HomeMy WebLinkAbout01-0102
IN THE MATTER OF
GARY KEEFER,
An Alleged Incompetent
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
INCAPACITATED PERSON
PETITION FOR APPOINTMENT
OF A TEMPORARY GUARDIAN
OF THE PERSON PURSUANT
TO 20 PA. C.S.A. 5513
1) Your Petitioner is Robert L. O'Brien, Esquire, Solicitor for the Cumberland/Perry
County Mental Health/Mental Retardation Office.
2) Respondent is Gary Keefer, an incapacitated person, currently receiving care at
1065 Mud Level Road, Shippensburg, PA., 17257. Respondent is an adult individual being
presently 48 years of age with a birth date of 7/23/52. Attached hereto, marked as Exhibit "A",
and incorporated herein by reference is a Petition prepared by the Cumberland County
MH/MR Office.
3) Petitioner requests that the Court appoint Harold Keefer, as guardian for the
limited purpose of executing certain forms and waivers that are required to insure the
continuation and availability of care and treatment for Respondent. An initial determination
has been made that, due to Respondent's low intellectual functioning, he is unable to make a
determination in reference to his placement/waiver, and that, in order to comply with
applicable state and federal laws, a guardian be appointed by the Court for the purpose of
making said election and signing the necessary forms.
WHEREFORE, Petitioner, Robert L. O'Brien, respectfully requests that the Court order
that Respondent Gary Keefer be adjudged an incapacitated person in reference to choosing
between community base and institutional services for the mentally retarded.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
BY ~(J6A.A.J/-
Robert L. O'Brien, Esquire
Solicitor for the Cumberland/Perry
County MH/MR Office
I.D. # 28351
17 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
IN THE MATTER OF
IN THE COURT OF COMMON PLEAS
COUNTY, PENNSYLVANIA
Gary Keefer
AN ALLEGED INCOMPETENT
ORPHANS' COURT DIVISION
IN RE NO.
PETITION FOR APPOINTMENT OF A
TEMPORARY GUARDIAN OF THE PERSON
PURSUANT TO 20 Pa. C.S.A. 5513
The Petition of
Gary Keefer
, respectfully represents:
1.
Your Petitioner is
Mr. Harold Keefer
2.
Gary Keefer
is currently receiving care at
1065 Mud Level Road, Shippensburg, P A 17257
3.
Gary Keefer
domiciled at 1065 Mud
Level Road, Shippensburg, P A 17257
4.
Gary Keefer
IS
48
years of age
having been born on
07/23/52
5.
Gary Keefer
marital status is single, never
married
6.
Those persons, if any, who are
Gary Keefer's
next -
of-kin and their relationship to same, of whom your Petitioner has knowledge are as
follows:
Mr. Harold Keefer
Mrs. Mildred Keefer
7. No other Court within the Commonwealth of which Petitioner has knowledge has
appointed a guardian for Gary Keefer
8.
9.
Gary Keefer
Because of mental deficiency,
is mentally retarded.
Gary Keefer
lacks
sufficient capacity to make or communicate responsible decisions concerning his/her
person as set forth in the attached Affidavit prepared by
marked as Exhibit A and made a part hereof.
10.
Gary Keefer
retardation services.
is in need of residential mental
11.
Gary Keefer
in the Person Family Directed Support Waiver
has been accepted for placement
upon
the condition that a guardian of the person be appointed to consent to said placement
on his/her behalf.
12. Mr. Harold Keefer
to Gary Keefer
of the Person of
Gary Keefer
, having no interest adverse
, has agreed to act as Temporary Guardian
if this Honorable Court
shall so appoint.
WHEREFORE, Petitioner prays this Court place Gary Keefer
under the temporary guardianship of Mr. Harold Keefer , pursuant to
20 Pa. C.S.A. S 5513 and empower said temporary guardian to provide substitute consent for such
community-based or institutional services as may be necessary to provide for his/her needs.
BY:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
AFFIDA VIT
Mr. Harold Keefer , Petitioner
in this matter, being duly sworn according to law, do depose and state that I am Mr. Harold
Keefer
of 1065 Mud Level Road, Shippensburg, P A 17257
and
that the facts set forth in the foregoing Petition are true and correct to the best of my knowledge,
information, and belief.
i~~/
Petitioner
SWORN TO AND SUBSCRIBED BEFORE
ME, THIS \?d~
Dtce (Y\ bu-
DAY OF
,20 DO.
~(\J.~k~_ ,S-\_lo ~ ~
NOTARY PUBLIC
NOTARIAL SEAL
DARCIE A. NEil, Notary Public
Shippensburg, Cumberland County
My Ccmmiss!o!1 Expires ~I~IJ. 24, 2001
IN THE MATTER OF
IN THE COURT OF COMMON PLEAS
COUNTY, PENNSYLVANIA
Gary Keefer
AN ALLEGED INCOMPETENT
ORPHANS' COURT DIVISION
IN RE NO.
COMMONWEALTH OF PENNSYLVANIA
SS#:
COUNTY OF
..J" 4ta bI. Areh-e "'^-~;-. t1D,
, being duly sworn according to law, deposes
and say that:
1. He is a licensed, practicing physician who is employed at /3r ~ h t. J {J' c c j'
f?.4 Y \/- ,/;.. "l 5
where on / tj 21 tJ1} , he examined patient therein:
viz: (Name) Gary Keefer , (Age) 48
(Sex) Male
, who was admitted from 1065 Mud Level Road,
Shippensburg, P A 17257 on
, 2000 , with a
history of
Mental Retardation
At the examination, the following symptoms were observed:
~ A'+~ -L ~ ~L, ki
~ /-2 -f4~ 7{ 1~u.L ,L.I"f. if- ~
% if"-- 7 ~-IjP ~~-
.~.
~~
from which the diagnosis made is: ~ AI.. ~
~ ~7:?--,-,
with a prognosis as follows:
~.
2. On the basis of the foregoing history and examination, the affiant is of the opinion
that
Gary Keefer
, because of mental deficiency, lacks
sufficient capacity to make or communicate responsible decisions concerning his/C
choice to receive community-based or institutional services for the mentally retarded.
3. Because of the physical or mental condition of said patient, hislBE welfare
~would not be promoted by his/_ presence in Court.
c9~D
3t:L
SWORN TO AND SUBSCRIBED
BEFORE ME THIS I ~ DAY
OF December - , ~C{i)
dwJ(l J lvLLj1OLflJJJ1tu--
NOTARY PUBLIC
Notarial Seal 1
Tr~va Forrester, N~ PubIlc
Shlppe~rg Bol'O, FrankHn C
My Comnllssion !:ltplres Mar '8~2
Member Pennsyl
. . vanIa ASSocIatIon ot Nl'11ari1:js
GARY KEEFER,
An Alleged Incompetent
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN THE MATTER OF
NO.
INCAPACITATED PERSON
NOTICE
A petition to have you adjudged an incapacitated person has been filed with this
Court by Robert L. O'Brien, Esquire. A hearing is scheduled in this matter for Jjl'dA y" ,
the ;1/vc/day of /77AIf..Lh ,200i, at3 :cV~, in Courtroom # 5', Cumberland
#OJ/
County Courthouse, Carlisle, Pennsylvania. You are strongly encouraged to be present at the
hearing, and you are warned that important rights may be lost as a result of the proceeding.
You have the right to be represented by counsel and the right to request the appointment of
counsel and to have counsel so appointed paid by the Court where you are unable to afford to
pay an attorney.
YOU SHOULD TAKE THIS NOTICE TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET
FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Court Administrator
Fourth Floor
Cumberland County Courthouse
Carlisle, Pennsylvania 17013
(717) 240-6200
JAN 2 4 2001.tfJ
GARY KEEFER,
An Alleged Incompetent
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No.21-01-'OZ.
INCAPACITATED PERSON
IN THE MATTER OF
ORDER OF COURT
AND NOW, this ;)5-th day OfUAJJIifllt! 200~, upon review of the attached
_.~I ... J ~ _ ,
Petition, a hearing is scheduled in this matter for.f.r.:':.b;5t ' the ~ /IIV'. day of /lJAiLL/J ,
200IJ, at;; (fJ ~ in Courtroom # S' , Cumberland County Courthouse, Carlisle,
ll. (){) I
Pennsylvania.
Personal service of this Order and accompanying Notice and Petition shall be caused
to be made upon the alleged incapacitated person by Petitioner in accordance with the
Probate, Estates and Fiduciaries Code. Notice shall also be given to all other persons and
entities required to be notified under the Code. Proof of service shall be furnished at the
above-scheduled hearing.
-.-' - J.
LdLA/A/l?~ L. {; LA /do L/.
/
IN THE MATTER OF
GARY KEEFER,
An Alleged Incompetent
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. O{l-C)I -IOJ-.
INCAPACITATED PERSON
IN RE: PETITION FOR APPOINTMENT OF A GUARDIAN
OPINION AND ORDER OF COURT
G"" " 4.c
BEFORE E),^,',<tCY, J.
The present case is before the Court on the Petition of Robert L. O'Brien, Esquire,
solicitor for the Cumberland/Perry Mental Health/Mental Retardation Office. It is requested
that Gary Keefer be adjudicated an incapacitated person, and that a guardian be appointed.
Following a hearing, the following Findings of Fact and Order of Court are made and entered:
FINDINGS OF FACT
1. The allegedly incapacitated person suffers from mental retardation, having an IQ
of approximately 20, which is in the severe mental retardation range. This condition impairs
the individual's capacity to make and communicate decisions.
2. The extent of the individual's capacity to make and communicate decisions is
severely limited by virtue of the aforesaid condition.
3. Notwithstanding that the allegedly incapacitated person has a very supportive
family and enjoys the support of the agency here involved, the individual does need
guardianship services.
4. The type of guardian required is a limited one of both the person and the estate,
based on the need to execute certain documents to obtain certain funding.
5. The duration of the guardianship involved would be pending further Order of
Court and would be limited to the period necessary for the execution of the aforesaid
documents and any follow-up documents.
6. The Court recognizes that a more permanent guardianship of the person and
estate is appropriate and will consider the same after receiving testimony from a physician as
to Gary Keefer's functional limitations and his physical and mental condition.
7. The proposed guardian, Harold Keefer, has no interest adverse to that of
Timothy Basom.
As a consequence of the foregoing Findings of Fact, the following Order of Court will
be entered.
ORDER OF COURT
AND NOW, this ;;,.1 day of f(I~ , 200L, based upon the Petition for
Appointment of a Temporary Guardian of the Person Pursuant to 20 Pa. C.S.A. 5513, and
following a hearing, the Court finds that the allegedly incapacitated person, Gary Keefer, is an
incapacitated person in that, because of mental retardation, he is unable to receive and
evaluate information effectively and communicate decisions sufficiently, and to such a degree
that he is, at least partially, unable to manage his financial resources or to meet the essential
requirements for his physical health and safety. He is, therefore, adjudicated an incapacitated
person, and Harold Keefer is appointed guardian of his property and person for the limited
purpose of executing necessary documents to qualify for the federal waiver program in
Section 2176 of the federal laws and regulations pertaining thereto. This Order shall continue
pending further Order of Court.
-E13(!'~1'\. B. ~A't'LEY, J.
~ct Gc... ,"cto
ROBERT L. O'BRIEN, ESQUIRE
Solicitor for Cumberland/Perry MH/MR
IN RE: Gary Keefer
An Alleged Incapacitated Person
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
; NO. ~ \ - 0 \ - b \ ad-.
: ORPHANS' COURT DIVISION
PETITION TO ADJUDICATE AN INCAPACITATED PERSON AND TO APPOINT A
PLENARY GUARDIAN OF HIS PERSON AND EST A TE
AND NOW, comes the petitioner, Leslie T. Keefer, by and through Jane Adams, Esquire,
and files this Petition pursuant to Title 20 Pa.C.S.A. 95511 and in support thereof avers the-...,
following: ~~ 0 ~
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1. The Alleged Incapacitated Person is Mr. Gary Keefer.
2. Gary Keefer currently resides at 8 Hartzdale Drive, Camp Hill, Pennsylvcin\~, 17!S 1.
He is fifty-five (55) years old.": :;
-~ -..j . .
3. Gary Keefer is not married.
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4. Gary Keefer's parents, grandparents, and only brother are all deceased. As far as the
Petitioner has been able to ascertain, the persons who are heirs under the intestacy statute in
Pennsylvania are: his uncles, Leslie T. Keefer, and Ross Keefer, and his aunts, Grace Miller,
Jean Washinger, and Hattie Ferrel. Each of these will be notified of these proceedings.
5. Petitioner is Leslie T. Keefer. Petitioner is the uncle of Gary Keefer. He is legally
qualified and suitable to be the Guardian of the Person and Estate of Gary Keefer.
6. Petitioner has no interest adverse to the alleged incapacitated person, Gary Keefer.
7. Gary Keefer is severely mentally disabled and has been for his entire life.
8. There is presently a Power of Attorney in place; however, it is believed that Gary
Keefer may not have had the mental capacity to consent to a Power of Attorney; Petitioner is
requesting a guardianship to ensure that he can protect Gary Keefer's person and property if
necessary .
9. An appointment of a guardian is the only remaining option to protect Gary Keefer's
health and property.
, . - )
"
,:J
10. Gary Keefer is unable to make informed decisions regarding healthcare including
decisions regarding medical procedures and prescription medications; therefore an appointment
of a plenary guardian over his person is required.
11. The guardianship would protect Gary Keefer from unscrupulous or designing persons
that may take advantage of him.
12. Gary Keefer is unable to handle his financial affairs; therefore an appointment of a
plenary guardian over his estate is requested.
13. Petitioner needs to access Gary Keefer's personal accounts and information, in order
to manage his income flow and property.
14. Insofar as Petitioner can ascertain, Gary Keefer's assets and income consist of the
following:
A. A trust fund with Merrill Lynch.
B. Income in the form of Social Security Benefits of $940 per month.
WHEREFORE, in order to prevent irreparable harm to the estate and health of the alleged
incapacitated person, Petitioner respectfully requests this Honorable Court appoint him to be the
plenary guardian of the estate and person for: Gary Keefer.
Respectfully submitted:
Date: /;}./;;6/o)
/'l ane Adams, Esquire
.D. No. 79465
64 S. Pitt Street
Carlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PETITIONER
VERIFICATION
I verify that the statements made in this Petition are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. g4904 relating to unsworn
falsification to authorities.
Date: {djJ-(j~l
IN RE: Gary Keefer
An Alleged Incapacitated Person
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-01-0102
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with the Court to have you declared an Incapacitated Person. If the
Court finds you to be an Incapacitated Person, your rights will be affected, including your right to
manage money and property and to make decisions. A copy of the petition which has been filed by
Leslie T. Keefer is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No.1, Cumberland
County Courthouse, Carlisle, Pennsylvania, on February 13 , 2008, at 9:45 A.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. If you do not have an attorney, you have the right to request the
Court to appoint an attorney to represent you and to have the attorney's fees paid for you
if you cannot afford to pay them yourself. You also have the right to request that the
Court order that an independent evaluation as to your alleged incapacity.
If the Court decides that you are an Incapacitated person, the Court may appoint a
Guardian for you, based on the nature of any condition or disability and your capacity to
make and communicate decisions. The Guardian will be of your person and/or your
money and other property and will have either limited of full powers to act for you.
If the court finds you are totally incapacitated, your legal rights will be affected
and you will not be able to make a contract or gift of your money to other property. If the
court finds that you are partially incapacitated, your legal rights will also be limited as
directed by the Court.
If you do not appear at the hearing (either in person or by an attorney representing you)
the court will still hold the hearing in your absence and may appoint the Guardian requested.
O.le: 0 1/04/2008 By: ~
Cl rk, Orphans' Court Division
Cumberland County, Carlisle, PA
My Commission Expires 1 st Monday,
January, 2010
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: GARY KEEFER
AN ALLEGED INCAPACITATED PERSON
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-01-102
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 01103/08
JUDGE'S INITIALS: EEG
TIME STAMP DATE: 01104/08
IN RE: CITATION
""""""""""""',"""""""""""""""""""""""""""""""""""""""""""""""""
SERVICE TO:
JANE ADAMS
LES KEEFER
ROSS KEEFER
GRACE MILLER
HA TTIE FERRELL
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
IZI USPS
DRRR
o HAND DELIVERED
o OTHER_
IZI PETITIONER
o JUDGE
o CLERK OF ORPHANS COURT
MAILED: 01/04/08
..""""""""""""""""""""""""""""""""""""""""""""""""""""""'"''''''''''''
GARY KEEFER
JEAN W ASHINGER
SERVICE TO:
ENVELOPES PROVIDED BY:
METHOD OF MAILING:
IZI USPS
DRRR
o HAND DELIVERED
o OTHER_
o PETITIONER
o JUDGE
IZI CLERK OF ORPHANS COURT
MAILED: 01/04/08
Deputy
Clerk of Orphans' Court
c.==
IN RE: Gary Keefer
An Alleged Incapacitated Person
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
; NO. '~\ () \ ()\b~
: ORPHANS' COURT DIVISION
PRELIMINARY DECREE
AND NOW, this 3elll. day of M- 2008, upon consideration of
the attached petition, filed by Jane Adams, Esquire, it is ORDERED and DECREED that a
Citation be awarded, directed to Gary Keefer, to show cause why he should be
not adjudged an incapacitated person and permanent plenary guardians of his person and estate
should not be appointed.
The time and place of the hearing on the Petition for the Appointment of Permanent
Plenary Guardian of the Person and Estate of the alleged incapacitated person are fixed for
f~ I 3>> , 2008, at ~ · L,J S"" a.m./~., prevailing time in
Courtroom No. .3ofthe Cumberland County Courthouse, Carlisle, Pennsylvania.
At least twenty (20) days written notice of the hearing on appointment of permanent
plenary guardians of the person and estate shall be given to Gary Keefer, the alleged
incapacitated person, by serving him or his Attorney personally with the Citation and this Order
of Court and a copy of the foregoing Petition together with an explanation of the content and
terms of the Petition.
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ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: GARY KEEFER
AN ALLEGED INCAP ACIT A TED PERSON
CUMBERLAND COUNTY
PENNSYL VANIA
NO. 21-01-102
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 01/03/08
JUDGE'S INITIALS: EEG
TIME STAMP DATE: 01/04/08
IN RE: PRELIMINARY DECREE
"""""""""",."""""""""""".""",','""""""""""""""""""..",."""""""".""".",
SERVICE TO:
JANE ADAMS
LES KEEFER
ROSS KEEFER
GRACE MILLER
HATTIE FERRELL
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
IZI USPS
DRRR
o HAND DELIVERED
o OTHER_
IZI PETITIONER
o JUDGE
o CLERK OF ORPHANS COURT
MAILED: 0 l/04/08
....""""""""""""""""""""""""""',','"""""""",........".""""""""""..""""""",.
SERVICE TO:
GARY KEEFER
JEAN W ASHINGER
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
IZI USPS
DRRR
o HAND DELIVERED
o OTHER_
o PETITIONER
o JUDGE
IZI CLERK OF ORPHANS COURT
MAILED: 0 l/04/08
~..
~~y~
eputy ,
Clerk of Orphans' Court
IN RE: Gary Keefer
An Alleged Incapacitated Person
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 21 - 01 - 0102
: ORPHANS' COURT DIVISION
AMENDED PETITION TO ADJUDICATE AN INCAPACITATED PERSON AND TO
APPOINT A PLENARY GUARDIAN OF HIS PERSON AND ESTATE
AND NOW, comes the petitioner, Leslie T. Keefer, by and through Jane Adams, Esquire,
and files this Petition pursuant to Title 20 Pa.C.S.A. 95511 and in support thereof avers the
following:
1. The Alleged Incapacitated Person is Mr. Gary Keefer.
2. Gary Keefer currently resides in a private assisted living home located at: 8 Hartzdale
Drive, Camp Hill, Pennsylvania, 17011. He is fifty-five (55) years old. His date of birth is July
23, 1952.
3. Gary Keefer's home is run by Impact Systems, 4 Beryl Road, Paoli, Pa, 19301.
4. Gary Keefer is not married.
5. Petitioner is Leslie T. Keefer, who is Gary Keefer's uncle. His address is 1065 Mud
Level Road, Shippensburg, Pa. 17257.
6. Petitioner is legally qualified and suitable to be the Guardian of the Person and Estate
of Gary Keefer. He has been in regular contact with Gary and has been taking care of his
personal care and financial affairs for an extended period of time.
f".~
7. Gary Keefer's parents, grandparents, and only brother are all deceased.cA.s far as @
Petitioner has been able to ascertain, the persons who are heirs under the intestacy~i:~te in ~
Pennsylvania are: . ;~p ~
":.r,
Leslie T. Keefer, uncle, 1065 Mud Level Road, Shippensburg, Pa. rZZ~7--~
Ross Keefer, uncle, 10450 Shale Rd, Shippensburg, P A 17257 ~ f2 -,;
.' ~J
Grace Miller, aunt, 10957 Mapleton Road, Shippensburg, Pa. 1725~~2 --I
Jean Washinger, aunt, 12489 Cumberland Highway, Orrstown, Pa. 17244
Hattie Ferrell, aunt, 129 Walnut Bottom Road, Shippensburg, Pa. 17257
Each of these will be notified of these proceedings. .
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8. Petitioner has no interest adverse to the alleged incapacitated person, Gary Keefer.
9. Gary Keefer is severely mentally disabled and has been for his entire life. He is
physically healthy, but is unable to take care of most aspects of his daily life without assistance.
He is unable to write a check, or perform any tasks to oversee his financial affairs.
10. There is presently a Power of Attorney in place; however, it is believed that Gary
Keefer may not have had the mental capacity to consent to a Power of Attorney; Petitioner is
requesting a guardianship to ensure that he can protect Gary Keefer's person and property if
necessary .
11. Gary Keefer is unable to make informed decisions regarding healthcare including
decisions regarding medical procedures and prescription medications; therefore an appointment
of a plenary guardian over his person is required.
12. An appointment of a guardian is the only option to protect Gary Keefer's health and
property.
13. Gary Keefer is unable to handle his financial affairs; therefore an appointment of a
plenary guardian over his estate is requested.
14. The guardianship would protect Gary Keefer from unscrupulous or designing persons
that may take advantage of him.
15. Petitioner needs to access Gary Keefer's personal accounts and information, in order
to manage his income flow and property.
~
16. Insofar as Petitioner can ascertain, Gary Keefer's assets and income consist of the
following:
A. A trust fund with Merrill Lynch.
B. Income in the form of Social Security Benefits of $940 per month.
WHEREFORE, in order to prevent irreparable harm to the estate and health of the alleged
incapacitated person, Petitioner respectfully requests this Honorable Court appoint him to be the
plenary guardian of the estate and person for: Gary Keefer.
Date:
I/;<I/of
Respectfully ~
Adams, Esquire
64 S. Pitt Street
Carlisle, Pa. 17013
(717) 245-8508
A TTORNEY FOR PETITIONER
ATTORNEY VERIFICATION
Undersigned counsel, Jane Adams, Esquire, hereby verifies and states that:
1. She is the Attorney of record for Leslie T. Keefer.
2. She is authorized to make this verification on his behalf.
3. The facts set forth in the foregoing response as known to her and not necessarily to her
client.
4. The facts set forth in the foregoing response are true and correct to her to the best of
her knowledge, information, and belief.
5. She is aware that false statements herein are made subject to the penalties of 18
Pa.C.S. 94904 relating to unsworn falsification to authorities.
Date 1!4~ r
1 e Adams, Esquire
6 S. Pitt St.
arlisle, Pa. 17013
Attorney for Leslie T. Keefer
.'
IN RE: Gary Keefer
An Alleged Incapacitated Person
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
~ NO. d \ .0 \ . \ () ~
: ORPHANS' COURT DIVISION
AND NOW, this
ORDER OF COURT
FINAL DECREE
~
/3 day of F~
2008, following a hearing, and
making a finding that Gary Keefer: (1) is severely mentally disabled to a point that impairs
his capacity to make decisions; (2) his condition will most likely not improve; (3) due to his
condition he needs a guardian of his person and estate; (4) the type of guardianship he needs is
plenary;
IT IS HEREBY ORDERED:
(1) Leslie T. Keefer, the uncle of Gary Keefer, is appointed plenary guardian of the
person and estate of Gary Keefer.
(2) The Guardian is not required to post bond.
(3) The Guardian shall file all reports as required by 20 Pa.C.S. Section 5521(c).
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cc: Jane Adams, Esquire, for Petitioner
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ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: GARY KEEFER,
AN INCAP ACIT A TED PERSON
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-02-0102
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 02/13/08
JUDGE'S INITIALS.. EEG
TIME STAMP DATE: 02/13/08
IN RE: FINAL DECREE
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SERVICE TO:
JANE ADAMS ESO
METHOD OF MAILING:
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D JUDGE
D CLERK OF ORPHANS COURT
MAILED: 02/13/08
SERVICE TO:
METHOD OF MAILING:
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Deputy
Clerk of Orphans' Court
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: GARY KEEFER, AN ALLEGED INCAPACITATED
PERSON
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-01-0102
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 02/13/08
JUDGE'S INITIALS: EEG
TIME STAMP DATE: 02/13/08
IN RE: FINAL DECREE
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SERVICE TO:
GRACE MILLER
JEAN W ASHINGER
LES KEEFER
HATTIE FERRELL
ROSS KEEFER
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
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DRRR
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[8] PETITIONER
D JUDGE
D CLERK OF ORPHANS COURT
MAILED: 02/14/08
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MAILED:
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SP 4-131 (5-2006)
COMMONWEALTH OF PENNSYLVANIA
NOTIFICATION OF MENTAL HEALTH COMMITMENT
The Pennsylvania Uniform Firearms Act, 18 Pa.C.S. 6105(c)(4) specifies that it shall be unlawful for any person adjudicated as an incompetent or
who has been involuntarily committed to a mental institution for inpatient care and treatment under Section 302, 303, or 304 of the Mental Health
Procedures act of July 9, HI76 (P.L. 817, No. 143) to possess, use, manufacture, control, sell or transfer firearms. This would include adjudication of
incapacity pursuant to 20 Pa.C.SA 5501. Pursuant to the Pennsylvania Mental Health Procedures Act, Section 109, notification shall be transmitted
to the Pennsylvania State Police by the judge, mental health review officer, or county mental health and mental retardatio~..aQministrator ~~n SEVEN
days of the adjudication, commitment or treatment by first class mail to the Pennsylvania State Police, Attention: ~cpnit, 180glmerton
Avenue, Harrisburg, PA 17110. A copy of this form must also be forwarded to the sheriff of the countY:,i::!:t.Which t~ person;
res ides in accordance with 18 Pa.C.S. ~ 61 09(i.1 )(2). The envelope should be marked "CONFIDENTIAL - A TTENt~EA~"
.;::; F;:;
Place an "X" on either Involuntary Commitment and indicate 302, 303, 304, or Adjudicated Inconip~~~t W
PRINT CLEARLY QR TYPE
302 303 304 OTHER
"
INVOLUNTARY COMMITMENT D
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ADJUDICATED INCOMPETENT III
w
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DATE OF COMMITMENT OR ADJUDICATED INCOMPETENT
2 /13/8
COUNTY OF COMMITMENT Cumberland
INDIVIDUAL INFORMATION -INDIVIDUAL INVOLUNTARilY COMMITTED OR ADJUDICATED INCOMPETENT
LAST NAME Keefer FIRST Gary MIDDLE Lee
JR., ETC.
DATE OF BIRTH 7
SEX ~ RACE
MAIDEN NAME
/ 23 /1952
ALIAS
SOCIAL SECURITY NUMBER 205-44-0794
Caucasian HEIGHT 5 I 9
WEIGHT 310
HAIR Brown
EYES Blue
ADDRESS 8 Hartzdale Drive, Camp Hill PA 17011
302 Commitment Requires Physician's Certification
Physician Certifying Ne(:essity of Involuntary Commitment
(Required in accordance with Section 6105(c)(4) of the Uniform Firearms Act)
Please Print Name and Provide Sianature
Hospital/ Facility Providing Treatment / Address
...........................................................................................
NOTIFICA TION BY (Please print name, address, area code, and telephone number of agency or county court.)
MH/MR Administrator/Review Officer
Telephone 717-240-6345
303-304 Commitment requires the Judge/Review Officer name authorizing the commitment, case number, & order date
Judge/Review Officer Edward E. Guido, Judge
Date of Court Order 2
/13 / 2008
Court Case Number 21-2001-0102
SIGNATURE OF NOTIFYING OFFICIAL
Date';'" / I 3/ ,,;erafi"
...........................................................................................
NOTIFICATION OF PHYSICIAN'S DETERMINATION THAT NO SEVERE MENTAL DISABILITY EXISTS
The physician shall provide signed confirmation of the lack of severe mental disability following the initial examination under Section 302(b) of the
Mental Health Procedures Act and pursuant to the Pennsylvania Uniform Firearms Act, Section 6111.1 (g)(3). Notice shall be transmitted by physician
to the Pennsylvania State Police through the county Mental health and Mental Retardation Administrator or ental Health Review Officer.
Name - Physician (Please print.)
Signature - Physician
Date
Original: Pennsylvania State Police
Copy: County Sheriff's Office (see web site: www.oasheriffs.ore: for current sheriff infonnation)
IN' RE: Gary Keefer
An Incapacitated Person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
rv
NO. 2l-O1-102
~ C..
ORPHANS' COURT DIVISION `~-`~m ~
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PFTITION TO APPOINT CO-GUARDIAN PFRSUN ANU "1'U arrUiN r.~i.,~i~~c
GUARDIAN OF HIS PERSON AND ESTATE ~-~ o
rn
AND NOW, comes the petitioner, Leslie T. Keefer, by and through his attorney, Jane
Adams, Esquire, and files this Petition pursuant to Title 20 Pa.C.S.A. §SSl l and in support
thereof avers the following:
1. The Incapacitated Person is Mr. Gary Keefer. He was found incapacitated by this
Honorable Court on February 13, 2008, and Leslie T. Keefer was appointed his plenary guardian.
A copy of the order is attached as Exhibit A.
2. Gary Keefer currently resides in a private assisted living home at 8 Hartzdale Drive,
Camp Hill, Pennsylvania. 1701 I . He is fifty-six (56) years old.
3. Gary Keefer is not married.
4. Petitioner is Leslie T. Keefer. Petitioner is the plenary guardian and uncle of Gary
Keefer. He is Legally qualified and s~iitable to be the Guardian of the Person and Estate of Gary
Keefer.
6. Petitioner has no interest adverse to the alleged incapacitated person, Gary Keefer.
7. Guardian, Leslie T. Keefer, was born on June 21, 1942, and is sixty-six (66) years old.
He is retired and frequently travels to Florida.
8. The Guardian, due to his age, and frequent travel, requests that a co-guardian be
appointed.
9. The proposed co-guardian is: Barbara Burkholder. Her date of birth is January 23,
1960, and she is forty-eight (48) years old. Her address is: 51 Thompson Creek Drive,
Shippensburg, Pennsylvania, 17257 and she is the cousin of Gary Keefer. c7
10. The proposed co-guardian has no interest adverse to the alleged incapacit~+,
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11. Under 20 Pa_C.S. X5514, the court may, without a hearing appoint a successor or co-
guardian after such notice to parties as it shall direct. Specifically, such section provides:
""The court, after such notice to parties in interest, may without a hearing
appoint a succeeding guardian to fill a vacancy in the office of guardian
or appoint a co-guardian of the estate of the incapacitated person."
Sec' 20 Na.C.S. §5514.
12. An appointment of a co-guardian is the best option to protect Gary Keefer's health
and property, since the appointed guardian engages in frequent travel, the eo-guardian lives in t:he
area and could he available for the incapacitated person if the need arises.
13. The co-guardianship would protect Gary Keefer from unscrupulous or designing
persons that may take advantage of him.
14. Petitioner is requesting that the co-guardian is appointed after notice is given to the
Petitioner, the proposed co-guardian, and the company, Impact Systems, which oversees Gary
Keefer's private assisted living home.
15. Petitioner is aware of no other persons who would be willing or interested in being
co-guardian. Gary Keefer's parents are deceased, he has never been married, and he has no
children.
16. "phis matter was previously assigned to Judge Guido.
17. Petitioner is not aware of anyone who would oppose his request.
WHEREFORE, in order to prevent irreparable harm to the estate and health of the alleged
incapacitated person, Petitioner respectfully requests, after notice, that this Honorable Court
appoint a co-guardian of the person and estate of Gary Keefer.
.,.,. 1/9/0 9
Respectfully submitted:
3°°' e Adams, Esquire
I. . No. 79465
W. South St.
Carlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PETITIONER.
SOUTH PITT STREET
RLISLE;'PA 1'013
(717) 245-8508
IN RE: Gary Keefer
An Alleged Incapacitated Person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
:NO. ~` ~ ~ ~Q `~
:ORPHANS' COURT DIVISION
ORDER OF COURT
FINAL DECREE
AND NOW, this 13~day of ~ 2008, following a hearing, and
making a finding that Gary Keefer: (1) is severely mentally disabled to a point that impairs
his capacity to make decisions; (2) his condition will most likely not improve; (3) due to his
condition he needs a guardian of his person and estate; (4) the type of guardianship he needs is
plenary;
IT IS HEREBY ORDERED:
(1) Leslie T. Keefer, the uncle of Gary Keefer, is appointed plenary guardian of the
person and estate of Gary Keefer.
(2) The Guardian is not required to post bond.
(3) The Guardian shall file all reports as required by 20 Pa.C.S. Section 5521(c).
J.
cc: Jane Adams, Esquire, for Petitioner
Jane Adams
ATTORNEY AT LAW WWW,ADAMSLAW.NET
--~ FAX (7 17) 243-9200
CONSENT TO BE APPOINTED AS GUARDIAN
I, Barbara Burkholder, consent to be appointed co-guardian of Gary Keefer. I
understand that I will be subject to all requirements of acourt-appointed guardian under
Pennsylvania Law. I have reviewed the petition, and I verify that the statements made in this
Petition are true and correct. I understand that false statements herein are made subject to the
penalties of 18 Pa.C.S. ti4904 relating to unsworn falsification to authorities.
Date: ~ , g
Barbara Burkl lder
51 Thompson Creek Drive
Shippensburg, Pa. 17257
VERIFICATION
l verify that the statements made in this Petition are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn
falsification to authorities.
.~ ~,
Date: ~ ~ eslie T. Keefer, Pet' over
IN RE: Gary Keefer
An Incapacitated Person
IN THL' COURT OF COMMON PLEAS
C UMBERLAND COUNTY. PENNSYLVANIA
NO. 21-O1-102
ORPHANS' COURT DIVISION
ORDER OF COURT
AND NOW, this ~ p~~Day of ~~~ , 2009, upon
consideration of the attached petition, a Rule to Show Cause is issued, to show why the relief
requested in the petition should not he granted.
Such Rule is returnable ~~ days after service upon the proposed co-guardian
and Gary Keefer's care provider.
cc: Jane Adams, Esquire, for Petitioner
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ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
In Re: GARY KEEFER, AN INCAPACITATED PERSON CUMBERLAND COUNTY
PENNSYLVANIA
NO.OI-102
CERTIFICATE OF SERVICE OF ORDER
ORDER DATE:
JUDGE'S INITIALS:
T[ME STAMP DATE:
IN RE: ORDER OF COURT
SERVICE TO: JANE ADAMS
METHOD OF MAILING:
® USPS
^ RRR
^ HAND DELIVERED
^ OTHER
MAILED: 01/12/09
ENVELOPES PROVIDED BY:
® PETITIONER
^ JUDGE
^ CLERK OF ORPHANS COURT
SERVICE TO:
METHOD OF MAILING:
^ USPS
^ RRR
^ HAND DELIVERED
^ OTHER
MAILED:
ENVELOPES PROVIDED BY:
^ PETITIONER
^ JUDGE
^ CLERK OF ORPHANS COURT
puty
Clerk of O ans' urt
IN RE: Gary Keefer 1N THE COURT OF COMMON PLEAS
An Incapacitated Person :CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-01-102
ORPHANS' COURT DIVISION
MOTION TO MAKE RULE ABSOLUTE
AND NOW, comes the petitioner, Leslie T. Keefer, by and through his attorney, Jane
Adams, Esquire, and files this Petition pursuant to Title 20 Pa.C.S.A. §511 and in support
thereof avers the following:
1. The Incapacitated Person is Mr. Gary Keefer. He was found incapacitated by this
Honorable Court on February 13, 2008, and Leslie T. Keefer was appointed his plenary guardian.
2. Gary Keefer currently resides in a private assisted living home at 8 Hartzdale Drive,
Camp Hill, Pennsylvania, 17011. He is fifty-six (56) years old.
3. Petitioner is Leslie T. Keefer. Petitioner is the plenary guardian and uncle of Gary
Keefer. He is legally qualified and suitable to be the Guardian of the Person and Estate of Gary
Keefer.
4. Petitioner has no interest adverse to the alleged incapacitated person, Gary Keefer.
5. Guardian, Leslie T. Keefer, was born on June 21, 1942, and is sixty-six (66) years old.
He is retired and frequently travels to Florida.
6. The Guardian, due to his age, and frequent travel, has requested that a co-guardian be
appointed.
7. The proposed co-guardian is: Barbara Burkholder. Her date of birth is January 23,
1960, and she is forty-eight (48) years old. Her address is: 51 Thompson Creek Drive,
Shippensburg, Pennsylvania, 17257 and she is the cousin of Gary Keefer.
8. The proposed co-guardian has no interest adverse to the alleged. incapacitated person,
Garv Keefer.
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9. Under 20 Pa.C.S. §5514, the court may, without a hearing appoint a successor or co-
guardian after such notice to parties as it shall direct. Specifically, such section provides:
"The court, after such notice to parties in interest, may without a hearing
appoint a succeeding guardian to till a vacancy in the office of guardian
or appoint a co-guardian of the estate of the. incapacitated person."
See 20 Pa.C.S. §5514.
10. An appointment of a co-guardian is the best option to protect Gary Keefer's health
and property, since the appointed guardian engages in frequent travel, the co-guardian lives in the
area and could be available for the incapacitated person if the need arises.
11. A Rule to Show Cause, was issued, under Leslie Keefer's Petition for a co-guardian,
returnable in twenty days after service of the proposed co-guardian and Gary Keefer's care
provider. A copy of that Rule is attached as Exhibit A.
12. Notice has been provided to the proposed guardian and care provider via certified
mail. A copy of Affidavits of Service are attached as Exhbit B.
13. As notice has been provided in accordance with the Rule, Petitioner is requesting that
the Court enter the proposed Order for a co-guardian.
14. This matter was previously assigned to Judge Guido.
15. Petitioner is not aware of anyone who would oppose his request. Petitioner's counsel
spoke to a supervisor with Gary Keefer's care provider and no objection to the request fora co-
guardian was expressed.
WHEREFORE, in order to prevent irreparable harm to the estate and health of the alleged
incapacitated person, Petitioner respectfully requests, after notice, that this Honorable Court
appoint a co-guardian of the person and estate of Gary Keefer.
~.~ ~I a6/aq
Respectfully submitted:
~ waams, r,squire
I . No. 79465
1 W. South St.
Carlisle, Pa. 17013
(717)245-8508
ATTORNEY' FOR PETITIONER
IN RC: Gxiy Keefe~-
An [ncap~icitatect Person
IN THE COURT OF COMMON PLEAS
CUN[BERLAND COUN'T'Y, PENNSYLVANIA
NO. 21-Ol-lU?
ORPHANS' COURT DIVISION
ORDCR OF COURT
AND NOW, this , ~ Day of , ?009 upon
~~~~~
consideration of the attached petition, a Rule to Show Cause is issued, to show why the relief
requested in the petition should not be granted.
Such Rule is returnable days after service upon the proposed co-guardian
and Gary Keefer's care provider.
cc: .lane Adams. Esquire, l-or Petitioner
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IN RE: Gary Keefer . IN THE COURT OF COMMON PLEAS
An Incapacitated Person :CUMBERLAND COUNTY, PENNSYLVANIA
:N0.21-01-102
ORPHANS' COURT DIVISION
AFFIDAVIT OF SERVICE
AND NOW, this February 26, 2009, I, Jane Adams, Esquire, hereby certify that on or
about January 2, 2009, I served a copy of the Rule and Petition for Coyguardian on the following
individuals, via certified mail, restricted delivery, return receipt requested, at:
Barbara Burkholder
51 Thompson Creek Dr.
Shippensburg, Pa. 17257
PROPOSED GUARDIAN
Dan Daly, Impact Systems
4601 Devonshire Road
Suite 103
Harrisburg, Pa. 17109
CARE PROVIDER
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so that t+ve can r'etum the card. to you. B. by ( ) C. Date of Delivery
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Respectfully Submitted:
J Adams, Esquire
.D No. 79465
West South St.
Carlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PLAINTIFF
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FEB 2 7 7(?~'9~
IN RE: Gary Keefer IN THE COURT OF COMMON PLEAS
An Incapacitated Person :CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-O1-102
ORPHANS' COURT DIVISION
ORDE~~R~~ O~~ F~~ QQCOURT
ANDNOW, this ~ Day of~•`~ti~- , 2009, upon
consideration of the attached petition, it is hereby ORDERED and DECREED that:
(1) Qarbara Burkholder and Leslie T. Keefer shall serve as plenary co-guardians of the
person and estate of Gary Keefer.
(2) The Guardians are not required to post bond.
(3)'ihe Guardians shall the all reports as required by 20 Pa. C.S. Section 5521(c).
...
E COURT;
cc: Jane Adams, Esquire, for Petitioner
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In Re: GARY KEEFER
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 01-102
ORDER DATE:
JUDGE'S INITIALS:
TIME STAMP DATE:
CERTIFICATE OF SERVICE OF ORDER
IN RE: ORDER OF COURT
SERVICE TO:
METHOD OF MAILING:
® USPS
^ RRR
^ HAND DELIVERED
^ OTHER
MAILED: 03/03/09
ENVELOPES PROVIDED BY:
® PETITIONER
^ JUDGE
^ CLERK OF ORPHANS COURT
SERVICE TO:
METHOD OF MAILING:
^ USPS
^ RRR
^ HAND DELIVERED
^ OTHER
MAILED:
ENVELOPES PROVIDED BY:
^ PETITIONER
^ JUDGE
^ CLERK OF ORPHANS COURT
eputy
Clerk of O ans' ourt
IN RE: Gary Keefer : IN THE COURT OF COMMON PLEAS
An incapacitated person :CUMBERLAND COUNTY, PENNSYLVANIA
:N0.21-O1-102
ORPHAN' S COURT DIVISION
ANNUAL REPORT OF THE GUARDIANS OF THE ESTATE
ESTATE: Gary Keefer
GUARDIANS: Leslie T. Keefer and Barbara Burkholder
PERIOD: February 13, 2008 -present
This report is filed with the Court in compliance with Section 5521c of Act 24 of July 16,
1992, 20 Fa.C.S.A. 5521.
We, Leslie T. Keefer and Barbara Bwkholder, Plenary Co-guardians of the Estate of
Gary Keefer, verify that the attached is an accurate report of the income and expenses of the
Guardianship Account.
~'
eslie T. Keefer
1065 Mud Level Road
Shippensburg, Pa. 17257
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IN RE: Gary Keefer
COUNTY
An Incapacitated Person
IN THE COURT OF CUMBERLAND
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-01-102
ORPHAN'S COURT DIVISION
ANNUAL REPORT OF GUARDIAN OF ESTATE
Principal receipts None
Principal disbursements, without prior $508.70 for new dresser.
Principal disbursements, with prior
court approval
None
Principal Balance
Income receipts
Income disbursements
$58 680.59 (as of May 30, 2009)
Merrkl Lynch Trust Fund
$1030/mo in social sec. Disability
$505/mo rent
$35/mo for prescriptions.
$150/mo for entertainment per month.
(Movies, bowling, snacks, etc.)
$75/mo for clothes.
Remaining funds per month go towards
Personal expenses, toiletries,
Basic needs, and spending money.
Comments: Most of Gary's money is in a trust fund with IyMerryl Lunch. Gary
currently has a modest income which meets his needs. There is sufficient income to
meet expenditures and hem him maintain his current lifestyle. It is not anticipated
there will be a~ large e~enditures of principal in the future.
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IN RE: Gary Keefer : IN THE COURT OF COMMON PLEAS
An incapacitated person :CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-01-102
ORPHAN'S COURT DIVISION
INVENTORY
We, Leslie T. Keefer and Barbara Burkholder, Co-guardians of the above incapacitated
person, verify that the items appearing in the attached inventory include all of the personal assets
wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said
incapacitated person, that the valuation placed opposite of each item of this inventory is accurate
to the best of our knowledge, and that the incapacitated person owned no real estate outside the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
inventory. I verify that the statements made in this inventory are true and correct. I understand
that false statements herein are made subject4 to the penalties of 18 Pa.C.S. section 4904
relating to unswon falsification to authorities.
Date: ~/~
Les Keefer, G dian
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IN RE: Gary Keefer
An incapacitated person
Description
Various Personal items
Clothes
New Dresser, purchased March 2009
Watch
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-01-102
ORPHAN' S COURT DIVISION
INVENTORY
Value
$100
$150
$508.70
$25
Merryl Lynch Trust Fund $57,902.89 as of May 29, 2009
1N RE: Gary Keefer : IN THE COURT OF COMMON PLEAS
An incapacitated person :CUMBERLAND COUNTY, PENNSYLVANIA
:N0.21-01-102
ORPHAN'S COURT DIVISION
ANNUAL REPORT OF THE GUARDIANS OF THE PERSON
1. Current Address of incapacitated person: 18 Harzdale Driver Camp Hill Penn~,vlvania,
17011 which is a private assisted living home operated by Impact Systems.. Inc.
2. Describe the type of placement and living arrangements of the incapacitated person, e.g.:
private home personal care facility, hospital, institution, etc. Gary is living in a private assisted
living home where he can get individual care and maintain a comfortable life style.
3. Briefly describe the incapacitated person's medical care and any social psychological, or
other support services he receives: Gary canperform some tasks, but needs assistance with his
medication meal preparation laundr}~ and all aspects of dail ly wing. He participates in an
appropriate daX.l2rogram in Carlisle and receives support with dailkl~sks at his residential home
4. As guardian of the person, do you think the guardianship of the person should continue, be
terminated, or modified? The guardianship should continue because Gary still needs assistance
with mana ig ng his finances and medical care It is not expected that his condition will chance
5. Number and length of time that you have visited the incapacitated person since your
appointment or last report. I visit Garv every Thurs av for several hours when I og to his
residence and take him out for lunch.
6. Briefly describe any concerns about the incapacitated person's physical or mental well being
or finances that the court should know. There are no concerns at this time. His financial
yyndition is stable Ga3y's mental anc~phvsical condition is stable and he is being well cared for
in his current placement.
Date: $1 ~ / ~ ~ ~l
` es Keefer, G dean
S.
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Barbara Burkh der, Guardian