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HomeMy WebLinkAbout81-00251 i:i ~ ~. . I ~ I .[; . ~ . . t.l I:rl I '\"'! {'S t.l tr.. ~ e ~ N {'S ,- '0 co . ,- tl) C\I ~ IV ~ . ..:J 0 z No. 21-81 251 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY In the Estate of GEORGE R. MUMPER , deceased. To Register of Wills for the County of Cumberland, In the Commonwealth of Pennsylvania. Petitioner(s) Is (are) the execut r ix named In the Last Will and Testament of Geor.re;i MllmpE'r dated __.lull' ?? 1 q77 Dece ent was a citizen of the United States and a resident of NE'I" r.llmhr.>,.l.qnr1 Township (Borough), Cumberland County, Commonwealth of Pennsylvania. Decedent died on Jr.>r1nE'Qrl.q y the --1-0t.h- day of Dr.>N'mheL- A.D. 19...8iL-, In the County of BrQw~rd ' State of ----ElD,.i r1.q at the age of ...6.9...- years. Decedent has (has not) been married and has (has not) had children born to him (her) since the ex- ecution of the above described Will. Decedent was possessed of personai property to the value of f 'I, ~CO. 00 and of real estate to the value of ~O-.-OO as near as can be ascertained; said real estate situated as follows 606 Linwood Street, New Cumberland, PA Therefore, your petltloner(s) respectfully apply(les) for the probate of the said Last Will and Testa- ment and for Letters Testamentary theron.~' 't '7))/7 . Dated APrw.?tJ ,19g/ _ ftt';/AlIJe- (Sl ~.z:J.:l,~;. , Name and address of Petitioner(s) Patricia A. Mumper 606 Linwood Street I, L New Cumberland. PA /7" 7 n COMMONWEALTH OF PENNSYLVANIA t COUNTY OF CUMBERLAND l ss 'J2A-"J:B.LeIILAL~!1J~,.I111 E fS.. named in above application. being duly _-8.ffirm~__ according to law say(s) that the statements set forth in this petition are true to the best of hi s knowledge and belief. A~fir:tll!!.~ and subscribed before ___ me. 11f't? It.. ?O)I'I'l{____iJfix___ 1J2 /,) .;j~, .) .: .,/'-'t C>t/r~~~~~~-n ....-~'l1t~-~72 (/0 Filed: April 22, 1981 :/ n___n_~..5=/~ RoBE~T-E R~W~-ESq. ~ Attorney ,I 48Q.3^; I '6/5 C-u.t>tBGR1.14A1e, sr. 15-~ 1.E811111~ IJ I PII. 17tJY.2.. ~ j REV. lS47EX (l-a2) BUREAU OF EXAMINATION PENNSYLVANIA DEPARTMENT OF REVENUE P.O. BOX 832 7 HARRIS8URG. PA 17105 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR 01SALLOWANCE OF OEOUCTI0NS. ANO ASSESSMENT OF TAX ASSESSMENT CONTROL NO. 101 DATE ESTATE OF MUMPER GEORGE R FILE NO. 21 81-0251 DATE OF DEATH 12-1 _ COUNTY CU NOTE: TO INSURE PROPER CREOIT TO YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS OF THE ABOVE COUNTY. MAKE CHECKS PAYAaLE TO REOISTER OF WILLS. AGENT." IF TAX PAYMENTS ARE MAOE WITHIN 3 MONTHS OF THE OECEOENT'S OATE OF OEATH. A 01SCOUNT OF S% OF THE TAX PAlO MAY aE OEOUCTEO. ROBERT CROWE ESQ 815 CUMBERLAND ST LEBANON PA 17042 PLEASE RETURN THIS PORTION TO REGISTER OF WILLS IF PAYMENT DUE ~1,!.LA!-9~~_'I.HJ~!-!N_E_________________________________ - - - ------ - - -- -- - --- - - -. NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR 01SALLOWANCE OF OEOUCTI0NS AND ASSESSMENT O~ TAX ESTATE OF MUMPER GEORGE R FILE NO. 21 81-0251 ) CHANGED TAX RETURN WAS: (X I ACCEPTED AS FILED APPRAISEO VALUE OF ESTATE: 1. Rea! Eslate (Schedule A) 2. Stocks and 80nds (Schedule BI 3. Closely H,o!d StocklPartnership Interest (Schedule CI 4, Mortgages and Notes (Schedule D) 5, Cash & Miscellaneous Personal Property (Schedule E) 6. Joint!y Owned Property (Schedule FI 7. Transfers ISchadule GI 8, Total Gross Assets APPROVED OEOUCTI0NS ANO EXEMPTIONS, 9. Funeral Expensesl Administrative Costs/Miscellaneous Expenses (Schedule HI 10. DebtslMorlgages/Liens (Schedule II 11, Total Deductions 12, Net Value of Estate 13. Charilable 8equests (Schedule JI 14, Net Value Subject to Tax ASSESSMENT OF TAX: 15, Amount of Une 14 taxable at 6% rate 16, Amount of line 14 taxable at 150/0 rate 17, Principal Tax Due TAX CREOITS: PAYMENT DATE 09-09-81 RECEIPT # OISCOUNT I"') !NTEREST H 029764 THIS ASSESSMENT IS 8ASED ON: ORIGINAL RETURN NO INTEREST 15 OUE IF PAlO ay 09-10-81 IF PAID AFTER DATE !NDICATED SEE REVERSE FOR INSTRUCTIONS (1) I 21 131 141 ( 51 ( 61 ( 71 ( 91 ( 10) (15) (16) ACN 101 OATE 04-05-82 57,060.00 .00 .00 .00 3,500.00 10,128.50 .00 I BI ----10,688.50 23,232.32 .00 111) 112) 1131 (141 23,232.32 47,456.18 .00 47,456.18 47,456.18 _)(,06- 2,847.37 .00 )(,16- .00 1171 __-.?t847.]L AMOUNT PAID I lr--- -~:'~~'-- TOlAL TAX CflEDIT 2 852.85 --BALANCi-ii, T Ai- Dui:--l 5. 48CR l._.._.... ,~"'_.._..._,.....,.._..._"..._._.,_._,...l.~,.____. ' (tl e.llflCO DUff I' leu th.n 61.00 no payment IS required) RET AIN THIS PORTION FOR YOUll flr.COlmS .00 'SS3HOOV HO~ ~008 NOI1:JnH1SNI xv 1 3:JNV llH3HNI 3Hl 33S .3SlJ3^3H 3Hl NO NMOHS ^LNnOJ 3HL HO~ SlllM ~O H31SID3H 3Hl 01 lN311'Wld HnO^ H1IM LI~8ns ONV ~HO~ SIHl ;0 NOI1HOd dOl 3HL HJV130 ----------------------------------------------------~----------------- OOSOO. slep 0 E SEEOO. slep OZ 69100. slep 0 I 88vOO. slep 6 Z 8IEOO. slep 61 ZSIOO. sl,p 6 ILVOO. slep 8Z 10EOO. slep 81 SElOO. slop 8 vSvOO. slep LZ V8Z00. slep L I 81100. slop L L EvOO. slep 9 Z L9Z00. slep 91 10100. slep 9 OZvOO. slep SZ OS ZOO. slep 51 58000. slop 5 EOvOO. 'Iep V Z LEZOO. slep vi 89000. sAep V 98EOO. slep EZ OZZOO. slep E I 15000. SAep E 69EOO. 'Iep Z Z EOZOO. slep Zl vEOOO. slep Z ZSEOO. slep I Z 98100. sAep II LIOOO. Aep L 090. S41UOW Z L SVO. S41UOW 6 OED' S41uOW 9 510. s41UOW E SSO. S41UOW L L ova. S41UOlU 8 SZO. S41UOW 9 010. S41UOW Z 050. S41UOW 0 l SEa. S41UOUJ L OZO. s41UOW V 500. 41UOW I --------------------------------------------------------------------- "lN3~V '511111 ;0 H3lS1!l3H" :01 31aV^vJ H30HO ^3NOW HO >l:l3H:l 3ltVW .11001 _ S8vZ .oas .S.d UI 1961 )010\1 xel alels3 pue aouelpa4uI 041 10 1001 uO!IOas Aq pep!^oJd se a:>nON 5!41 ;0 Id!80aJ Jalje s^ep (09) A1XIS U!41!M loafqo Aew luawssasse pue \uawas!eJdde a41 41!M paHsl1es IOU 'a^nelUaS8JdaJ leUOsJad a41 pue 411eaMuowwO:J 841 Bu!pnIOU! 'ISaJ81u! U! A1Jed AU'V OL.9C:0'Z$ luaUJled )0 aleo 01 lSaJa\u! pue xel 1'1101 OL.9Z $ 1+) luaUJled 10 Olea 01 lsaJ91Ul snld OO.OOO'Z$ onp xel )0 aouele8 0L"9Z $ SEEIO. x OO.OOO'Z$ lS3H31NI IS8Jalul ;0 BleH anp xel jO aouelee :U! Sllnsal::l 08-EZ-S 01 08-EO-E UJOJ) lSaJalUI SEEIO. SEEOO. + 010. ::; IS8J81U! 10 aIel::! = sleo OZ = S41UOl/ll Z 'anp xel 10 a:>ueleq alH 01 IS9J91U! a41 PP'v' e d3!S 'IS9J81UI 10 aleJ a41 Aq' anp xel 10 aoue,eq a41 Aldlllnw Z d3l5 "MOlsq 8lqe1 841 WOJ! IS8J81U! 10 SleJ 841 au!wJ81aa I d31S :MOlaq paleO!pU! se paleln:>le:> S! lS8J8lU! a41 'Oa-EZ-S UO apew S! luaw^ed pue '08-E-E WOJj SntelS lUanbu!18p e U! S! OO'OOO'ZS 10 anp xel 10 aoueleq e 11 :31dV\lVX3 (M0138 31d~1.JVX3 335) 'xel Pledun 10 lunowe 841 uo wnuue Jad lua:>Jad (9) X!S JO aleJ 841 Ie paBJe40 S! lSaJalul '41eap S,lUapaoap a41 Jaue S41UOW (6) au\u luanbullsp SaWO::l8q xe1 aouelpa4ul 'paMolle S! Pled xel 841 10 %9 }O lunooslP e '41eap s,luapaoap a41 Jaue S41UOW (E:) 88J41 U!41!M p!ed 51 xel 841 II .IS8vZ uOlloas .S.d U) 1961 )0 1:>"1 xe1 81el53 pue aouelpa4uI 841 10 60L uO!1:>as Jspun u8^!B eq 01 paJ!nb8J 8::l!10N 841 S! luawnoop S!41 NOll V~HO~N! OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND Before me, the Register for the Probate of Wills and granting of Lellers or Admini~lrlltion In nnd ('or the ('ouuty 0(' Cumberland, personally came 'P~iI~;l!iA A. (Y/t(I'tPE.~ ---- who, being duly <:, W 0 Il N , dOE>; , depose and say that as~~~ of the last Will and Testament of tJ-EoR.IH:. ~, fI1I.{MPE.f2- __dcccnscd S 1/ e. will well and truly administer the goods and chattels, rights and credits of snld decell~ed lIccordlng to 11Iw. And also will diligently comply with the provisions of the law relating to Trnn,(fer Inh~r tanees:or6~' I I sub,lcr cd before me. , '- . t...- fJ, / APRIl- 2.0 A.D., 19~ "- , . - U~;U '(~;~Uj! (/ 'ifap(~) ~ :.0 ...j 'QJ Ol i~ Ol :~ .-4f 'QJ \0 In: co, u.. ~I:: ~ 0 r-t: .!.I: , lr. ...J D::; 8 "" N \fl' "" N: ...J [ii; ~ : I' p.., - ....t ..-<' :E:' - .r<: - .~ co' S ::>, ::= 1-1' I' :E:, pj ~ ..-<, l:l oS ..:\ N~ '. .~ CO D::, 'tl "" QJ ..., " 0 [ii' 'tl ~11 .. ,-! Z \9' 0 D::' tJ C\l .s 0' ~ ~ 11 s [ii' ~ 0 L'i - <II .~ VJ Po< ~ Z ~ <Il Be it remembered tbat on the DECREE 22nd. dny of April 81 ,A.D,.19__, there was probated and recorded the last Will and Testament of George R. Mum~ New cumberl and late of Deceased. Lellers Testamentary wcre grantcd lo__,__~~_~ri::.in Witness my hand and official ~cal the day and ycnr aforc~aid. 1 ,.' '\ II' ~ J .__. Cumberland County, Pennsylvania, A. Mumper ~l I J i j' II '{' / ,I /' "I:.i . " .- f ,/ .} /~_twJ Register In the Motter of the Estote of George of New Cumberland INVENTORY AND APPRAISEMENTS l>l I-tl .,,<6/ R. Mumper lilleoflhe City . in the Connty 'C~_l~Wa of "cnnsylvonln. decellsed. REGISTER OF WILLS TOTAL ASSETS: 606 Linwood Street New Cumberland, PA All brick Cape Cod home situated on lot 75'xl50' 57,060 00 1979 Chrysler New Yorker Automobile 3,500 00 Certificate of Deposit #21921 Dauphin Deposit Bank and Trust Co. (~ interest) 5,000 00 Certificate of Deposit #127-011157 First Federal Savings and Loan Assoc. of Harrisburg, PA. (~interest) 5,000 00 Checking Account - Dauphin Deposit Bank and Trust Co. (~ interest) 128 50 , tt:- \.,,; '-' c. :,1) "- '''r''- -' ,~. ' 'I...' 0. ~ ~~;.~ c.' .- c". 01-" w-. ,:.;.:: ~~-; o::u:' '" ' .. Oc= ~p~ <'>w 0:-) \::!'" ~ ~C:l ~ W Tota.l Assets REGISTER OF WILLS 70 688 50 Coun/yofLebanon.": Patricia A. MIIIl\Per ~JeflheEslateof George R. Mumper deceased, being duly affirmed according to law, depose and say that the items appearing in the forgoing Inventory and Appraisement include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said decedent; that the valu. atian placed opposite each item of said Inventory represents its fair value as of he date of the dccendent's death, and that decendant owned no real estate outside the Commonwealth of Pennsylvania except that which appea s in a ~morandum at the end of this inventory. , /;u '.to OJ '-WJI/17t. Affirmed Glori. Iv\h~.rri(k. Nol.ry Pub~ 'lIlfo\'b!%\I~bll !>.;,,, A,,,;! 10. day of H'''ilbUlO.Sleptemtli!!'rt (,,"If A.D.. 19 81 v4A.u-* J' ':7?J. &......A(Notarv Public) My Commission Expires: '1111//:3 and subscribed x / REGISTER OF WILLS INVENTORY AND APPRAISEMENTS In the Matter of the Estate of of ;ic',." ['u. ': :;..)i "( ~,; , : ~ i late of the . in the County of Lebanon. State, of Penosylvania. deceased. ~. ' TDTi\l., A: (~Of L,.n'J,:()i)' '.\.:~ ;;(~\. C,yrnbt.:)'; ';U,' 'f::; :\ L J. .; ,,1. '.1 ,;" 1C:7'j (.hl~Yi~...~'i' (,:!':tH-:: J '\ C' t,: I) .:"l::'l.!,tJ .;'\,1';; .:_'11 ':~ (. ";:.: " Cr -r t' ~, J" J " ~.' I.. {) 1. ~:: c " " ,", ~:~ ) ,:1", n':,C': ...,. \ i I , I I I ] I I , I \ I .1 I , REGISTER OF WILLS Coumy of Lebanoll, ss: Ai:fm'h'istr'~t'of the Eslate of Execut' ... deceased, being duly ., ~ according 10 law. depose and say that the items appearing in the forgoing Inventory and Appraisement includeallofthe personal assets wherever situate and all of the reat estate in the Commonwealth of Pennsylvania of said decedent; that the valu- ation' placed opposite each item of said Inventory represents its fair value as of the datc of thc dccendent's death, and that decendant owncd no real ef;tate outside the (:ommonwealth of Pennsylvania except that which appears in a memorandum at the end of this Invcntory, and subscribed berore me this day of 'L A.Il..19 "'/", , ,j':.":' C~>:." REV.1500 EX + (9.81) BU",EAU OF EXAMINATION PENNSVLVANIA DEPARTMENT OF REVENUE P.O. BOX B327 HARRISBURG, PA '7105 DECEASED CHECK APPRO. PRIATE BLOCKS /1-~3~ - f INHERITANCE TAX RETURN RESIDENT DECEDENT File Number ...dJ - ~ J -0.l5/ Decedent's Address (POlo "'.I'lWood. S+vu4 NwJ ~b.LUW, pa ,.10,0 1. Originel R.turn [KJ 2. Supplem.nt.1 R.Wrn 0 3. R.m.inder R.turn 0 4. Lifo Est." 0 5. F.dor.1 Esta" T.x 0 RBlurn R.quired. 6. Deced.ntdiedtest.t. r:tl 7. Ooc.d.nt m.int.ined. living 0 B. Numbarofs.f.doposit 0 (Att.ch copy of Willl W trust (Att.ch copy of trust! boxes inv.ntoried All correspondence end confidential tax information should be direct.d to' CDRRE. SPONDENT N.m~ r Telephon. No. RECAPIT. ULATION AND TAX CALCU. LATION Recapitulation 1. R.al Estate {Schedule Al 2. Stocks and Bonds (Schedule BI 3. Close!y Held Stock/Pa'1nership Interest (Schedule C) 4. Mortgagos and Notes (Schedul. D) 5. Cash & Miscellaneous Personal Property (Schedule EI 6. Jointly Owned Property (Sch.dule FI 7. Transfers (Schedule GI B. Total Gross Assets (total lines 1.7) 9. Funera! Expenses Administrative Cests/Miscollaneous Expenses (Sch,dula H) 10. Debts/Mortg.ges/Liens (Sch.dule II 11. Total Deductions (totellines 9 & 10) 12. Net Valuo of Estato (line B minus line III 13. Charileble Bequests (Schedule J) 14. NBl Value subjectto lex Uine 12 minus line 131 City Zi { II ( 21 ( 3) ( 41 ( 51 ( 6) ( 71 5'1,0 (g0.00 3,1500,00 \0 j I OJ. ~ . 150 ( 9) (101 ( BI 10 1.~~.5a l (11) J.~I:B~ 3 ~ 1121 41, L\- ~.I (131 (14) 4Vi'St..I!? x.06= ~1~l.\1. ~1 x.15= (171 ;;)&~1.?>1 , Computation of T.x 15. Amount of lin. 14 lexablest 6% rete 115) 41,l-{6l.., \)S linclud. values from Schedul. KI 16. Amount of lino 14 taxabl..t 15% rat. 1161 lincludo v.lues from Sch.du!e KI 17. Principal tax due (edd tax from lin. 15 plus tax from lin. 161 lB. Tot.1 Prior p.ym.nts: (01 Amount Paid (b) Pius Discount (c) Minus Interest (IB) 19. Bal.nce Oue(lin. 17 minuslin. lBI (191 Mak. Check Peyeble to' R.gister of Wills, Agent ... PLEASE RECHECK MATH'" Under penalties of perjury,l declere thet I have examined this return, including accomp.nying schedules end stetements, and to the best of my knowl.dgo and b.lief, it is tru., cor eet, and compl.te. Declaration of preparer other then tho personal representative is based on ell iI,form.tion of which preporer has any knowledgo. ~ I f e I g ~ SIGNATURE OF P AODRESS . OATE DATE . , HL::.....4040 (,-aD) COMMUNWE^LTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIOENT DECEDENT AFFIDAVIT OF FIDUCIARY (Instruction!> on Rcvonu Side) ~:~ ~ . '1,e;.,A> ~. -m, 1'f~.0i~~~ I, ,It . '''';~ "to , . "4'-!tP "~ .'-:-'i:b'~ I _._'_.;...-:::--=.=_.-::-.-;7.,,;-:...,.:._,__,_:-:""-"=_"-:-:-::-:':=-C'C::'__':_";':;..:,:,,;,;,;::~~.:.=:_~.-:::.~-;::::~-===__."_=::.-:==:-_~:..:.o'=-:':L'::.r;.,~tr-_ Estate of George R. Mumper Dole of Deal!. __.D.ecember_~0.,-1980__..__. .-- Sociol Security No. __172-01-.9_80.5_______..._ Last Address.....6_0_6_Linwoo.d-Str.eet__._-- New Cumb.erland.,-EA..-UQ.7J)_ Bureau File No, ..____._.___.__.___ (e" VI 1ST,' TEl (:.If') " . C: 'r.J County File No. _...1) -,j"! .-,-1...:2_'-__ 1. Decedent died, ( ) Intestate (without 0 will) ( X) Testate (leaving a lost will--copy ottached) 2. Is the filing of a Federal Estate Tax Return required for this estate? Yes_ No _X- 3. (X) Executor/Executrix Admi n istrator/ Administratr; x Name Patricia A. Mumper Address 606 Linwood Street New Cumberland PA (CITY) (STATE) 17070 (ZIP) 4. All correspondence should be moiled to (X ) Attorney ) Fiduciary. 5. If an ottorney is representing the estate, indicote: Nome Robert C. Rowe, Esquire Address 815 Cumberland Street Lebanon, (CITY) PA (:-:TATE) 17042 (ZIP) List all safe deposit boxes registered in the decedent's individual namehor jointly with, or as an agent or dop,,')' of another, or in decedent's individual name with right of access by onot er os agent or deputy. Include the "n"", and address of the bank or other institution where the safe deposit box is located, the nome (s) in which the box is registered and the relationship of the joint holders to the decedent, NAME AND ^DDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX r NAME OR NAMES IN WHicH SAFE DEPOSIT BOX IS REGISTERED RELATIONSHIP OF JOHn HOLDERS TO DECEO.EN~:;.-:== Dauphin Deposi t R'mk l'. 1'rl1~r Co , Highland Park Branch George R. Mumper Patricia A. Mumper Decedent Daughter Under penalties o! perjury, I declare thot tho e examined this relurn, including occomponying schedules and statements, and to the best of my knowledge c d belie! it is true, correct and complete. X a{::~_La.17Jf((l" A / ~7 ~/_q SIGNATURE OF FIDUCIARV (J . ~~ PENNSYLXANLA.INHEI1ITANCE TAX GENEHAL INFORMATION 1. 1'E I\SO_N.~_ill:S~_Qli?1Jl1.LFl) II RJ.TlI flU. Snclioll 101 III Ihe 1IIIlI1ntilllCIl :Jnl! Esl~te T~x Acl of 1961 plOvides th~tthe followill,~ persons shall prepare and file ~ return: ~, Tile personal replCsenl~tive 01 the est~te of the decedent ~s to property of the decedent administered by him and sucli addition~l property which is or may be subjecllo Inherit~nce T~x of which he/she sh~11 h~ve or ~Cqlll re knowl edge; b. Tile Irillisferee 01 properly upon Ihe transfer of Which Inheritance Tax is or may be imposed by the 1961 Statute, including a trustee 01 propelty transferred in Irust, providcdllwtno separale return need be made by the tr~nsferee of property iucluded in the leturn 01 ~ personal replesentative. 2. PLACl.!'-Q..fjJILlNG The return is to be filed in duplicilte with Ihe Register of Wills 01 the county wherein the decedent resided. 3. TIME FOR FILING The retullI i,; due nine 1II0nll1s after the decedent's deilth, unless ~n extension for Iiling h~s been applied for and grilnted by the Secretmy of Revenue within the nine-month period. 4. FAILURE TO FILE RETURN Section 791 or Ihe 1961 Slatute piovides th~t " . . .i1ny person who willfully f~ils to file a return or other report reQuiwd of hilll. . .shall be personillly li~ble. . .to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever I s the lesser to he recovered by the Department of Revenue as debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at rhe rilte of 6% on tr~nsfers to lineal descendants, such as father, mother, husband, wife, son, daughter, grandchildren, grilndparent, son-in-law and daughter-in.law and at the rate of 15% as to all others. 6. PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of 6% per annulII accrues thereafter until payment is made. All payments received ~re first applied to any intere~;t which may be due with any rem~inder applied to the tax. IF TAX IS PAID WITHIN 3 MONTHS AFTER THE DECEDENT'S DEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED. All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue. 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real plOperty, which lien remains in effect until the taxe, "nd interest Ilave been p~id in full. The taxes nlilY be sued for i1gainst any real property in the decedent's estate or "gainst any plOperty belonging to a trilnsferee li~ble for the t~x. 8. FILING OF FALSE RETURN Any pelson who wil!fully nlilkes iI false return or report required of him shal!, in accordance with Section 793 of the 1961 Statute, be guilty of a misdememlor and, on conviction thereof, sh~1I be sentenced to pay a fine not exceeding $f,UOO 01 undergo imprisonment not exceeding one year or both. - RECENT CO.~AP^RT~_A~ES Location 134 16th St., New Cumbo Price $56.000 Date 4/24/81 Construction Cape Cod - Alum. Age & Condition 30 yrs. - Excellent Size of BuildingApprox. same as sub ;ect Designate Rooms LR. DR, K. 4 BR's, 2 B, % Variation from & FR Subjec~ -1% plus pool value Location 807 Allen St.. New Cumbo Price $ ~4 000 - Ff~\ Date 4nM81 Construction Stone A111m Frame Ag~ & Condition 30 yrs. - Excellent Size of BuildingSame as subiect Designate Rooms TR aR K 1 BR's % Variation from' . Subject 1 B. & FR 4-1% plus pool value Location 521 8 th S t., New Cumb. Price $60.900 Date 6/15/81 Construction Brick & Alum. Ranch Age & Condition 2~s. - Outstanding Size of BuildingSame as subiect Designate Rooms LR. DR. K. 3 BR's, l~B, % Variation from+ inground pool, Rec Rm. Subject -1% ~arport Location 503 Hillside Rd. , New Cumbo !.'rice m ,500 Conv. Dat.e 516'/81 Con.s!:rucr.:1cn All Brick Ranch Age & Condition 20 yrs. - Excellent Size of Bldg Slightly smalled than sub ;ect Designate Rooms LR, K-DA, 3 BR's, I B. Carport % Variation from Subject' +3% plus pool value Location 9 Gale Rd., Camp Hill Price $55 , 000 - Conv. Date 3/25/81 Construction All Brick Ranch Age & Condition 19 yrs. - Excellent Size of Bldg Approx. same as subject Designate Rooms LR, DR, K, 4 BR's, l~ B, Air condo % Variation from Subject -2% plus pool value Location Price Date Construction Age & Condition Size of Bldg Designate Rooms % Variation from Subject EXPLAIN PROPERTY COMPARABILITY: Most .11 comparables excect one do not have inground pool. loIhile a new pool ,;auld be close to SB 000 to $9.000 complete re-sale value would be $5,000. Value by Comparison........ ........... ....... I. .... II II' .... II ............. ... .$)7 tUUU~UU BREAKDOuN OF VALUE Dwelling Porches Basement Petio Garage Land V,~ lue Landscap1.ng Personal Property Total Estimated Value 38 X 32 = 1216 $1. 500 $1. 000 So. Ft. X $ 35.00 PSF" $ 41,560 l.,500 1,000 10,000 1,000 5.000 $ 60,060 Dec.80 3,000 $ 57,060 $10.000 $1. 000 S~,OOO (inground swimming pool) ...... . .................. . ............ .........$ $60,060 le~s 3,000 for decorating since TOTAL ESTINATED VALUE AS OF DEC. 1980 4 QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two yems of death, make ilny tr~lIsler 01 ,my rllateri,i1 p~rt of his estate withoutreceivinp, valuabte and adequate consideration? (Answer "Yes" or "No",) _liCL.. 2, Did decedent, within two ye;1IS of death, tr,msfer property liomlllln';r~11 hl!rsr~lllllhilllsell/hr.rself ~nd another party or parties (including a speuse) in jllint ownerslllp? IArls'/Iul "Yes" or "No",) .Yes_ 3. If the answer to one or two above is "Yes" ;Ind the lrilnslers ,ne cl;limul! to he lIontaxahle, provide the lollowing iofornwtioo: a. Age 0 f decedent at time 0 I transfer, 69 b, Copy of death certificate. c. Affidavit by the allending physici;1II indicating the state 01 decedent's he~lth at tillle of transfer. d. All other inforlllation supporting nonlilxabilily of Iro1l1ster. 4. Did decedent, in his/her lifetime, lIIake any transfer 01 property wilhout receivillg a valuable or adequate consideration therefor which WilS to take effect in possession or elljoyment at or aftelhis/her death? (Answer "Yes" or "No".) .lio- a. Was there any possibility lhal the properly trnnsferredlllight return to transferor or his/her estate or be suhject to his/her power of disposition? (Answer "Yes" or "No".j JiLA- b. What was the transferee's ap,e al time of decedent's deilth? N/ A 5. Did decedent in his/her lifetime milke any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/llCr life or any period which does in fact end heiore his/her death: a. The possession or enjoyment of or tile right to income from tile property transferred? (Answer "Yes" or "No".) ~ b. The right to designate the persons who shall possess or enjoy the properly transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b. al:ove is "Yes," state whether the right was reserved in decedent alone or others. N/ A 7. Did decedent in his/her lifetime lIIake a transfer, the consideration for which was transferee's promise to pay income to or for the henefit or care of transferor? (Answer "Yes" or "No".) No 8. Did decedent, at any time, transfer property, the bOleficral enjoyment of which was subject to change, because of a reserved power to alter, amend, 01 revoke, or which could revert to decedentllnder terms of transfer or hy operation of law? (Aoswer "Yes" or "No" ,) No 9. If lhe answer to eight above is "Yes," was the pOVler to <liter, amend or revoke the interest of the beneficiary reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) N/A 1_-.-.... ~, .._-_....~_.. '~" . J..~. ...."., ..'.".' J,AST \'TILL MID TES'r.:,}rENT OF oo:mGE R. HUHPER I, George R. /{umper, of Nml cumberland, eumbcrland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for rrr<J Last 'dill and Testament, hercby revoking all I.,ills and codicils at any time heretofore made by me. First _ I direct that all l11'J just debts and funeral expenses, shall be paid from rrr<J residuary estate as soon as possible aft!lr rrr<J decease as a part of the expense of the administration of my estate. Second _ All the rest, residue and remainder of ~! estate, both real and personal, of every nature and wherever situated, I give, devise and bequeath unto rrr<J beloved daughter, Patricia A. Humper Third - _ I direct that all taxes that may be assessed in conseq,uence of rrr<J death, of whatever nature and by whatever jurisdiction imposed, shell be paid from my residuary estate as a part of the expense of the administration of my estate. Fourth _ I authorize my Executriz and her. successors to exercise the follo~,ing pO~lers in addition to those given by lalol, to be exercised in their sole discretion: (a) Retain any real or personal property l'lhich may at any time form part of my estatej (b) Sell any or all of my real and personoJ. property at public or privatc sale ~lithout security and ~1ithout court approval, and (c) make distribution in cash or in kind or partly in each: Fifth _ I appoint my daughter Patricia A. Humper Executrix oj,':this my Last Hill and Testament. I direct that my E.xecutrLx shall not be required to give bond for the faithful performance of her duties in any jurisdiction. In witness, Ilhereof, I have hereunto set my hand and seal this 22 day of July 1977. J:1~(\.i-' f? '))'1,,, ."Ad- GeorgV:t. Humper I Signed, sealed, published and declared by George R. M~~per as and for his Last Will and Testament in one presence of .us I.,ho, at his request and in his presence and in one presence of each other, havc hereunto subscribed as Hitnesses. ..-;::l L "t;? ~, '~__ . ........'\.A--t..l<.../- (.;.-<'-'1............. (Harry ROhrer)residing in 11m-I c~~berland r ~ - !(...,a."" , (Jo"'" "'''''',) rt,idi,g in II,. ",,"bor"" ~ i:::: < \J.l \J.l ~ ;>< ;>< n . ~ n~ 0:> :'IJ~ 1 ~ Z S.~..u '-~('") Ui"~' ..0 0 "" :l}?J :-r1,. ,"1-, ..10 \J.l ~~~ ~~ 'Q ::If'''1 tIl ~ ~l'? ;:l ':': :~,- .J' .'::\ " 'q ...1 '.-' ., .., < V U z ~ ,:, - 0 :f. 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Ja410 'alelsa JO luapaoap aql Aq paJJnou! slqap 01 UO!l!ppe UI 'amsa alqexel Ja4/S!4 ISU!e6e olq!pnpap oJe 41eap Ja4/s!q 01 Jopd luapooap oql Aq pOJJnOU! san!l!qe!l pa!lS!lesun NOl1ltW!:lOdNI Xlt130Nltlll:!3HNI1\f!:l3N3D 1 I , 1 IN RE: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF THOtJLAS A. DOPP, INCOMPETENT ORPHANS' COURT DIVISION NO. YEAR OF 19B1 WAIVER I, the undersigned, being a resident of the Commonwealth of pennsylvania, County of Cumberland, and the wife of the alleged incompetent, THOMAS A. DOPP, do waive notice of the hearing of the petition to adjudicate THOMAS A. DOPP incompetent, and request the Court to grant the Petition of RUTH P. DOPP and appoint PENNSYLVANIA NATIONAL BANK AND TRUST CO. as guardian of the Estate of THOMAS A. DOPP. >~ ~ #d-f-tM . RUTH P. DOP DATED: ~ 8 , 19B1 'I !i I. ,.'~:\ ..L..)-.., i ;,vt Id-L. I I I I I I I , I j IN RE: I I I ! I i I IN THE COURT OF COMMON PLEAS I CUMBERLAND COUNTY, PENNSYLVANIA I I , ESTATE OF THOMAS A. DOPP, INCOMPETEN'l' I' !! II I' Ii ij II I, II I " i: ORPHANS' COURT DIVISION NO. YEAR OF 1981 A F F I D A V I T i COMMONWEAL'fH OF PENNSYLVANIA II SS: 'I COUN'fY OF DAUPHIN " ., Ii i: " JAY J. CHO, M.D., being duly sworn according to law, deposes and says that: 1. He is a practicing physician, a graduate of -.1J;)1.t,' h1<l/,,/(,J!;I",,-_~("-h.l',li!i.!:!"...!.~ in the class of /9fJ'__, and , is licensed to practice medicine in the Commonwealth of pennsylvania. 2. He is the personal physician of THOMAS A. DOPP, he has treated since May, 1980. 3. THOMAS A. DOPP is suffering from physical and mental, infirmities and is unable to care for his property, make businesJ I I I I , I I judgments, and might become the victim of designing persons. 4. Because of his mental and physical infirmities, it would not be in the best interest of THOMAS A. DOPP to be present I , I I. " .l..lk I:..t J.00 I I I whoml I I , I I at a Court hearing on the petition to adjudicate him incompetent and to appoint a guardian of his estate. 5. This Affidavit is being made in accordance with The pennsylvania Probate, Estate and Fiduciary Code 85518. e)'tv --~ J, I ). I (. I /ltl-' ,-1Y1 .!J ,I ~I.D.---- I I i i I , I , I i ! I I , , Gtl'flll, l'\ I J. ./CHO, SWORN and subscribed f th' -'l be ore me 1S ~.I~.I i! day of TIII\,'..'i:I.JJ:.:l___, 198~, 'Ii ~ I /;, ,) 'I Ii (UtLl...d b.t.t"tJ.iA:L"{/LL- '! Notary .ubl1Q) I, . 'I' !i ~_,,,:,,,,,, I "IRrmH rt':r'U(""('l~l, t-!dMV ruo Ie ,!~'. ",HI 11, 'I" '. , 1(' P ,.>\...", \"'U~~./t,;~,~'b":''!, C"r~'J,,;,,~llc ,')" Q. ," ~.~,,,,-., ~. .'M,yJ&n'!.<i')';O:'l ~~pitc: Nov. 21, I@ .;;'" r.,...... ..' ("I,t 1'1 '. \.\ ;'. '~ :~~I\~\.'V i1(f~'.:o ';;. "('," -' ..,.,' /,/, . .-:'. ,- .t' .;:~. "~ ',.~...' ~ _ .". t,) ,..... . ~ ;-.~~:"b.., ~ '. '0';". ,;f. 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J: H Z H LAW Of"f"tCCS HEPFORD, SWARTZ, MENAKER & WILT H. .JOSEPH HEPFORO LEE C. SWARTZ BONNIE 0, MENAKER WALTER W. WILT .JAME:S O. MORGAN,..JR, CHRISTOPHER M, CleCONt c. KENT PRICE SANDRA L, MEILTON lit NORTH FRONT STREET ~,Q. BOX BB9 HARRISBURG, PENNSYLVANIA 17106 TELEPHONE (717) 234-4121 April 28, 1981 Honorable Dale F. Shughart President Judge Cumberland County Court of Common pleas Cumberland County Court House Carlisle, PA 17013 Re: Estate of Thomas A. Dopp, Incompetent No. 251 Orphans' 1981 Dear Judge Shughart: A petition to appoint a guardian in the above-captioned case was filed April 21, 1981 with your Honorable Court. The hearing was scheduled for Monday, May 4, 1981, at 9:30 A.M. On April 24th we received a notice from the Court to serve the alleged incompetent with the petition within 10 days of the hearing. I was out of town on that date and would have had to serve the alleged incompetent that particular day in order to comply with the notice. Obviously, I was unable to do this and for reasons which I will state later, I elected not to delegate this responsibility to anyone else. By way of background, you should be aware that this young man has sustained serious brain damage in a truck accident in West virginia approximately one year ago, and suit has been filed here in the Middle District of pennsylvania in a case which could result in a very substantial recovery. The purpose for our petitioning to appoint a guardian, at this time, is because we feel that the client, himself, is unable to actively understand legal advice which we are giving him and surely will not be com- petent to control any funds which might result from the litigation. Part of Mr. DOPP's mental problems resulting from his accident involve an aggressive, paranoid type mental condition which causes him to be extremely distrustful of people around him. For this reason, I wanted to personally have Mr. DOpp come into my office and try to explain to him the reason for the legal proceedings in such a way as to be able to retain his confidence in me to represent him since he will probably have to give factual testi- mony and may well be competent to do this. Before realizing that the la-day notice would be required, I had scheduled to have him come into my office on Wednesday, April 29, 1981, for a complete -. o:j 'J;", :;0 .~ ~", nl('") '. '.~r.:l I ~1) ~ ,CJ t' 'I .,r.~ ".,.,) .,. , , ' I .. i Ul <1;1 ""H CD H>< 0 P<Ul Z P< ~ ... Z 0 ..-i p.. ~ ZZ H '" 0 ~ N I- 0{ 001 Ul '" Cl U I- .J ~ P' H ..-i 'H 0: ~ " Z :> , 5; <( OC 0{ ~ ~ 0 - H .c:1:-< . ~~ ~ m U>< Cl Ul Z ~ " ~ m >- E< Z UlO1 Ul u Z m U1 Ii<Z ~ ~ $1:-< ;; 0 x Z " 0: OC 0 O~ ~, 01 Ii< 0 ci " . z 0 ~ ~ OP< 0 W ci w ~ 0: :I: .. I:-<U 0 0:::<: ~ ~ p:: U 0 1:-<0 E-i .J 0 <( oc 0: 0 0 ~Cl U H l1. Z z 0:: OZ ..-i Ii<Z ~ 0. 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I v/.r( 4c._.(/' ~ "__""./ ..!~ i (I . I ~ I/, \")" !/?' (;c. .:; ..__ ./(/;--.~,r:v V';L .. /1..1/. ~- '1-1..( r7;\.'"( I (.I ,::.... I . . .).:3<'('1' ({ll.v 'e' / :'.. i/(t/{J">;/JL it i,.....~(i.;f(LLC. I . ,- - ' IJe vi lit:','. . / \ I' . ( , \ "I/.' ') . ! ' I'll .:- >1..\ (,~I ~L/l tSl..l,/..J IJ-t.l ( I \ , ! ,( I ..' !-J. 1'-. ( I I/f. ( '- & OCl~~I' ...--::-:-(~'Q~; ( ,-I (:-- f."'ll 'I-;-"(~--c-.'J-- Ii ( I ,....( '( V ~ ___o-.........-.~.,. ,/'" /' , () ,/i) --4._~1 '-, \. I h~ crt' (- (~. l '.,1 ~f I! ./ ' Ij ~/:.,.:::;:.L {.(f!,.3 ~. . .'" ~-( ! .1, .'(1 . l_..~.:/ )f::.~,IIit-(.) l .~J, .4 E3 (eA. <. .Ic' l::-')'}' c,...... (.:(- L.~ ,/'Y I / ,:/ ,(.(' Nt;) (---..~ ..-, (1"7 /, '(f / /. .,';)-.1.. t('t.( \ i;).-tC.~,IIt..:.It.,J' -.J - I ( , (.. t(', cl ..~' .._. .~....._'~_' N _,_..,__.~._" ._-'", . ~~rrc,,( (<-(., ../- .. ..... ..........................-7:}.....'......... Monday, Nov. 29, 9:30 - Pet. to Adjudicate Competent - DOPP - Tom Williams. A'1"'(' ' <, ,,),\., /1/ (V I' -(1//' p~ ~ ~~ D, t (f-.('" '1 \ V\ f\ / r ^(\rV\J t,y \ , \ t I~\J- eA/ (J cPI')' UJ cb "'7,l, ' .' '!F''! i'Y" J ~ r J \ ," I/' 0\ ~~ j , ~~JYql(> ~' \l\~ ,vr ~ . - ...... IN REI ESTATE OF IN THE COURT OF COM1~ON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA THOMAS A. DOPP, ORPHANS' COURT DIVISION AN INCOMPETENT NO. 25l-A ORPHANS' 1981 IN RE. PETITION FOR ADJUDICATION OF COMPETENCE AND REMOVAL OF GUARDIAN ORDER OF COURT : ,',..'.. AND NOW, November 29, 1982, at 11109 a.m., after hearing on the above matter, the court is not satisfied that the prayer of the petition should be granted based on the testimony produced, and, therefore, the case will be held open and the court will attempt to. engage the services of a psychiatrist, at the .cost of the estate, to appear and testify at a later date. The court requests that at the :time further.'.hearing is set that the father and brother of Thomas A. Dopp be advised of the purpose of the hearing. By the Court, -.' ~ J. Williams, Esq. For the Petitioner Dale F. Shughart, P.J. Charles H. stone, Esq. For CCNB Bank NA lpbl STONF., SA,IF.1l & St'F.WAIlT ^ PHOP'CGlIONAL CORJlORATlON ATTORNEYS AT LAW 414 BRIDGE STREET rOST OFFICE DOX I! NI~w ClJMIIIUII.ANIl, 1',\. 170'j"n TI:LEI'lmNt 171"'7"."":1'\ CHARLEI II. 8roNE 01:R"",0 T. .AJER RfCI1ARO W. STEWART May 23, 1983 I I I I I \ I , I I I I I [' I i I I I I 1 I \ Thomas J. Williams, Esquire 10 East High Street Carlisle, PI\. 17013 In re: Thomas A. Dopp - No. 251-11. Orphans' 1Y81 Dear Tom: Miss Duke called me about setting a hearing uate ill the nbove matter. The Bank will not oppose the removal of the guardianshlp provided that Tom agrees to keep his money in an irrevocable trust arrangement of some kind. Tom has verbally agreed to this arrangement. As you know, Ruth Dopp has retained Bruce Grove, Esquire, to represent her in a divorce action which she has filed. Miss Davidson, the CCNB Trust Officer handling the guardianship, came to my office last week with Tom Dopp to review the divorce proceeding and to discuss a possible settlement. We think such a settlcment should have court approval so long as the Bank is Tom's guardian, It seems an inappropriate time to schedule n hearing. Perhaps you would agree to ask Miss Duke to defer setting a hearing at this time. It may be possible to have an order terminating the guardianship entered without nny oppos itlon, which wIll certainly save the court's time. ~ / Very truly yours, (0 ~.. -(;-^--l...l ST?!_~,_~~JER & STEloIART ~h:~U :2~(::~'\L ( v '~~-G\ IJ~ I rlr ":f..-'~J"I/ rr/ ~ ~'f'J, It \CI)arles II.. Stone J (j ~I;); txA. t. "r r:/ I ''1 VIA. \ CHS:jd ') 0 ,", cc: ML<;s Bernice'l. Duke, Court Administrator '1 t?; " Cumberland County Courthouse '(;\ 'V . liP. J-'> ~~"I!'~""'r";''''''''''''i" "l,:!.,"'!i'.,';, ' , -t:tr LMfljl:'" ,'I , il"'i~.ll, ' " ~~}i;t. '1,_ f I i,;':('~jlrij;~\:i;-:;:"";)!I': "::1;,.,:, ,/."",t,,,,,1 t/::i!i11!hf:;j\~lr::'i' . ... '~:_"-,':tI~~"",,!; ;.:;~~~~;~~;rJY \' [.ElIT'()"r"'" \ ",' 'I , . . )OIlN M. IIUME, M,D.. ),0. HIli 1.0GAN STIU\E'l' IIAIllllSI\UllG. I'A. 17110 ~ PETITIONER'S J if ~HIBIT II; J}.o .l VJId.. 1'dcllhone (711) 2}K.6')2 January 6, 1983 The Honorable Dale F. Shughart President Judge Cumberland County Court of Common Pleas Carlisle, Pennsylvania 17013 Re: Thomas A. Dopp Dear Judge Shughart: I saw Thomas Dopp for competency to manage his financial affairs on December 27, 1982. At that time he indicated that he had been brought by his sister, although his wife had asked him if he wanted her to bring him. He indicates that currently the Cumberland County National Bank is guardian of his estate and the Trust Officer is Jane E. Davidson. This information is correct. He states that the guardianship was appointed in July 1981 when he was found incompetent. He states that he remembers the trial and indicates that it arose because he wanted attention from his wife, so he threatened suicide. He stated that at the trial, they didn't ask about his arithmetic abilities. He states that he didn't really understand what the trial was about, so he didn't say anything of any significance. He was able to recognize that his response was not the best, stating, "Maybe I cut my own throat." When asked if he was represented, he stated that it was an attorney from Lee Swartz's office but did not remember exactly who it was. He states that at that time he was getting $242.00 a week from Workers' Compensation and that his wife got it and spent it. He states that she was giving him an allowance of $10 to $20 a week. Additional funds were received by Mr. Dopp from Social Security Disability. When asked what his relationship with his wife was like, he answered, "After last night, it's pretty rocky. She's living with someone else, James Brunner, at 630 Edwards Drive in Mechanics- burg. She said she was living with a girlfriend at the furniture - 2 - The Honorable Dale F. Shughart Re: Thomas A. Dopp store, She commJ.tted perjury J.n Judge Shughart I s Court. She gave a friend's addreHB when she was really living with him. We've been separated almost three years. I had my sister-in- law, Wendy Dopp, up to thllt address. I wanted to see if they were still living together, I hud my sister.in-law along to avoid any police problemH, I felt like threatening Mr. Brunner but I didn 't, My legH were Hhnking, That was some experience." January 6, 1983 When ml<al tndeHCribe the allocation of his resources, he states thut hlH wife IH l',ntting $650.00 a month from the bank, al though she works II s II secret:lll:y for S. M. Transport in He- chanicsburg, One Bon, LouiH Allen Dopp, is currently living with I'll', DOpp'B wlf:e Ilnd he states that it is not right to bring the child up when your wlfe is living with somebody else. He states thut he 11/Iu two other children, Kim and Tom, who live in Harrisburl\ with their mother who was Mr. Dopp' s first wife. There is no Support Order for these two older children but he believes that they receive Social Security benefits from his disability circumstances, \~hen asked to describe what his financial resources were, he stated thllt he gets $300.00 a month living expenses from the bank I that his $175,00 per month rent, electric and other utility bills are pai.d directly by the bank so that he has $300.00 above the rent and utiliti.es. He states that he has only his personal possessions, that any real property he owned was sold at Sheriff's Sale for an unpaid mortgage this past July. This was a house in Etter s I Pennsylvania, the purchase price was approximately $40,0000 and was bought around December 1979 or January 1980 before his acci- dent, He was not aware of the exact amount of money in his Trust account but stated that it came out of the settlement from his acci- dent of $125,000, He indicates that his attorney received $40,000 in fees out of that, $20,000 is in Escrow with interest because there is tbe IHlliBlbility that he may have to pay back from his award money that he hun recelved from his Workers' Compensation. He .states that his wHe III no got $13 I 000 of the settlement and that he got $52,000, When uHked if he knew what the fee was for the Executor handling hlu I~utate and tending to his affairs, he said that he did not know the percentage but that he knew they would not do it for nothing. He called me the following day, to indicate that his cur- rent balance IH approximately $58,000 because Ms. Davidson did not huve the fUe In front of her to give the exact amount and that the money In hlll account: has come from the settlement, Social Security Hlld Workeru' Compensation. He is aware, that the money in his account: III invested in money market funds bringing the highest, cur- rlmt: !'lIte of Income return. - 3 - The Honorable Dale F. Shughart Re: Thomas A. Dopp When asked what advantages there would be to his being declared competent, he replied, "I wouldn't have to pay her any- thing. Two, I would like to invest it the way I want." When I asked him what this would involve, he states that he would buy a motor vehicle if he got his license back. He states that he might also wish to invest some of the money in Flying Tiger Lines which is the parent of Hall's Motor, the subsidiary where he was employed at the time of his accident. January 6, 1983 When I asked him if he would be willing to pay me $1,000 to guarantee to get his job back at the Hall's Motor because I knew some of the top executives, he stated, "It would ruin your integrity. It's not a proper arrangement, although that turns me on, I know you have to spend money to make money." He states that he has not been to the bank more often to check precisely on his account because he does not have trans- portation and it is difficult to get to the Camp Hill branch. He says that he does get to the store to get groceries and can do that by walking since it is only two miles. He has opened a Savings Account in his own name with Dauphin Deposit in Highland Park and indicated that it currently contained $51.86. In terms of his mathematical ability, he has some diffi- culty with basic computations. This was confirmed by psychological testing which was done by Jeffrey Cohen, at the request of Mr. Swartz back in August of 1982, His arithmetic abilities are approx- imately at the equivalent of a 5th grade student. In summary, Mr. Dopp appears to have a reasonable under- standing of the amount, source and nature of his assets. He appears unlikely to squander or hoard his resources to his disadvantage and he does not seem likely to become the victim of designing persons, For those basic reasons, it is my feeling that Mr. Dopp is competent to manage his own financial affairs. Thank you for the opportunity for reevaluating this inter- esting gentleman. Very truly yours, C/p;t4/{/xk<'1LU {J;nk:. Hume, M.D., J.D. JMH/ms CC: Thomas J. Williams, Esquire PRINCIPAL RECEIPTS 10/28/82 4/26/83 settlement of Litigation from Yellow Freight System Establish Value for control purposes: Veterans Life Ins. Co. Pol. #MP00431 Transfers from Income for investment from 4/13/82 to 12/29/83 Total principal Receipts $52,000.00 1. 00 3,187.87 $55,188.87 CONVERSIONS INTO CASH Gain Loss 1/26/83 $239 CCNB CMA Proceeds $ 239.00 Account Value 239.00 1/27/83 $103 CCNB CMA Proceeds $ 103.00 Account Value 103.00 2/1/83 $650 CCNB CMA Proceeds $ 650.00 Account Value 650.00 2/3/83 $15 CCNB CMA Proceeds $ 15.00 Account Value 15.00 2/8/83 $300 CCNB CMA Proceeds $ 300.00 Account Value 300.00 2/9/83 $300 CCNB CMA Proceeds $ 300.00 Account Value 300.00 3/1/83 $650 CCNB CMA Proceeds $ 650.00 Account Value 650.00 3/3/83 $324 CCNB CMA Proceeds $ 324.00 Account Value 324.00 3/4/83 $820 CCNB CMA Proceeds $ 820.00 Account Value 820.00 3/9/83 $649 CCNB CMA Proceeds $ 649.00 Account Value 649.00 :LlJ '-' I.~, L .jJJ6 -3- PRINCIPAL DISBURSEMENTS 12/20/83 Thomas A. Dopp and Ruth P. DOpp - Divorce Settlement 12/20/83 Diane G. Radcliffe, Esquire - Divorce Settlement Total principal Disbursements $ 5,000.00 10,0<1.Q.:..Q.Q, $15,000.00 PRINCIPAL INVESTMENTS 4/13/82 $ 2,500 CCNB CMA $ 2,500.00 11/1/82 52,000 CCNB CMA 52,000.00 1/18/83 3,127 CCNB CMA 3,127.00 1/21/83 242 CCNB Ct~A 242.00 \ 1/28/83 242 CCNB CMA 242.00 2/2/83 339 CCNB CMA 339.00 2/4/83 845 CCNB CMA 845.00 2/11/83 242 CCNB CMA 242.00 ! 2/18/83 242 CCNB CMA 242.00 I 2/25/83 242 CCNB CMA 242.00 I I "') . 1.,-,': J . . I ',,' ..'. ~. ._.l,.. j I,.... :<_Ll_ -7- : PRINCIPAL INVESTMENTS 3/2/83 $ 344 CCNB CMA $ 344.00 3/11/83 242 CCNB CMA 242.00 3/18/83 242 CCNB CMA 242.00 3/25/83 242 CCNB CMA 242.00 4/5/83 375 CCNB CMA 375.00 4/6/83 678 CCNB CMA 678.00 4/11/83 193 CCNB CMA 193.00 4/19/83 242 CCNB CMA 242.00 4/22/83 242 CCNB CMA 242.00 4/29/83 242 CCNB CMA 242.00 5/3/83 371 CCNB CMA 371.00 5/4/83 678 CCNB CMA 678.00 5/6/83 242 CCNB CMA 242.00 5/13/83 242 CCNB CMA 242.00 5/23/83 242 CCNB CMA 242.00 5/27/83 227 CCNB CMA 227.00 6/2/83 382 CCNB CMA 382.00 6/6/83 825 CCNB CMA 825.00 6/14/83 242 CCNB CMA 242.00 6/17/83 242 CCNB CMA 242.00 6/24/83 208 CCNB CMA 208.00 7/6/83 1,306 CCNB CMA 1,306.00 7/11/83 242 CCNB CMA 242.00 7/15/83 242 CCNB CMA 242.00 7/22/83 242 CCNB CMA 242.00 8/2/83 420 CCNB CMA 420.00 8/4/83 678 CCNB CMA 678.00 8/5/83 152 CCNB CMA 152.00 8/12/83 242 CCNB CMA 242.00 8/19/83 242 CCNB CMA 242.00 8/26/83 152 CCNB CMA 152.00 9/6/83 596 CCNB CMA 596.00 9/9/83 242 CCNB CM.l\ 242.00 9/23/83 242 CCNB CMA 242.00 10/5/83 1,090 CCNB CMA 1,090.00 10/7/83 242 CCNB CMA 242.00 10/14/83 242 CCNB CMA 242.00 10/21/83 217 CCNB CMA 217.00 10/28/83 242 CCNB CMA 242.00 11/2/83 375 CCNB CMA 375.00 11/4/83 920 CCNB CMA 920.00 1l/14/83 242 CCNB CMA 242.00 11/18/83 242 CCNB CMA 242.00 11/25/83 242 CCNB CMA 242.00 1/2/83 206 CCNB CMA 206.00 12/12/83 242 CCNB CMA 242.00 . 12/16/83 242 CCNB CMA 242.00 1/6/84 394 CCNB CMA 394.00 1/16/84 242 CCNB CMA 242.00 -: U'" ,. ~ .' .; U r....;.. ...:.1.d -8- 2/18/82 3/24/82 12/28/82 3/23/83 8/5/83 12/21/83 12/29/83 9/4/81 9/23/81 9/23/81 9/23/81 9/23/81 9/24/81 9/24/81 9/24/81 INcmlE RECEIPTS Interest on CCNB CMA from 5/3/82 to 1/3/84 Social Security Disability benefits from 11/3/81 to 11/3/83 Hall's Motor Transit Co. - Workman's compensation from 9/3/81 to 1/13/84 Total Income Receipts INCOME DISBURSEMENTS Domestic Relations Office - Cost of proceedings Stone, Sajer & Stewart - Attorney's fee for services from 11/9/81 to 3/18/82 Stone, Sajer & Stewart - Attorney's fee William F. Martson PC - Attorney's fee from 11/2/82 to 3/11/83 re petition Martson, Deardorff, Williams & Otto - Attorney's fee from 4/29/83 to 7/4/83 CCNB Bank, N.A. - Special fee for additional activities Martson, Deardorff, Williams & otto - Attorney's fee from 12/6/83 to 12/20/83 Domestic Relations Office - Monthly support payments from 3/1/82 to 1/3/84 CCNB Bank, N.A. - Guardian~ compensation from 12/2/81 to 12/3/83 Transfers to Principal for investment from 4/13/82 to 12/29/83 Reserve for filing costs Stone, Sajer & Stewart - Attorney's compensation Total Income Disbursements INCOME DISTRIBUTIONS FOR WARD Leader Nursing & Rehab Center - Allowance for Tom U. G. I. Corp. - Service to 8/4/81 at 745 Erford Rd., Camp Hill P.P.&L. Co. - Service to 8/4/81 at 745 Erford Rd., Camp Hill Riverton Conso1. Water Co. - Service to 8/5/81 at 745 E~ford Rd., Camp Hill Bell of Pa, - Service to 8/17/81 Calico - Premium to 11/14/81 on Pol. #680N-G00240 CCNB Mastercard - Payment on account Kenneth H. Ginter, Treasurer - 1981 East pennsboro Per Capita Tax I ,~ - 'u' r 1.. :,} 1":'_L'i , lolL... -9- $ 5,627.97 16,691. 60 30,008.00 $52,327.57 $ 31. 50 780.00 812.50 838.00 120.00 2,500.00 577.50 14,245.00 691. 39 3,187.87 100.00 .J:.ill5 .00 $25,758.76 $ 40.00 29.20 105.49 12.13 386.69 90.06 32.00 39.20 9/24/81 9/25/81 9/25/81 10/8/81 10/9/81 10/13/81 10/26/81 10/26/81 11/10/81 11/13/81 11/17/81 11/19/81 11/23/81 11/27/81 12/17/81 12/17/81 12/17/81 1/8/82 4/23/82 5/7/82 5/24/82 6/10/82 7/14/82 8/18/82 11/4/82 11/4/82 1/25/83 2/3/83 3/2/83 3/3/83 4/6/83 6/3/83 6/27/83 8/4/83 8/8/83 8/25/83 INCOME DISTRIBUTIONS FOR WARD Bell of Pa. - Balance due $ General Motors Acceptance corp. - Car payments due 8/14/81 & 9/14/81 Philadelphia National Bank - VISA payment on account Dr. William Sisson, Optometrist - Contact lenses for Ruth $67.00 Glasses for Lewis 87.00 Acme Movers - storage to 9/3/81 CCNB Mastercard - payment on account Harrisburg Hospital - Services to Ruth on 7/17/81 Philadelphia National Bank - VISA balance paid in full Blue Cross & Blue shield of Kentucky - Application fee CCNB Mastercard - Balance paid in full Holy Spirit Hospital - Services to Ruth on 6/12/81 Harrisburg X-Ray Assoc. - professional services to Ruth on 7/17/81 Ruth Dopp - Travel expenses Stor-Mor Warehousing Ltd, - storage for automobile Ruth DOpp - Christmas presents for Tom, Ruth & Lewis Ryder Truck Rental Inc. - Moving expenses from Kentucky to pennsylvania Ruth DOpp - Gasoline for truck General Motors Acceptance Corp. - Ruth's car payments to 1/14/82 Joseph McGraw Inc. - Appraisal fee for property at R.D. #2, Etters Charles Bolton - Expenses to Harrisburg for Tom's Deposition' CCNB Bank, N.A. - Balance due on loan #001-0091460 Charles Bolton - Transportation expenses Greenberg's Stores Inc. - Clothing for Tom Northwood Manor Mobile Home Park - Rent to 9/1/82 $81.90 plus security deposit $200.00 Jeffrey A. Cohen EDD - professional service to 8/19/82 Lee C. Swartz, Esquire - Reimbursement for Geiger & Loria Reporting Service $395.61 and Dr. Hume $150 Leland F. Patterson, MD - professional services on 1/21/83 John M. Hume, MD - professional services on 1/11/83 Liberty Mutual - Insurance premiwn to 3/2/84 on Pol. #A02-231-373541-003 Doc's Garage - Purchase 1976 Dodge Dart Veterans Life Ins. Co. - Premium to 4/1/84 Brothers & Hayduk Assoc. - professional services to 5/31/83 Liberty Mutual - Premium on Pol. #A02-231-373541-003 William D. Thomas MS - Professional services to 7/21/83 Thompson Institute - Application Fee $50 plus Deposit $100 William D. Thomas MS - professional services to 8/18/83 -j ll:- '.,j" / ~ '- L:r..: .l.. \,,' IhL,r '::..Ld -10- .30 503.88 450.00 154.00 32.00 48.00 100.00 285.74 2.00 493.68 7.00 55.00 200.00 75.00 350.00 291. 50 189.00 780.85 150.00 750.00 76.93 100.00 98.90 281. 90 250.00 545.61 80.00 75.00 242.00 1,739.70 96.00 95.00 18.00 90.00 150.00 90.00 " 9/1/B3 9/1/B3 9/15/B3 9/27/B3 10/5/B3 10/7/B3 10/2B/83 11/22/B3 l2/7/B3 INCOME DISTRIBUTIONS FOR WARD Harris Lodge Apts. - pro-rata rent Sept. $275 plus security deposit $325 Lower's TV & Appliance - purchase TV, Model #FGC455W Thompson Institute - Fall Tuition Sa~nons communication Inc. - Cable TV service to 10/3l/B3 William D. Thomas, MS - professional services to 9/22/B3 Thompson Institute - Books Sammons communications Inc. - Cable TV service to 2/l/B4 Thomas Auto Alignment - Repairs & purchase two tires on 11/14/B3 Thomas Auto Alignment - Repairs on ll/30/B3 Esther Alt - Rent at Northwood Manor from B/27/B2 to l2/30/B2 Met. Ed. Co. _ Electric service at Northwood Manor from 9/24/B2 to 1/25/B3 General Telephone Co. of Pa. - Service at Northwood Manor from 9/29/B2 to 1/26/83 Rite Aid Corp. _ prescription service from 3/B/B3 to 11/l/B3 Harris Lodge Apts. (now Rodin Management Inc.) - Rent from 9/30/B3 to 12/30/83 p.P.&L. Co. _ Electric service at Harris Lodge Apt. from 10/14/B3 to 12/B/B3 Bell of pa. _ Service at Harris Lodge Apt. from 9/7/B3 to 12/27/B3 Richard A. Fortenbaugh DDS, PC - professional services from 1/25/B3 to 9/23/B3 Thomas P. Kunkle, DO - professional services from 2/2/B3 to 5/6/83 Frances Bolton _ Room & Board from 4/8/82 to 7/B/82 Francis DOpP - payments from 10/9/Bl to 3/B/82 Reimbursement for misc. expenses $ 22.64 Tom's Allowance 240.00 Maintenance 800.00 Ruth DOpp _ Expenses for Lewis from 10/1/Bl to 2/1/82 stephen DopP _ Room & Board from 1/7/83 to 9/8/B3 Thomas DOpP _ Reimbursement for misc. expenses and monthly allowance from 1/29/B2 to l2/27/B3 Total Income Distributions for ward $ 600.00 392.15 901.00 10.67 120.00 94.95 56.52 99.BO 22.79 B75.00 376.B4 400.34 346.01 1,500.00 l5B.44 24B.22 220.00 45.00 1,200.00 1,062.64 800.00 2,475.00 7,323.93 $29,011.06 CCNB Bapk, N.A. BY : . .. \ ,;,~., 1/ .~) ." )(//.//,j,.A-i() Assistant vice president and Tr~st Officer, Guardian of the Estate of Thomas A. DopP, An Incompetent i :: ~~: ~i ('. r, _Lut~ r':.l'[ : i". '.!._L"_} -11- 'Thcn,~s Dopp . Page 2 '. 4 Bender Gestalt Test TEST OBSERVATIONS AND FINDINGS: Patient was examined at the Rehab 1I0spital in ~Iechani csburg, Pol. lie was seen to be a man of average height and one who was llloderr1tely obese. He was examined in a wheel chair and yet, his nurse, fliss Louann Bishop, R.N., states that he is starting to do nicely in ambulation in physical therapy. His speech was slurred and his exhibited a noticeable drull out of the right sideof his mouth. /lis whole right cheek is extremely swollen and, he is 'to go back to Hershey fledical Center to evidently take the stitches out of his jaw. His jaw was wired but he broke this. He is taking 15 mgs. of Pheno- barbitol twice a day and 75 mgs. of flelaril at bedtime and 50 m~s, of flFlaril during the day. He has had temper outbursts and on occasion has struck his wife and his young boy. He has a low frustration tolerance, at this point. , Intel,lectual measures are fairly uniform and pretty much within the mild mentally retarded range; however, he shows a little more potential in terms of maintaining his verbal concepts and expressive vocabulary skills and habits of attention and rote memory. Relative weaknesses are quite pronounced in terms of his general range of information aod memory for recent and remote events. He had difficulty in recalling figures of the Bender Gestalt and, when asked what the colors of the American flag were, he stated "green, red, white, and silvE:r." II'hen asked "what is the shape of a ball?" he tended to perseverate color and stated that "it's orange," Abstract reasoning is decidedly poor as are tasks. involving alertness for visual detail and visual-motor speed and spatial rel~tionships. TIlere is uo question at this point thnt his judgment is impaired and he has poor intellectual and cmotional controls; for eX.1Inple, Ioo11en a.ked what he should do if while in the movies he were the first person to Bee ulllokc or fire? he iu,nediotely said "hol1erJII . B.1sic acadcmic skills again show a residual of his pre-morbid average intellectual functioning as this relates to word recognition skills. At this point, no effort was made to assess his reading comprehension skills although this will be done later. Spelling and math computati9n and reasoning skills are seen to be at a high second grade to beginning third grade instructional level. Copying of geometric shapes exhibits a rather marked constructional dyspraxia and certainly fits in with the severe brain damage that this man has sustained. He hsd trouble in manipulating a pencil with his right hand and tended to simplify his figures and .to want to "give up" under slight pressure or encouragement by this psychologist. He was only able to recall two of the nine stimulus figures and thus exhibited decidedly below average visual imnediate recall. With respect to his social competency, he functions like an elementary schocl child at a second grade level or chronologically one who is about seven years of age. He is able to bathe himself and feed himself but does very little in the way of reading or letter writing and using a telephone directory. His diet is a soft one since his jaws were wired and he has not had much opportunity to see what he can do in terms of mani- pulating a knife or cutting his meat. Again, according to his nurse~ Miss BiShop. he is making good use of speech therapy and physical therapy and occupational therapy and will continue this on an out-patient basis three times a week. ....-..,..-.. -. ...-..-.--,..- -- . - Patient: Address: Sex: Race: Age: Birthdate: Marital Status: Educstion: Occupa t ion: Referred by: Reason for Referral: Date EXalbined: Tests Administered: FINDINGS: PSYCHOl.OGICAI. ~;VALUATlON Thoma" A I Jell 1101'1' Ramsey'. Trailer Court, New Cumberlaod, Pa, 17070 Hale \Vh ite 32 January 27. 1948 Separated Grade 11 at John Harris High School and later patient claims to have completed his G.E,D. through the U, S. Harines where he subsequently received an honorable discharge. Truck driver---currently unemployed Jay J. Cho, H. D. and Walter \V. loIilt, Esq. Psychological evaluation to assess current functioning and needs and to see whether or not this man is mentally competent to mansge his own affairs, January 5, 1981 1 Wechsler-Bellevue Intelligence Scale I Performance Subtests Scaled Scores Verbal Subtests Information Comprehension Digit Span Arithmetic Similarities Vocabulary Verbal LQ. Performauce LQ, Full Scale LQ. Scaled Scores 10 11 3 4 to 6 10 12 Picture Arrangement Picture Completion Block Design Object Assembly Di gi t Symbo 1 13 11 7 10 7 95 103 99---Classification: AVERAGE Reading (Word Recognition) Spe 11 ing Arithmetic 1978 Ed i t ion Grsde Standard Score 9:0 10 1 6.0 84 3.6 78 2 Wide Range Achievement Teat 3 Botel Word-Opposites Test -- Form A (ReadinA Comprehension) Frustr,ation Level: Grade 13 Instructional Level: Grade 12 ~ PETITIONER'S 1 EXHIBIT I fJ.. Pagc 2 Thomas Allcn 001'1' 4 Vine land Social Maturity Scale (lnformsnt: Patient) Norms Uscd: C.A, 18-0 S,A, 11-6 S ,Q. 69 Socia 1 Compe tency: 1l00WERL INll ~mNTAL RETARDATLON 5 Bender Gestslt Test 6 Trail Making Test -- Part A 64 Seconds; Part 1\ discontinued after 3 minutes and 3 errors 42"8'3716-9/F-KL/ TEST OBSERVATIONS AND FINDINGS: 7 Mini Mult Patient is seen forthe second Hospital in Mechanicaburg, Pa, on from a truck accident when he wss in an accident on March 5, 1980, was functioning in the mild range and functioning and severe mentsl time, having first been evaluated at the Rehab May 24, 1980. At that time, he was recuperating a driver for Hall's Motor Transit and was involved At that time, his brain damage was such that he of retsrdation with respect to mental capabilities retardation. with respect to social competency. Currently, this man has made gains and now functions pretty much within the average range; however, one notes concentration difficulties andpoor habits of attention coupled with emotional lability and impulsiveness which colors his overall judgment and capabilities; for example, when asked what should he do if while in the movies he was the first person to see smoke or fire? he immediately replied "yelll" Needless to say, this would cause panic and possible disaster. While his right cerebral hemisphere seems to be more functional and stabilized, he nevertheless also exhibits difficulties with respect to spatial relationships and tasks involving visual-motor speed, This is further corroborated on his rather poor showing with the Trail Making Test, particularly Part B which is a visual-motor and conceptual type of task and also involves left temporal lobe functioning. His copying of geometric shapes again indicates impulsiveness and mild difficulties with angulation particularly in figures 7 and 8 on the Bender Gestalt Test, He was only able to recall 4 of the 9 stimulus figures and therefore, his viaual memory is seen to be below average. His reading on the Wide Range Achievement Testis somewhat improved from the previous examination of Msy 24, 1980. At that time, he earned a reading score of 8.1 and now is at 9.0, He also improved from a beginning third grade level of spelling to a beginning sixth grade level of spelling snd improved only slightly in math computation and reasoning from a 3,0 to a 3.6 sccre on the current examination. He makes use of context however, and is able to comprheend what he reads at a twelfth grade leve 1. His social competency is still within the retarded range but he moves up from a moderate level to the borderline level of mental retsrdation on the Vine land Social Maturity Scale, Greatest deficits appear to be in written communication skills which is not to his liking. lie also has not had tco muchopportunity to use tools other than a hammer to do any repair work or making cf any objects or engage in arts and crafts ,. Thomas Allen Dol'P Page 3 kinds of activities. Heis now living with his brother, Steve, but feela there is a good chance he and his wife can patch up their matiral difficulties. lie get. onto a bus by himself and goes into HalTisburg and uses some of the money that his wife gives him to buy personal needs. lie states on occasion he wi 11 buy socks and other clothing and accessories and then again his wife will do this for him. He now dresaes himself and shaves with an electric razor and bathes and takes care of h is toile t needs. He does not, however, go out by h imse If in the even ing. lie follows current events but is moreparticularly interp.sted in sports activities but knows somewhat what is happening over in Iran with respect to the hostage situation and that Ronald Reagan will be our next President. Personality measures indicate severe disturbance. This man is not now psychotic and no longer has irrational moments and temper outbursts as he had previously. He states that he has had some psychiatric care along with his plastic surgery recently in Wkeeling, West Virginia at the Ohio Valley Medical Center. lie is not taking any medicational at this point, however, and does not seem to have any definite plan in terms of follow-up care other than the possibility of going to the Rehabilitation Center in Philadelphia for some type of physical restoration. Hopefully, too, he may continue in his psychotherapy and need for emotional support. He appears to be fearful of close emotional involvement with others and has yet many conflicts with respect to sexuality and emotional dependency. There is moderate depression and he seems to tire easily and also under mild stress or pressure becomes resentful or argumentative. He finds that with I\is wife cheating on him and going with his best boyfriend, that this obviously makes it difficult for him to trust other people. Diagnostically,he would seem to present a non-psychotic organic brain syndrome with head trau~ and secondary emotional overlay of schizophrenia, schizo-affective type in remission. It appears that as long as stresses are kept to a minimu~ that this man has a chance of continuing making progress in his quest for rehabilitation. At present, however, in light of his emotional vulnerability and impulsiveness, it is felt that this man is still incompetent to manage his affairs and that he needs more psychotherapy and physical therapy and occupational therapy to continue his gains and recovering his lost functions and abilities. t- ~ ft' GcrI"''1, tf'i/, '0, Leonard M. Cohen, Ed.D. r Clinical Psychologist LMC:sc F I~D ~S.~?_'t~~.QL'~'_!.~~^L EV i\LU^'~' tON Occupation: 'l.'homus At h'n DoPt' 7/,', ErfMd lI"",J, Camp Hill, Pa. l7011 '1;Jle ',.,Ib i te 33 January 27, Iy48 ~I[lrried (;rade 11 at John Hanis lIigh School and later his G.E.D. t'nc!1l?loyC'd -- was previous ly a truck driver Patient: Address: Sex: Race: Age: Birthdate: Marital Status: Education: Referred by: ].'1y J. C!1('l, ~1. D. and Lee C. Swartz, Esq. Reason for Referral: Ysychologicnl evaluation to assess current ~unctioning nn~ needs. Dates Examined: 'lay 11, 12, 13, 1981 Tests Administered: 1 Luria-Nebraska Neuropsychological Test Battery T Scalcs --Critical level T score of 58 Motor ()l) !~uri:1 !, Q. of 9l Rhythm 58 Tactile ()9 Visual ()5 Receptive Speech 43 Expressive Speech Reading \~riting Arithmetic Memo ry Intel~igence Pathognomonic Left Hemisph(!re Right Hemisphere I~ -; 57 PETITIONER'S 57 .. 68 \ EXHIBIT 60 3 Cd. 59 79 75 TEST OBSERVATIONS ~~D FINDINGS: Tom was accompanied by !lis wife. They seem to have hac some kind of reconciliation. He tells me he very much wants to ',.Jork again :mc. :11though he cannot drive a truck now, he states he would :'.I.e to '.Jork on the' I!uck at 1-',n1.;.s ~~otor '!~ransit. '1.e also informs me that he is not too happy ",,~th his ,\~roup t....l?rn:>y DrO~~T'3r!1 at Holy Spirit Hospital. He is taking HaIdol 5 mgs, :3 ti:T!['s .:1 cay ,'1no 'HrH"qu:m lOU T!",~s. at bedtime for his depressive episodes. The Baldo:. ('v;.dcn~ly \(':1'5 to cmot:~or:l~ly stabilize him and to ward off any p~ychotic types 0 r(,.1c'':~.l)ns. It is qU:1, tQ appare:nt frOPl t1w ~un('!: :,olling on the !..uria-~ebraska Neuropsychological Test Battery tll:lt this man s'.:~:: shoy:<=:: 'n;!rkpd t'esi(:u:ll~~ 0: '.n:-t!:.n cmnage one year after his a(c~'_dent. \o.Thile t1,~.~!..,.' ""':';ln~ t':':1 'e CY~;~'Jn\":i'J"~~'.'_~ :'.:, :'('Ith hemispheres, the greatest d<1r.1age would anDC',Tf ':OJ "-)(' P\3>{.;r.L'.;~P< in t:\I' ',"-t ce~'(':'r:lJ. ~emispi1ere but with signif:~c.mt dama~~e also f'0'J"~ i'l ,~;w 1<.",11: St"1~()':\' ~'H,'.,"'r ;,...t':~ .1nd the right parietal-occipitnl lobe .1no t,_, ,: e::<'~':''' "X'::I."", .;.n ~...!',' :'i;,-": '.t'm~o'_',1: area. His speech is somewhat slurred but nevel"'.:ltl..'~"~'s ~.nt\'l:i).',__\):'-' anc ~l" rU~lcti.ons well within th<? normal range with respect to :)(.\t~~ :"CCt~?:, >:~" :1'"'" "X~H.I'~siVI,,~ ttln}!,'J:!ge skills and his Page 2 Thomas Allen DoF~ general reading and written conunullCC"C\"" ,,',,','.", "'" ',:1,1 <I' c,i.Clllty with writing down simple Homan numerals [l'ld \.'as q,:i.l.:t' S"Ji'.:'.:_sh or sl.i\\.... ~n :,oLving simple problems with respect to mental ~lrit~\lll('tLc sUl'h ,'JS 31 minus 7 0:' ,fIll ;)l.tI:~ 57 or 7 t~mcs 8. He also had difficulty nne! shO\.'(>d ~Ol\\(' mi.l(~ c\ltl~l.Ision ;.n de~1Oti.IW. the mis~;ing sign from an equation and confusing tIll' r.i.vi.s~()n si;.:',n ror lllat uf' a plus sil!,n at onc point, At times, he tend,.d t" approxi,m'Jt(' ,In answ,>r 'lOl' in gun"ral ho1d di ffi ('lllty with slowness in serial subtract Lon from OIH' ~ll\nc!r(.d \\V SeVPllS :1.I1(l al so (rom one hundred by thirteens. He had dir~_:cuLty fl.lrtll(:'ri.n ill~:t'rpr",ting pictures with respect to visual perception and also in visual sPCj,uPI1,'iQg and in being able to tell what is llcomic.:11 or a'bst1rcr' .:l.~>out the ptctures h,1 wa~"; shown. There was .11!:3o concreteness and difficulty <';Pl'n in inter~)rt~ti..np, proverbs and in interpreting analogist relationships and rC::Lsoning both VJ~.t"', resp(~("t t'o \....ord relationsh,i.ps and also again, with respect to ,impte numerical, reasolli..ng. ',:ark,.,d defi,cit was seen in spatial-based mov',ment sLlch as eonf",ing r "",ll,: Olnd l~ft d; F,c','enccs and imitating the psycho1,og;.st "ith hOlnd tnove!1wnts and r,,,,ioconsin "pete". 'Ie also had trouble with kinesthetic :)~lSec moveml.?nt such :i~~ be;,n~~ i1bl\" to imitalt! a motor movement pattern such as putting his rl?,ht thum':) :\f::ainst his :"if:h fi!l~',('\'" '..:hen this wns shown to him and being blinl~ folded, he than had to inti.tRtt~ this 'out ('.clt,!~d not do this. It was difficult for him due to his oraL surgery to purse his ,.i.ps and to try to whistle. He also showed sensory imperception \"ith :,oth imperccivin,\.', tll(~ pin prick on his left wrist and in two point discrimination on llis ri~lt and 10ft hands greater than 10 milimeters. In addition, l1t~ \Vas con:-used and un.JJlc to lli~tinguish and number three written on the back 0:- the right nnd l:W ;.cft \oJr~sts. and misinterpreted the drawing of a cross on his right wrist and felt ,nstead th,,': ohi,s was the letter "L," He seemed more sluggish \.:i':h lC'ft h.:tnded errors and took more time in perceiving and responding with his left hand. He mis}'>ct"ccived a paper clip when held in his left hand nnd felt it was a "p~;,n. II 1~'(~ [l~SO knew that lw llad .:~ coin i.n his left hand but was unable to tell what d;~nomination t:lis coin mi.ght ')c (a quarter). Visual acuity and naming of pictures WOlS di:ficuct as was visual-s",,;iaJ. organization and interpreting sentences calling Cor both l.tnderst::mding and immediat(> :luditory memory. While we see nice gains from the original evaluation. particularly as this relates to a general level of intellectual f\..'.nctioning. Pn~viously in May 24, 1980, he was within the mild mentally n'tardc(~ rn':1ge 0':1 the l...\~cnsler Adult Intelligence Scale, earning a Verbal !.Q. of 68, P~rfor~3nce I.Q. o~ 51, and ~ Full Scale I.Q. of 58. Currently, his Luria I.Q. of 9~. is p~ett:.. I1H.1C:l in aCCl)rc: \"ith the full scale of 99 on the Wechs1er-Bcllevue Inte,~',:.:..t~(~nc0 ':;c.~,~_t' -- ~:'orm I .1l~;':1i,ni~tered on January 5, 1981 (his Verbal I.Q. was 95, Perronto1nCe 1.(!, '-03, and Fu',c :.;.:a'-e !.Q, 99). One also sees some nice gains in terms o~ ('motiona'!. control .:'\nd t1" ;~:Ict that he is not as irritable and having psychot::.c reactLons OL hal,l"ucin:1tor:,' e:--.pericncC's where he feels the Viet Cong arc after him or that hr~ \oJantfi ':0 chock ILL,S 1it'.:le boy. Nevertheless, his responses and ?t"ofile on t\1(' ~uria :~l.'bras\a woule; ir1r.:~ l~.1t~ mocerutc brain damage and neurological dy~runction',;.n~.':.. ',I.I~ i,s c;t.:i t ~ ~;('en t{J ~1e i"l')l.!',StVL'. and impatient .'lnd also to some e:<tent m<-lni:Hl~ativl'~: -.:h.1t ~~;, :.f he d(~,;"": ~,~~~: hav(' :~H~ !)eoplc at Holy Spirit go along \vith his 1,..'is':H'~;, hi' s t:'i'.'n rC'iH~Y tt) ,.",,:-,1 ,,' "',,,bc!"C'.;\ in tb~s case return to Dr. CO;H~n to havp "'L1')iH1!'': 'nr "tS Y'(>1~_'!"'n !:o ,...'C""r:. "':"~'<'; ~)~;ych()logist spoke to the personnel man at H.:l~ls \l.'-"~llr '~'r,'r1~<t" ~t.,... .)a:l~"'~ :':. :';:~ri.vpr. :--:r. Shriver was told that he might l1tryll ~o '1.:1\'\' ':'O:!l '",',"'r<-: on(> (I\'" ~\,'" Ci,;!~'~': ;1 ....11.1':, ,1'" iJ doc-k \Vorker to see how :1(' could do but t~::~t '10 mo"!, '::).1'1 ~:'-\ .~, ','.I "h;"t lP wO'.lld l1l't lJ('comc unduly fnti~~ued and pos~~.bly prel..'iSli~~'>' n sp'.?u"" In' ':)"C\~!"'-' 'r~lS'.:.t':.ltl~'d and have .1. psychotic outburst. Tom is slated [O~- ,'l:,,~~:;('r ',U1"\~ery :It t~1.1 .",(1 of Jun\.' ,1n(~ he will have more