HomeMy WebLinkAbout09-27-78
IN THE MATTER OF
LILLIAN PROCHASKA
IN THE COURT OF CO~10N PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
AN ALLEGED INCOMPETENT
ORPHANS' COURT DIVISION
NO. 493 19 78
AFFIDAVIT OF NOTICE
JOYCE A. HORNER
, being duly sworn
according to law, deposes and says that she gave notice
of the hearing scheduled on
October 12, 1978
on the above-captioned matter by sending by Certified Mail,
Return Receipt Requested, a copy of the Court Citation and
a letter of explanation from Edward P. Carey, Assistant
Attorney General to all next of kin of the above-captioned
person at the addresses supplied by the institution of
which the alleged incompetent is a resident. A copy of the
Citation and the letter(s) are attached.
~ 0, ukvw~
r Y9 A. HORNER
Sworn to and Subscribed
Before me this 13th day
of OCTOBER , 19~.
I) .(Y .
t;__/~/lXj f~ ~.-?~...A"-
Notary Public
NC:TAr;'y ~L.,3L1C
11\ i CGMMISSICiN EXPIRES
MAY 13, 1982
I'~ THE Hi\TTER OF
IN THE COURT OF CON110N PLEAS OF
Lillian Pro~hRska
(nClme)
COUNTY, PENNSYLVANIA
An Alleged Incompetent
ORPHANS' COURT DIVISION
.N o. L/ q j [)LjJ./A~~ .
19/t
CITATION
TO: LILLIAN PROCHASKA
~\Te command you to appear a t a hearing in the Orphans' Court
of
Cumberland
, County, to be held at
Har~isburg State Hospital on October 12, 1978 , 19
9:30 a.m. h ' h Id t b d d d .
at ___:}1.., to s ow cause wny you s au no e a ju ge an lncompetent,
and a guardian appointed for your estate.
and to be heard
Citation Returnable khe 12 day of
October
19 78 .
HITNESSETH:
The Honorable
Dale F. Shughart
President Judge of said Court, sitting in the Orphans' Court this
13
day of
September
, 19 78.
~,P!1
r)
fa
CLERK
COURT DIVISION
IN THE MATTER OF
IN THE COURT OF COMMON PLEAS
LILLIAN PROCHASKA
AN ALLEGED INCOMPETENT
OF CUt~BERLAND
..
COUNTY,
PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 19
AFFIDAVIT OF SERVICE
Dorothy Musico,
being duly sworn according to law,
deposes and says that he/she personally served the within
Citation and Petition upon
Lillian Prochaska
at Hi'lrr; Rhl1rg St:i'lh~ H()~pi t:i'll, Harrisburg, Pa.
on
a.m./~J~J, by reading to
September 25. 1978
at 9: 30
him/her the contents of the Citation and Petition and leaving
with him/her a copy of said Citation and said Petition.
/ (
,A;L/1 AS- A J j
l ~
/J r'./, ,;)
_ A "',,' <~ -< !;.
SWORN TO AND SUBSCRIBED
BEFORE ME! THIS :../~)
DAY OF '!J1-/) 1~n ; /;i/i~ , 19 7,f.
/ I
't' 't/i0 e.
( ~"_"). (A'-!J..V-~
NOT Y PUBLIC
NOTARY PUBLIC
f.l.; r", ..
fIl"_' :-...!'!',mlsslon ExpirQS June 21), l'ily
",~rr sburg, P.l. L'R:...;rh>. C..i..."ty
REPORT OF COMPETENCY EXAMINATION
NAME
pROCHASKA LILLIAN
INSTITUTION
DATE
ADDRESSOGRAPH PLATE
INSTRUCTIONS: Set forth below your opinion as to whether the patient/resident meets the legal standards of incompetency
Include the medical and factual basis for that opinion. If you have used a competency worksheet (state centers and M R units
only) it can serve as the factual basis for your opinion. Attach a copy to this form. Under Pennsylvania law, a person may be
adjudicated incompetent if he or she, as a result of mental illness, mental retardation, or old age:
(1) is unable to manage his or her property; or
(2) is likely to dissipate that property; or
(3) is likely to become the victim of designing persons; or
(4) lacks sufficient capacity to make or communicate responsible decisions concerning the use and
management of his or her entitlements.
Your opinion regarding competence must make reference to at least one of these standards. Use as much space as needed and
be as detailed as possible. Medical basis should refer to both diagnosis and its manifestations. Factual basis refers to questions
and answers regarding the four standards above. Please sign on bottom. If additional space is required, use an attached sheet.
1~.Uf,~tAtr (-'f'u.r-tv\c1A(.~) ,,-t{UV~l~V~~ e.> .l.",'v"'-J / !,,)..tllv..4;t;.'-,} (.Aj..[,',,-c~ CA..d.iA.4:~~,t)
I '! f! ,I . I. .. ,,' , - - ,f,. " ."L :-. A"" A(
~.~c"j ~U./~':"'J ~I^. (j"\"':,":"r.L<. ,}(r V.v"r'" .A)"J :,,-.(/l'v~11',,~, l y~h..., "'V1~'
.J ('"'Ill It (j '} / 1 l . ,JJ .; ~-;.. y ccC,......'..<"....v. .(
~c,i.{ ~'.~l ~4..\ , .:y-,~ ""L-O) ...f.( fu.l,~) +0 A:J.\....{..-t'",.<.~\~ "V' v, " 'L.. !j (j
.....!t{ \/>Aif' ~7\...Ae O'v:../L..-:: /J/;,.:(+: t-U'./.",;{ cAiC;f1\'!.li'J -ft-' }ha..I<-C1,
,( 11~' ,.J f. '''-;'r\~' ......A (' ,>.\..,{.J L't. .j, "-';.'\,~t..:.
J\,t'l.if-t/y-..v_}-.~(. d.:{'/vV...'YfI..A L..~'l''-/'.(/'/I''..\. .,~(} r v",. "f[ {(i
CONCLUSION: (Please respond Yes or No)
DYes BNO
G'ves DNo
Qy~S UNO
The patient/resident is capable of managing his/her financial affairs.
The patient/resident is incapable of managing his/her financial affairs.
(If Yes, respond to the following question.)
If the patient/resident is incapable, is the patient's/resident's incapability to manage his/her
financial affairs a product and/or manifestation of his/her mental retardation, mental illness,
or old age?
o Competent Qincompetent
VJc'W'"D~it7;(1f/; Iftl Of~0 ~~
SI~NATURE OF REVIEWING /~~l':A>tRIST-PSYCHOLOGIST SIGNAllJrtEOF APPR?:JL B UPERINTENDENT
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC ~LFARE SI533-8-77
IN THE MATTER OF
IN THE ORPHANS' COURT OF
LILLIAI~ PROCHASKA
CUMBERLAND COUNTY.
An Alleged Incompetent
No. of 19
COMMONWEALTH OF PENNSYLVANIA,
: ss. :
COUNTY OF CUMBERLAND
V. G. del Rosario, M.D.
, being duly sworn
according to law, deposes and say that
1. He is a regularly licensed, practicing physician
specializing in psychiatry, who is employed at the hospital or
Harrisburg State Hospital
located
institution known as
at Cameron & Maclay Streets, Harrisburg, Pa. 17105
where on Sept. 26,
, 19~, he examined a patient therein,
viz: (Name) LILLIAN PROCHASKA
(Age) 84 , (Sex) F
The examination revealed that the above-named patient's condition
has not changed since the examination of December 30, 1977
2. It is the opinion of the affiant that
Prochaska is still incompetent.
Li 11 i an
3. Said patient is in such physical or mental condition
that he/she is capable of appearing in court and his/her presence
in court will not endanger others in the court room.
OR
~ Because of the physical or mental condition of
said patient, his/her welfare would not be promoted by his/her
- -
presence in court, and his/her presence might endanger others
-
in the court room.
Sworn to and subscribed
",
before me this / /' 'V-day
_of , 19 78.
;/ ~. fr< {/, /4 /-~
M.D.
c~~~.
'N 'I~' 'rv '\:'J\\t
(lJ ~';'_tC; I-l. llflO'JJ. ',k '. 1 !r,81
. '" .~,d~ll':,,'\. l .
Pf'. c"".,.;'\'Ofl .A~" c.",hin \.c;:nt'l
l\oz';''.:cU''), FA