOQlt v~ V--, __/;/ . .011. -s XG. 2.~ " COpy' . Mail to Court Admlnlstralor al completion of service "'-r." . 0'1 -( 'j.' G '-" N c._ CC N ~ :;: ~- . 1~ "0: P .25 (I:: Uv .....' . , CASE NAME: I:IOURL Y RATE: DATE: Mildred B, Leyder $45.00 Thursda~, May 15, 1997 DATE ACTION BILLABLE TIME AMOUNT TIME CHARGED DUE 4/2 Telephone Call From David C. Gority of 10 min 10 min $7.50 Financial Trust Company 4/2 Telephone Call From Anthony DeLuca, Esq. 5 min o min $0.00 4/4 Meeting with Anthony DeLuca, Esq. 20 min o min $0.00 4/10 Phone Call From Donald Leyder 10 min o min $0.00 4/14 Phone Call From Donald Leyder 10 min o min $0.00 4/17 Review of Petition to Invade Principal 30 min 30 min $22.50 4/22 Draft Answer to Petition to Invade Principal 45 min 45 min $33.75 4/26 Filing of Answer to Petition to Invade Principal 20 min 20 min $15.00 4/26 Draft Letters to Opposing Counsel and Area 10 min 10 min $7.50 Agency on Aging TOTAL.. . .. ...... ......,. , .. . .. . .. 160 min 115 min $86.25 AUTHORITY TO PAY COURT APPOINTED COUNSEL MAY 2 1 1997c?!A....""\tI 1.CQUnT 2 VOUCHER o Olslncl Justice 0( Common Pic.. a Appoll.lo a Olhc' ----- -., NO 2427 3 FOR 10 J, C P, APPELLATEI 4, AT ICIIY/STATEI 50UO~~r.;zOE I - ..1.'/1- " t;,r) 6 IN T"E CASE OF 7. CHAnGE/OFfENSE tPUROON CITATIOf41 8 0 PETTY OFFENSE vs o FElONY 0 MISOEMUNOR 9 PROCEEDINGS (Oo$ctlbe bflellyl 1\, PERSON REPRESENTED 12. CIVIL OOCKET NO A\\,,-~c:.1. 7c.~':-'Q""" , a o.r.""."t....du1t C:hq'nQ."~ CA :t"...c:.~pc..<:.\.\c.\,,~ , " Of'I~"d...,'.Ju..!\lle ';;l\-,\(,,-\O\.\\ ?c.\-.\-\t..., l,,, "':!:"..,..."'c/..... C:.~~_ J " Al)l)l'lIll\' 13 CRIMINAL OOCKET NO . " "po"lI~. , " H.lb".,Pehho"fl' . lJ .....'.,...IW,ln." , n P,,'ohtl C""'of''' W.th "'o'oI',on to PEPSON REPRESENTED (Full Namel 8 U p,on.hO"'" C""'Qed W,th "",oll"on '4 APPEALS OOCKET NO 9 ~OI"I" r(',,\~'('c:.P ~. Lc.'i~ ,.po,o..r.~ 16 NAME OF AnORNEY/PAYEE ANO MAILIN~AOORESS -Pe c:..... -:::r. k?......s~~ (Q\ Wc.~"r 1...0.. ",.""c.... 5 \-yc."-\ -::r. We:!>\c."j C"\\~ r ::r.... CO....\I:!.\t. ?~ no\~ NAMe OF COMMON PLeAS JUDGe ASSIGNeD TO CAse . 17 TEl~ONE No. '8. SOCIAL SECURity NO OR EIU fiQ <,n ;;I,\q-';;n~ \ <::).5- ,,(,,-?RS~ CLAIM FOR SERVICES OR EXPENSES 19, SERVICE HOUPS OATES AMOUNTS CLAIMEO a Arr'Ignment andlor PI.. MultIply file per hour limes 10111 b Prehmlnary H..rlng tlau" to obl.in "In Court" com. pensalion. Enter 10111 below c. MotIons Ind AeQuul. .. d. BI.I Hu,inOI 0: ::> " S.ntenee Hu,tngs 0 U I. Tr.al ;!; 0- Re"ocallOn H..,inQS h Juvenile Heltlngs I. AOpo,I, Court 194. TOTAL IN COURT COMPo i Ottler ISD'C"Y on addlllona' sheelsl TOTAL HOURS. X $SO PER HOOR -$ a 20. a. Interviews and conl,r.ne.. "- Mu1llply rll. per hou' times 101al b Obll."u'IQ and "'fl.....'no lecords "=>",c,, hours_ Enter 10111 .Cul ot Court- ..... compensation below. 00: e leoal ruearCh and brlel .....rl!lng ~ ..::> ::>0 :llnveStlga\lV9 and 01~e' worlt (Speol'y on adcMonal sheets) 204. TOTAL OUT OF COURT OU COMP, \.C\r1 ~S -$ ~lo . d'5 TOTAL HOURS. X lAC PER HOOR 21 ITEMIZATION OF RelMeURSABLE EXPENSeS AMI PER ITeM ~~'llIci1no S2S-oor mllo . 0: w :l: 2'11. TOTALITEMIZEO EXP, .. 0 -$ 0 22. CERTlFICATlOU OF ATTORNEY/PAYEE 23 GRANO TOTAL CLAIMEO Has compunS3!lon and/or ullmbu"emenllor work in Ihls cale prlllvlou.1y been IPpllea lor? ~YES o NO -$ Sb.'d5 II yes. WOff! you POl1d") 'r:J YES o NO lfyes.bvWhomWereyoupald7CQ\lT\lr-f How much? ,"" <g. 4BO 24 OEOUCT, PRIOR PYMTS, Has the pe"on ,ep'osenlrd plld any money to you, 0' 10 YOOl knO"fll'ledQe anyone else,ln connecllon wIlh the maner lor which you we'll! ,lPPolnted 10 p'o'4'lde fep'es~~ ~~t!S NO II yes. Qlve d81111s on additional sheets -$ I swear or 3t1l1m lh~ Irulh 0' eOfTectness .. :nro q, - 25 NET AMOUNT CLAIMEO 01 Ine aDowQ slalomllnts SiQnllu'. or AIt,oU\eV/P.YU Ollft -$ ~1o.'dS 26." J'''I..1 :'\ ~. ) L~ ~U/ 27 AMT, APPROVEO Ii'" S~n3lult!l 01 v11, ) g ,l"(9) -$I<b.Zs-" ,'.....,... JudQe .011. 1 COpy 1 . Mall to Court Administrator 01 complellon 01 SeNICe CASE NAME: HOURLY RATE: DATE: Mildred B, Leyder $45,00 Thursdav, Mav 15, 1997 DATE ACTION BILLABLE TIME AMOUNT TIME CHARGED DUE 4/2 Telephone Call From David C. Gority of 10 min 10 min $7.50 Financial Trust Company 4/2 Telephone Call From Anthony DeLuca, Esq. 5 min o min $0.00 4/4 Meeting with Anthony DeLuca, Esq. 20 min Omin $0.00 4/10 Phone Call From Donald Leyder 10 min Omin $0.00 4/14 Phone Call From Donald Leyder 10 min o min $0.00 4/17 Review of Petition to Invade Principal 30 min 30 min $22,50 4/22 Draft Answer to Petition to Invade Principal 45 min 45 min $33.75 4/26 Filing of Answer to Petition to Invade Principal 20 min 20 min $15.00 4/26 Draft Letters to Opposing Counsel and Area 10 min 10 min $7.50 Agency on Aging TOTAL . . . . . . . . . . . . . . . . . , . . . . . . . . . , 160 min 115 min $86.25 $ ,,.---.- AUTHORITY TO PAY COURT APPOINTED COUNSEL FEB ' , i98'h,t1'" J ~ , COUIlT 2 VOUCH Eli' o Dlslnct Jusllce ..,t. Common PICi15 fJ Appollaln o OIM' -...- .. ---- ..-. - ----..--- N~ 2426 .- J FOR 10 J. C P. APPELlATC) .. AT ICilY/SUlCI ~ nUDGCT CODE I'll ~,~C)", _1.,111 -1J'~i' 6 IN Hie CASE or ' CHAflGEJOITC"S[ (pullom, elf A lIOf,! B 0 PETTY OFFENSE " o FELONY 0 MISDEMEANOR 'J pnOC(EOING510"~Cflbe bflell'tl 11, PCR50U nEPn[S[U1[O 112, CIVIL DOCKET 30 , tJ 0."""'1'1" ...all!! Qfp/lCLt)'S CL. I\\\t.~c.d. "'J:nc.c.{>C\c. \~ C\\c.~ I II Of'.I\",I'II Ju,./'l,r" -a \- 0. '" - \ 0 4 \ '?e.r~l)n , II "DP,I1I/l' 13 CRIMINAL DOCKEI NO . II &(111,,'1.. , 'J Il.b<t., P'''',o''''' . tl ...'lrl,..IW....'"'' , II P.'oh,. CI\"Of',1 W.." ",(JI.t.O., 14, APPEALS OOCKEI NO 10 rE.fl~ON n(PI1(SOHEO (Full U,amcl " U '-'Oh,',I)"" Ch"U.,J '11,'1'1 V'OIJlhO" 'l '" 0'"'' 1'\\\~4 ~. k'16<:.r Apll,O,IP ,:::Ii \, l. \qL 16 "AME OF AnCRNEY/PAYEE AND MAILING ADDRESS Q",::.~O ?e:\<:.r' -:s-: -:r: L.)c.~\~i O\.....-:r.... ~\ W<:.~-\ L.O...~hC... ~\...c:.c:,:\ NAME OF COMMON PLeAS JUDGe ASSIGNeD TO CASE Car\\~k, ?R no \:. 11 TELE,;HONE No 18 !>>OCIAI.SECURITYNO OA(ltWO "n -a~ 0,- ~'(n 01S-"c..,.- -i,qU CLAIM FOR SERVICES OR EXPENSES 19, SERVICE HOUPS DATES AMOUNTS CLAIMED . An'lgnm.nl Ind/o' PI.. Mul1lPty tile PIt haUl 11m.. 10111 b Prehmlnary H..,ino hour. 10 obtain -In Cour1'" com. pentlllon. Enter 10tll btlcw e:. Molions and Request. ... d. 8111 HUMg. 0: :> " SenlenC' HII,lnO' 0 0 I. TfI.1 " o R.vocallon Hurif\QI h Juvenll. Hutlng. l ADpe.I, tau" 19" TOTAL IN COURTCOMP. I Othe, (SDIClly on .deMlen.1 .flettsl .", 15 ~I~lq, TOTAL HOURS- X~kRHOUR -$ \1o"6."'S 3.1S 20. t. lnle",...n and conl.flne.. See. MulllPty tat. PI' hour 11m.. 10lal b Obla.nlng and flvlew"'g II'COfd. A~.,\'<'" houri. Enter lolal .Out of Court- ...... compensation tMlow. 00: c. leQ.1 ,.,II'C" .nd brlel wrlllng ...:> :>0 d. Inve.llO.ll.... And Olhflf work (Specify on addtllOrW sheets) 20" TOTAL OUT OF COURT 00 COMP, ~.. -$ S 80. oS TOTAL HOURS- \':1. ~'\ X l'O'PER HOUR 2' ITeMIZATION OF REIMBURSABLe expeNSES AMT. PER ITEM Mlo300 S 25 nnl milo . 0: w :t 21" TOTAL ITEMIZED EXP. ... 0 -$ 22 CERTIFICATiON or "nCANEY/PAYEE 23, GRAND TOTAL CLAIMED Has compenullOn and/or ,eimburllmenl 'Of work In Ihls ca.. pr.vlOUlty been applied lot? o YES l!(NO -$ .., 4 'g. gO II yes, WQ'~ yOu paid? o YES o NO lI'tes.by.....homwereyouplld7 How much? 24, DEDUCT, PRIOR PYMTS. Has lho pefson 'eofosentt!d plld any money 10 you. or to yOUl knowledQe anyone el!ft. In connecllon with Iho maner lor -$ 0 whiCh you well! olPPolnted 10 p,ovlde feprese~.J.c. 0 ('l~ NO II yes. Ol~e dill Ills on additional sheels I SWe,)' 01 alll,m the tlulh Of coneCtnlSs ... - ~ J IS I Q1 2~ NET AMOUNT C~MED O'II'II! .lbovO slalQmn"Is Signature of "nomey/Pay..- Oala -$ -1'..\ 'ii. 0 ;.; 26 ~""'0l1..1 :~\ . "". , })~fl. m. ft'L 21. AMT, APPROVED ,.... S.q"AIUI.ol ,"',Im -$ "c.l-5(.~O 1'&9001' ~I JuOl,Je .011. Copy 1 . MailVto Court A~minist,J.Dr al completion of service' .J .. /); /1 () .!J IX . , . T PPO TED COUNSEL $ . AUTHORITY TO PAY COUR A IN ;".-> I coum -,( Common Plca~ 2 VOUCHER o Dlslrlcl Justice 0 Appollalu o Olhor ----.. _.._---,----_..__._~.._~-- N~ 2426 3 FOA to J. C p, APPELL"TEI 4 AT ICIlY/STATEI 5 eUDGET CODE I I . .,., - /,111- (,', 6 I" UtE CASE OF I. CHAnGEJOFFE~jSE tPURDON CITATlONI B a PETTY OFFENSE " o FELONV 0 MISDEMEANOR 'J PROCEEDINGS IOtJ5Cf1be btUllly) " PERSm4 REPRESENTED '2 CIVIL OOCKET jO t ~J OII_MI"t.Adull C't'pnlUl'.s U_- 1:\\\~':::Jc.d. -:r:nc:c.~ac. ,-\ a\cc\ , " O~'f!"d~1\1 Ju..".llI -a \- '\10 - \ 0 '-\ \ \=lcr~l)"'" ] " App"lI,,,'ll . " "011,,'10'... 13 CRIMINAL DOCKET NO , "~b"n PI!h110"''' I) :J I,.Ijll!/'''' 1'1,1"", -' 1,; p..!(,I..., C"'.Irq!!" WoIl'l V'OI.l"on 10 p(n~;o~' RI.::PReSENTeO (FUll Name) 8 ~, P'otJ.."Of"'" C".'IlIl<1 W,lll I/,olll.on 14 APPEALS DOCKET NO 9 "f<. 0'''01'' f('I\\<hC4 ~. k"1o~r '''' 0,," )';l \ II. \qL 16 NAME OF AnCRNEY/PAYEE AND '-10"0 ADDRESS R",::.~o \ e. ~ c.r -:s-: :r. L.)c.~\~";I O\"..,-::r.... Co\ We..~~ LO"'~"'c.r ~\...c..c::,:\ NAMe OF COMMON PLeAS JUDGe ASSIGNeD TO CAse Ca'r\\~\~, ?A \I 0 I:' 11 TELEPHONE No 18 SOCIAlSECURt1..,t.lOOREltl~.O (, \,\ 'd\.\ a.. a"cl\ ~n'5- c,c.- 3cnl'is CLAIM FOR SERVICES OR EXPENSES 19, SERVICE HOUPS D4TES AMOUNTS CLAIMED a ArralQnmenl Indlor PIli Multiply 'III pet hour limes 10111 D Prellmlnlry H"rlng houfI to oblaln -In Coun- com. penullon, Enler 10'11 below e. Motton. and Requlltt ... IS a,,\ HlltIi'O' 0: :> It Sentence Hu,'ng. 0 U I.TI'al 0; o Revocahon Heating. h. JuvenIle He",ngs I APOIII, COur1 19A. TOTAL IN COURT COMPo I Ol"e' ISPIIClty on Iddlhonal shutsl 3, "75 ~Iblq, TOTAL HOURS. 3.'S XJ,~ERHOUR - $ \ Ie 'iI.'" S 20, a InleNlfI\OI' Ind conl".nces See. Mulllpty 'II. per houl lime. 101.1 b OblllnlnQ ."IS IIvU,,,,,'''O 'KO'd. A ";;;\:<.l. houlS. Enler lotal "01.11 01 Court'" u..... ccmDt"Ulion bllow. 00: c. LeQal re,urch and b'le' .rlllng ...:> :>0 d IMYe!otlqilllve and Ol~e' wOfk.ISpecily on addloonal sheelS' 20A. TOTAL OUT OF COURT au CaMP. ~. -$ S 80. OS TOTAL HOURS. \J.ll"\, X S<e'PERHOUR 21 ITeMIZATION OF RelMBURSAeLE eXPENSES AMI PER ITEM Milo:lco S 25 DM milo . 0: w :l: 2\ A. TOTAL ITEMIZED EXP, ... 0 -$ 22, CERTIFICATION OF ATTORNEV/PAVEE 23, ORAND TOTAL CLAIMED Has compunsahon and/or ,eimburaemenllor work In this cal' prevloulty been IPplled lor? DYES I1(NO -$ -, 411. ~o II yes. WfJre you paId? o YES a NO Uyes. bywhom were you paid? How much? 24, DEDUCT, PRIOR PYMTS. Has the porson ,ep'esenled paid any money to you, or to your knowled<3e anyone else, in connecllon wilh the maner lor whICh you wer" appOInted 10 prOVIde 'epreset.....~~~~)S. NO \I yes. give delllls on Iddllional sheels -$ 0 I swur or altum the trulh 0' conectnlSI ::::II .... ~ J IS I q, 25 NET AMDUNT CeMED 01 the .1bo\fo slalemflnls Signalure 01 Altorn!!',P.wu Olle -$ .'-\~. 0 26~,'r"(,,I :'1 SoQ""lu,e of ~. t ~U]7 rI/. ft'L 21, AMT, APPROVED f,," I~ l'>'n - $ I"J <4S': S Co ".''''''f' JudQ" .0.1. Copy 1 . Mail~to Court A~minlSlfllor at completion of service ,//) .' j ./J //t e/(_ ~ -c:?'i tj 1 . , '. " - o :~~ - C:-! r- <:( "1~ - 0- " , - N CO uJ I:. 11 t.' U ,;, ",Q" a:- E U) ::J Gu ~ , ~ ..J <l: f- o f- OJ E F~ "0 0 ~J: ~ c: 11l- .c: <.) OJ Cl ~ I1l .c: <.) ~ z :3 iD f- Z w ::i o ~ OJ "0 >- OJ ..J "0 OJ ~ :g ~ o o o t-- ~ o III N o M M o t-- t-- o III o t-- .0 N o r~ ~ t-- t-- III ~ N ci 0 t-- ~ o r~ ~ o Cl ~ o III ~ t- O 0 III "! 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Ql Ql Ql Ql Ql Ql en Ql Ql Ql a) Ql ~ Ql c: Ql Ql b ~ iii iii iii iii iii Ql Ql Ql iii Qi Ql '" Ql I1l Ql iii l- I- I- I- I- a: ~ ~ l- I- ~ u. a: ~ ~ ~ l- I- -- -" - - - - - - - - I- - - - - ,.. ,.. ,.. I' 1- ,.. ,.. I' ,.. I' ,.. ,.. ,.. Q1 l1? m OJ l1? l1? m m 9> 9> Q1 m m ,.. ,.. ,.. ,.. ,.. iD iD - Ol "- -. m OJ m m m "" '" ... ... ,.. ... ... ... ... ... in t]i l?i ~ t: !:" !::. !::. ... ~ ~ ~ ~ ~ ~ r:? ~ ~ -. -. N ... ... "'1 ..., ... , ... ... ... ... ... ... ... ... N N N N =,.d=' I l= . J . .J' '. $ r .or-- AUTHORITY TO PAY COURT APPOINTED COUNseL FEB J .;; i0~ A, n" I coum -,( Common Plc.u 2 VOUCHER o District JUStlCD 0 Appnllato a OIM' - N~ 2426 3 FOR 10 J, C p, APPELLATE) .t. AT ICIIY/STATCI 5 nUOGET COPE 1,)\ -,:J >1., _1..111 -D'i,. 6 IN UH: CASE OF I CHAllG(Jorr[,,5E !PUROQ', CllATIONI a a pmv OFFENSE " a FELONY II MISOEMEANOR - T:i2, CIVIL OOCKET NO lJ pnOCEEOlt4GS IDucflbe bltellyl II PCRSON REPRESENTED I " 0.1,,,",,,, .....,\11' CXr/l<Ul'.s CL) I\\\e.~e.d. "":I:nc:::.aflc.C. ,;. c..\c~ , 11 0.1,""<111' ,Ju.,..,lt -a \- C\ 10 - \ 0 1..\ \ '?c.r~lll"l I 11 ...PO.II....' 13 ClUMINAL DOCKET NO . " AOOIlI1... , " tUb..,P""IQ"'" . U ....'....IW.'nn' 1 11 P.I.ol... C",..rQr" W.,,, V'QI,I.on 10 PEnSON nEPRESENTEO (Full t,.mel ft lJ P'OIl.loO"" O'.'Q.d W,ll'! V.al.',Ol' 14 APPEALS OOCKET NO OJ}< 01"" f(\,\a,.cA ~. k'1o~(" "" 0... ):::l \ II. \qL 16 NAME OF AnOnNEY/P.AVEE AND M~NG ADDRESS Q", :':'0 \ e.~~r -:r-: ~ LJc~\C'J O\r",~"'" ~\ W~:,-\ Lo....~'nc... ~>,. rc.c:.:\ NAMe OF COMMON PLEAS JUOOe ASSIONeO TO CASE CaT\\~\~, ?A \/0 I:' 11 TELEPHONE f40 18 'iOC.,I,l';[('.UAlt,hOQAllh'IO h n\ 'd~q- ~'-al <''''5- G,(.- ?,ql\'is CLAIM FOR SERVICES OR EXPENSES 19, SERVICE HOuRS OATES AMOUNT5 CLAIMEO .. Arr"o"manl Indlot PIli Multiply rate per hour 11m.. 10111 b Pr.t,mlnery H..rlng hou't 10 oblaln "In Court. com penutlon Enter 101.1 below c. Molions .nd Requltl. ... IS. al,1 Hllrinol a: ::> III S.nlence Hearing. 0 U l. T"I' " o Ravocalio" He.tlng, h. Juvenile HllIlno' l ApPell. Court 19" TOTAL IN COURT COMPo ~ Olhe' (Specify on add.Uon.1 "\lels, "" "75 ;,1~lq, TOTAL HOUAS- X~kRHOOR -s \1o~."S 3.'S 20, a. Inte~'ewl .nd conferene.. Sc: C. Mulhpry ral. PI' hoUf 'Iml.lol.1 b Obl"nino and 'r.1",,"Q IICOtd. AII..\o.c.l. haulS. Enll' 10111 .01.11 of Court" ...... compenllUon balow. 00: Co leoll reu.tch .nd brief wtlllng ...::> ::>0 d. InvesliglDvt and OlMf work (Speofy on .ddtDO~ sheets) 20"- TOTAL OUT OF COURT OU COMPo ~'i -s S 80. OS TOTAL HOUnS . 1-:1. 'is'\ X l4O'PER HOOR 21 ITEMIZATION OF REIMeURSABLE EXPENSES AMI PER ITEM Mloa-ne $.25 per mae . a: w l: 21" TOTAL ITEMIZED expo ... 0 -s 22 CERTIFICATION OF AnORNEV/PAYEE 23, GRAND TOTAL CLAIMED Has componsahon andlor flimbut'I.menllOf worit In this cue p'ovloul~ been ,pplled fat? a YES ~NO - S -, 4~. gO II yes. were youDald' a YES C NO Uyes. by .hom wo,o you paid? Howmuch? 24, DEDUCT, PRIOR PYMTS, Has tho person fepresented paid Iny money to you. 01 to your knowledge enyoM el,e, In connection with the manar lor whICh you wore apPOinted 10 provide rep'e'e~~~~Ji.. NO II yes. Qlve details on addItional sheets -s C I ,wur or allum the Ituth or conectness - ,.,. ~ I IS I cr1 25 NET AMOUNTC~MED ollne abovq statemonts SiQnalur. 01 A"ornty/Pey... O.t. -'1'-\.'1;.0 26 ."'I'''I,~1 :" "". , :Uil. r#. i Ft"L 14 1')'1? 27. AMT. APPROVED Ill" SoQnalu'.o4 -s '1~5i: So "",,,",1...1 J"OQe .011.. Copy 1 . MallVIO Court AVmlnisl,Jor al eompleUon of service' " , , .. /It " (/ .:'J IX o STATUS REPORT UNDER RULE 6.12 Name of Decedent: --5Yl \ \ d.ltiLJ.:j kt',jrll" V- Date of Death: qjgl9~ will No. ,~ I ~ C(l ~. n i 0 '-I I Admin. No. Oln'-ll pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, 1 report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ,,/ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes ~ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: AUG 2, 3 2000 Si, , K0y~tonc Finuncial Dank-Trust Dept. Name (Please type or print) 1 \~ lIioh Street Carlisle. P^ 17013 Address ( 717 ) 240-4505 Te 1, No, Capacity: x Personal Representative Counsel for personal representative (MAH:rmf/AM3)