Loading...
HomeMy WebLinkAbout06-13-08IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT IN RE: ROBERT G. TRAVER and LOIS j. TRAVER n CD ;_ ~ }ZC7 ~~rn O.C. No. 21-2008-5fi~~? :,=o° _~ ~_ -o --i PETITION FOR ACCOUNTING N Q C., (..,.' :~ w :~:. ~, Petitioner, HCR ManorCare -Camp Hill ("Petitioner"), presents this Petition for Accounting and, in support thereof, respectfully represents that: 1. Robert G. Traver has been a resident of Petitioner's skilled nursing facility .~ -,,; _.-_ .j F. - -; t --, located at 1700 Market Street, Camp Hill, Pennsylvania, 17011, since his admission on or about December 17, 2004. A true and correct copy of the Admission Agreement is attached as Exhibit "A" (hereafter "Robert Traver's Admission Agreement") 2. Lois J. Traver has been a resident of Petitioner's skilled nursing facility located at 1700 Market Street, Camp Hill, Pennsylvania, 17011, since her admission on or about January 25, 2006. A true and correct copy of the Admission Agreement is attached as Exhibit "B" (hereafter "Lois Traver's Admission Agreement"). 3. Pursuant to the Power of Attorney documents provided to Petitioner, Anna Messimer, of 1095 Pinetown Road, Lewisberry, Pennsylvania 17339, is the daughter and Agent of both Robert G. Traver and Lois J. Traver, and, as such, has certain fiduciary duties as outlined in the documents, as well as in Title 56 of the Probate, Estates and Fiduciaries Code. True and correct copies of Robert G. Traver's ONIGINAL~ Power of Attorney and Lois J. Traver's Power of Attorney documents are attached as Exhibits "C" and "D" respectively. 4. Upon information and belief and to the extent of Petitioner's knowledge, Anna Messimer has exercised control over both her father's assets and income and her mother's assets and income as agent-in-fact. 5. Upon information and belief and to the extent of Petitioner's knowledge, Robert G. Traver and Lois J. Traver receive monthly income consisting of Social Security in the amount of $929.00, and pension and annuity payments in the monthly amount of $9,443.00. See 2006 Joint Income Tax return, a true and correct copy of which is attached as Exhibit "E." 6. In the year 2006, the most recent year for which information was available to Petitioner, Robert G. Traver and Lois J. Traver received $40,964.00 in installment sales income pursuant to the sale of properties to Hughes, KraIl and Eppley. Upon the information and belief of Petitioner, and to the best of Petitioner's knowledge, Robert G. Traver and Lois J. Traver still receive installment sales income pursuant to these transactions. See Exhibit "E," IRS Forms 6252. 7. On Apri110, 2008, the Cumberland County Assistance Office denied Robert G. Traver's application for Medical Assistance benefits, stating that: Robert Traver has been determined ineligible for Medicaid including services in a Long Term Care facility due to excess resources. As of 06/01/07 requested effective date, the total countable resources including Mr. Traver's half of the farm owned jointly with his spouse on that date were: $576,676.41. The limit for Mr. Traver, based on his income is $8,000. (NOTE: The total shown above excludes verified medical expenses paid after 06/01/2007 totaling $7,526.44) 2 See the Medical Assistance Notice to Appliccntt, dated Apri110, 2008; a tl-ue and correct copy of which is attached hereto as Exhibit "F." 8. To the extent of Petitioner`s knowledge and based upon information and belief, Anna Messimer has been receiving some or all of the aforementioned income of her father, Robert G. Traver, and her mother, Lois J. Traver. 9. An outstanding balance in excess of Ninety-Two Thousand Nine Hundred Twenty-Four and 42/100 ($92,924.42) is due and owing to Petitioner for skilled nursing services provided to Robert G. Traver. 10. An outstanding balance in excess of One Hundred Thousand Five Hundred Eighty-Seven and 98/100 ($100,5$7.98}Zis due and owing to Petitioner for skilled nursing services provided to Lois J. Traver. 11. Pursuant to the Power of Attorney document, as well as her duties under the Probate, Estate and Fiduciaries Code, at all times material hereto, Anna Messimer has had a fiduciary duty to provide payment to Petitioner for services and skilled nursing care provided to Robert G. Traver and Lois J. Traver, and she has failed to do so and continues to fail to do so. 12. This Court has mandatory jurisdiction over all matters pertaining to the exercise of powers by Agents under Powers of Attorney documents and has the authority to order the relief requested herein pursuant to 20 Pa.C.S.A. § 711(Z~). ~ Because Robert Traver is a current resident, the outstanding amount owed continues to increase ead~ month by approximately $6,500.00. '' Because Lois Traver is a current resident, the outstanding amount owed continues to increase each month by approximately $6,500.00. 3 WHEREFORE, Petitioner requests that this Honorable Court issue a citation directed to Anna Messimer to show cause, if any there be, why an Order should not be entered requiring her to file a full and complete accounting of all transactions undertaken by her with respect to Robert G. Traver s assets and income and Lois J. Traver's assets and income from February 23, 2006, to the present. Respectfully submitted, Dated: `1 l ~ G 6 By SCHUTJER BOGAR LLC Kirk S. Sohonage Attorney I. D. No. 77851 (717) 909-8160 Brandon S. Williams Attorney I.D. No. 200713 (717) 909-5922 417 Walnut Street, 4th Floor Harrisburg, PA 17101 Attorneys for Petitioner 4 VERYFICATION The undersigned hereby verifies that the statements of fact in the foregoing Petition for Accounting are true and correct to the best of my knowledge, information and belief. I understand that any false statements therein are subject to the penalties contained in 18 Pa. C. S. § 4904, relating to unsworn falsification to authorities. Dated: D ~ ~~3 ~O J os e !~. ~Ul~ r r i c K Print Name ~~ tit / ~ !S ~ /`¢~D U_ Position 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL .SCR Manor Czte ADMISSItON . GREE NT ~.~~~ PAGE 11 Pennsylvariiu This Agret:rnent is entered into by and among Nightingale Nursing Home, l:nc., d.b.a. HCR Manor Care ("HCR Manor Care"), the Resident, and the Responsible party, if any, for the purpose of providing for the rights and responsibilities of the parties with respect to the Resident's stay at this HCR Manor Care's Center ("Center"). Center: I+ta1i rCare Health Services Cam Hil[ ,Resident: ~o 'b~ r ~ Tro` V-~.l/ Responsible Party; ~p; S Tro~v~ Admission Date: 1~~~1d~ Deposit; $ ~, Q~ Tee: This Agreement begins on the day the Residenrt enters the Center and ends on .the day 'Ehe Resident is discharged unless the Resident is readmitted within fifteen (15) days of the Resident's discharge date. L RIGHTS AND RESPONS[BILI~-iES OF THE RESIDENT 1.OI Room and Board Rate. For the basic services provided for in Section 3.01, the Resident will pay the applicable Room and Board Rate set forth on Attachment A hereto. The Room and $oard Rate is subject to change upon thirty (30) days written, notice. The Room and Board Rate set forth in Attachment A is payable in advance and is due upon receipt, The Resident is responsible for the Room and Board Rate for the day of admission as well as the day of discharge. This Section. will not apply if the Resident is covered under a governmental program (see Sectie~n I.OS) or by a third party payor or managed care organization (see Section 1.06). I.02 aciliar~hai=qe_s. The Resident will pay to Center all charges for additional medical, therapeutic. or persona! care services or supplies that may be requested by the Resident, ordered by the attending physician, or provided in the Resident's 1?lan of Care. The Center reserves the right to charge for personal care items of the Resident if necessary for the well-being of the Resident. Su~~h "Ancillary Charges" are described on Attachment B hereto, and ~ current ancillary charge list i;3 maintained at the Center's business office for review during regular business hours. Ancillary Charges will be included in the Resident's statement for the succeeding month, and are payable in fu~'I, along with the Room and Board Rate upon receipt. RR UOIC/It111C JVL-LI-i VUI\1 Rtl IU~J4 1IIIJ ILIU7 ~ - ~. UIC 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL PAGE 12 I.03 C~1lecti s/Late Pa ents. Payment is due in full. within t ' 30 da s ofbillin ..- Should the Resident's account for any reason be tamed over for cogeetion~~the Resident will p y the Center's collection costs, including attorney's fees. 1.04 indepe dent Providers. The Resident is directly responsible to independent providers, including but not Limited to, the Resident's attending physiciap for any health or personal program ::n accordance with the terms of the progam. 1.05 ~'±emmental Programs. If the Resident is eligible for coverage under any governmental program, such as Medicare, Medicaid, or through the Veterans Administration, and tare Center particiF~ates in such program, the Center will acce a accordance with the terms of the program as set forth in the cunt acct the Center hear withe program, The Resident is responsible for any co-insurance, deductibles or non-covered charges, according to the same terms and conditions applicable to private pay residents. The Resident must comply with all program requirements. >n the event the Resident's coverage under the govemmentat program(s) cease for any reason, the Resident will be charged at the Center's rate for private pay residents in accordance with Sections 1.01 and .1.02, The Center participates in the following progams: x Medicare, _x~.Medicaid and/or VA. Medicare may pay for some or all of the Resident's care. If Medicare agrees to pay for the Resident's care, th~.re is a required co-payment, which Medicare updates yearly. If the Resident also participates in Medicare Part B, for physical, occupational, or speech therapy or other billable charges {which are not covered by Medicare Part A), the Resident agrees to pay any required deductible, any required co-insurance, and any non-covered services according to the same terms and conditions applicable to private pay residents. The Resident and/or Responstble Party are responsible for apptying for Medicaid. If the Resident receives Medicaid, most of the Center charges such as R~~om and Board and nursing services are covered, although Medicaid may require the Resident to pay a portion of the Room and Board Rate from their monthly income. The Resident agrees to pay on a timely basis, as set forth in this Agreement, the contribution amount as determined and periodically adjusted by the State and/or Local deparcmerrt(s) handW~g Medicaid. If the Resident fails to pay the contribution amount, the Center may take such legal action as necessary, including requesting a court to order such payment. 1.06 Thircl Party Pavors and Managed Care O 'zatiQns. If a Resident is a participant in a plan offered b)- a Hurd party payor such as a Health Maintenance Organization ("HMO"), Preferred Provider Organization ("PPO"), Provider Sponsored Organization ("PSO"), o~ Physician Hospital trganization ("PHO"), indemnity plan or another similar entity with which the Center has executed a provider agreement, the charges are governed by the applicable ageement. The Resident is responsible for any co-payments, deductibles or non-covered charges, according to the same terms and conditions applicable to private pay residents. If the Center has not executed a provider agreement with the Resident's third party payor, the Center Kx ua~eiilrfle uu~-cr-cuur~rKi~ iu,3u rrrr3icia~ r.ui~ 07/27/2007 11:33 7177372189 ~ MANORCARE,CAMPHILL PAGE 13 will bill the Resident's third party payor as a service, but the Resident remains liable for charges not paid or covered by that third party payor including charges -not paid within -a reasonable period of time. I.07 Private Pa Resident. The ~~esident is responsible for paying the Center for items anal services provided during, the stay at the Center and during which time.the Resident has not been determined eo be eligible for any governmental program or covered under any third party payor or managed care organization plan. The Resident and/or Responsible Party will notify the Center promptly if there is insufficient income or assets to meet the financial obligations to the Center or to make prompt application to Medicaid for benefits. The Resident and/or Responsble Party wilt notify tl'~e Center in writing when application to Medicaid is made. The Resident and/or Responsible Party will cooperate fully .in applying for Medicaid and in the eligibility determination process. If the Resident is no longer able to pay for care at the Center or to have payment made on the Resident's behali; the Resident will 6e notified of the Center's intention to discharge the Resident for non-~~ayment in accordance with this Agreement, Resident Handbook and state and . federal laws. 1.08 Admission Information. The Resident and/or Responsible Party will notify the Center and provide any needed information regarding all third coverages on admission and throughout the Resident's stay including copies of insurance cards, identification or ve~ifcation of eligibility and coverage information. The Resident and/or Responsible Party will provide the Center in writing with notice within five 5 da s of the Resident's disenrollment, enrollment, change in health care coverage, failure to pay premium(s) or renewal of insurance coverage and any cancellations in coverage as the Ce:ater relies on the inforrraation supplied regarding such coverage. The Resident acknowledges that if the Resident fails to provide such information, the Resident may be responsible for any denied charges due to tack of suihorization, ineligibility, non-coverage or other costs associas:ed with the failure to provide such notice in accordance with the terms and conditions of this Agreement. I.09 Application for Benefits, The Resident and/or Responsible Parry will apply for coverage and to establish eligibility under any governments third a private insurance ro ~ PRY P$Yor, managed care or p gram. The Center has no obligation to bill any third party payor other than the .Responsible Paryy and, when applicable, a governmental program third party payor or managed care organization with which the Center is under contract. I.10 Primr Res onsi ill r Pa a t. Except for payments for services covered under governmental. programs or other third party payor provider agreements, the Resident remains primarily li~rbte for eery and all charges for which the Center ma party. The Resident and/or Res nsible P Y agree to bill a third Po arty acknowledge that the insurance company, HMO, PPO, PSO, PHO or managed care provider may not pay for non-covered services, supplies, equipment, medicati~~ns, and other care and services which may be delivered by the Center or its subcontractors. This agreement serves as a written notice that the Center has notified the Resident and/or Responsible Party that services provided at the Center nnay not be covered by a Ris.uo~ciiamc JUL-LI'LUUI~IRIJ iu;~u iiii~icio~ r.uiu '07/27/2007 11:33 7177372189 MANORCARE,CAMPHILI_ PAGE 14 governmental payor, third party payor or managed care organization. The Resident and/or Responsible Party will be responsible for non-covered services. A price Iist of services is maintained at the Center's business office and is available for review during regular business hours. 1.11 Personal Phvsician The Resident has the right to choose a personal physician, provided that the physician selected is properly licensed and abides by applicable law and the rules and policies of the Center. At the time of admission, the Resident must supply the Center with the name of his/her personal physician. If the Resident changes physicians at any time after admission, the Resident and/or Responsible Party must immediately notify the Center of the new physician's name. If the physician chosen by the Resident fails to provide needed coverage and attendance or fail:- to abide by applicable laws and regulations, the Center will call another physician to attenc: to the Resident and the fees charged by such physician will be borne by the Resident. 1.12 ~ Pha-m~c_y. The Resident and/or Responsible Party has the right to choose a pharmacy of choir,., provided the pharmacy selected is properly licensed, packages and supplies pharmaceuticals in accordance with state law, abides by the Center's policies and procedures and has a medication distribution system similar to the Center's ancillary pharmacy's medication distribution system. II. RIGHTS ,A.ND RESPONSIBILITY pF ~'HE RESPONSIBLE PAR~'X 2.01 Leg~tl__Authority. The Responsible Party represents that he/she has .legal access to the Resident's in.corne or resources and that the documents supporting such authority, if any, have been delivered to the Center. 2.02 ~re~ment to Make Pa ants ehalf of esident. The Responsible Party will pay promptly from 'the Resident's income or resources all fees and charges for which the Resident is liable under this Agreement. The Responsible Party will incur personal financial liability on behalf of the Resident should the Responsible Party fail to pay the charges for which the Resident is liable under the atpeemerat from the Resident's income or resources, 2.03 R~rn~ed Items, The Responsible Party will be personally liable for arty services or products specifically requested by the Responsible Party to be supplied to the Resident, unless such services or products are covered by a governmental program. 2-04 lrxhau ion of Resident's Funds. If the Resident's frnancial resources change such that the Resident maybe eligible for Medicaid, the Resident and/or Responsible Party must notify the Center in writing; and must promptly apply for Medicaid benefits. If the Resident and/or Responsible Party fails to notify the Center in writing or fails to file far Medicaid or provide such information as .Nadi paid representatives may require to qualify the Resident for eligibility to Medicaid, the Center may end this agreement and transfer or discharge the Resident for nonpayment upon reasonable and appropriate notice, as provided in Section 4.06. In addition, if the Responsible Party faits to notify the Center in writing or fails to file for Medicaid in a timely __ R 1G, UOIC/ 111110 JUL'C I'LUU I l l R! J I U• J4 I I I I J t L l U7 f U I J 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL PAGE 15 and proper manner, the Responsible .Party will be personally liable for all charges and fees not covered by Medicaid which otherwise would ha~re been covered had application been made in a timely and proper manner. 2.05 C~~o era 'on for Financial Assistance., If the Resident is eligible for Medicaid, the Responsible Party must provide such information about the Resident's finances as Medicaid representatives require for continued coverage of the Residem and be personally responsible for any charges denied the Center due to arty lack of cooperation. If the Resident and/or Responsible Party fail to provide such information as Medicaid representatives require for continued eIigibifity for Medicaid pa3mtents, and as a result Medicaid does not pay for the Resident's care, the Resident may be discharged or transferred upon appropriate and reasonable ~ notice for nonpayment, as provided in Section 4.06. 2.06 Acceptance U on Disch~~ Upon termination of this Agreement as provided in the Resident Handbook; the Responsible Party agrees to arrange and pay for the departure of the Resident from thc; Center. If after notice, the Resident is not removed ~ as requested, then the Center is authorized and empowered to remove the Resident by reasonable means of transportation and to deliver the Resident to the residence address of the Responsible Party, if the Resident's condition permits, who shall unconditionally be obligated to accept the Resident or immediately make medically appropriate alternative arrangements and to pay promptly all charges, 2.07 Ad.3itional_ Responsi~ The Responsible Party will comply with the other duties and responsibilities for the Resident and to the Center as set forth in this Agreement, Resident Handbook, and Attachments. 2.08 mouse of Re ident Funds. In the event that the Responsible Party misappropriates the Resident's incc>me or resources or otherwise illegally transfers assets for purposes of avoiding the Responsible Party's obligation to make payments on behalf of the Resident under Section 2.02 or for purposes o1' qualifying the resident for Medicaid efigibiIity, the Responsible Party may be liable to the Medicaid agency andlQr the Center for care that should have been paid for front the ResideM's income or resources. Such misappropriation of the Resident's income or resources may also result in the imposition of criminal or civil sanctions against the Responsible Party. ~. RiGHTS E-NA RESPUNSIBILI'I'lES OF'1<`HE CENTER 3.01 Ra-m and Standard Services As part of the Room and Board Rate, the Center will furxtish basic room, board, common facilities, housekeeping, laundered bed linens and bedding, general nursing care, personal assessment, social services, and such other personal services as may be required pursuant to the plan of care prepared by the Resident's physician and the Center, with the Resident's consent, for the health, safety and general well-being of the Resident, 3.02 Oth~;r •ces. The Center will act which is incorporated by reference in this Agreement. in accordance with the Resident Handbook, 5 KX.UdCe/IlIOe JUL-C1-CUUIlrK1J IU:~U IIII~IC107 r.U10 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL PAGE 16 3.03 Aepgsit. The Center acknowledges receipt of the D osit if a beginning of this •~greement. The Deposit will be applied to the char es for~the first month of the Resident's stay at the Center. 3,04 l~e:funds. Arty refund owed to the Resident for advance a the Center within thirty (30) days after discharge or transfer or within the timentframe requireda by State Law. In the case of Medicaid Residents, any such refund will be paid within thirty (30) days of the Center's receipt of the final Medicaid payment for care of the Resident. I'4'. GENERAL PROVISIONS 4,01 Con ent to elease o Information. The Resident and/or Responsible Party hereby consents to the release of the Resident's medical records to the following persons: Center personnel, attending physicians and consultants; any person, fi tm, government entity, third party payor or managed care organization responsible for all or any part of the payment or reimbursement of the Resident's charges, ,including any utilization review or quality assurance reviews or paymer;t audits performed by such; the personnel of any hospital or other health care facility or provider to whom or which the Resident may be transferred; the Center's Liability insurance carrier; and any person authorized bylaw to review the medical records. 4.02 Conse~r t to Treat, The Resident and/or Responsible Party consent to the use and disclosure of Resid em's protected health information for the purposes of receiving treatment from the Center, obtainnig payment for healthcare services provided to Resident, and the Center's own healthcare operation needs, The Resident and/or Responsible Party, by signing this Agreement, authorizes the api~ropriate staff of the Center to perform such functions, care and services (hereinafter "Treatment") as. are necessary to maintain the weq-being of the Resident, including but not limited to, assistance with bathing, hygiene, dressing, toiletry, and daily activities; and general nursing care, the administration of medications and treatments, and the performance of therapies, as prescribed by the Resident's personal physician in the Resident's .Plan of Care, or as required from time: to time in the exercise of good nursing judgment, subject to arty rights provided to the Resident by federal and/or state law, As applicable, the undersigned Responsible Party represents that .he/she .has the Legal authority to make health raze decisions on behalf of the Resident, that documents supporting such authority have beery delivered to th.e Center, and that such Responsible Party consents on behalf of the Resident to the Treatment described above. 4.03 went to Photo anh_ The Resident and/or Responsible Party consent to the Center taking a pha tograph of Resident for use in idernifying the Resident, for placement of the photograph in the A~[edication Administration Record or other records and for any other similar uses of the photograph for Center and staff to identify the Resident. 4.04 Notice--of Se 'ces p 'cies d Additional In~ormati The Resident and/or Responsible Party acknowledge that the items listed below have been explained and have received copies of the items or policies and procedures, if applicable. The Resident and/or Responsible R R U O L C/ 1 1 111 C .J U L- L I- L V U 1\ 1 R 1 / I U D J 4 1 I I I J I L I U 7 ~ - ~ I U 1 1 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL PAGE 17 Party acknowledge they have had the opportunity to ask questions and questions have beers answered satisfactorily. a. Assignment far Payment of $enefits. See Attachment C. b. SNF Medicare Aetertnination Notice. See Attachment D. c. .Medicare Secondary Payor Questionnaire. See Attachment E. d. At the request of the Resident and/or Responsible Party, the Center will maintain the Resident's personal funds in compliance with the laws and regulations .relating to the Center's management of such fiords. A description and/or policies and procedures of protection of resident funds and the Personal Trust Fund Agreement, ,Resident Personal Funds Authorization and any other related documents. See Attachments F-1 and F-2. e. Center Supplement: 1. Policy and procedure on bedholds, election of bedholds and readmission. 2. Social Service Agencies and Advocacy Groups addresses and phone numbers. 3. Name, address and phone number of Ombudsman. 4. ~.ocation in the Center where the names, addresses and telephone numbers of state client advocacy groups, state survey and certification agency, the state ticensure office, the state ombudsman program, the protection and advocacy network and the Medicaid fraud control unit. 5. The name, specialty and way of contacting the attending physician, medical director and other physicians who serve the Center. 6. Procedures, name, address and phone number on how to ~ file a complaint with the state survey and certification agency concerning resident abuse, neglect, mistreatment and misappropriation of pr. operty. £ The Resident Handbook. g. ResidentlPatient Rights. h. Medicare/Medicaid information and display of such information including how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for previous payments. R ]CUO LC/I1HIC JUL'LI-LUU1~1 R1/ IU. J4 IIIIJIL IU7 07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL f U 1 V PAGE 18 i. Receipt of information on advance directives including a copy of "Refusal of Life Sustaining Treatment", which summarizes HCR Mantor Care's Limited Treatment practices and a copy of the State summary of its laws governing the Resident's right to direct his/her medical treatment. See Attachments G-1 and G-2. j. Privacy Act Notification. See Attachment H. k. Notice of Information Practices and Receipt of Notice of Information Practices. See Attachments I-1 and I,2. Ancillary Services Management Form. See Attachment J. ,~~ 4.05 4~ssig_rurtent of Benefits. The Resident and/or Responsible Party request that payment of authorized government and/or third patty payor benefits as described in Sections 1.05 and 1.06, if any, be made as set forth in Attachment C to this Agreement either to Resident or on Resident's behalf for any service furnished by or in the Center. The Resident and/or Responsible Party authorize tl!,e Center and ar~y holder of medical or other information to release such information to the Centers for Medicare and Medicaid Services "CMS" and its agents and to third party payors any information needed to determine these benefits or benefits for related services. 4.06 Ten inati Disch a and T fer. This Agreement may be terminated as set forth below and as set forth in the Resident Handbook under the Section Heading "Discharge". The Resident andll~r Responsible Party may terminate this written notice of the Resident's desire to Ieave at least seven ~t by providing the Center ('~ ys in advance ofthe Resident's departure. If the Resident [eaves before the end of that time, the Resident must still pay for each day of the require:I notice unless the Center fills the bed before the end of the notice period, Except in the evert of an emergency or death, the Resident will be responsible for all charges for the Room and Bo;~rd Rate artd for all services performed up to the end of the day that the admission ends. Ischarge from the specialized units such as the ~'ransitional Cate Unit or Subacute Unit may require less than seven (7) days notice. If discharge or transfer becomes necessary because the Resident and/or Responsible Party or someone else abusexl the Resident's funds, the Center will request that local, state and federal authorities, as apprt~priate, investigate, which may result in prosecution. 4.07 Indemnificaxion. The Resident will defend, indemnify and hold the Center harmless from any and all claims, demands, suit and actions made a resultin from an a.arn gainst the Center by any person g y age or injury caused by the Residem to any person or the property of any person or entity (including the Center), except in the case ofnegl.igence ofthe Center's employees and agents. 8 .ln. uu.. ... .... a. ~v~. ~. ~.vvi~~~iaJ ~u. Jq 11t IJIIIU] ,07/27/2007 11:33 7177372189 MANORCARE,CAMPHILL r. ui~ PAGE 19 4.OS ~~es ~ the Law. An or unenforceable ~~s a result of a chant Y prov~s~on of this Agreement that is found to be invalid provisions of this ~ ~ state or federal law. will not invalidate the remaining Agreement and, it is agreed that to the extert possible, the Resident and the Center will continue to fulfill their respective obligations under this Agreement consistent with the law. THE UNDERSIGNED CERTI]F'Y AND ACKNOW~,EDGE TAAT THEX HA EACA READ A:IVD UNDERSTOOD T1IE FOREGOING AGREEMENT, AND T$AT TAY RAVE DAD AN OPPORTU~-~ TO ASK QUESTIONS AND TART ANY QUESTIONS DAVE BEEN ANSWERED TO THEIR SATISFAC'I70N. Signature of Resident: Date: Signature of Responsible Party: Q~o~~~i~~~" ~'v ,~ ~/~-- O f~ Date: ~ < / Center ,Representative. Date: c~- ~~p d _ _ _ --'-- -~..•`~•,~ 1'n-yi 1VRl.HfCG>~..r-~rir niLL r'HbC bl ~ _~ ~C~Z 1t~annr Core PennsyluQnia AAMISSION A.GRE)E1~~ENT This Agreement is entered into by and among Nghtingaie Nursing Home, Inc., d_b.a. HCR Manor Care tT`HCR Manor Care"), the Resident, and the Res~orsible Party, ii a<<y, for the purpose of provrdtng for the rights artd responsibilities of the parties with respect to the Resident's stay ai dvs HCR Manor Care's Center ("Center"). Center: ManorCare Health Services Cam~hlill Resident: ~o~~s ~ ~rQ~ ~~ I~esporrsib)e F$rry: Admission Date: ~ ~ ~ Deposit: $--~.gg._ Term: This Agreement begins on the day the Resident enters the Center and ends on the day the Resident is discharged unless the Resident is readmitted within fi$een (15) days of the Resident's discharge date. I- RIGH'T'S AIVD RESPONSIBTX,ITIES OF THE RESIDENT 1.01 Room and Board Rate_ For the basic services provided far in Section 3.4I, the Resident will pay the applicable .Room and Board Rate set forth on Attachment A hereto. The Room and Board 1ZrEte is subject to change upon thirty (30) days written notice. The Room and Board Rate set forth in Attachment A is payable in advance and is due upon receipt. The Resident is responsible for the Room and Board Rate for the day of admission as well as the day of discharge. This Section aril] not apply if the Resident is covered under a governrnernal program {see Sectio.:r I.OS) or by a third party payor or managed care organization (see Section I.06). I.OZ Aricrllar~r C'har~es. i he Resident wilt pay to Center all charges for additional medical, therapeutic, or personal care services or supplies that may be requested by the Resident, ordered by the attending physician, or pro~~ided in the Resident's Plan of Care. 7~he Center reserves the right to charge for personal-care items of the Resident if necessary for the well-being of the Resident_ Such "A.ncillary Charges" are described on Attachment .13 hereto, and a current ancillary charge list i:: maintained at the Center's business ofTice for review during regular business hours_ Ancillary Changes will be included in the Resident's statement for the succeeding month and are payable in fill], along :vith the Room and Board Rate upon receipt_ i _43 Cal.ections/L,ate Payrzrents_ Payment is due in fi111 within thirty (34} days of biIIing- ~hould the Resident's account for any reason be turned over for collection, the Resident will pay the Center's collection costs, including attorney's fees~ I.44 pendent Providers. The Resident. is directly responsible to independent providers, including but not limited to, the Resident's attendine pltysiciAn for any health er personal program in accordance with the terms of the program. 1.45 G~ernmental Programs. If the Resident is eligi~Ie for coverage under any governmental program, such as Medicare, Medicaid, or through the Veterans Administration, and the Center participates in such prograrr>, the Center will accept payments under such program in accordance with the terms of the program as set forth in the contract the Center has with the program The Resident is responsible for arty co-insurance, deductibles or non-covered charges, accozding to the sane terms and conditions applicable to private pay residents- The Resident must comply with all program requirements- In the Pj,ent the Reside„t's coverage under the governmental program(s) cease for any reason, the Resident will be charged at the Center's rate for private pay residents in accordance with Sections I.O1 and l _02. The Center particip~ites in the following Programs: _x_Medicare, _x Medicaid and/or VA. Medicare may pay for some or all of the Resident's care- If Medicare agrees to pay for the Resident's care, there is a required co-payment, which Medicare updates yearly. If the Resident also participates in Phedicare part,: B, for physical, occupational, or speech therapy or other 6iIIable charges (which aze not covered by Medicare part A}, the Resident agrees to pay any required deductible, any required co-insurance, and any non-covered services according to the same terms and conditions applicable to private pay residents- The Resident and/or Responsible party are responsible for applying for iiredicaid. !f the Resident receives Medicaid, most of the Center charges such as Rc>om and Board and nursing services are covered, although Medicaid may require the Resident to pay a portion of the Room and Board Rate from their monthly income. The Resident agree:: to pay on a timely basis, as set forth in this Agreement, the contribution amount as deterrninc;d and periodically adJusted by the State andlor loca} department(s) handlitrg Medicaid. If the Resident fails to pay the contribution amount, the Center may take such legal action as necessary, including requesting a court to order such payment- I.Ob Third P a ors and Mang ed Care Or anizations. If a Resident is a participant in a plan offered by a third party payor such as a Health Maintenance Organization ("I-I~O'• Preferred Provider Organization ("PPO"), Provider Sponsored Organization ("PSO"), or Physician Hospital Organization ('PHO"), indemnity plan or another similar entity with which the Center has executed a provider agreement, the charges are governed by the applicable agreement. The Resident is resp~~nsr~Ie far any co-payments, deductibles or non-covered charges, according to the same terms ~md conditions applicable to private pay residents. If the Center has not executed a provider agreement with the Resi.dent's third party payor, the Center 2 _.. .. _~.,. ~~ ~, ,Jf ~1~~. MHr+urc~~aKt>cr~rirhl~~ ~~ _ . ~a~~- e ~ wilt bill the Resident's third party payor as a service, but the Resident remains liable for charges not paid or cover, by drat third party payor including chargers not paid within a reasonahIe period of time- 1.07 Private Pay Resident- The Resident is responsible for. paying the Center for items and services provided during the stay at the Center and during which time t_h_e Resider:t 1:~~s nct been determined tc~ be eligible for any governmental program or covered under any third party payor or managed ,gal-e organization plan The Resident and/or Responsible Party wrll notify the Center promptly if there is insufficient income or assets to meet the financial obligations to the Center or to make ,prompt application to Medicaid for benefits. The Resident and/orr Responsible party ~l notify the Center in writing when application to Medicaid is rnade_ The Resident and/or Responsible Party ~rili cooperate fully in a,Pp1Y~g for Medicaid and in the eligibility determination process. If the Resident is no longer able to pay for care at the Center or tG have payment made on the Resident's behali; the Resident will be notified of the Center's intention to discharge the n esid2nt i ;r noes-pt.ymerlt in accordance with this. _A_greP ..rC:ent, Resident ~IardbGO's arld State arLd tederal law$- I d8 A~fission Information. The Resident and/or .Responsible Parry wiIl notify the Center and provide any needed information regarding all third party payors or governmental coverages on admission artd throughout the Resident's stay including copies of insurance cards, identification or verification of eligibility and coverage information. The Resident and/or Responsible Party will provide the Center in writing with notice within five (S~ay~ of the Resident's disenroIIment, enrollme~ change in health care coverage, failure to pay prerxuum(s) or renews} of insurance coverage and any cancellations in cove-rage as the %enter relies ort the information supplied regarding such coverage. The .Resident acknowledges that if the Resident fails to provide such information, the Resident may be responsible for any denied charges due to Iack of authorization, ineligibility, non-coverage or other costs associatE~d with the failure to provide such notice in accordance with the terms and conditions of this Agreement I.09 Ap_pti~~ation for Benefits. The Resident and/or Responsible Party will apply for coverage and to establish eligibility under any governmental, third party payor, managed care or private insurance prc~grarn. The Center has no obligation to bill any third party payor other than the Responsible Party and, when applicable, a governmental program third party payor or managed care organszation with which the Center is under contract. I.IO l?rrmary RcsQOnsibiIitY for Payment Except for payments for services covered under governmental programs or other thud party payor provider agreements, the Resident remains primarily Iia ~Ie far any and alI charges for which the Censer may agree to bill a third party- The Resident and/or Responsible Party aclalowledge that the insurance company, HMO PPO, PSO, PHO or managed care provider ma not equipment, medications, and other care and services whicph may be deIioered by tEiecCenterporyet subcontractors- This agreement serves as a written notice that the Center has notified the Resident andlor ResF onsible Pasty that services provided at the Center may not be covered by a 3 rir-~rvu. F-'~-51~t b5 governmental pay,~r third party payor or managed care organization. The Resident and/or Responsible Party will be responsible for non-covered services. A price list of services is maintained at the Center's business offrce and is avarZable for review during regular business hours. I.-II Per;.onaI Ph ieian- The Resident has the right to choose a personal physician, provided that the physician selected is properly licensed and abides by applicable law and the rules and policies of the ~~enter. At the time of admission, the Resident must supply the Center with the name of his/her Fersonal physician- If the Resident then es adrrrission, the Resident and/or Responsible .Party must imtnediatelp notify the Center of the new physi~an's name. If the physician chosen by the Resident fails to provide needed coverage and attendance or fails to abide by applicable Iaws aczd regulations, the Center will call another physician to attend to the Resident and the fees charged by such physician will be borne by the Resident _ ] _ I2 Pharmacy. The Resident and/or Responsible Party has the right to choose a pharmacy of choice, provided the pharmacy selected is properly licensed, packages and supplies pharmaceuticals in accordance with state law, abides by the Center's~policies and procedures and has a medication distribution system sirriilar to the Center's ancillary pharmacy's medication distribution system- ~- R~GS`T'S A'~ Hl/SPCdPdSTBl!I,i"i 3~ IMF THE ~t1ESPpNS)<BLE PARTY 2.OI Lena( Authority- The Responsible Party represents that helshe has legal access to the Resident's income or resources and that the documents supporting such authority, if any, have been delivered to the Cerrter- 2.02 Agret:ment to Make Payments on Behalf of Resident. The Responsible Party will pay promptly from f ie Resident's income or resources all fees and charges for which the Resident is liable under this Agreement- The Responsible Party will incur personal financial }lability on behalf of the Resident should the Responsible Party far? to pay the charges for which the Resident is Iiable under the agreement from the Resident's income or resources. 2.03 Requ~:sted Items The Responsible Party wiII be personally liable for any services or products specificz.lly requested by the Responsible Party to be supplied to the Resident, unless such services or products are covered by a governmental program. 2.04 Exhaustion of Resident's Funds .tf the Resident's financial resources change such that the Resident may be eligi-b]e for Medicaid, the Resident and/or Responsible Party must notify the Center in writing and must promptly apply for Medicaid benefits. If the Resident and/or Responsible Party fails to notify the Center in writing or fails to file for IVZedicaid or provide such ~n.formation as Medicaid representatives may require to qualify the Resident for eligibility to Medicaid, the Center may end this agreement and transfer or discharge the Resident for nonpayment upon reasonable and appropriate notice, as provided in Section 4.06_ In addition, if the Responsible Part} fails to notify the Center in writing or fails to file for Medicaid in s timely a rir,tvvr~l..-rr[C~~,w-irnt~.L t-!-0Or I~b _ _ and Proper manner, the Responsible Parry tivill be personally Liable far all charges and fees not covered by Medicaid which otherwise would have been covered had application been made in a timely and proper rnanner- 2_Q5 Coe erati n for Financial Assistance. Lf the Resident is eligible for Medicaid, the Responstble Party must provide such information about rhP R wQ- F _ representatives require for continued coverage of the .Resident andtbe personally reponsibe or anY charges denied the Center due to any lack of cooperation. If the Resident and/or Responsible Party. fail to provide such information as Medicaid representatives require for continued eligl~bility for Medicaid payments, and as a result Medicaid does not pay for the Resident's care, the Resident may be discharged or transferred upon appropriate and reasonable notice for nonpayment, as provided in Section 4.06_ 2.06 Acct. fence U on ischarae. Upon termination of this Agreerraent as provided in the Resident Handbook, Ilte Responsible party a'~re~s tc u_ ~ un a and Resident from the Center. If after notice, the Resident is not removedras requested, then the Center is authorized and empowered to remove the Resident by reasonable means of transportation and to deliver the Resident to the residence address of the Responsible Party if the Resident's condition permits, who shaIl unconditionally be obligated to accept the Resident or immediately make n~ediealIy appropriate alternative arrangements and to pay promptly all charges 2.07 Additional Responsibilities The Responsible Party wi1I comply with the other duties and responsibilities for the Resident and to the Center as set forth in this Agreement, Resident Handbook, and Attachments. ~- 08 Misuse of Reside t Funds. In the event that the Responsible Party misappropriates the Resident's income or resources or otherwise iElegally transfers assets for purposes of avoiding the Respons~Ie Party's obligation to make. payments on behalf of the Resident under Section 2.02 or for purposes of qualifying the resident far Medicaid eligibility, the Responsible Party ~y be Gable to the Medicaid agency and/or the Center for care that should have been paid for. from the Resident's income c~r resources- Such misappropriation of the Resident's income or resources may also result in the: imposition of criminal or civil sanctions against the Responsible Party. 7XI. R>[~HT$ A.PII~ RiESP®NS.It~3II.ITII~S (3F TIDE CENTER 3.OI Room.: and Standard Services As part of the Room and Board Rate, the Center will famish basic room, board, common facilities, housekeeping, Iaundered bed linens and bedding, general nursing care, personal assessment, social services, and such other personal services as may be required pursuant to the plan of care prepared by the Resident's physician and the Center, with thE: Resident's consent, for the healt'~ safety and general well-being of the Resident . 3.02 Other ervices. The Center will act in accordance with the Resident Handbook, ~~hich is incorporated by reference in this Agreement. s e~~~errer~rJr~ it:~~ il~~~!"L1tiy MANORCARE,CAN?HILL PAGE 07 3.03 ~tosit- The Center acknowledges receipt of the Deposit, if any, noted at the begrnning of this ~,greerrtent_ The Deposit will be applied to the charges for the first month ofthe Resident's stay at the Center. 3.04 Refi.tnds_ Any refund owed to the Resident for advance payments will be paid by the Center within tthirty (30) days after discharge or transfer or within the ti_TnP t' State law. In the case oflvledicaid Residents, any such refund will be aid within the r~3Q eda s of the Center's recE;ipt of the final Medicaid a p ~ ~ ~ y p yment for care of the Resident. N- GENERAI, PROVISIONS 4.OI Consent to Release of Ir?.forination. The Resident and/or Responsible Party hereby consents to the release of the Resident's medical records to the following persons: Center persant-eI, attending physicians and consultants; any person, firm, government entity, third party payor or managed care organizatiosr responsible fry aII :._ ~ r reimbursement of the Resident's charges, including any utilization review or qualit, ssurancoe reviews or payment- audits performed by such; the personnel of any hospital or other health care facility or provider to whom or which the Resident may be transferred; the Center's liability tnsurazr_ce carrier; and any person auffiorized by Iaw to review the medical records- 4.02 Con,,ent to Treat. The Resident and/or Responsible party consent to the use and disclosure ofResident's protected health information for the purposes ofreceiving treatment frrom the Center, obtaining paymezrt for healthcare services provided to Resident, and the Center's own healthcare operation needs. The Resident and/or Responsible Party, by signing this Agreement, authorizes the appropriate staff of the Center to perform such functions, care and services (hereinafter "TreatnrenY') as are necessary to maintain the well-being of the Resident, including but not limited to, assistance with bathing, hygiene, dressing, toiletry, and daily activities; and genera! nursing cart; the adrxunistration of medications and treatments, and the petformazrce of therapres, as prescribed by the Resident's personal physician in the Resident's Platt of Care, or as required from time to time in the exercise of good nursing judgrrrent, subject to any rights provided to the Resident by federal and/ar state law As applicable, the undersigned Responsible Party represents that he/she has the legal authority to make b.ealth care decisions on behalf of the Resident= that documents supporting such authority have been delivered to the Center, and that such Responsible Party consents on behalf of the Resident to the Treatment described above 4.03 Consf:nt to photo a h. The Resident and/or Responsible Party consent to the Center taking a photograph of Resident for use in identifying the Resident, for placement of the photograph in the Medication Administration Record or other records and for any other similar uses of the photograph for Center and staff to identify the Resident- 4.04 I\TOticc: of ervices. Po ties an dditi aI Information. The Resident and/or Responsible Party aclcnow[edge that the items listed below have been explained and have received copies of the items or policies and procedures, if applicable- The Resident and/or Response-ble 6 ..... _....,... ~ .. ~... . ~ , , ~i ~ ci ~ ~ M~1NUKl,AKt, C.A~'lF'H1LL YQ!vF 9Y Party acknowledge they have had the opportunity to ask questions and questions have been answered satisfactorily. $~ Assignment for Payment of Benefits. See Attachment C. b. SNF Medicare Determination Notice. See A-ttachrnent L- c. iVledicare Secondary payor ~uestiopnaire. See Attachment E. d At the request of the Resident and/or Responsible Party, the Center will maintain the Resident's personal funds in compliance with the Laws and regulations rela[ing to the Center's rnanagemezrt of such funds. A description irnd/or policies and procedures of protection of resident funds and the Personal '[-rust Fund Agreement, Resident Personal Funds Authorization and s,~J ether related documents. See Attachments F-1 alnd F_~_ e tenter Supplement- 1- Policy and procedure vn bedhoIds, election of bedhoIds and rea-dmission. 2- Social Service Agencies and Advocacy Groups addresses xnd phone numbers. 3- Name, address and phone number of Ombudsman. 4. Location in the Center where the names, addresses and telephone numbers of state client advocacy groups, state survey and certification agency, the state licensure office, the state ombudsman program, the protectian and advocacy network and the Medicaid fraud cozrtrol unit 5- The nam-e, specialty and way o_f contacting the attending physician, medical director and other physicians who serve the Center 6- Procedures, name, address and phone number on how to file a complaint with the state survey and certification agency concerning resident abuse, neglect, mistreatment and misappropriation of property. L The Resident Handbook- g- Resident/Patient Rights. h Medicare/Medicaid information and display of such information including how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for previous payments. 7 ~+ ~ c~v ~ 11 JJ r l r r J/ L 1 0 7 MANUKI;f-~Kt , 1;~1MF'H 1 LL P1aGE B9 t Receipt of information on advance directives including a copy of "Refusal of Life Sustaining Treatment", which summarizes HCR Manor Care's Limited Treatment Practices acid a copy of the State summ governing the Resident's right to direct his/her medical treat~meniitsS! ews Attachments G-1- and G-2. J Privacy Act Notification- See Attachment I-i. k- Notice of Information Practices and Receipt of Notice of Information Practices. See Attachments I-I and I-2. Ancillary Services Management .Form. See Attachment J- 4.[~S Assi:~nment of Benefits. The Resident and/or Responsible Party request that payment of autltorZ;red goverttrnent and/or third party payor benefits as described in Sections LOS and 1.06, if any, be made as set forth in Attachment C to this Agreement either to Resident or on Resident's behalf fer any service furnished by or in the Center_ "1'he Resident and/or Responsible Party authorize the: Center and arty holder of medical or other information to release such information to the t:enters for Medicare and Medicaid Services "CM5" and its agents and to third party payors any inf?rmatio:t needed to determine these benefits or benefits for related services. 4.06 Tern-inatio D' char e and Transfer. Thus Agreement inay be terminated as set forth below and as set forth in the Resident Handbook under the Section Heading "I}iscltarge>° The Resident and/or Responsible Farty may terminate this Agreement by providing the Center written notice of the Resident's desire to leave at least seven (7) days in advance of the Resident's departure_ If the Resident Ieaves before the end of that time, the Resident must stilt pay far each day of the required notice unless the Center fills the bed before the end of the notice period. Except in the event •~f an emergency or death, the Resident will be responsible for a1I charges for the Room and Boa.-d Rate and for aII services performed up to the end of the day that tfte admi-ssion ends- Discharge front the specialized units such as the Ttansitionai Care Unit or Subacute Unit may require less than seven (7) days notice. If discharge or tran3fer becomes necessary because the Resident and/or Responsible Party or someone else abuses! the Resident's funds, the Center will request that Iocal, state and federal authorities, as appropriate, investigate, which may result in prosecution- 4-07 Indemnific__ motion- The Resident will defend, indemnify and hold the Center harmless from any and a[[ c1;3ims, demands, suit and actions made against the Center by any person resulting -from any df.mage or injury caused by the Resident to any person or the property of any person or entity (inclrtding the Center), except in the case of negligence of the Center's employees and agents. 8 u ~ ~ < < ~ cuu ~ u . ~,~ r i r r.3 r u [sue _ ML1NUkC;IaK~, ~ ~AMNH;.LL PAGE l0 4-~$ Chf~nges in the Law. Any provision of this Agreement that is found to be invalid or unenforceable f~ a result of a change in state or federal Iaw provisions of this A will not invalidate the remaining g"eement and, it is agreed that to the extent possible, the Resident and the Center will continue to fulfiIi their respective obligations under this Agreement consistent with the Iaw. THE UNDERSIGNED CERTIFY AND ACKNOWLEDGE THAT THEY RA,~E EACH READ Ai~ID UNDERSTOOD THE FOREGOING AGREEIV,IENT, AND THAT THE}, RAVE HAD AN OPPORTUN'iTY TO ASK QUESTIONS AND TART ANY QUESTIONS HA YE BEEN ANSWERED TO THEIR SAT~SFACTION_ mil/ ~ ~~. Signat-~reofResident:'`` ,~ ~ "~ - ~ ~~~ ~~, na, .~_ Signature ofRespoiisible Party Date: Censer Representative: -- Dafc: ~- ~~ 05/03/2008 10:32 7177372189 MaNORCARE,CaMPHILL PAGE 01/11 •- - NONCE TO THE ~RINCX~AL GRA TANG A SOWER Ok' ATTORNEX THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS "f0 HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF .A.NY REAL OR PERSONAL PROPERTY WTTHOU'~ ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. 'T'HIS POWEtZ ©x A'~ I~ORNEY 170ES .1ti0 T IMPOSE A 7L i~Y ON YOux~ AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, XOLTR AGENT MUST USE DUE CARE TO ACT FOIL lc'OUR BENEFIT AND ~1.ACCORDANCE WITH THIS ROWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIti'EN HERE TkTROUGHOLTT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMT.T THE DL)RATION OF THESE POWERS OIt'YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BE~IALF TERMINATES YOUR AGENT'S AUTHORITX. YOUR AGENT MUST KEEP YOUR FUNDS .SEPARATE FROM YOUR AGENT'S FUNDS. A COLIR.T CAN TAKE AWAY THE POWERS OFYOUR AGENT TF IT FINDS YOUR AGENT TS NOT ACTING PROPERLY. TIiESE POWERS .AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 2Q PA. C. S. CH. 56. iF THERE IS ANYTHING ABOUT TH.T.S FORM THAT YOU DO NOT UNDERSTAND, XOU SHOULD ASIA A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. l ~~ ,;~ ~ JV ovew ~n• l~ ~ ~,S ROBERT C:. TRAVER, PRINCIPAL T]tf'LTS 1~T1 f]C fA0 ~ f]O 1 (] . /17 LDf1M_ 79 7~7'~77q Oft DATE 05/08/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 02/11 DURABLE GENERAL POWER O~ A~'TORNEX I, RO)E3ERT G. TRAVER, now of 1.076 Pinetown Road, Lewisberry, York County, rcnnsyivania l x339, appoint my wire, LOTS .i. TRA,viN~R, now of iui6 Pinetowx, Road, Lewisberry, York County, Pennsylvania 17339, an..d my daughter, ANNA M. M.ESSIME.R, now of l 095 Pinetown Road, .Lewisbctry, York County, Pennsylvania ] 73 39, to act jointly or individually, as my Co-Agents. If either of theirs predeceases me, resigns as Tny Agent or fails to complete the duties as my Agent, then the survivor of them shall serve as m_y Agent. LO)CS J. '>CRAVER and ANNA. M. MESSIMER are referred to as "my Co-Agents" in this document. If. and in the event that both of my Co-Agents predecease me, or do not complete the duties Vt A.Ay *:~ae and lati:f~sl Co-Aberts, then a:.d iL; such e•~c:~t, lherebyr:.a'~e, GOSiSt~ utc and appoint my sax, RONAJ~D E. TRAVFR., now of 1100 Pinetown Road, Lewisberxy, York County, Pennsylvania ]7339, as my Successor/\gent,with all therights and dutiesherei.nafter stated. I intend to create a Durable Power of Attorney pursuant to 20 Pa. C_S_ Section 5604 (or the con:csponding provision of any subsequent state law). Tl~e effective date of this Power is Novennber 16, ZOUS_ It is my express intent and direction that this Power of Attorney a-od the authority and powers hereby conferred shall not be affected by my subsequent disability, incapacity or incompetency, or the adjudication thereof, or later uncertainty as to whether I am dead or alive, and shall be fully exercisable notwithstanding the same. My A.ger.-t i.s hereby given the fullest possible powers to act on. my behalf, with the same powers, for ail purposes, and with the same validity as I could, if personally preseT~t. Without limiting the general powershcrebyalready conferred, myAgent shall havethe following specific powers, including, but not limited to: 1. To collect and receive any money and assets to which I may he cntitied; to deposit cash. and checks in. any of my accounts; to endorse for deposit, transferor collection, i.n my name and for my account any checks payable to my order; to draw and sign checks for rz~.e and in my name, including any accounts opened by such Agent in my name at any bank, savings society, money market fund or elsewhere; to receive and apply tl~e proceeds of such checks as my Agent deems best; and, to close accounts. 2. To take all lawful steps to recover, collect and receive any amounts of money now or herea$er owing or payable to me; and, to compromise and execute releases or other sufficient discharges .for such amounts; 3. To make loaP.s, secured or unsecured, in such amounts, upon such trims, with. or without interest and to such firms, corporations, and persons as my Agent deems appropri ate; 2 RF('FTVFn G15-GIR-' GIR 101.42 FRf1M- 7177`~771R9 T(1- Srhiit iar Rnrrar T T (' PfAfA7/f~11 05/08/2@08 1@: 32 7177372189 MaNORCARE,CAMPHILL PAGE 03/11 4. To institute, prosecute, defend., compromise, or otherrise dispose of (and to appear for me in any proceedings before any tribunal for the enforcement or for the defense oi} any claim, either alone or in conjunction with oth.Er persons, relating to me or to any property of mine or any other persons; to obtain, discharge and substiriite counsel and to - ~,..,,.~ ., ~~ to'~e vi.*.ere~? fl~T me lf1 any such aot;nn or nmceeding; aataort~a appeara,.ce oL ,u,.~~ coL.~s... and, to compromise or arbitrate any claim. in which 1 may be interested and for that purpose to enter nto agreennent or coinpromi se or arbitration and perform or. enforce ar-y award eniered pursuant to such arbitration; 5. To lease, sublet, sell, release, hire professional managers, convey or mortgage any real property owned by me (including any residence) or i~a whi.eh I have an interest now or in the future, upon such terms and conditions and under such covenants as my Agent shall determine, including the sale of rray real estate anal to sign, execute anal deliver deeds and conveyances therefor: 6. To I,n~rchase or otherwise acquire any interest in and possession. ofreal property and to accept all deeds £or such property oar. my behalf; and, to manage, repair, improve, no.aintaan, restore, build, or develop an.y real. property in which T now have or may have an interest in the future; 7. Ta execute, deliver and acknowledge deeds, deeds of trust, covenants, indemturES, agrEements, mortgages, hypothecations, bills of. lading, bills, bonds, notes, receipts, evidences of debts, releases and satisfactions of mortgage, judgments, ground rents and other debts; g. To collect, compromise, endorse, borrow against, hypothecate, release and recover any promissory note receivable, whether secured or unsecured, and any related deed of trust; 9. To buy, purchase, geil, repair, alter, manage and dispose of personal property of everykind and nature at private or public sale and to sign, execute and del~vec assignments and bills of sale therefor; 10. To enter my safe deposit boxes and to open new safe deposit boxes; to add to and to remove any of the contents o~ any such safe deposi t boxes; and, to close any of suck- boxes; 11 _ To borrow money for my account on whatever terms and conditions deetnEd advisable, including botxowing money on any insurance policies issued on my life fox any purpose without any obligation on tb.e part of such insurance coir-pany to determine the purpose for such loan or application of. the proceeds, and to pledge, assign. and deliver t11e policies as security; 12. To apply for and to receive any government, insurance and retirement benefits to which I may be entitled and to exercise any right to elect benefits or pa}~ment options; to 3 ntrrTStzn Q~_fA4_~fAQ 1fA•!17 FAf1M- 7177'2771 R4 Tfl- Srhntiar Rnrrar TTf' PG1~12/1~11 05/0^c/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 04/11 temninate such benefits; to change beneficiaries or. ownership of suchben..efits; and, to assign rights or receive cash value in return for the surrender of any or all rights I may have in life insurance policies or benefits, annuity policies, plans of benefits, mutual fund and other dividend investment plans and retirement, profit-sharing and employee welfare plans and benefits: 13 _ To take custody of any stocks, bonds and other investments of. all kinds, to give orders for the sale, surrender or exchange of arty such investments5 and to receive the proceeds therefrom; to sigt and deliver assignments, stock. and bond powers and other documents required for any such sale, assigrnnent, surrender or. exchange; to give orders for the purchase of stocks, bonds and other investments of any kind; to give instructions as to the registration thereof and the mailing of dividends and vnterest therefrom; and to deposit coupons attached to any coupon bonds, whether now owned by me or hereafter acquired; 14_ Tc_-purchasefortneUni.tedStatesofA~nericaTreaswyBondsoftbekindwhich are redeemable at par in payment of federal estate taxes; to borrow money artd obtain credit in my name from any source for such puxpose; to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefor, to pledge, mortgage a.nd assign any stocks, bonds, securities, insurance values and other properties, real or persor-al, in which T may have an interest; and., to arrange for the safekeeping and custody of arty such Treasuzy Bonds; 15_ To open, close, or maintain accounts (including accounts on margin or other leverage device, and accounts in options, calls or futures) with stockbrokers, investment counsel, financial advisors, or other similar agent or intermecliary, or through an account held by my Agent in an on-Line service, and to buy, sell, endorse, transfer, hypothecate, leverage, margin, orborrow against any of the accounts, stock, bonds, capital accounts, fiitures, option..s or other securities; 16. To vote at all meetings of shareholders (whether general, regular or special) of any corporation whose shares 1 own, on any questions which. may arise at any such meeting, az~d to do everything respecting such shares of stock, including the calling of meetings of directors or stockholders or making and giving consents and ratifications, and any other act which I could do if personally present, intending hereby to confer upon my Agent full power aad authority to do (with referencE to such sb.ares of stock) everything which I might or could do as owner of such shares; 17. 7'o continue the operation of any business belonging to me or in which. I have a substantial interest, in such manner as my Agent may deem advisable or to sell, liquidate or incorporate any business (orinterest therein) on such terms as my Agent may deem advisable and in my best interests; l 8. To procure, change, carry or cancel insurance of such kind a~~d in. such amounts as my Agent deems advisable to protect from risks affecting property or persons due to liability, damage or a claim of any sort; to claim any benefits or proceeds on my behalf; and, to purchase medical insurance for any dependent of mine; 4 RFf'FTS1FTl aS-GiR-' G1R 1 Gi • Q7 FRf1M- 7177'2771 R4 Tfl- Srhiifi i ar. Rnrra r T T f' Pf~(~Q /G111 05/08/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 05/11 19. Zfmarried, to join with nZy spouse or my spouse's estate in filing income or gift tax retums for an}~ years for which I have not filed such retums and to consent to any gifts made by my spouse as being nnade one-hal f by me for gift tax purposes, even though such. action subjects my assets to additional liabilities; 20. To prepare, sign and file federal., state and Local income. gift or other tax and information returns of all kinds; claims for refunds, requests or extensions of~time, petitions to the United States Tax Court or other courts regarding tax matters and any and all other tax related document`, including, withoutli.m.itation, reeeipts,offers, waivers, consents (inncluding, but not limited to, consents and agree~rents under Internal Reven..ue Code (hereinaffier IRC) Section 2032A, or its successor), powers of attorney, and closing agreements; to exercise any electioa~s I may have under federal, state and local tax laws; and, generally to act on mybehalf in all tax matters of al.l. kinds and for all periods before all persons represEnting the internal Revenue Service and any other taxing authority, including.receipt of confidential information and the posting ofbonds. 21_ To make gifts, unlimited in amount, as set forth below, eith.E:r outright or in trust or, in the case of minors, in accordance with the Uniform Gigs to Minors Act and., for gifts made in trust, to execute a deed of trust for such purpose designating one or more persons, including myAgent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more permissible donees. The pattern followed on the occasion of any such gift (or gifts) need riot be followed ozr the occasion of any other gift (or gifts). The power. to make gifts shall be litraited to my brothers and sisters (whether by the whole or half blood), spouse, parents, grandparents, and Pineal descendants and any organizati.or.- described in 1RC Section 501(`)(3)_ My Agent and the donee of the gift shall be responsib)e as equity and justice mayrequire to the extent that a gift made by my Agent is itaeonsistent with the prudent planning of my estate or financial management of my property, or with my )mown or probable intent with respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall onlybe made in conformitywith mypre-nuptial agreement, if any such agreement exists. 22. '1'o execute a deed of trust, designating one or more persons (including xny Attorneys-in-Pact) as original or successor trustee(s) and to transfer to the mist any or all property owned by me as .Tray Agent may decide. The income and principal of the trust may, but need not, be distributable to me or to the guardian of my estate, or be applied for xry benefit, and upon my death, any remaining Principal or unexpended income of the trust may, but need not, be distributed to my estate_ 1=urthermore, this tract or deed of trust may be amendable or revocable at any time by me or my Agent, or the trust or deed. of trust naay be irrevocable by nae or my Agent; 23_ To add at any time, any or all of rh.e property owned by me to any trust in existence for my benefit when this power was created. The income and principal of the trust may, but need not, be dist~7butable to me or to the guardian of my estate or be applied for my 5 Dtf tTt)LTl r~~_rao_~ rao ~ r~ . n~ ~pnM_ ~~ ~~?v~~ Qo Tn_ c,-~,,,+ ;o,- v~,.~,- r r r pr~r~~ ~r~~ ~ 05/08/2008 10:32 7177372189 MaNORCaRE,CAMPHILL PAGE 06/11 benefit during my lifetime and upon iry death any remaining principal and unexpended income of th.e trust may, but need not, be distributed to my estate; 24. To withdraw and receive the income or corpus of any trust over which t may lla`.,o a _^.pht nf,y;th~r2.~r~~ anr~ tC r°_^,"~St an~ r~Ce)`Ip th_ in~Cm~ ~r Co r,~s ofany tnict ,frith respect to which the trustee thereof has the discretionary power to make distributions tome or on zn.y behalf, and to execute a receipt and. release or a similar document for the property so received; 25. To convey or release any contingent or expectant interests in property, marital property rights, and any rights of survivorship in..cident to a joint tenancy or a tenancy by the entireties; 26. To elect to take against the will. and conveyances of ix~y spouse. after death; to disclaim any interest i.n. property which I am required to disclaim as a result of such elect7on; to retain any property which I have the right to elect to retain; to file petitions pertaining to the election, including petitions to extend the time for electing, and petitions for carders, decrees, and judgments; and, to take all other necessary actions to effectuate the election; 27. To accept and acquire or release and disclaim on my behalf any interest in property acquired by intestate, testate or inter vivos transfer, irieluding the release or. disclaimer, or acquisition of any interest in property through the exexcise or surrender of any right to revoke a revocable trust; 28. To continue any fidueiarypositions to which I have been or may be appointed including (but not limited to}personal representative, trustee, guardian, Agent, and officer or director of a corporation ox political or goverTamental body; and, to resign such positions in which capacity I azn. presently serving or to which I may be appointed; 29. TO HAVE THE AUTHORITY TO GIVE CONS.F_N'1' FOR, A.ND AUTHORIZE, SUCH MEDICAL AND SURGICAL PROCEDURES AND TREATMENT (INCLUDING LIFE-SUSTAINING TREATMENT), TO BE PERFORMED ON ME AND TO AUTHORIZE, ARRANGE FOR, CONSENT 'TO, WAIVE AND TERMINATE .ANY AND ALL MEDICAL AND SURGICAL PROCEDURES AND TREATMENT (INCLUDING LIFE-SUSTAINING TREATMENT) ON MY BEHALF, INCLUDING THE ADMIMSTRATION OF DRUGS OR TO WITHHOLD SUCH CONSENT; PROVIDED THAT ANY LIVING WILL WHICH I MAY HAVE THEN IN EFFECT SHALL TAKE PRECEDENCE OVER THIS PROVISION; 30. To arrange for my entrance into and care at any hospital, nursi ng home, health center, convalescent home, retirement home, or similar personal care, sheltered care, intermediate care, or skilled nursing facility; and, to pay all costs for my care as my Agent, based on m...edical advice, determines in good faith to be necessary and for my well-being; G Dz(''T:Tt1~T1 fi~_f1Q_~ fAQ 1 fA • n7 1=T7f1M_ 71 772771 QQ T(1- Crh,it icr Rr,rtar T T ( PfAfAf, /f,111 05/08/2008 10:32 7177372189 MaNORCARE,CaMPHIL~ Pa6E 07;'11 31. To employ lawyers, investinent counsel, accountants, physicians, dentists and other persons to render services to me or my estate and to pay the usual and reasonable fees and eoznpensation. of such persons for their services; ~7 Tn tl;~ ovt'nt nt+t ntliP?l~t/lSA Off°Ctl„al,i r~rtlr~,aoii :?l tl:P :?'?~:TQCj,.lr-*^•r j~ p2.r~~^T. 2*t?ll • ~ .r.. of this Power o f Attorney, to appoi nt and substi tute under hi msel f and them.selves, or. a or more substitute or Successor Agent for any or all the purposes herein described, pursuant to Pennsylvania Consolidated Statutes Title 20, Section 5602(b)(3) or t11e cor-respondi.ng provision of any subsequent state law; 33. To snake an anatomical gift of all or part of my body or decisions concerning procedures relating to such gift(s) ox procedures, either before or after my death, provided that any Such power shall be subject to and limited by any power granted to my surrogate under my ><,i.viz~g Will; 34. To obtain healthinformationorzbehalfoftheprincipal,includin.gan.accounting of health care and information disclosures, anal to enforce my rights regarding health care and information through all means including, but r~.ot limited to, filing complaints and appropriate appeals, to thern.a~imum extent permitted by 45 C.F.R.. 1C4.502(g) such that my agent and Agent shall be considered to act fully in my place for all issues concerning health care coverage, insurance, and information under the Health Insurance Portability and Accountability Act of 1996, as amended; and, 35_ To direct the conveyance, transfer, or delivery of my mail, including, letter bills, packages, and correspondence, of whatever rate, type or kind, with such power. as may be necessary to receive such correspondence, change the address for delivery of such correspondence, or otherwise act in my stead with the federal Postal Service or other institution handling correspondence. Accordingly, A,_ Except as my Age~~t may waive any fees, my Agent shall be entitled to receive for services actually performed hereunder their normal and customary charge for performing similar services during the time the services are performed. B. This Power of Attomey maybe accepted anal relied upon by anyone to whom it ispresented until such person either receives written notice ofrevocationby me orhas actual knowledge of my death or the revocation of this Power of Attorney, C. All actions of my Agent pursuant to this Power of Attomey during nny absence or any peziod of my disability or incapacity shall have the same effect and inure to the benefit of and shall bind me, my heirs, distributees, legal representatives, successors a.nd assigns, as if I were present, and competent and not disabled, and .for the purpose of inducing anyone to act in accordance with th.e powers I have granted herein, i hereby represent, w<~rrant and agree that, if this Power of Attorney is terminated or amended for any reason, I and my heirs, 7 ncr=rt~cll fAG_I14_r fA4 1 fA ~ ~7 ~Af1M_ 71777'71 QQ Tfl_ Crhiit for Rf,R'~r T T (' AfAfA7 /6111 05!08/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 08/11 distributees,l.egalrepresentatives, successors and assigns willhol.d such partyharrraless forany loss suf~'cred or liability incurred by such party while acting in accordance with this Power of .Attorney prior to that party's receipt of written notice of arty such termination or amendment. Tl f ,-otrnke all r^,riOT f;onrr2l L,r Tl~iraljl~ Pnvr~rs ~f Att~~01 that T may 1~gvF executed and I retain the xight to revoke or amend this Power of Attom..ey and to substitute other attonr~eys-in-fact in place of the Agent appointed. herein.. Amendments to this Power of Attorney shall be made in writing by the personally (not by my Agent) and they shall be attached. to the original of this Power of Attorn..ey. E. Pursuant to Pennsylvarxia Consolidated Statutes Title 20, Section 5604(c)(2) or the corresponding provision of any subsequent state law, if incapacity proceedings for my estate or my person are hereafter conam.enced, I hereby nom.in..ate, constitute and appoint the above-described Agent as the guardian of my estate and my person. If and in. the event that m}r Agent predeceases me, or does not complete the duties of my true and lawful Agent, then and in such event, I hereby nominate, constitute anal appoint th.e above-described Successor Agent as the guardians of my estate and my person... F. I understand that this Power of Attorney is an important legal document. Before executing this docurn.ent, my attorney-at-law explained to nc~e the following: (1) This document provide,5 my Agent with broad powers to dispose of, sell, convey anal encumber my real and personal propezty; (2) The powers granted in this Power of Attorney will. become effective upon. the execution of this document and will exist for an. ir~.det~nite period of iatne unless I limit their duration by the tents of this Power or revoke this Power_ These powers will continue to exist notwithstanding my subsequent disability or incapacity; and, (3) I have the right to revoke or terminate this Power at a~iy time. G. Questions pertainingtotbevalidity,constructionandpowerscreatedunderthis Power of Attorney shall be determined in. accordance with the laws of the Commonwealth of Pennsylvania_ Where herein used, the plural shall include the singular, and the singular shall include the plural. IN WITNESS WHEREOF, and intending to be legallyboundhereby,l have signed this Durable Power of Attorney, this 16''' day of November, 2005. J~' /, J ~ . - - _ (SEAL) ROBERT G. TRAVER RF('FTSIFTI (~S-f~R-' G1R 1 G1.4~ FRf1M- 71?7'~7~1 R9 Tfl- Srhiit iar Rnaa r T.T.C PGiGiR /GI11 -.l 05/08/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 09/11 On this l.6`'' day of November., 2005, the above-named, ROBERT G. TRAVER, in our presence declared the preceding instrument consisting of this and ten (10) other typewritten pages, to be his Power of Attorney, and we, in the presence of the above-named AL1~~'AT ~. Ti~A1~JTiJ~ v~d .^. the pr~conrR {.f oar11 nt}1Pr gt tT~r ra~~£et of 121F» i~Aye subscribed ow names as wimesscs. '~ r ~~~ Witness's Signature COMMONWEALTH OP PENNSYLVANIA Wimegs's Name (pant) SS: COUNTY OF CUMBERLAND On this, the ~ ~ day of November, 2005, before me, a Notary Public, the undersigned officer, personally appeared ROBERT G. TRA,VER, known to rrze (or satisfactorily proven) to be the person whose Warne is subscribed. to the within Durable Power of Attorney, and acknowledged that he executed tl~e same for the purposes therein contained. IN WITNESS WHE><2,EOF, I hereunto set my hand and official Seal. .~ Notary Public My Cornmi.ssion Expires: see- LerrgYne ~• ~ ~~ ~ pp~urtission F~cphas ~ 27.206 member. ~scx~~^ ~~'~- 9 RT=('T:T~7T:T1 f~~-~1R-' G1R 10.47 FRf1M- 7177'2771Rq Tfl- Schnfi for Rnnar T T (: PG1fAq/CA11 05/08/2008 10:32 7177372189 MANORCARE,CAMPHILL PAGE 10/11 A,CI~lOWLEDGMIENT EXECUTED )BY PRIMA. Y AGENTS AN AGENT SHALL HAVE NO AUTIFIORITY TO ACT AS AGENT UNAFR TT3.IS POWER OF ATTORNEY UNLESS THE AGENT HAS F)<RST EXECUTED AND AFFIXED THIS .ACKNOWLEDGMENT TO TAE POWER OF ATTORNEY DOCUMENT: We,LOIS J. TRAVER a~od ANNA M. MESSIMER, have each read the attached power of attorney and arc the persons identified as the co-agents for the principal. We each hereby acknowledge that in the absence of a specific provision to the contrary in the power of attorney or iT- 20 Pa_ C. S. when we act as agents_ 1_ We shall each exercise the powers for the benefit of the principal; 2. We shall each keep the assets of the principal separate from our. assets; 3. We shall each exercise reasonable caution and prudence; and, 4. We shall each keep a full and accurate record of all actions, receipts and disbursements on behalf of t11e principal. .~ ~'~ L IS J. TRA R, Ca-Agent Date NA 1VI. MESSIME . , Co-Agent 1a~ Date 10 A~f'T:TL1T:r1 fA~-fiiQ-~fAR 1G1~d7 T:R(1M- 7177~7'71S2Q Tfl- ~rh„tior T?nrr~r TTf TJfA1fA/fA'1'1 05/08/2008 10:32 7177372189 MANORCARE,CAMPHILL_ PAGE 11/11 A,CK-NOWLEDGMENT EXECUTED BY SUCCESSOR AG1~.NT A SUCCESSOR AGENT SHALL NAVE NO AUTHORITY TO ACT AS AGENT UNAER THIS POWER OT ATTORNEY UNLESS TJET.E SUCCESSOR AGENT HAS FIRST EXECUTED AND ATFIXED THIS ACKNO~V><,EDGMENT TO THE POWER OF ATTORNEY DOCUMENT: I, RONALD E. TRAVER, have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the power of attorney or in 20 Pa. C. S. when I act as agent: 1. I skull each exercise the powers for the benefit of the principal; 2. I shall each keep the asset`s of the principal separate from our assets; 3. I shall. each exercise reasonable caution and prudence; 4. I shall each keep a full and accurate record of all actions, receipts and disburse;nents on behalf of the principal. RONALD E. TRAVER, Successor Agent ni:rt:r~~i:n rac_no_~rao ~ra.n~ LD~1M_ '7'1'77'~'7'~'IOa pate ll Tf1_ C,-L,..r ;...~ D.,...,.- T T (' Dfa'I 1 /fA'I'I . :., - F ~ ~ ~~' ~~ ~ ' ~ `~ ~~ NOTICE TO THE PRINCIPAL GRANTING A POWER OF ATTORNEY THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YO UR PROPERTY, W RICH MAY INCLUDE POWERS TO SELL OR OTHERWLSE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GNEN HERE -, THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME ~~ ~ 1 INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF J !L THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF TT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THESE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN ZO PA. C. S. CH. 56. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME TFIIS NOTICE AND I UNDERSTAND ITS CONTENTS. OIS J. TRAVER, PRINCIPAL DATE ~~07~PPUCABLE FOR PiN Nt}MBE~ ~,~, ~ ~~~ ~fl9~ •~~Fs~ 05/12/2008 4:07:15 PM YORK COUNTY Inst# 2008012185 -Page 1 ~ ~ li U i ~ I ! LJ..u ,.J. ~ n ~ ~ • DURABLE GENERAL POWER OF ATTORNEY I, LOIS J. TRAVER, now of 1076 Pinetown Road, I.ewjSberry, York County, Pennsylvania 17339, appoint my daughter, ANNA M. MESSIMER now of 1095 Pinetown Road, Lewisberry, York County, Pennsylvania 17339, as myAgent. ANNA M. MESSIMER is referred to as "my Agent" in this document. If and in the event that my Agent predeceases me, or does not complete the duties of my true and lawful Agent, then and in such event, I hereby make, constitute and appoint my son, RONALD E. TRAVER,Enow of 1100 Pinetown Raad, Lewisberry, York County, Pennsylvania i 7339, as my Successor Agent, with all the rights and duties hereinafter stated. I intend to create a Durable Power of Attorney pursuant to 20 Pa. C.S. Section 5604 {or the corresponding provision of any subsequent state law)_ The effective date of this Power is November 16, 2005. It is my express intent and direction that this Power of Attorney and the authority and powers hereby conferred shall not be affected by my subsequent disability, incapacity or incompetency, or the adjudication thereof; or later uncertainty as to whether i am dead or alive, and shall be fully exercisable notwithstanding the same. My Agent is hereby given the fullest possible powers to act on my behalf, with the same powers, for all purposes, and with the same validity as I could, if personally present. `Vithout limiting the general powers hereby already conferred, my Agent shall have the fallowing specific powers, including, but not limited to. 1 _ To collect and receive any money and assets to which I may be entitled; to deposit cash and checks in any of my accounts; to endorse for deposit, transfer or collection, in my name and for my account any checks payable to my order; to draw and sign checks for me and in my name, including any accounts opened by such Agent in my nazne at any bank, savings society, money market fund or elsewhere; to receive and apply the proceeds of such checks as my Agent deems best; and, to close accounts. 2. To take all lawful steps to recover, collect and receive any amounts of money now or hereafter owing or payable to me; and, to compromise and execute releases or other sufficient discharges for such amounts; 3. To make loans, secured or unsecured, in such amounts, upon such terms, with or without interest and to such firms, corporations, and persons as my Agent deems appropriate; 4. To institute, prosecute, defend, compromise, or otherwise dispose of (and to appear for me in any proceedings before any tribunal for the enforcement or for the defense 2 05/12/2008 4:07:15 PM YORK COUNTY Inst.# 2008012185 -Page 2 e „ ~U.~, of) any claim, either alone or in conjunction with other persons, relating to me or to any property of mine or any other persons; to obtain, discharge and substitute counsel and to authorize appearance of such counsel to be entered for me in any such action or proceeding, and, to compromise or arbitrate any claim in which I may be interested and for that purpose to enter into agreement or compromise or arbitration and perform or enforce any award entered pursuant to such arbitration; 5. To lease, sublet, sell, release, hire professional managers, convey or mortgage any real property owned by me (including my residence) or in which I have an interest now or in the future, upon such terms and condirions and under such covenants as my Agent shalt determine, including the sale of my real estate and to sign, execute and deliver deeds and conveyances therefor; 6. To purchase or otherwise acquire any in#erest in and possession ofreal property and to accept all deeds for such property on my behalf; and, to manage, repair, improve, maintain, restore, build, or develop any real property in which I now have or may have an interest in the future; 7. To execute, deliver and acknowledge deeds, deeds of trust, covenants, indentures, agreements, mortgages, hypothecations, bills of lading, bills, bonds, notes, receipts, evidences of debts, releases and satisfactions of mortgage, judgments, ground rents and other debts; 8. To collect, compromise, endorse, barrow against, hypothecate, release and recover any promissory note receivable, whether secured or unsecured, and any related deed of trust; 9. To buy, purchase, sell, repair, alter, manage and dispose of personal property of every kind and nature at private or public sale and to sign, execute and deliver assignments and bills of sale therefor; 10, To enter my safe deposit boxes and to open new safe deposit boxes; to add to and to remove any of the contents of any such safe deposit boxes; and, to close any of such boxes; 1 1. To borrow money for my account on whatever terms and conditions deemed advisable, including borrowing money on any insurance policies issued on my life for any purpose without any obligation on the part of such insurance company to determine the purpose for such loan or application of the proceeds, and to pledge, assign and deliver the policies as security; 12. To apply for and to receive any government, insurance and retirement benefits to which I may be entitled and to exercise any right to elect benefits or payment options; to terminate such benefits; to change beneficiaries or ownership of such benefits; and, to assign rights or receive cash value in return for the surrender of any or all rights I may have in Iife 05/12/2008 4:07:15 PM YORK COUNTY Inst.# 2008012185 -Page 3 insurance policies or benefits, annuity policies, plans of benefits, mutual fund and other dividend investment plans and retirement, profit-sharing and employee welfare plans and benefits; 13 . To take custody of any stocks, bonds and other investments of al l kinds, to give orders for the sale, surrender or exchange of any such investments and to receive the proceeds therefrom; to sign and deliver assignments, stock and bond powers and other documents required for any such sale, assignment, surrender or exchange; to give orders for the purchase of stocks, bonds and other investments of any kind; to give instructions as to the registration thereof and the mailing of dividends and interest therefrom; and to deposit coupons attached to any coupon bonds, whether now owned by me or hereafter acquired; 14. To purchase for me United States of America Treasury Bonds of the kind which are redeemable at par in payment of federal estate taxes; to borrow money and obtain credit in my name from any source for such purpose; to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefor, to pledge, mortgage and assign any stocks, bonds, securities, insurance values and other properties, real or personal, in which I may have an interest; and, to arrange for the safekeeping and custody of any such Treasury Bonds; 15. To open, close, or maintain accounts (uzcIuding accounts on margin or other leverage device, and accounts in options, calls or futures) with stockbrokers, investment counsel, financial advisors, or other similar agent or intermediary, or through an account held by my Agent in an on-line service, and to buy, sell, endorse, transfer, hypothecate, leverage, margin, or borrow against any of the accounts, stock, bonds, capital accounts, futures, options or other securities; 16. To vote at all meetings of shareholders (whether general, regular or special) of any corporation whose shares I awn, on any questions which may arise at any such meeting, and to do everything respecting such shares of stock, including the caIling of meetings of directors or stockholders or making and giving consents and ratifications, and any other act which I could do if personally present, intending hereby to confer upon my Agent full power and authority to do (with reference to such shares of stock) everything which I might or could do as owner of such shares; 17. To continue the operation of any business belonging to me or iii which I have a substantial interest, in such manner as my Agent may deem advisable ar to sell, liquidate or incorporate any business (or interest therein) on such terms as my Agent may deem advisable and in my best interests; 18. To procure, change, carry or cancel insurance of such kind and in such amounts as my Agent deems advisable to protect from risks affecting property or persons due to liability, damage ar a claim of any sort; to claim any benefits or proceeds on my behalf; and, to purchase medical insurance for any dependent of mine; 4 - i.~,.~....^r ... ..,.... .. .. . 05/12/2008 4:07:15 PM YORK COUNTY Inst.# 2008012185 -Page 4 19. If married, to join with my spouse or my spouse's estate in filing income or gift tax returns for any years for which I have not filed such returns and to consent to any gifts made by my spouse as being made one-half by me far gift tax purposes, even though such action subjects my assets to additional liabilities; 20. To prepare, sign and file federal, state and local income, gift or other tax and information returns of all kinds, claims for refunds, requests or extensions of time, petitions to the United States Tax Court or other courts regarding tax matters and any and all other tax related documents, including, without fimitatian, receipts, offers, waivers, consents (including, but not limited to, consents and agreements under Internal Revenue Code {hereinafter 1RC) Section 2032A, or its successor), powers of attorney, and closing agreements; to exercise any elections I may have under federal, state and local tax laws; and, generally to act on my behalf in all tax matters of all kinds and for all periods before all persons representing the internal Revenue Service and any other taxing authority, including receipt of confidential information and the posting of bonds. 21. To make gifts, unlimited in amount, as set forth below, either outright or in trust or, in the case of minors, in accordance with the Uniform Gifts to Minors Act and, for gifts made in trust, to execute a deed of trust for such purpose designating one or more persons, including my Agent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more permissible donees. The pattern followed on the occasion of any such gift (or gifts) need not be followed on the occasion of any other gift. (or gifts). The power to make gifts shall be limited to my brothers and sisters (whether by the whole or half blood), spouse, pazents, grandparents, and lineal descendants and any organization descnbed in IRC Section 501(c)(3). My Agent and the donee of the gift shall be responsible as equity and justice may require to the extent that a gift made by my Agent is inconsistent with the prudent planning of my estate or financial management of my property, or with my known or probable intent with respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall onlybemade in conformitywith mypre-nuptial agreement, if any such agreement exists. 22. To execute a deed of trust, designating one or more persons (including my Agents) as original or successor trustee(s) and to transfer to the trust any or all property owned by me as my Agent may decide. The income and principal of the trust may, but need not, be distributable to me or to the guardian of my estate, or be applied for my benefit, and upon my death, any remaining principal or unexpended income of the trust may, but need not, be distributed to my estate. Furthermore, this trust or deed of trust may be amendable or revocable at any time by me or my Agent, or the trust or deed of trust maybe irrevocable by me or my Agent; 23. To add at any time, any or all of the property owned by me to any trust in existence for my benefit when this power was created. The income and principal of the trust may, but need not, be distributable to me or to the guardian of my esta#e or be applied for my 05!12/2008 4:07:15 PM YORK COUNTY Inst.# 2008012185 -Page 5 ~ ~ 1 11 1~ ~ i is dL~ uil4 i ~~~ ~ ~ benefit during my lifetime and upon my death any remaining principal and unexpended income of the trust may, but need not, be distributed to my estate; 24. To withdraw and receive the income or corpus of any trust over which I may have a right of withdrawal, and to request and receive the income or corpus of any trust with respect to which the trustee thereof has the discretionary power to make distributions to me or on my behalf, and to execute a receipt and release or a similar document for the property so received; 25. To convey or release any contingent or expectant interests in property, marital property rights, and any rights of survivorship incident to a joint tenancy or a tenancy by the entireties; 26. To elect to take against the will and conveyances of my spouse after death; to disclaim any interest in property which I am required to disclaim as a result of such election; to retain any property which I have the right to elect to retain; to file petitions pertaining to the election, including petitions to extend the time for electing, and petitions for orders, decrees, and judgments; and, to take all other necessary actions to effectuate the election; 27. To accept and acquire or release and disclaim on my behalf any interest in property acquired by intestate, testate or inter vivos transfer, including the release or disclaimer, or acquisition of any interest in property through the exercise or surrender of any right to revoke a revocable trust; 28. To continue any fiduciary positions to which I have been or may be appointed including (but not limited to) personal representative, trustee, guardian, Agent, and officer or director of a corporation or political or governmental body, and, to resign such positions in which capacity I am presently serving or to which I may be appointed; 29. TO HAVE THE AUTHORITY TO GIVE CONSENT FOR, AND AUTHORIZE, SUCH MEDICAL AND SURGICAL PROCEDURES AND TREATMENT (INCLUDING LIFE-SUSTAINING TREATMENT), TO BE PERFORMED ON ME AND TO AUTHORIZE, ARRANGE FOR, CONSENT TO, WAIVE AND TERMINATE ANY AND ALL MEDICAL AND SURGICAL PROCEDURES AND TREATMENT (INCLUDING LIFE-SUSTAINING TREATMENT} ON MY BEHALF, INCLUDING THE ADMINISTRATION OF DRUGS OR TO WITHHOLD SUCH CONSENT; PROVIDED THAT ANY LIVING WILL WHICH I MAY HAVE THEN IN EFFECT SHALL TAKE PRECEDENCE OVER THIS PROVISION; 30. To arrange for my entrance into and care at any hospital, nursing home, health center, convalescent home, retirement home, or similar personal care, sheltered care, intermediate care, or skilled nursing facility; and, to pay all costs for my care as my Agent, based on medical advice, determines in good faith to be necessary and for my well-being; 31. To employ lawyers, investment counsel, accountants, physicians, dentists and 6 . , ~ , ~ p- - ~~_r~_~..~ .. _.. _ _. _ .. . , - , 05/12/2008 4:07:15 PM YORK COUNTY Inst.# 2008012185 -Page 6 other persons to render services to me or my estate and to pay the usual and reasonable fees and compensation of such persons for their services; 32. To the extent not otherwise effectively provided in the introductory paragraph of this Power of Attorney, to appoint and substitute under himself and themselves, one or more substitute or successor Agents for any or all the purposes herein described, pursuant to Pennsylvania Consolidated Statutes Title 20, Section 5602{b)(3) or the corresponding provision of any subsequent state law; 33. To make an anatomical gift of all or part of my body or decisions concerning procedures relating to such gift(s) or procedures, either before or after my death, provided that any such power shall be subject to and limited by any power granted to my surrogate under my Living Will; 34. To obtain health information on behalfofthe principal, including an accounting of health care and information disclosures, and to enforce my rights regarding health care and information through all means including, but not limited to, Sling complaints and appropriate appeals, to the maximum extent permitted by 45 C.F.R_ 164502(g) such that my agent and Agent shall be considered to act fully in my place for all issues concerning health care coverage, insurance, and information under the Health Insurance Portability and Accountability Act of 1996, as amended; and, 35. To direct the conveyance, transfer, or delivery of my mail, including, letter bills, packages, and correspondence, of whatever rate, type or kind, with such power as may be necessary to receive such correspondence, change the address for delivery of such correspondence, or otherwise act in my stead with the federal Postal Service or other institution handling correspondence. Accordingly, A. Except as my Agent may waive any fees, my Agent shall be entitled to receive for services actually performed hereunder their normal and customary charge for performing similar services during the time the services are performed. B. This Power of Attorney may be accepted and relied upon by anyone to wham it is presented until such person either receives written notice of revocationby me orhas actual knowledge of my death or the revocation of this Power of Attorney_ C. All actions of my Agent pursuant to this Power of Attomey during my absence or any period of my disability or incapacity shall have the same effect and inure to the benefit of and shall bind me, my heirs, distributees, legal representatives, successors and assigns, as if I were present, and competent and not disabled, and for the purpose of inducing anyone to act in accordance with the powers I have granted herein,l hereby represent, warrant and agree that, if this Power of Attorney is terminated or amended far any reason, I and my hens, distnbutees, legal representatives, successors and assigns will hold suchparty harmless for any 05/12/2008 4:07:'1 S PM YORK COUNTY Inst# 2008012185 -Page 7 u u It 1~1 ~LLI~¢nwl ~LL LJ loss suffered or liability incurred by such party while acting in accordance with this Power of Attorney prior to that party's receipt of written notice of any such termination or amendment. D. I revoke ail prior General or Durable Powers of Attorney that I may have executed and I retain the right to revoke or amend this Power of Attorney and to substitute other Agents in place of the Agent appointed herein. Amendments to this Power ofAttorney shall be made in writing by me personally (not by my Agent) and they shall be attached to the original of this Power of Attorney. E. Pursuant to Pennsylvania Consolidated Statutes Title 20, Section 5604(c}(2) or the corresponding provision of any subsequent state law, if incapacity proceedings for my estate or my person are hereafter commenced, I hereby nominate, constitute and appoint the above-described Agent as the guardian of my estate and my person. If and in the event that my Agent predeceases me, or does not complete the duties of my true and lawful Agent, then and in such event, I hereby nominate, constitute and appoint the above-described Successor Agents as the guardians of my estate and my person. F. I understand that this Power of Attorney is an important legal document. Before executing this document, my attorney-at-law explained to me the following: (1) This document provides my Agent with broad powers to dispose of~ selI, convey and encumber my real and personal property; (2} The powers granted in this Power of Attorney will become effective upon the execution of this document and will exist for an indefinite period of time unless I limit their duration by the terms of this Power or revoke this Power. These powers will continue to exist notwithstanding my subsequent disability or incapacity; and, (3) I have the right to revoke or terminate this Power at any time. G. Questions pertaining to the validity, construction and powers created under this Power of Attorney shall be determined in accordance with the laws of the Commonwealth of Pennsylvania. Where herein used, the plural shall include the singuiaz, and the singular shall include the plural. 1N WITNESS WHEREOF, and intendingto be legallyboundhereby, Ihavesigned this Durable Power of Attorney, this 16~' day of November, 2005. ~~' Es EAL.} LOIS J. TRAVER 8 ~. - , . - ~Tr~~---~. , , ,.... _ . .. ~ . , . 05/12/2008 4:D7:1 S PM YORK COUNTY Inst.# 2008012785 -Page 8 On this 15'~ day of November, 2005, the above-named, LOIS J. TRAVER, in our presence declared the preceding instrument consisting of this and ten {10) other typewritten pages, to be her Power of Attorney, and we, in the presence of the above-named LOIS J. TRAVER, and in the presence of each other, at the request of her, have subscribed our names as witnesses. V ~\' Witness's Signature Witness's Name tnri~fl ~ Witness's Narne {print) COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND >" On this, the ~ ~ day of November, 2005, before me, a Notary Public, the undersigned officer, personally appeared LOIS J. TRAVER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Durable Power of Attorney, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official Seal. _ !/ ` Notary Public My Commission Expires: L n M' f ~~ ~'~ ~'~ +Or 9 . .~ _ _ L~..rf._ _' ~ . .. _ .. _ .. ..: . 05/12/2008 4:07:15 PM YORK COUNTY I~st.# 2008012185 -Page 9 I II li I r Ii L~ku~ Mir ~ r, i t r ACKNOWLEDGMENT EXECUTED BY PRIMARY AGENT AN AGENT SHALL HAVE NO AUTHORITY TO ACT AS AGENT UNDER THIS POWER OF ATTORNEY UNLESS THE AGENT HAS FIRST EXECUTED AND AFFIXED THIS ACKNOWLEDGMENT TO THE POWER OF ATTORNEY DOCUMENT: I, ANNA M. MESSIMER, have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the power of attorney or in 20 Pa. C. S. when I act as agent: 1. I shall exercise the powers for the benefit of the principal; 2. I shall keep the assets of the principal separate from my assets; 3. I shall exercise reasonable caution and prudence; and, 4. I shaII keep a fiill and accurate record of all actions, receipts and disbursements on behalf of the principal. ~~ ~~~ J~ A M. MESSIME Agent Date 1Q r r ,... ~ l ~T_--i ... .... , _ . . r . . 05/12/2008 4:07:15 PM YORK COUNTY inst.# 2008012185 -Page 10 r ~ r I I II LL 1 ~ L41LLI4 uH4 1 ri i J ACKNOWLEDGMENT EXECUTED BY SUCCESSOR AGENT A SUCCESSOR AGENT SHAIIL HAVE NO AUTHORITY TO ACT AS AGENT UNDER THIS POWER OF ATTORNEY UNLESS THE SUCCESSOR AGENT HAS FIRST EXECUTED AND AFFIXED THIS ACKNOWLEDGMENT TO THE POR'ER OF ATTORNEY DOCUMENT: I, RONALD E. TRAVER, have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the power of attorney or in 20 Pa C. S. when I act as agent: 1. I shall each exercise the powers for the benefit of the principal; Z.. 1 shall each keep the assets of the principal separate from our assets; 3. I shall each exercise reasonable caution and prudence; and, 4. I shall each keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. RONALD E. TRAVER, Saccessor Agent 11 05/12/2008 4:07:15 PM YORK COUNTY Date Inst.# 2008012785 -Page 11 E 0 LL e 2 `a Y S d i 3 g! ~. B ~ 8 3 T o R Q D F ° a __ ~ ~ ~ ~ g n ~ ~ a g N u Y Y ~ ~ ~ m ~ PI N N {~7 '- N N !~ H ~ _~ cCm Y N 6~x ~~a ~ ~8 aW~ Ii i~.0. ~ (g 2 E E ~ ~ `o P TO Vp~ p~V ~m m°~ N=ON Y~ O LL Q pO p 8 2 4 0 ~ ' C d c ~~ c =o O C d r c m d 7 d N 1 I 1 ~< 1 r~ : 1 ~~, : I 1 ~m 1 P~ : ' m-- 1 1 1 I ul ~Q GI 1 ~$~aya ' y 'CIr F m YI L~~ °' ~~F vi ~9g y~ a -~~ HI mvD bl cm~ O ~'~ alp I - p'Ijl~ ~+~ ~ ~~5 ~ H 3 ~ q m 8'0` 8 ~ ~ ~ ~~ :~;~~~ sk a= ~g T ki ~_~~2~,~CP~~~ I 1 1 1 1 °~ 1 I m 1 1 4 N„: 1 1 - 9 : 1 1 . I g I 1 I I In ~: ,: 1 i 1 1 - I~ ~ Im N t_ 1C `O IN mm m u~ alp i° §z 1~ Ida N M `m 9 `g ~ ~ g p~~ a y a25.. ~n,9g~~~>~ 40o L°~~°g ~ ~~~i t~~~ 0 z I ~~ ~ I 1 c m m ~~ _ 8~ j~ m ~ ~ I m : I ~ I m m N 8S ~ y : 1 ~ m m~ 1 9 ~ o ~ ~ `o 9O >Y ° _ _o . ~~ 1 ~ i V ~ ~ ~ _ i b _ ~~ a~ am: Is: ~ . Vim= ~a: ~ ~ °L. 1 8 °~ ~~ s ~° '~: m `O i o ~~: ;J $ ~ s o~ Wq ~~ I ~ .4 $' I m'O~ I o~ a~a~ Jm o ~a 5 LL i ~ m a m g y.E g m ~~ = E ~"`o ~ ~~ ~ Q o g 4~ ~ ~ ~~ $ ~ ~ E ~'-a ° ~ ~ m ~ m ' ~ ~ ~ aa 9 N m L > m 4 8 Yf ~^^^000 QY app O° m° 0~-_ ~ ?m S • ~ $~ o„ ~10 5 4m v 8 ° E Z m ~° `oa 8 m ~ Q m 8E ~QE " ~ E` c-~= = ~ ~ ~o n m •L g VI ° y ° DID N aouc? $'b I ~ al+. a Ivy- ~~ t i 1 1 I I 1 1 i 1 °e rn r ~ co s ~ £ r r .. m N ~ m p r 9 0 a 1 3~ Q I1 1 iy m V ' m O~ N N N Ip > N 01 a b _ : r N ~ N I° : _ _ I I ~ A r m N ~ N rl Iq - _ : 1 1- 1 1 I I I 1 I 1 ~$ a _ ~ i 8m c M N b n O ~- N M Yl p {y M ~ m ^ ' IO ' R1 FI N N y~ N ~ 1 I 1 ~~~p} C~ ~ t C g°~i ~ da ~ i~~ ~ l : ~ Iii 1 1 I I ~ i i i i~ 1 I ~ I 1 i i m 1 i i _O ~ ~€~ OL n~i ~` M: m - 11 '~~ 1 1 1 1 : - ~ .~ i l l- 1 1 C l l j 1 S 1 Yl° ° 4~ 0 .°.. ~ r= o n f~ c I 1: i I as : 1 1 I I g - :~ 1 I t I~ : z ~ ~ ~ ~~ ~ .~ I 1 p- I I ~ 1 1 = c- i 1 I[ y 1 I ~~ W f 1 V 1 _ 55 - o° ~ EE~ ~ d w m N Q ~ ' ° $ ~ i 1 ~ 1 I ~ I 1 1 l a ~p1~ 1 I 1 Iy "9 lY .. I 1 I l ~: ~ o~ ~~I E ~ ~ I 1 I I i s >~ I ~ $ I 1- o ~ 1 m 1 mm u ~ m.g S ~L m 9 ~ • U 2 $M N ~ : 1 1 I e LL €g 1 1 1 1- o n= G~ ~~ ~ ° : ~ I _ SN 1 I 1- I 1 E 1 ¢ i D C ~ aOO N a Y C E E m $^ I~ '^ l ] 1 I ow I I I I 1 I I I= uNi ~ ~ I`$ ~ t : o-q ~ T E ~~ 11:8 ~ I[N u~~ .-o I I I a I I Pj 1 m 1 ~ 1 o ~~ Q F N 9 .~ P S i l lg 1!' : : ~ - m : : o : ~ O 1 ~~ 1 I E 9- I I I 1~ o " ~ E f~ ~ t ~tV ~ I : ~ ~ I ' _ E• 1 1 1 1 ~ o I 1 E a i o ~ - ~ ~^ ul n~= o .: O~ _~ I~ ~. ~ y ; 2 8 3. ~ I 1 1 I^ u. $ I 1 1 1~ t u ~ t E ~. p L Q m ° N I I 'L` I I- m4 1 I E 1 I c (~` ~ ~ I 1Sil 1 o M CN L E i` -~ pi v ~~` ~~~E m Em~s Im u~~~lt ~~ 1 1 1 ILL ~n ~ 3 1 I 1 le~ ~ ~~~°1111~N t u - >~~ ~ 3 -:r V_°o :at m N my 1 1t~I-S? c ~Si 11m 1 INav= ?Q~Ildc•IL NE .G ~ I .. c > °-~°~ ~iA~~~ O p E~` 't G 1 Y~ n I o J g yg ~ I 1 I I ~ I I 1 I B m ~° ` ~ t Ln '~ j .a ° O ° t I I _ 1 4 e O m m~ I I C I 1~ ~ D ~l[~Of 5 C n 1 M Q .c u~ 9 m a ey+ [i ~, 3 N O $ m_ g c i~ ~ ~~ m 1 n m '^ -' ~ I 1 I 1~ - u' ~ ~ E 1 1 1 1 ~ :O ~ C ~ ~. : E S N p ~p o m - ~ ° m O m L of N N 9C m 1 1._ C O 1~' $-GO (l~1 1 IA E IRj ~ m ~ - E 1 I .G O g- d >Q ~ h a~ ~g~ V Iln Ica ~ C ~ I m _ - 1 I 1 I EE m x B• ~' 1 1 1 t o ~ tRm ~mQ Iii $ ~{ X~ m 1 I m ly== ~~ m I 1$ m e I m ~ I t Y ~ a 1~.~. -S Q m mFI~ E F 1 I I Ic~~.G ~® ~~Ll ~S ~ Ea 1 1n~m IS~4~ '3 1 ~ 1 Em_C N gg + ~ uci ~ ~ O 41 C ~ m {a ~1 ya NKd 0671Q ~ ~E'c 1 1 1 I- ~ ~ o °a a m ~ o qq m ~ v 7E O ' ~ ~ mm I 1 ~ n la ~ - $ p ° ~ Z } ©r ~ a d O r7 ~ N M Q MI N n m T -_ 1 1 1 1 - O c t oU m O - I I I O ~ 1 Q ~. a E N O I N - L Q ~ FF E ,I S ~ ' M R Ill ~ ~ e0- p a ~ y ~ ~ p Y N N N ~ tV N N n N c O N ~ .. 8 • ~ a~ ~ O [ E+ 1. ~ ~ ~ c :S ~pOO ~ c ° ° _ L ~~} V ~ ~ ~ a°i E O S - `cY G $9~C m ' ~ ItV mS - m 'd ~ 'F- a mb O°~Im ~ ~ oy. Egg` y~ 2 Trm=~ DS ~i' 8x~ gY ~ ~ WV Y9 ' c ~~ 87 c ~~ ~ J ~ y~ - ~ OG ••i { f~OX NC + ~a° `> IL'= ia~c°o c3cii _mo~~~ c~i~ Om °afa llm.'= 9 Sf$ 9 1°--__°o° R 97 N e 3 a p • • ~ N C ~~ 9 ~u~ L N 03 ~ £~ 55 t C a^ N VN 1~ C - y p m O.~ C 0 C O ~° Y ~ Li C ~ 0 ISO ~ ~ C - p . p pO ~~ V ~ ~_ c ~+ ~ ~ topm L `ay og ~ ~ $ : ° ~ ~ Q,g ° ~ u ~ •, ~E ; c7 ~ _ ^SHQ m E g -a of .- o li : m L E ~ ~ S ~ H V3 33 U v o u _ m ~ ~m . L _ Lo m ~ ~ c~G ~ E CmLL 0 j Tp _ ~ z P ~ ~ E .C ~ ~ m ~; rq a o'3a =b pop p$Q$~'~8 dE py~= N ^tl~ O ~ ~ ao L ~ m m ~o m m ~ o ~ c~° ~~ Vp _ W E ~t ~ ~ ~ S = 5~ m ~ ~ a aSZ d 5 ' =` m ^' ~ ~ E ~ m ~ ~~~ ~; p t n Eo ~ $ u > _ r - ~~ _ ° e~~ c~ ~ m E o :, 3s . >c~ zc ~ ~ ~ ~ ~ ~ $ (~ •N- ~ O g~ ~~ R ~ N€ ~'~ ~ ~..~" Y v p ~ N s N ~ r J ~ M ~€ o` S= o y~ a ~ xo~ .°~ 2 ~ y C ~ ~ Y S C N ° Y ~ ~ N U Z : N Q .A. $ _ ~ dr. d A N U ~~ O Sy J $~ a e a N N ~? c O =~ 0.' ~. v a H m ~ OFF h G ~' ~ O ~ ~~ ~ a s v N ~„ d~ 5 0 D S ~ ~ H _ € ~~ ~ H ~ ~ 3 a .,e a~ s~ Y ~A ~~ ~~ vy €~ •~ s~ ~ ~ N f° ~~ pp .~..b ~ c $ ~X ~ _ N : ~ m Ya m - ~ '° ~ E ¢° : t C O A ~ ~ ai3 § CC~~ ~ ~ = I 1p n $ i b Lek d + 1 8~P r € o ~~ ~ a rs ~ pE d ~ ° w 'r n $ aE ~7 m nO ~ U ~ 8 ~ 0 ~ O O p~ Y <~ ~ = ~E C N ZZ LLL o ~C ~o € ZZ ~ ~1 O s LL O ~ = ~ B ~ € m1 a{L 4 ® n ~ " E =~ ~ ~ '- ~ o ° s ~ ~ g ~ , F ~~ ~ O ~o ~ L ~ ~ ; 'v E± w g E g ~ m° s s'~ im `oo o~ ~ o +g 3 v d $ ~ ~ >~LL 2 • . i $^ ^ 4 4 a d ~: } D ~ - L y C L M Q ~X S c E a t a .t D ~ ~ ~ 3X U : C 3 a ~°, : 6 ~ E ~ ° ' `` o o m °- 7 8 C 4 y m E : 5 9t ° L Q '~ o t i pA T : O ' ~ 8 W b °u _ m a y G ~ J of ~~a m " C ~ . i m ~~ m:S e f n ~pp ~ ~ ' S ° r t -~ g.c E 'a 3° ` v o~ ? € ' 0 30 , h E .q c € ~ c ~ o~ ti J o b ~ ~~ o i w3 s ~~ a- ~~ i~ s ~~ vV $~ ~E ~~ ~ °~ a ~ E c Yz 2~ ~ n . d 5: ' m d~ 2 ~ o ~ N o m G = i a ~8 § ~ti _ $ . o n: ~a € a v~ ~ € r ob ~ } o u5 E : .°G Y o:a C L m E E ~ :.t c° ~ a m }F~ m N : o A E e °:g = n L - g:E o ° -d s ~~ ~ c n~ o a~ ~-~ n a O~ O 7~ z0 V : - „ _ C ' c a i J ~ D °~ ~: o .i o e Q : E : ~ o ~ e ~ Q 6 - V = _ ~ E < ' t A: °:o - m : ~ 5 . ~ € m ~ pp:$ IU U Z m G O . 2 g o 0 2 $S ~ -v 3 ~; 9 9 ~~ CN LL ~ qn° 3 °3 g 5 31 ~'~ g~ 4 ~~ %~~ ' r e r o e r o ~y asi m a a O) m O1 PI q m ~= ~ a m Q m m n ~i'I ~, I m I m ~ e¢ ~EEE~ _ ~ '~S 3 : g . , m g~ E-0 N ~ ~°:~ ~~_ w c ~ : Q°i ~ g-m d~~~ . ~'So :-°3 ~Ed £ E ~ EW - c3 ~m • O~ 6° ~C ~Lm m y~ a g ow °~7 : ~ ~ i ~ ~ m v $~$ ~ £s gG ~ ~ : ~~~ d~~~ ~ ~~ 8~ E o ~$R gW~~ ~ ~ am ~ yy ?? z ~ +r~~ " ~o a ~~ ~a ~ ~ Q~~^~lo C~mm.4 r~ ~ S o ~°' ~ c ° ~ ~ a m y m. tm S ~ m E y m ~m a ~ i t 0 ~ 3 £ Fi S m ~ ~ .~ ~ ~~ goS~ ~ a~a .Gm g oms i • o ~pp~~ yp 0 ~ = W CN ~~~0 N =~+'~m ~ a n~ ~u~ ~ `dv s= ~ S an ',$ E E-:~ 40° m~mQ- Foo ~ 8~ a 1` _ ° a ~$o P~o~ ~~ ~ ~ $ a ~ B = mo wo ~ N~c op m mm ~ C'SO ~ C~ C N N Y ~~ ~=g o v`o°78 ~~ -~ N L U .yrys E~~B m ~L C qqT C7 N N (7 U6 CN $CDA1 2 ~C m Qu1mn m m a1 Y •A r d t- C C 10 ~' O ~ d~ ~_ as I Y H 0 0 2 0 E LL a ~Nm Qamm~' ~, ao m 4 ~s~ m~~ ~ r o-cm ~ E c oar : u~ $^ - 8 ~ $~E o m a r~LL E: m E _ r ° KN ° v ~ iFm m . t -m a.-:r W m C^ w .`5 mGa C m m S D g eon: ~: }~ m c~ o .o - _ ~ ° ~ og V°d x o "tj EE n d_ ~o ~ ~.~LL : ab ~_inE 0~2 ~£ - ~ -E ~'O off: ~ c ~ a~e tg~~a a'- _ mm . v~i~ :m :oEmO1 ~ om Eoa ~S : ~ ~ LL ~ mE LL~ m SSy N o : E " ~ ~ m ~ ~~ o.yjm ^ i m m = i . ~ mN tae F 1 ~ m c cE "~°d _ -a :5 hm - m~wh c~o m s o g ~ ~ E m E'O ~~ muE ~ : a 9 ~ .mcs ~ ~ o .c~~' ° ag ~.Ee° q : N : L Q 5 -S_ a g_ ~ ~ a ~ _F a ug s $Sc S'Q a a o m O 0 E a LLm .L.m~m amy 1`°i ~ O C7 Z O O m -5ta K. o ' ~ m ~ ~ ~ ~ m w a Q m Z m O m g m h m v m °` a ~° ~ O 10 t0 YI m b N t0 i O 0 ~ ti~ j ~, N N N N ~ 1 ~ ~: E £ ~ g• Lam' 4 .~-1 £ ~ .sue o NB~;s z ~ _"~ z ~~ €~v~~ ££ as mQUa+e nwn mom ~ at$a~~i~Ft.$~A~FS ~S •5$17~.8~~ 'AS ~i ri alai ~ aLL ~I m [, _ = 0 ~ 1 1 I 1 ( ~ m i e u ul d~ - 0~ I I 1 I 1 ~ m O = m C m; m 1 1 1 1 1 `~ G -~ I 1 I 1 1 p game OO ~ ON ~N ;V ~1 1 I 1 1 13~ LLL 4 m m q° ~ O - VI 1 1 I 1 ~ o ~z a~ ~ m m= € a ~~;; E pI 1 I I 1 -g B b am ~y m~ ]g t arAl I I 1 1 ~ 2 S~ nm w m m t ~: m~ ui C " g - S_ ~ 1 I I I ~~ OI'^ ° ~¢ ' f f ~ !W m y ~ r'_ s ' g G p1 1 1 1 1 ~ ~ - g$ a s a s - m m m- c m~ UI 1 t I I ~ c ° •~ ~ F E B~ •-N 10 ~D n m 5 J - nj^. L ~ E 0 y - ~ HI I 1 1 1 - ~_ - ~ C _ ~~ tiv°S ~~N[~jl11II ~I I>N A 1°LL .V. - S E 2 _ _ E ~ 4 m E~ C C .° ~~ m OI I I I t : '- ~ i' a LL 1. ~ ~? ~, •-• v ~~ ~ O~ 03 G n O m m _ A u 1 I I 1 1 '~ ~ V ~$• u c oS t ml 1 1 1 t o - F i Q ~ ~v° ° m _ T- '!C @C V~~ n~ $a0 ~ m qPI I I I 1 ~ o CN m u o~ n •}vn pp`o ~ ~ Y~f ~¢o +m~ K mN mm fon ~e~uy ~>n• eO GPI ~I °lal •1 S oey E C° mmE III SN a ~ LG .Gm L C Nl~ NNN~~1 MfMel N SN~ Ni°~n ~~~ g }}figg-~ a ~ N ~.o .. ~e "> ~_- 3 = ~ ~ R. m~ ~ ° w o -a m w• - d8 r a a o ,z~ °•maeo r €° _ ~8 -~Inm~~ :n Fm ~ g :fg e N c g $c3~ p _ N SS d_ 33 1; $ • ~ ° pE9 m : ~ : - C - : m : W C ° V ~ ~ C a0 C ~ U o A a ~ ti L ~~~~ :n ~~ ~ ~ ~: ~=mow ~= °a-g°~s €~ 3 ~'Qy LO ~° a o o:Q~ -E=go^SE~~= m a ~ ~ tt O~ ~ o pay ~ g ~ m _ ~ : ~ X21 p {y m - .G Cp ~ -s N4 0 U ~' mYj , O q °~ C~~ - m ; N- P- Y J4 ~ m Q m n m ~ N N N N N N~ [~~1 O ~b 8 0 O L~ ~a O oO O_ - L Lp E ~ NL5 _ ~ G $ IL/1> T A vl .~ H ~ r m O q0 N~ - - O ~ O~3 ~s-m p a ~ m=ms~~~En c~m ~.~:~F q~~c-U=p: - a $m4~.~VLm~z • ~ Uo .m ~ ~~ m m m - o w ~ ms 17~ I ~ ~ ~ ~E~ 3 ~ n H ~ ~m: .. ~ E a b ~ I l ~ ~ - ~ E S o : ~ .~= o- In_ ~ ~ 9 c a - 76 m a rn °¢'`- ~ Ott o0 Y: ~'E u~ gmE °~A~~$xc~ g ~ a~~ ~ ~ m~m u~} gN ~c°at ~ ~-:=~g ~~mv ~y77 - o~ti 5 >5 B ~ C~ uoBN$w Qm o"m°am ~ -C2 ~FF a~3 gHS ~ ~^n~ 4- F E3X ~ S : Ea SSE-gg ~aEaY E qy d ~ ~ E g m U m~ m~ a E _~ b ~ E- C3 0 ~ y m c ~~ S- o ~ $ c mLL E° ~LL~ S t~ z ~ id 3 ` E ~` €o ~o ~ o Yi 8c - W F o m ?5_?>wD N~ L o° Y ~~-~' s~m wa~v 9 - co.~-° mLi~S .~ g ' o c ~aLS=o_o~~8S6 s` E ~m nolio° ~~$ ZpE .~~m Ts m-°~ ~~ m -$ g °`a 8 ~~ e~c s -- ~. mS~m$,~,E°-~~dm ..~ ~ ~7F N.- ~° !+ ~0~~•€6>'os t°, ~°.° W a' L yWF.s y coee m oa m g-pp pEp UUU o EoE_ Lx o° _ m pcpm gnpr$m t°~.4 $ $ s S _._-_ ___ ° = C E~'o fA d O c¢ S N V NNUQ V ~fJ CSd ^ U O~ (7L ~ pia {s U~~i Ox- WOlmi lmi li C7 Y 0 $ F° Z• • T• • 1°i CC •O V N L~ ~~ ~ a¢ U V w.. NmQmmn m a. ~ ~ ~ a ~ ',? ~ °r ''N & aaV N wa ~ 7R F; ri 0 c Q a ~~ 0 ~ N 0 u c io H C W N C 0 0 a FF O 3oE `es~ ~ a€ 3y1 T; C c^ $~ LE o a5~ `,8 nn ', ~~ a~ ~ ~O ?~ O g N O 0 O a~ DoE `ee~ ~ a•~ 3 ~~~ V O~ t ~~ a-°~' ~~S ~° V C d C H C ~ I E 1 1~ 1 Ip IN In 10 la 10 I• 1 Ip Ir 1 ID 1 I I~ 1~ la - 1 I la= Ip la I 1 a I I I 1 m I I e I Z Z g ID N N NO G - ~ I a W = I p~ q ~ 0 ~ ~e f~ m N O ^ N : C O ~ C~ ~m0 d : YO ~ ~ i Z E N Y ~. w ,ll ~ eMN '~ m 1 ap~1~~m Nva g~` 1eon o ~- :~ -91E m E c ~ o coe ~i411-II ~ ~~ d 3 _ _ ' a m E~ _~ .t ° : ~ ~ ~ a d $ to oa $ m: m m- N 3 d y o~ ~ a fo 4 a~ela u~m ~°F m :._mc~a o $o=-nai co 1o m ~ -~m :2y zmc _g I ai^-c'°= -o ~ E o _ o ° o-E~ ~ e c ~t4,Z FIB m m~0 m q _mg m _P`7 E ~t~iE s£'~ -„ - a -EC 1~l~amoo9 0°= D~m ~e ~ ~m~~ c~ a q aN~~a ~ D w s~ C ~ c n 3~ Q€ ~ 1~ ~ m Y q -> m a ~, :~ q N C ~ ;_ ° _~ _ tt C,~ e n o r'q i S ~ ~ $§ ~ ac S M y 0 0 .' n9 e N ~ Bx GE~S`O~gCt h~Ng O_~t mO ~t my ~O~N ~~~ Oda ~~LT~N'~~m1°L~'-" ~mao lj =~~E~ ON m~zoe o.lGnGp yak oa ~ ~ -"J ~ `m c 1~ ~ w o m ~~- ~ 8 ~? r ~. ~ ~ ~~ » n N YN 5i ~~mm9 rd S=e.4 Pl-~--_n Co c~ E m £ £a .E vm s° .°. ~ E E~ n k~ gg q N c 5 c o~£ a ~o33°u maNln gEc4a~~1°vlEn~ r~ ~~'~Cmb ~ N M p N IO 1~ m '' {' ''' b' b p N H N N ~ N lV N ., .. mm m OI m m h ItI a O m O) m m m N z~ O pp ~1pO ~1pp m i - M ~ ~ ~ ~~ 0 0 IV N ~ N N~ ~ N ~ - _ i - a n $ ~ q .I ~ ~ I : A ~ _ E p ~ a m ~ £ :.c m~m ~ I __ : e ~ ;,mom.. °: : ~ R ~ e ~ K o o- $ e `q ~ : m l 1 .e d a ;t ~~ d : ~: : ~~~ I L1`a n° s - o ff: 0 5~ Sm : m t m~ ~ I ~£ ~ ~+ g t m o~ w m- : g w o` c mm m_ r : m~_ i m r er ~' :~ p g n L m- O : 3. ~p ~ V 'a - C ~ m m ~yqi p p ~ _ ~ u ~ - : N3 i.' C p : ~ V7 b ~ W ~... i6 = m Op - 3 ~ ~ ~ U Q Vl - O N U (7 ~ 0_ {Qy ~LLp~ ~ IWp1 ~1Npp ^^Z 1 I I Z 2 I C i'~ ~ Iq T ~ Im ~ IN 1 1 u i.Ni 1• - 1^ I` IT 1 T O 2 la ~ I~ ~_ . 1 p T I~ H d 1 ~ Z g Iw o Ip ^- Id ~- [ 1 m o a _'~ I 2T ~o I Dm 1 ~ .m I w w~ I C IIO O $q Ffm~77l l~ b ~ b ~el~ c Ee r„\ N mio ~ ~Si +I L~ m~ wtl• ¢ m. fl1 ~ 0 0 S aO1am 9O I gb ... ~ Nt + ~' .c s 4 p O ` I n E ~ ~ t CI ov°o~1 z u° ° ~ m ~ ~~ 0 4 3 3°u ~Ilwi In s I IZ P 1 IN IT ~~ C 1 .4 1 p1•~1 • I : L SR W m ~f ICI le tp Al Al 1-o a P I _ V 1 C ~c I V q.~ I ~ GCy i C ~ m CO I~ ~ s~ ~ ~C~ ~ ~ N i~ a aD O 5~ : - ~O C It~ ~~gg 'ton 51°0 "yc 1~s s~~~~w~ c° ~~~ c-~pomm .. d~ 10$ ~m~ I b ~i a~~ m N ~~ ~ p: p~ o la r ~y ~ c m ~ ~4 1 ~ ~ c` 'o m -Q ~ - v 10 Q tm O q 0 ~~ ~~ ~ ~ '~= "~xuymm~g~ :m ~ t° 1`~ q Y> $ C m~ e y~ C m ~g m~mm8 ~-g I $ = 790 ~ 1p ~ ~ F e 3c °fi ~.. met o to S ~n m~ m ~NVb ~_~~$~ro to N m o~ w~~ m ~ m° o `o° g t l a p ~~ ~ q ~44 ~~ o~ ~ m v~ o mC Ci p.tl ii'~ w_ O q W e ~~~~ o~~ Q'e°mo~x ~~sF2F'n,~~. I°Or ~~naagm a`-~'o ~.k~co 1°#~ R~~~I~~o ~~~~~T~ I~ y Lm 1`d Lm tm ~ a~- Iv +~f l-`E F ~ F _nS _Cp oBb °mb I D U ~ ® N W ~Wy ~I-epJ1 pN y~~ ~1Wpp 14~~~) N N ~ a ~~ X111 111 17 17 F1 1 l Ip Iz t f f Q ~ ~„ ~ } I o {- -, l_ I o c _ I - E ~ s I: M pp oo 4 N m gNy ~7 T pp m y~~p 111 Iq ^^ A 1-o 1 ~ _ I ~ 1 a p - c q i 1 _ q 1 . G : ~ C~ `y O ~ C - W ~ b ` 8 t~ o I c° r ~ ° ~ q ~ m-~ ~ ~ b p ~~ cY n~~~" -m~Y$S _ ° o O IH .O 1 .b 'r'+ ar 8~ C m Nu ~S V a o N t~ b_ o m E 0~ ~ t~~ - :-L° ~ 50 ac ~ Imo: _ cv £ F .Q a m ~ ~ m a ~ o mgpmoK$$ -~ mp ICgi~ N~ VI ~ Cub _ T -q ~ 9 c L~ ~ S g Im q ~ L- o c- ~ e °F~ s I° S,n~a o ~ :g ~ E ~ c I m- n 15 E N q O F ~'~ St 0eoa = c ~ ~- q o 5 ~ $ ~+ ~ ° ~'Fi x G G leu p 0 e o yN~S n~o Wm opp~ to - o$ocoa_1-V° mE°~om tY ~f o lOA C 3_.g3O~D ~^~L-he111 Tj Im ~°o. I v a d ',°.em 3 c0 _ a~ 4,-E r9i 3'^N' o J"11e o N- s N K N 0~ 0 C~ ~ O m = W d•L F y . C Y O ~ O 'O O mL n ~ m~ ~ 1d yx ~ ~ ~ v Cym V F F m0 ~ ° o ~~~ ~m ~QQ g o~° ~ 1 Im ~~ ~ Ecm°~ t R = 1mn 1mn i ~ ~ a~ 1 1- $c a~ a_- S m ~ g ¢ a Fct ~ ~ ~ ap ~= a e ~ ~a =9a- ^ ® - e < W I =~7 n W f 41 E W VI 4 s ~ W ~i 1 ~ Y f u a o ~i ~'1 1~ nl 1~ p1 }9i ~i n a° cfl pc N E Y N c d r h E H o 10 i ¢ ~ ro C 5 o ~ N C v^^ 0 d$ l0 Q C li d d N 0 me- Yq 7 7 U Y NN m N r w o N e ~ ' N ~ ' m ~ e 1 O ~ Z'$ E w v e 11II ~ ul ei ""YY ~~~ 100 .N 1 t~0 OI .m-1 N ~~S 'O$~ ~~y = Y m a 1 .y w rl 1 m v 1 .~ a N 1 e ~ 1 m m rl • v Q I I 1 I 1 I i 1 I 1 I 1 1 p1 ql 1 I 1 t I 1 1 I 1 I I 1 1 qI ql 1 1 1 1 1 1 1 I 1 1 I 1 1 1 ~I 1 1 1 I 1 I I I 1 1 I I 1 I I 1 I I I 1 1 1 1 1 1 I I I I i 1 1 1 1 I I 1 I I 1 I I I I I 1 I 1 1 1 1 1 1 1 1 1 1 I 1 I 1 1 1 I 1 1 I 1 1 I 1 1 I 1 1 1 I I 1 1 1 1 1 1 I 1 I 1 1 I I I I I I I I I I I I I I I I 1 1 I 1 I 1 I 1 I 1 I I 1 1 1 I I I I I I I I I I I I I I I I I 1 I 1 I I I I I I 1 i 1 I I I I I I I I I I I I I I I 1 1 1 1 I 1 1 1 1 1 t 1 i 1 1 I 1 l 1 1 1 1 1 I 1 I 1 I 1 I I 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 I i 1 1 1 1 I 1 I 1 1 1 I 1 I I I I I I I I I I 1 I I I I I 1 1 1 1 I 1 1 1 1 I 1 1 I 1 1 1 I 1 I 1 1 1 I 1 I 1 1 1 I I I I 1 1 1 1 I I 1 I I 1 I I I 1 I I I I 1 1 1 I I I 1 1 I 1 1 I I 1 I I I I 1 I 1 I I 1 I 1 1 I 1 1 1 1 I 1 1 1 1 1 1 I I Ip OI ~Ilp al la I I I 1 I I { 1 1 1 1 I I i 1 1 I 1 I 1 1 1 1 I I 1 1 1 1 i 1 I 1 1 1 1 ~I'~ F I 1„ I IN I I 1 1 1 1 1 I 1 I I 1 i I 1 1 I I 1 I 1 1 1 I { 1 I I 1 I I I I 1 1 f I I I 1 I I I I 1 1 1 1 I 1 1 1 1 1~ p '61q I MM Y l 1~ 'LI p7 F ll R l ~1~ M1~ ql I i 1 1 I 1 1 1 1 I 1 1 1 1 1 I I 1 I I I I i 1 I I 1 I 1 I 1 1 1 1 1 I 1 I 1 i 1 1 1 1 I I I 1 t I 1 I I 1 I I I I I 1 1 I 1 g m1 I a w Yll F 1 1 1 , g g11N ~I F] rrrr 111 $ ~i N] ~aI l 1 1 1 1 i 1 I 1 I I i I i I I I I I 1 1 1 1 1 I 1 I l I 1 t I i 1 1 1 1 I 1 t I 1 1 I t I 1 I I 1 I I 1 1 1 I 1 1 I I 1 I I 1 1 1 I I I 1 1 1 1 I I 1 I I I I 1 1 I I 1 1 I 1 I 1 1 1 1 I 1 I I I I ly 1 1 I 1 1 1 I 1 I I 1 1 1 I 1 1 1 I I 1 1 1 1 1 I 1 1 f ~ I 1 1 1 I 1 I I 1 I 1 1 I I t 1 I I 1 I I 1 t i I 1 1 1 I I I I 1 1 I 1 I 1 1 1 t 1 1 1 I I I I 1 I I I 1 1 1 1 1 1 1 1 1 I I I I 1 1 1 1 1 I I M U A = 1 1 gl I 1 I 1 I 1 1 i 1 1 I 1 i 1 1 1 I I i I 1 I I I I 1 I I 1 i I I I I 1 1 I 1 I 1 I I I I 1 I I I I 1 1 1 I I I I 1 I 1 1 I 1 I 1 1 1 1 I I I I 1 I L K p ~ ~1 1 AI I 1 NI I 1 I I 1 t i i 1 1 I 1 I 1 I 1 I I I 1 1 I I I i 1 I 1 1 1 I I I 1 1 1 1 I I fi p . ~I ~I ~1 I I 1 1 1 I I 1 I i 1 I 1 I 1 I 1 1 1 1 1 1 1 1 I i I L~ 1 ~I SS~~~1 ~1 qi ~1 1 1 1 1 I I 1 1 I 1 I I 1 1 1 1 I I I 1 1 1 I I 1 1 I I 1 1 I I I 1 1 I 1 1 1 1 1 I 1 1 a ~i ~li of i i ~ i ~ i ~ i i ~ ~ i ~ i i i i i i 1 NI aI 1 I 1 1 1 1 1 1 1 1 1 I 1 I I I 1 1 I 1 I ~ I ~ O ~ N 0 a $~ ~~ E e8~ ~~~ o~~ S a€~ • : 8. n~ O v c d1 R y C H C N •~ W E O I 1 1 z° z° I is ~ ~ IN IN to 10 1 I• - I~ : Im . T U = 19 Q ? ~ ~ o m ~ m 1~ , r ~ g - C m ~ ~ la ~' d $ I m„- m n m w o ~ N q o. a pp . N Iow $- m o ~ E~: 1 mm ~ N p ~ - ~ A 1 ^r„ 1 m- ot: ° `m i T1`o` 1 ~Dm ~.5t m= s- ~ v m ~ ~ £ ~ 1 q y 1 ^ mm ` F • ~ ~ m 3 : y o a o c m Sm pia ~ ~ ~ E o E ~ E "m U c vn = s~ v E- o ry 1gl'1 '2 Em f i E q- C o= m qlO ymN U v r' d a te- m I 2` a~ ~ 1• o ~ m s 5 : ~ ~ t gl j - m o ~ c ~4 c c m mm . l °m m~ . . ~ - o ~ o uoi n ° ~8 E W Ala o ~ o°°'16 ~ m LL N m o-s $ c9 m m ry C d O g 0 m ~£ ~~=d ~~~ ~ • ~ ND m ~ a~ ~ a `0 9 Ip go N a ~ r m_ o 9,m°n ~n a ~ uqi Il~ m ~~ N m o ... m Y d v n n a~mm~ a _ t o$ o u N= o c aos`s~a„ ~~aC~a~ ~~33aa r N m Q a o p N~H mC~S ~U=~N Jn C1N m n m m Q m b n n m a `m a 0 oa m'O a-o mo mm ~~ ai o 1 ~g P I m 1} I E ~ _ ~ c ~ _o. i r .. ~' I C ~ a 1 C ~ m Co C I ~- ~ m~ Vq 3 I m_ A 0 ~ I• 8~ ~ ~° 1m~ av ~ ~m . I '~ ~ ~ U $~ Ig• ~EP~~~m ~ :.c .tm.,., - ~ `~ - I§s" ~~?~ E sqa ~~ §Z oN Ss s ma = i~b .OUgmZ~ - Q ~~m DoE ~9 g= ~Ny~ ~ `~ I.n ri ao ~t m C$ 2 °5 o o' „° og Sam'$o _ ~~ ~~aQ I N s r~ Jyi~ ° 5 `u u~ m~& pp Y o m m a5m~m coq~ 1no ''~ m ZtSfi ~~ • m t '- ~ m ~ ~ `°~ q: ~~ ~ mN G~ m ~O w r.- o `o u r I N j. E8 m Q E a9,° m o m E H ~v 1 a • me ~ ~ .n° B ^° ` - `o ,~°~ I ` - 3. h ~ ~ £a o £ - h I$ °° -c° m 3° e v m IaQt "4m o-9'S?aFOm°m°tc I °j °°9m 6n_ ..~i 3''~ im=o o_a FF mo o~-plm~r I m ~~ umi~ c vmi ~ g~~ a a E= c n I£ urEH~~`~n.6 a`Imoa °a`~ 1 0 ~ _ C 1O .U~.® NW W1-NFW w O ~l N m~ m N nl N N N '7 N C m fK 0 0 f r m a+ ^~ c E M y I Y ~ ~ I O ~ E a O ~ C ~ w ~ N ~ m e u < O ~ t .~ Y n a c u ~ a 8 w o o' m ~ ~z c ~ ~ O ~ w J q'1 ~ O C 1- O C O ~ C J C ~ a ~ n ~ W t.° W J 0 a ~ °m~ x o °° o~°S S°n°r ° r ° ~ Q~ ~ ~ N / ~- ~ m S S ~'. 9 ~ o g~ ~~ ~ ,~~ '° m:~ c ° o ~a o°~ ~ u ~i F »~ F N° m IL d ' ¢ a i m g o € Q ~ a 0 ~- a i rums rn..ormo- ° a ~m ~. U B ~ Z Z fY ~ Z X z~ z m c ~ W ` ~ _ a m z N E m~ .~-1 ' ~ O Z 6p. W _ m 7 ° p ~ ~ ~o'o ~ ~ K e I i ~' H ~ ~ 8 0 - ~ ' ~ o ~~ e .G'C o W 3 c g o o r v ~m a ~` ° 4. ~ m o-. m ° ~ ~ o ~ n op ~ g t noc '~ ru ~ a 3< ~ i -Sf E ~ Q~~~ E c a~ ~ g` N . o ~ ~ rl c E a c ~ ° rL E ~ ° ~ V o a c ° m ~ ° c ~~ $ o u'f a • ~ ~ ~ ro~ m °~. ~ c a E 3~ o nS m ~ ~ ~ yy$ S~ m C yy N $ ~ ~ g~ C~ OQ _ 6~ N Rl q v C a d 0 e end a~ °o ~ ~S4 ~~ nS o ~ o o ~ ~~ _`0,5 c o R Q ~ o CQ cA o .t o h o ~v o a M1 W ~ . $ m E p ~° ~ J° o i c o ~ _ ~ R' r,_, H d W ~ To n 23 ~ .,, g o FF S B ~ g Q~ c a $ ° m W ~ > W N W > .D N H '~ ~. ~ ®~ m~= p, o ~~ ~ a ~a B~1 ~Eq Sm t S ~~ ~ ...U ~ O O ~ r 3 a u = Z ZZ IV (7 FCi ~1w Q r~ 1-- ~ J r.., ~ J N AI Q N N A O N j Z ° a 0 0 LL8 Ny N a W ° m A ra 0 ° J 1 1 ~ I r ~ I ° ° Y C 1 1 f- Z ~ ° ,$ C ` 2 .1 I O ° 0 1 a cS a I ° a o Ea°¢° .M-t ~ ~ Z `o S o +a w I 1 p- ° W ~ Y o `c ~~E w ° < esT n d ~ n f n c° a m 0 e O a m > m a o ' J w e Z O O R 3 G m q k ~ ~ ° m N ~ x '~ ~ N ~ F b mx 8 ~ z 0a H ° ~ N ~ o y w j ~ a ~ ° tk A ~ a b ~ O q W O q b G y ~ m . j ~ ~ z ~ ' x N q O ~ q O N o y w ~p a ° ° o c e m ~ ~ ~ u a m ~ a+ g a ~p M D Z ~ N rNl N m I S r 3 '1 O [~ +± ~ m~ Y C 1 i ° ri O f- Y W K 'JS O q U O O O iC O m 1 S Z K H W a q u a °i "i o I 1 ..a ~ ~ r- rr W K W a m - V y p O y 3 µ I~ > W> N rn p ...0 H m • ••~ y 7 •i L q U ° O I~ a maH K O K O f~3 m ° W a f~ i a 'h C O m .~ G m s'ri g +/ " ~_ 1~ [-0_' F-J AJd A xaa aw ~ ~ as° .m u °v to . z o~~o ego 0 0 ms.raN .~ .i Y1 m N r [~ c ' ~ N N ~ 9 O .. (A ~ T C O Fm 3 V c N m a m m 'n v m m m n ~ m ~( ~ D CC o 3 rml m O - : ~~ ~ _ ~ x ram ~ _ ¢~o ~ m mC • m .- - r ~ b ~ ~ - C m R m m r Op ~oN ~ ~ y0 - ~ ~ ~ ~ C O ~ ~ e O ~ ~ o Cmm ~ o ID ~S r 7 v CC_ V ~ ~ ~ L p Yc• ~ ~ ~ d o N `~' q m C m ~ 0 9 0 m C t C § O E C~~N ~m~N NS aE O N 000 N ~- - m ~~ i v v~ y J i~ u n : a m 7 g N ~~ ~ _ E v ~ ~ F C '° :~ ~ '$ w x q m fl tEt~~ V~11 ~ Y ° ~ m 5 mmc ~ d C~° E o C ~ N ~ ~ ~ a q ~ Q °m ~5o~ F ~ ~ 5 Jin c ~ ~ I a -~ Yl - 'a $ m v N c ou'S;d ~='r'S' vi0o ~ c O= ~ 6 ° ~ g2 t4 m tn:W o ~ 3=~ O '~ 4tt~a £ ~ $ ^'N q=w a gaa.'O ~FF~ m oe.~ 5 m~q J m~ `~ v E Nt, ~ o u~ W a m v- ~~ m '~ S ~ 2q°O SR ~.~ Ev~ d~ 9 2 a v o. c ~_ ~'~ f9m J3 ~ Hogs oON m$~ U ~~.oaQ ~~ c~i°'~~E~ sec g ~.`Ltamy g~ ~ ° ~ din o ua 3 a E3~a~p5G ~ o ~ ~avQ m o°C4 ~f a~ N~ o c -7 ~E° c¢ $ =aid ~ZOa ~inay $o¢~ ~ V:~~t=~~~ to g a a N t~~ ~ ppG a~~ pp~6 ~ ~ ~ o ~ ~ ~_ Edo p~ idm ~ s ~ a ~ ~ d__a a Bm~ O Fl ° .°t E~ g O E+ o m y q~ m m S~ ~ [+ oSm ~ po ,.a7t yM7 Sf ~ ~'~ ~ $~ c ~ ~ ~~a~.3 b1 E~_~u pyO~ ~$~ ~ ~~~7 ltpp6~K.1 g~~ ma_ $ ~ qm ma ~¢ m ~S~ aZ§~ ~ obi ~~ B W O~~~ O O S~° i m O ~~ 6 p~ $~' W~ O~ p~~~ ^~ H Q 1f4G~ z 1- O O ~ I- T f V T OE f~~ Z .- N~ F f S~ F J 1~FLL~ O~ c¢i= m~ ~ a~ G N m v m m : ~ N m C m a i a m v m m r m O A .~ O 00 00000 00 00000 00 00000 0 0 a a .~ .~a o 0 m ru ru ru a ~ A rl A A O O ~ O mn rtrm su»r~ u-n-o.a NmS~n.n r~ u-o.arum s ~n ra.a aa.-a.~.a ArINN NfUNNN NN rummmm m m Z v j L W = o ~ S c c . S > G m ° Iii £ ~ A !- D r V N ° N ~' ~ 9i q $ A ti o ~ c- p ~ c m ~ E g g v , V o c m ~ o m L ¢ p 2 T m° 8 0: _ ° _ 3 O ~ W ~ N N e O _' ~ N m N D S u~ ~ ~ Y N O 4 N a N O V .. ~ o yi v~ t$ `a ~o o a`9 Y o ~ ~ E'4 '~ e E ~ v~ y° ~ .. w m o jt r ~` m~~~-- • ~ m 8 _ $ u g m Q~ oo_ _ ~~ o c ~ o j a~ N~~ ~ t m rr e~ 3 D 9 e m 3 t S E ~ qi ~ b y9 • U naJ U 9 q`'fi$ °' S~ m 6 i "' y 0 N~ a5 in ~ ~&f9e ° ~ E; t 9 B p~p N~ M1 ~ ~ g~ FF F ap. ba o~ O N r a dad° v ~ a rW ~5 E 3 0~ O ~ E ~ °,T o 9 oQ O o O 0 ~ S as 9 aEt'y: ~ Jr°~ S`pE V Eine ~c ~c~3o3~ 3 3 Y YQ b' dm -° a ''' g't ~fi ~.. ~;~ E' om ~ mew m ~ xN m¢ $ j 3 J > >o =° ~°°ma~ °. ~°. s ~~ ~ a o_ ~; g 4 ~' s 'v ru_ e: V .. a D g ~'Jz c v c~ E J ~ .p r zt-o 5 £ E W m j° o J .°°.~ ~~ ~ N m? gc ~= o E E o £ qc ~ ~ o> cS a~ ~ --v a~~ o JLL ILL x a ~ X~~ : oSS` L N m W O ~ `-07 ~ O J ~ m qoo'~`~ 1~ ~ G 1 J `c ~O e-e°O~F°C' oim ~y E$ ~• oE" G H l~ N N Z F o~ : E LL O F t K ~- F - F a- L F - t F R V d d O aK ¢Q ^ ~ ~~ ~ m F ~~ N N pp a N~ N N N ^^ pp ~~ pp {{ C S C N N N C Ff Pl ql O O N M1 ~ gg O O 3 ~ O c d ~ 2 S n Z S ~ m € ~ m N ~Q s : m : o = E~ 1Oa a~ ~`o o b m ~ N ~"~ O O p O ~ Q 'i n a .D A O A O O ..O a O A N a O J ..O S ti ti O O 0 y z 0 M O ~ W ~ ri ~p ; fll E .a OG 11 N N ~ O ~ v r - ~ ~ O Pi l+1 e m a E t~ M ~ x m _ y r ~ ~ ~ ~ ~ aa m 0 0 ti m 0 v W o` o -~ w d W _~~ ~ U ~ ~ yo°a° dN0 ~~n °~ ~d ~~ ~~~~ $ °& ~~~~g m '"a E O O o o fl ~~F a ~ ~ ~~~ O E ~ 3~~9 N ~ P ~• __ z _ r $~a°~ F ~~c5~ W W o`~ $ ~~~ O W m ~ g d~°Oa°°~ _ as=gam W = ~ O ~ - ~9f ~G~ f A v a a QqN ~ C. tnC s a a sS~~ p7 i ~ Es ` ~ ~~y~ p~m ~~~ 33 3 ~ H .9 ~a-" L 7~ - ~ py { p E p ~~~8 ~ x ~'a~ao m ~a 0 0 N m a 0 .n 0 g~ Y a N m 0 .n a m 0 0 0 .n 0 a m a O m a O J . .. ° ~ ~m ~E dC ~ ~ 8 ~~ a m d m 5~~ r° ~ $ m~ 2 ~ Y 3£~ d m LL ~ 8 0 70n '- mcog `~ a$~ ~ O _~_ FFt7- 3F ~i d ao vi ~ o T a ~L~ p ~ bob. a 'a N ~~ ~ N u~i ~NOµµ Na 3n 0 W8d dQ O Ea ~ VYcO ZpLL W O C WEB _ °s ` JW~ N-~ E E ~ /mot C - v Q ' W ~ 2 - W o- ~~ o a s~ F~~ ~ ~ u ~~ Hm~ ?0 ~ 3 Q Q a ~< Own z Y o ~ m ~ r ~ ° 5 ~~~ s a~Y ~c ~ o°, . ~s V ~. ~ ~° i .a j m3 ~ -a E ,~ ~ m,. m3 E ~~~I c am- TO O ... Ca ;~NL O np m Q 7~ n m ~,eg a.89 a_ c Fes- G f yao c Q o za ~dm S R ~L O O ~ O _e ~'oa N n ~c~ N m°n .°n ~+a a 0 W8a f ma O Ea CC Vco' O = m" i N W "° J-M y.c E Ft~ ~ Z--._ Q ~'z Wom d G ~~~ ~ .1'~a 'G S° avm ~ ~ Ndo Vl g ? o a ~'-°' Q v Oan a ~e ~m° i FQ3 ' dN£ ~m~ J U~,.. t m n .E o~ e 0 m . 3 3 C C m m p O O m N m m m N m m m C N N O N O N m N O 1fi m N m v m m n m p e ~ rn i cl o ,^ 6 ~ `m o ~ - ~ [~~I _ 0 m m ` m ' o n ~. ~ - ~ - ~ _ ~ - o ~ o m ~ m '~ p h n : o - N : ~ - ~ tv _ O y ° ~ m °~ $ 'm a m ~ i - o°~ g mt o ~ ~ ~ m : t _: g a m ~ - U >° ~ $ ~ m - ~ Sg - m ~ ~ n ~ . o ~ ~ f g „5 o~ a~ ~ € _ .~ _ t ~ : £ 8 m~ ~ 1~ ~ o _ ~ ~ ~ m ~m m$ ° N ~ S c E $ 3' ~ ~ C ~ n s ~ tJ o co Y~ v ~ ~o m g ~ a ~ o ad ~ c ~3 E c j ~ "m m~ m ~ ~ ~ - ~ E t °m q ° 5 m E ~ - ° A t _ °E vi o o m° E ~ ~ = ~ m~ ~ ~^ .c° go E~ o ~ ~ ~' 5 c° a ~ N g f c m o E o~ c d ° m> ~ - 0 ° ma - ~16 of C q .a° ~ ~ m ® $ . ~ _ ~ - ~ ° $ : d O J n y 0 ~ O m u C U= C: N ~ ~a • m a o m m " ~ m E ° .~ o~ ~ FF i 3b u~ lY o m .o u~° ~ u ~° uR F q u~ ~ o E r , ~ ~ ~m a g}~t .S o g u b ° t `o ~ 5 ~ ~ ~E m °~ ~ oC o Y ~b Q ~ '~y n - a~ m m E $ e -m A ~ w ~S w n ~ ~ ~ ~ $ ~ o a¢ (~'4¢° b m' b£ tS n a ~. LL a ° ~ o ~ o m z ~ N m a m m n m p ~ ~ .- m ~ q v 0 m p O 0 .y o m O nl .a 0 m O m r 0 o q .-1 m 0 p p N m 0 q q N .- N m e m m n m p v .n m q o~ ` E _ j a - ° ~ m ~ m . ~: rs; ~ N O - N ~ ~ m - '^ ~ : n C ~ T ~: ~ ~ ~- ~ m ~ ~.[ E: °u a: $ 'L' ~ m $ r a ~ 9 ~ ° - ~ Q : o~ S ° o ~ i - o 7 ~ o 0 w -' m m ~ 8' ~ U a U° : ~ c . a° ~' y~ . m ~ oY m m ~ ~~ _ r o a _ ~5 ~o ~ ~ m d 8 0~ ~ ~ w° o ° "~ t S o ° s~ k = ~ ° t r o o ° n ~ w = a `o ~v g m S B ~ r& ~ ~ n~ ~ c m: ~~ ° ~ - j E ~ 0 0 ~ m ° o ~' p of t ° ?~ o u ~ t m E ~ o L j H ~ °g n o3 a Ti ~ - ~cd ~ o o .m m .n `m .m a ~ m~ E y +~'c i S ~ au - ~m 'B as a ° m - ~ w a. °~ c iO® ~ ~ o m ~ o $ m ~ c a - o ~ YS a ° - ° ¢ $~ 2 - E ~ ~ m c~ d ~ E °m ° E . m N m °_~ J 4 `m cE ~ a ma m w _ n _ m ~ . ., Y XE ° z ~ mYi s a m5 E - °J o ° u cE E ° m m m ~8 In' N m J o v om Q m ~ $ ~O E v n v cn - as c~¢ m p a f'n ^ ~ v n o a` ! , ~ ~ ^ c a ^ ~ ° a~ ' ~ ~ qo i ~m d s 0 s 0 n O 0 a S O 0 a N W 0 0 O N R 2a F O s O 0 N N v J i ~ N O m m O O Q a 3 ° ~° a E 'sc°~ m3 E . N ~ c ~ N o . .. °_` '~ ° ~N a E 5~5 ~~ c° ~ ~ e Y i ~E~ ~ ~ a og o ~ ~° a a s F~a° ~ ^ y~g a$~ a '' `o ~- ~t '~ ` a $ ~ IjS o -d ~ ^ o a ~as O ~ ' o i ~ o~ ~ ru p_ ~ - ru °°a `~a a - m 0 wta g OEa cc i~a W $ o ~ c - N ~ a~ Y yGE r Ft '" w ~ 2 W o- _ a pp d Q ~~4 - v' ~ d ~ a= m f-m.. N s s v ~ ?S~ {A ~` a ~~ 4'°? oma °' o~s ~ ~ ~ a - Q-g i ° d ~ c, , a. 7 n; dot ~ vi L F ~ : a ~° O~~ s v> y 1 ° ~ ` ° ~ ~ g E. ° a i .~ a 8 a r n N ~ m 111 ~ a tp ~ N r ei o N r .~ .c 111 1 1 1 I : ~ 1 1 1 _ ~ ~ v ~c ~ ~ _ VI t I ~ g: _a ~z I I Ig=~n. ~[ m V N 0~ pI I i m[ ~ ° ~ ~ ~ - m E UI I I a~ - c ~ a ~ E ~ HI I I ~ °° ~a ~ ~ ° - ~ ?I Y ° 0.1 i I ° ~~ C 1R ® q o ~i OI I 1 m m ~'oj : ` ~ I I 1 w E 3 m q ~ ° 0 Q 3 °p ~ Z ~ ~s o L" °° m m .~ m qq1 I I o m ~~y< ~ a5 - ' °- °E m a1 ° ° m $ ;I I I o o mm Oa°rc KNI/1 y' f-'j j 0 a u1-I-~uE € - ~i~ ~~Fi~l~l~~~i Z%i ~i~~ g N - v OI 1` o ,y V s N v [~ ~~ al o I _~~ g~ ~ : Q a I i ° t : ~ `~ n ° - ~i Jq 4 O a : : - N ~ : ~ ~ E ~ m d m °c _ $ N ~ m m m~ a E °'o n: ~ m° 9 0° ^ g~ 9Fb,~ ~L ow qa u ~~ q ,bL ~~ 3 8 $ Am S a p ~ ~ ~ ~ y a C ~ p p ~~ ° a4 m E ~ 2 ° ~ ~ q J ~ ~J C ~ ° m ° ~ ° u ~C' $ { d - ± ~-m ~ rb U a W O li li 1~ C7 = n a u ~ ~ ~ S iw` ~~='r° ~ °~$FFlS3 ~!0'R1 ~ e ~c i K I$ C c gc ~ ~ ~{ ct ~~ o° o c II s O e de ~~ N~ v E ~a E c -t, N R > 1 a YI D u9 ~$ 0 ]~ 0 ~ ~, N l~l O, O O _ 1° b N N b N b b m N 1~(1 r1 N ~ '{ .- N m e ul .o n m a ~ ^ c e ^ ~ ~ ~ _ _ 5 m ° j ~ Y1 ~ Y p _ ° ° M n _ ° ° ~ °- ° ~ 5 u ~. 7 ~ ~ F3 ~° a° S u ° C & ~ - _ m 8 N: m ~ ~ n e ~ °~ - o n ~ am ~ Q: -~ a ~~ O~ E - ~ ~L N m - S~ U T' ° c ° . ~ 5 ° ~ ~: ~ ~ °: ~ 8 °~ ° ~ „a - 4 € t € o = ~ t s m ~° s `° ~~ _ ° J m ~ : ° c ~° E 'oR a ~ ~ ~ ~ ~~ m o - B o ~ o £ n m ° q G ~ IR ~ ~ o 1 '1 > W ~ d ~ ~ `° m° T 3 _ _ o oa C Q mu ~ a m a W D a N In r ~ D a -aa E °E ~ n A~ ~ ~ ~ ~~ o g o m v ~ ~m c ~ ~ ° ._ T ' _ j n~ ~ ? ao ~° c _ E ~a ~ c m v~ a .t B o 1 n a ina ~ < eo m c "a c ~ ~ ~ ° < ~ m'm v o u ° Ec = _ o ~ gc s g n ° o ~ ° ° . r in ~o° ~ N u 1'n U o m 1., o~ 5 a¢ e E U° ~ c° a C7¢ m a a ~ m U ~ a ~ a. 1°c ~ -a i a` ~ E~m ° a = .- '~ m ~ ~ ~ a° z ~ m° R .- S O 0 A m 0 W I N n s O 0 m v J O O N N 0 R s O 0 O .a 0 0 J • • . ^ 6ENEFIT o~T~ 33 WESTMINSTER DRIVE PO BOX 599 CARLISLE, PA 17013-0599 ^ ASSISTANCE CHECK After the first check which may be a special amount you will receive $ ^ Twice a Month ^ Once a Month ^ In the Mail ^ At the Bank D MEDICAL ASSISTANCE ~ ^ You have a patient pay liability of $ for the period beginning and ending ^ Effective Date ^ FOOD STAMPS You will receive $ for the month(s) of then you will receive food stamps in the amount of $ a month from to ^ In the Mail ^ At the Bank L!I ~,q~~ FiDn~ Cqp~ f Level of care authorized you are expected to pay $ a month toward your care. ^ SE~RVI ICES ^ ec THE FOLLOWING PER SONSQRE INCLI#D ED. - -- - "' _- ' _, NO. NAME CHECK STAMPS ASST SERVICE N N'~E T M T. S VIC 01 Robert Traver • ~ ~ • ~ _ ~ Regulation178 1 Reason Code 079 Opt D Robert Traver has been determined ineligible for Medicaid including services in a Long Term Care facility due to excess resources. As of 06/01/07 requested effective date, the total countable resources including Mr. Traver's half of the farm owned jointly with his spouse on that date were: $576,676.41. The limit for Mr. Traver, based on his income is $8000. (NOTE: The total shown above excludes verified medipl expenses paid after 06/01/2007 totalling $7,526.44) _ -- - - =~ t'-0Ob S17.U~11~$ .. °-- Nombei• of Persons ~ - .-- _ ., ~ AS$ISTANCE GHECK _:; _ _ ,_ _, Numtiero€Per;;ons'~ _ ' Name EARNED INCOME Name M HLY EARNED INCOME $ $ $ $ _ $ $ Name UNEARNED INCOME Name M UNEARNED I N LY NCOME $ $ _ $ $ - $ $ - TOTALGROSS MONTHLY INCOME $ TOTAL GROSS MONTHLY INCOME $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MEDICAL COSTS $ - c - - - - .Telephone Water/Sewage 0 MEDICAL ASSISTAtdGE _ Number of Persons ~: -, Electric Garbagelfrash _ Name R M N LY EARNEDINCOM Gas Ulility Installation $ Cil Other $ GROSS UTILITY COSTS/UTILITY STANDARD' $ $ RENT/MORTGAGE $ Name UNERNEDOI N OME ' TAXES $ $ _ INSURANCE COST ON HOME $ $ _ TOTAL SHELTER COST $ $ TOTAL GROSS MONTHLY INCOME $ NET MONTHLY INCOME/NET SEMI-ANN UAL INCOME $ INCOME LIMIT $ CO RECORD NUMBER CAT CTR DIG DIST 21 0112071 LTC 00 ShutjerlBogar, LLC ATTN: Brandon Williams 417 Walnut Street 4th Floor Harrisburg PA 17101 ~ ~~ ! / 04/10/08 717-240-2707 _ - ~~~~v Worke L J if you do nohunderstand our decision or have any questions, contact your worker. ~' CLIENT ^ APPEAL COPY a o~ynamic - U ~ ~ ware ~elepnOne Number LEGAL HELP ISAVAILABLE AT ' LEGAL SERVICES INC. 8 IRVINE ROW CARLISLE, PA 17013-0000 (717) 243-9400 ^ CASE RECORD COPY PAlFS 162 ±~07 CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Petition for Accounting was served via first-class, United States mail, postage prepaid, upon the following: Anna Messimer 1095 Pinetown Road Lewisberry, PA 17339 Date: ~ ~ 3 ~ ~ William Keslar, Paralegal